{ "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": 90, "pageCount": 342, "prevPage": 89, "nextPage": 91, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 2, "notes": "The slide uses a testimonial to highlight a shift from a collaborative 'backyard relationship' to a profit-driven 'utilization at all costs' model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/90", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-90", "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "callout", "text": "MGH soured on the relationship, bypassing protocols to run up the cost to $200K; “utilization at all costs”", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b8402b96-a2ea-4c0e-849a-d77a42300fb5", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "MGH soured on the relationship, bypassing protocols to run up the cost to $200K; \"utilization at all costs\"", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a978-19ae3f671232", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Massachusetts General Hospital, a pre-eminent high-volume transplant center, detailed the exact same abuses on the east coast that UCSF and the OPO alleged on the west coast – indicating that TransMedics’ scheme is national in scope.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "1d798d61-308f-42bd-8288-d874a6beed5b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.32 }, "kind": "paragraph", "text": "We interviewed a longtime transplant administrator, who described – echoing his peer at UCSF – how TransMedics circumvents their controls and he has to “get involved at 2AM on a Saturday” because MGH suddenly gets hit with outrageous charges for a routine organ recovery: “I find out down the line...it’s upwards of $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "96d89c46-f61b-4462-aaf4-cbf4edf39aec", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "MGH is one of TransMedics earliest and closest customers – “we were up front, first users of the device because we had a backyard relationship” – but stated that the company’s “tune has changed” and it’s now “about utilization at all costs.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f05e2140-91f7-4dd2-8817-339fb6de4d3e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.57 }, "kind": "quote", "text": "“When I first became involved with the discussion of partnering with TransMedics for their liver and their heart OCS device, and then lungs after FDA approval...yes, it does come at a cost, but we were upfront, first users of the device because we had a backyard relationship with them, but also, we, at my institution, were trying to be innovators across all fronts, and that’s also one of the reasons why we wanted to partner with them. As the relationship evolved over the years, the tune has changed. It has become less about what can we do together and trying to figure out the best way, the best logistical setup, and the best-aligned incentives to achieve our mutual goals to become more about utilization at all costs, meaning sometimes there would be situations where I get involved at 2:00AM on a Saturday because so-and-so had said we want to use the OCS device and then now the entire team takes a hold of the entire logistical setup and I find out down the line that something where it’s a typical we fly out the teams, we take the procurement team with us with the modules, and now it’s upwards of like $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "accfb9e1-e283-43cf-b83f-b888f3921c18", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"When I first became involved with the discussion of partnering with TransMedics for their liver and their heart OCS device, and then lungs after FDA approval...yes, it does come at a cost, but we were upfront, first users of the device because we had a backyard relationship with them, but also, we, at my institution, were trying to be innovators across all fronts, and that's also one of the reasons why we wanted to partner with them. As the relationship evolved over the years, the tune has changed. It has become less about what can we do together and trying to figure out the best way, the best logistical setup, and the best-aligned incentives to achieve our mutual goals to become more about utilization at all costs, meaning sometimes there would be situations where I get involved at 2:00AM on a Saturday because so-and-so had said we want to use the OCS device and then now the entire team takes a hold of the entire logistical setup and I find out down the line that something where it's a typical we fly out the teams, we take the procurement team with us with the modules, and now it's upwards of like $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.\" — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a978-1e3ed10723de", "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": "cf9cf686-2fdd-450a-adbc-a180077c0fcf", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }