{ "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": 196, "pageCount": 342, "prevPage": 195, "nextPage": 197, "slideType": "villain_critique", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 1, "notes": "The slide uses direct quotes from a transplant surgeon to validate the claim of incompetence and poor operational performance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/196", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-196", "components": [ { "bbox": null, "kind": "callout", "text": "A surgeon and “super user” stated that 10% of organs retrieved experience significant mistakes or are unusable because of surgeon error.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a980-a20ef5c41923", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "Taking four hours to retrieve a liver; not capable of retrieving livers properly", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "12511f57-7390-40f9-b2ab-aa56443c5cba", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "list", "text": "Hiring inferior surgeons who “inadequate skills” lead to loss of organs; 10% of organs lost due to mistakes", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "91c24954-1854-4c95-8219-9f45d6fc3406", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.23 }, "kind": "paragraph", "text": "A surgeon and “super user” stated that 10% of organs retrieved experience significant mistakes or are unusable because of surgeon error - “they’ve brought on more surgeons that are little bit more questionable skillset...not always the best skilled people...organs have been lost due to inadequate skill of the surgeon...things that are significant.” Organs must be retrieved rapidly as they deteriorate after 30 minutes of warm ischemic time after circulatory death - but TransMedics surgeons are incompetent to the point it “takes four hours from the time of death”; “the most common thing...is it’s taken too long to get the liver from the donor to the pump...ischemic time in between has caused damage....”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "73d26a90-2b6b-4c00-a616-e007ec5208a0", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "quote", "text": "“As they’ve expanded, they’ve brought on more surgeons that are a little bit more questionable skillset...they’re building out their program with not always the best-skilled people...mistakes get made when things take too long. I’m sure organs - I know that organs have been lost due to inadequate skills of the surgeon...things that are significant and not just transplant surgeon nit-pickiness, I would say maybe 10% of cases have something significant that should have been done that wasn’t done, or an organ that could have been used probably wasn’t used because the surgeon wasn’t skilled enough - 10% maybe.” - Transplant surgeon at a high-volume academic center", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4e9e4e73-58d0-421b-a839-f6e608d0d0ae", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "Q: “Ten percent is pretty significant.” A: “It is, yeah. The most common thing that’s happened is it’s taken too long to get the liver from the donor to on pump, and I think that ischemic time in between has caused enough damage that the liver, even though it got put on the device, was not good. If it takes four hours from the time of death and the liver gets on the pump, you lost a lot of the benefits of the pump.” Q: “Is that because of the surgeon’s skill, or just because they couldn’t get their crew out there on time?” A: “No-no, surgeon skill. Surgeon skill. Yeah, the donor dies, and they just couldn’t get them or weren’t capable of getting the liver out, getting back tabled, and getting it on the pump on time. Sometimes, there might be a vascular reconstruction...perhaps an artery wasn’t handled well, or something wasn’t tied properly, and then you get some bleeding after the implantation and things like that that are of consequence...” Transplant surgeon at a high-volume academic center", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "5740030e-7bc1-4633-ab57-bc1c60bb5c38", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“As they’ve expanded, they’ve brought on more surgeons that are a little bit more questionable skillset...they’re building out their program with not always the best-skilled people...mistakes get made when things take too long. I know that organs have been lost due to inadequate skills of the surgeon...things that are significant and not just transplant surgeon nit-pickiness, I would say maybe 10% of cases have something significant that should have been done that wasn’t done, or an organ that could have been used probably wasn’t used because the surgeon wasn’t skilled enough - 10% maybe.” — Transplant surgeon at a high-volume academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a980-a786f3aba039", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "15871f29-ab05-4a45-b9db-27aed7bb3120", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The ex-executive’s surgeon grim assessment is shared by its highest-volume users – making their usage even more troubling, consistent with a perverse incentive whereby organs are steered their way as kickbacks.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3bceb106-6054-48d7-9b4c-9e39e6becfdd", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }