{ "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": 169, "pageCount": 342, "prevPage": 168, "nextPage": 170, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses direct quotes from anonymous experts to build a case of 'expensive abuse' of medical technology.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/169", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-169", "components": [ { "bbox": null, "kind": "callout", "text": "Highest volume users have doubled transplant volumes through \"very expensive abuse\" with no improvement in outcomes", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97e-5fb9ae6639b9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Mayo Arizona and Houston Methodist came up repeatedly in our interviews, with surgeons alleging that they use dubious practices to spike their TransMedics device usage. We quoted an OPO executive who alleged that Methodist uses the pump even when the donor and recipient are in the same hospital. UCSF shared similar conduct at Mayo, where both retrieval and transplant were at their center but “the surgeon decided to put that organ on TransMedics because they were doing another case” – “when I shared that with one of our surgeons, he was like oh, I could see how that would be cool.” A leading liver transplant surgeon, perhaps the most influential in the world, described what he stated were conversations with Ghobrial at Methodist, which suggested off-label usage as driving their growth and TransMedics usage: “Ghobrial has definitely grown his program, more than doubled its size...the guy in Mayo Clinic in Scottsdale has more than doubled theirs...this is potential abuse of technology...a very expensive abuse...you’re really doing a disservice because you’re increasing the cost without incremental increase in outcomes.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "09c5daaf-523a-461a-921e-d317962a134e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Mayo Arizona allegedly using device when donor and recipient are both in the same hospital. “I heard that there was a donor at Mayo in the hospital where the transplant program is. And the surgeon decided to put that organ on TransMedics because they were doing another case. So, that kind of convenience. It’s not like it was coming from a far distance or anything clinically was required for this donor. But it was a convenience thing. When I shared that with one of our surgeons, he was like oh, I could see how that would be cool.” - Executive at a pre-eminent West Coast academic transplant center, one of the highest volume in the world", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "149fa66f-62c0-48ac-a8c5-ee3b36a0acb9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "Highest volume users have doubled transplant volumes through “very expensive abuse” with no improvement in outcomes. “Mark Ghobrial has definitely grown his program, more than doubled its size. The guy in Mayo Clinic at Scottsdale has more than doubled theirs. Part of it is that they’re willing to take organs that others haven’t been willing to - older donors, all that stuff.... I remember Congress jumping up and down about the Cost Report because they were saying it’s being abused. Well, this is potential abuse of technology, a very expensive abuse...if you took it to the extreme and talk about an $8 billion industry, you’re really doing a disservice because you’re increasing the cost without incremental increase in outcomes.” - One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "7fb78f36-78ca-4090-baf9-4a9c85189112", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"I heard that there was a donor at Mayo in the hospital where the transplant program is. And the surgeon decided to put that organ on TransMedics because they were doing another case. So, that kind of convenience. It's not like it was coming from a far distance or anything clinically was required for this donor. But it was a convenience thing. When I shared that with one of our surgeons, he was like oh, I could see how that would be cool.\" — Executive at a pre-eminent West Coast academic transplant center, one of the highest volume in the world; \"Mark Ghobrial has definitely grown his program, more than doubled its size...The guy in Mayo Clinic at Scottsdale has more than doubled theirs...Part of it is that they're willing to take organs that others haven't been willing to - older donors, all that stuff....I remember Congress jumping up and down about the Cost Report because they were saying it's being abused. Well, this is potential abuse of technology, a very expensive abuse...if you took it to the extreme and talk about an $8 billion industry, you're really doing a disservice because you're increasing the cost without incremental increase in outcomes.\" — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97e-606b4af33bc9", "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": "e7563ccb-234d-4f00-b9d4-de40cb5a53d8", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }