{
  "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": 63,
  "pageCount": 342,
  "prevPage": 62,
  "nextPage": 64,
  "slideType": "expose_contradiction",
  "function": "expose_contradiction",
  "density": "dense",
  "nDataPoints": 1,
  "notes": "Includes direct quotes from a transplant administrator/executive at MGH.",
  "elementsJson": [
    "paragraph",
    "quote_block"
  ],
  "metadataConfidence": 1,
  "imagePath": null,
  "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/63",
  "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db",
  "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json",
  "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-63",
  "components": [
    {
      "bbox": null,
      "kind": "callout",
      "text": "MGH corroborated key aspects of TransMedics bundling and extortion scheme",
      "attrs": null,
      "subkind": null,
      "toolName": "Visual emphasis",
      "toolSlug": "visual-emphasis",
      "confidence": null,
      "componentId": "019dd953-70f3-714d-84bf-99ebe3dcafc7",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.35,
        "w": 0.86,
        "x": 0.07,
        "y": 0.11
      },
      "kind": "paragraph",
      "text": "MGH is one of the leading medical centers and transplant programs in the world, and may have a longer and deeper history with TransMedics than any other program given their physical proximity. An MGH surgeon was the lead author on the company’s pivotal PROTECT trial. We spoke with a transplant administrator, as well as a transplant hepatologist in a leadership role, who confirmed key aspects of the scheme and the dubious business practices that have led them to sour on the relationship. They stated that they are forced to use the NOP service and that the pricing is much more expensive as a result of the bundling: “that’s the only way you can use it”; “we’re kind of forced to...we don’t really have an option”; “two years ago TransMedics said...we’re going to dictate the terms of the utilization of our pump...we are not going to let transplant centers buy our pump”; “they have to use our service...so that’s why it’s so much more expensive.”",
      "attrs": null,
      "subkind": "paragraph",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "96a4acd7-f74a-4105-b4e8-ac512e8e5292",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.35,
        "w": 0.86,
        "x": 0.07,
        "y": 0.55
      },
      "kind": "quote",
      "text": "Q: “For those liver cases that you use TransMedics, are you also using their NOP service?” A: “That’s the only way you can use it - there is a model where, our center has three surgeons trained on putting livers on pump...so, we do have three surgeons trained for a TransMedics pump. Of the 38 OCS pumps that we’ve done, our surgeons have done only two of them, to give you an idea.” Q: “One thing that I’ve heard from a lot of people is that they’re not even allowed to train on the pump. That if you want to use the pump, you have to use their NOP service. So, you’re saying that you use it because you actually don’t even have any other option even if you wanted to?” A: “Yeah, financially, we’re kind of forced in that way. We don’t really have an option because the pumps reside with TransMedics. So, they have to send a team anyway...That there’s no what we call back-to-base model, where we own the pump, we can bring a liver back here.. So, two years ago, TransMedics said we’re going all in, and we’re going to not only set the pricing for our pump but we’re going to dictate the terms of the utilization of our pump, which includes we’re going to use our own surgeon, we’re going to use our own perfusionists, we are not going to let transplant centers buy our pump. Not only do they have to use our pumps and the cartridges and the equipment but they have to use our service line. So that’s why it’s so much more expensive than the other pump options.” – Veteran transplant administrator/executive at Massachusetts General Hospital",
      "attrs": null,
      "subkind": "testimonial",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "5db79f55-b5d0-45f1-9cc0-bd85f37de96e",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": null,
      "kind": "quote",
      "text": "“That’s the only way you can use it - there is a model where, our center has three surgeons trained on putting livers on pump...so, we do have three surgeons trained for a TransMedics pump. Of the 38 OCS pumps that we’ve done, our surgeons have done only two of them, to give you an idea.”; “Yeah, financially, we’re kind of forced in that way. We don’t really have an option because the pumps reside with TransMedics. So, they have to send a team anyway...That there’s no what we call back-to-base model, where we own the pump, we can bring a liver back here.. So, two years ago, TransMedics said we’re going all in, and we’re going to not only set the pricing for our pump but we’re going to dictate the terms of the utilization of our pump, which includes we’re going to use our own surgeon, we’re going to use our own perfusionists, we are not going to let transplant centers buy our pump. Not only do they have to use our pumps and the cartridges and the equipment but they have to use our service line. So that’s why it’s so much more expensive than the other pump options.” — Veteran transplant administrator/executive at Massachusetts General Hospital",
      "attrs": null,
      "subkind": null,
      "toolName": "Authority citation",
      "toolSlug": "authority-citation",
      "confidence": null,
      "componentId": "019dd953-70f3-714d-84bf-9cb12a55d437",
      "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": "e9e257f7-4060-45cb-97b9-2053299cb5cb",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.02,
        "w": 0.55,
        "x": 0.07,
        "y": 0.52
      },
      "kind": "title",
      "text": "MGH corroborated key aspects of TransMedics bundling and extortion scheme",
      "attrs": null,
      "subkind": "action-title",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "40505e43-ecbc-463d-b1e4-d2c8aae9c540",
      "frameworkName": null,
      "frameworkSlug": null
    },
    {
      "bbox": {
        "h": 0.03,
        "w": 0.45,
        "x": 0.07,
        "y": 0.07
      },
      "kind": "title",
      "text": "Case study 1: Massachusetts General Hospital",
      "attrs": null,
      "subkind": "headline",
      "toolName": null,
      "toolSlug": null,
      "confidence": null,
      "componentId": "5899897e-860a-4ca0-b107-92df7cfca43b",
      "frameworkName": null,
      "frameworkSlug": null
    }
  ],
  "metrics": [],
  "tools": [],
  "frameworks": [],
  "arcBeats": [],
  "loops": [],
  "imagePathAlt": null,
  "thumbSrc": null,
  "thumbSrcAlt": null,
  "locked": true
}