{ "docId": "019dd923-622c-750b-8b9a-40e2965928db", "docSlug": "e5bffbaac707", "documentTitle": "TransMedics (TMDX)", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2025-01-10 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 164, "pageCount": 342, "prevPage": 163, "nextPage": 165, "slideType": "quote_slide", "function": "expose_contradiction", "density": "balanced", "nDataPoints": 0, "notes": "The slide uses a primary headline followed by a detailed supporting quote, highlighting the ethical and financial concerns regarding off-label use of perfusion technology.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/164", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-164", "components": [ { "bbox": null, "kind": "callout", "text": "The off-label usage is simply unsustainable – centers are on to the game that surgeons are playing and cracking down on usage.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97e-06f78c788219", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "“Outrageous organ acquisition charges” simply for surgeon convenience; surgeons fabricating clinical excuses as a cover “The convenience of pumping...is even more bizarre that they would take on such a cost just for convenience...the organ procurement area, I mean, legality - you would think that there would be some overseeing body that says you have to charge x amount or you have to cover x percent. You can’t have outrageous organ acquisition charges to make up for your organ procurement poor performance or for the surgeon’s convenience. But there just isn’t. You could say you need to pump. You wanted to see how it does. You could always say that. I mean, sure, I don’t know if they will put that in the chart, but they’ll pump. They can pump anything and say, look, I was wondering about the functionality of the lungs, and I need to check it out for a couple of hours. And these surgeons want their convenience, so they would say that in a heartbeat and not blink. It’s hard to prove that the surgeon didn’t want to see the liver function improve or, lung O2 improve, or heart function improve, and that it was really around OR convenience. I doubt anybody would say that out loud....they wouldn’t put in a patient’s chart that they’re pumping something to free up an OR.” – Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "subkind": "pull-quote", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "51eb493c-f0c1-4c6b-9989-29279169f0b8", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“bizarre that they would take on such a cost for convenience...you can’t have outrageous organ acquisition charges...for the surgeon’s convenience.” He doubted the legality of surgeon’s simply fabricating a clinical indication – “they can pump anything and say, look, I was wondering about the functionality of the lung, and I need to check it for a couple of hours...I don’t think anybody would say that out loud.” — Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97e-0ad59f5086d3", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "dade5d46-0d7b-4cb1-aa6d-9f2135dda5e2", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The off-label usage is simply unsustainable – centers are on to the game that surgeons are playing and cracking down on usage. An influential, longtime OPO executive who serves on UNOS committees called it “bizarre that they would take on such a cost for convenience...you can’t have outrageous organ acquisition charges...for the surgeon’s convenience.” He doubted the legality of surgeon’s simply fabricating a clinical indication – “they can pump anything and say, look, I was wondering about the functionality of the lung, and I need to check it for a couple of hours...I don’t think anybody would say that out loud.”", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b2e78edc-f84a-4599-b8d1-2d8080ef0263", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "51fb5bfb-b05a-436a-8037-b59360cc2e9e", "evidence": "The slide explicitly frames the behavior as 'fabricating a clinical indication' and 'unsustainable' cost-shifting.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }