{ "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": 189, "pageCount": 342, "prevPage": 188, "nextPage": 190, "slideType": "villain_critique", "function": "expose_contradiction", "density": "dense", "nDataPoints": 1, "notes": "The slide uses a Q&A transcript format to substantiate claims of fraud and kickbacks.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/189", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-189", "components": [ { "bbox": null, "kind": "callout", "text": "He indicated that some centers were happy to jam Medicare for a $90,000 consumable, even when the device was unnecessary, just to use the NOP organ recovery service – a practice our research is prevalent among smaller centers lacking staff and who we believe to be paying for the device as a kickback in exchange for organs steered their way by the NOP program.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a983-c4d4558081c7", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Ex-procurement surgeon alleged device used for “organs that don’t need to go on the pump”\nA: “The price keeps getting higher and higher to the point that doesn’t make a lot of sense for a lot of people, especially for a transplant program that has 20 or 30 or 40 livers. It has become very, very expensive. However Medicare is going to pay for the cost, and I see some transplant centers are using them on many organs that don’t need to go on the pump.”\nQ: “You’re saying there are a lot of livers that go on the pump, the TransMedics pump, that don’t need to go on the pump?”\nA: “Yeah, some centers are using them as a recovery service as long as somebody else is going to pay this chunk of money.”\nQ: “So, they’re using it as a recovery service even though they don’t really need the—”\nA: “Yes, I’ve seen organs in young patients - I’ve seen very good organs that went on the pump.”\nQ: “So, young patient, very good liver, it’s fine for cold storage, then hospitals are using it just because they want to use the NOP?”\nA: “Just because they want to use the pump or the service for TransMedics.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b27d164c-13d3-4021-8ea5-ebfeac0e9ab9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A former procurement surgeon who worked with TransMedics told us he resigned because he was forced to engage in various types of inappropriate and unsafe conduct. We redact the duration of his tenure, which was significant: “I was actually one of the top three surgeons...I probably did 100 to 150 livers.” He corroborated the vast scale of the off-label and over-utilization scheme, as he personally observed such organs being retrieved and put on the pump, and stated the pump was unnecessary for most of the organs placed on it – “it has become very, very expensive...centers are using them on so many organs that don’t need to go on the pump...I’ve seen very good organs that went on the pump.” He indicated that some centers were happy to jam Medicare for a $90,000 consumable, even when the device was unnecessary, just to use the NOP organ recovery service - a practice our research is prevalent among smaller centers lacking staff and who we believe to be paying for the device as a kickback in exchange for organs steered their way by the NOP program.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "69073cc3-e8fd-43c1-bc20-c2e22fa0e761", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I was actually one of the top three surgeons...I probably did 100 to 150 livers.” — Former procurement surgeon. “I see some transplant centers are using them on so many organs that don't need to go on the pump.” — Former procurement surgeon. “Yeah, some centers are using them as a recovery service as long as somebody else is going to pay this chunk of money.” — Former procurement surgeon.", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a983-caeb3cd68125", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.3, "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": "d412c3e7-71ea-4479-89da-7cb3f87a48b8", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "f2d80d1c-175e-4d84-8041-dfd449d1b085", "evidence": "The slide explicitly alleges kickbacks and Medicare fraud.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }