{ "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": 332, "pageCount": 342, "prevPage": 331, "nextPage": 333, "slideType": "villain_critique", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide presents a Q&A format to highlight a specific technical failure mode (necrosis) attributed to the device's design.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/332", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-332", "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "TransMedics pump “scrunches” organs into a small area and results in necrotic livers", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "cb4d09a9-c2c8-44e1-ae64-ea8d351b327a", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "it happens even more with TransMedics...it doesn't have enough blood supply...the reservoir....can be tight or the liver can be under pressure...a portion of the liver can get necrotic before or after transplant...if it happens after transplant, the outcome could be bad...it's reported only in the normothermic machine...I know for sure that happened...I don't know how many times....I know for sure that it happens.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5374-767b-b3be-5cfd7497af5b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Q: “[Redacted – CEO of major OPO] mentioned the issue of liver necropsy where the liver is upside down. He said there’s an indentation and they lost some livers because of it. He stated you didn’t want to be involved with the device anymore because it had some issues. I don’t know if that’s accurate, What is the issue?”\nA: “The reservoir that holds the liver, sometimes the liver can be big, and it’s just scrunched into a small area, and with the other machine, it happens even more than with TransMedics; a portion of this liver is necrotic - it doesn’t have enough blood supply and gets necrotic. The reservoir of the liver itself, where they put the liver in the machine, can be tight, or the liver can be under pressure. And a portion of the liver can get necrotic before or after transplant. Before transplant, that’s unfortunate, but you can’t always tell from looking at the liver. If it happens after transplant, the outcome could be bad. It’s reported only in the normothermic machines. I know for sure that happened. I don’t know how many times...I know for sure that it happens.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2f234fc0-8955-4ce0-a051-edeec3b06a43", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We then spoke to this former TransMedics procurement surgeon, who provided some of the most damaging color on the company’s practices, as detailed in other chapters. He stated livers become necrotic as the machine’s reservoir “scrunches” them into a small container: ““it happens even more with TransMedics...it doesn’t have enough blood supply...the reservoir....can be tight or the liver can be under pressure...a portion of the liver can get necrotic before or after transplant...if it happens after transplant, the outcome could be bad...it’s reported only in the normothermic machine...I know for sure that happened...I don’t know how many times....I know for sure that it happens.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "7f94ef50-1b5b-45b6-b9f1-4342aeae03ed", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“The reservoir that holds the liver, sometimes the liver can be big, and it’s just scrunched into a small area, and with the other machine, it happens even more than with TransMedics; a portion of this liver is necrotic - it doesn’t have enough blood supply and gets necrotic. The reservoir of the liver itself, where they put the liver in the machine, can be tight, or the liver can be under pressure. And a portion of the liver can get necrotic before or after transplant. Before transplant, that’s unfortunate, but you can’t always tell from looking at the liver. If it happens after transplant, the outcome could be bad. It’s reported only in the normothermic machines. I know for sure that happened. I don’t know how many times…I know for sure that it happens.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5374-767b-b3be-61eb941bee90", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "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": "21efa856-2283-4921-829d-7dc3be59d988", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [ { "name": "Villain slide", "slug": "villain-slide", "agent": null, "layer": "slide", "matchId": "cafca373-9102-4107-b244-e85ea7229779", "evidence": "The slide presents a critical view of TransMedics, highlighting damaging information about their practices.", "confidence": 0.9 } ], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }