Tuesday, November 1, 2011

NASS: A Harbinger of Things to Come

Well Spine Nation, tomorrow marks the beginning of the 26th Annual North American Spine Society meeting in the Second City for exhibitors. Are there any words to express the euphoria you all must be feeling? NASS was kind enough to send TSB an invitation to drop by for some Halloween Candy, and you know what Jack Torrance said in Stanley Kubrick's infamous 1980 psychological thriller, "all work and no play makes Jack a dull boy," so maybe Wendy when least expected We may stop by and tickle your fancy.

This will be an interesting meeting, to say the least. The theme of the meeting should be called "The ShinIng." In all likelihood there will be various national media outlets attending the 2011 lovefest as a result of many stories that have found their way onto front page news for the American public to read. Yes, fellow bloggers, TSB is sure NASS will be monitoring attendance. This will amount to a mere side show in comparison to what will be going on down on the exhibition floor. The recent Medtronic Round 1 TKO over NuVasive will definitely be worth watching, in addition, many will be monitoring how the V Brothers behave in response to being named as a party to the Olympus scandal that is unfolding on a much larger scale. Will they continue to party on, or will they be less flamboyant, even Marshall Mathers from Deutsche Bank says that this deal has nothing on the real Slim Shady,"may I have your attention please."

Lately, it seems that some of the luster has been knocked off the billion dollar baby. At close yesterday, NuVasive was rapidly approaching its 52 week low of 14.81, by closing at 14.82. It will be interesting to attend NuVa's Investor luncheon on the 3rd to hear the company's strategic plan and see whom the loyalista's are that will sit on the surgeon panel. If there is any truth to Key surgeons jumping ship to the competition, could this be a sign of some fatigue beginning to set in at NUVA? For those that have criticized our reporting on NuVasive, could they have ridden XLiF into the ground? Pioneering a surgical approach is formidable, building upon these advancements is where the challenges lie. So,who will bail next? If there is any truth to surgeons jumping ship, could investors be next? If NuVa's public relations firm is ever going to earn its keep, this meeting will be a telltale sign, considering NuVa's market cap has plummeted faster than a speeding bullet. If today's market (14.03) is a barometer of things to come as Keith Jackson use to say, "whoa nelly," As for some of our fellow bloggers whom attack TSB for NuVa bashing, get over it, the company's on the hot seat and in the news, what would you write about, the Spine Technology Awards? Sometimes it's better to be humble and stealth like, rather than roar like an engine on a 757. Panache is a double edge sword.

Another company to keep one's eyes on is Zimmer. Are they poised to do something in spine,or is spine truly the bastard step child? Let's be honest, when Zimmer acquired Spine Tech, they had no clue as to what they were getting into, and neither did their then savior Ray Elliott, the acquisition was well a Clusterf#*k from the get go. Abbott Spine just exacerbated the management deficiencies that exist at this company. Dvorak massages the analysts' by telling them the patients will come back when they are no longer afraid of losing their jobs, and they are investing in their sales infrastructure. So where will the growth come from in a zero-sum market? By raiding other companies distributors? For some the lure of a signing bonus or additional commissions will be attractive, but in reality, aren't you jumping out of the Frying pan and into the fire? And, how long before your hospitals declare you persona non grata? There has to be some innovation, if not, some type of product acquisition to jump start this Edsel.

And what about the North America Spine Society, aren't they coming into this meeting with a battered and bruised reputation based on the recent publicity some of its members have received in the press. How many more front page headlines can you withstand before the organization's governing body has to assess its policies and procedures, again. It really doesn't bode well when class warfare between surgeon and sales people becomes the rule rather than the exception, considering that we are all in this together. Thanks to some well known surgeons that believe that with the advent of Skype sales people will be replaceable, your organization does nothing more than throw gasoline on a burning fire. So fellow bloggers it's another year, and it will be your turn to judge who has the best booth, who is offering the best new technology, and how much traffic you get at your booth will be dictated by how late we all stay out, hopefully we can thank each other for making it thru another year without killing each other. PS, and don't be surprised if one of our TSB models stop by your booth and give you a squeeze.

180 comments:

  1. Who cares about those two companies... Globus will not be going public this week but drumroll... launching an expandable lateral implant similar to Caliber. Any word on how the Depuy and Synthes merger is coming along?

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  2. Don't forget to stop by the Vertiflex booth. Thanks for the free plug TSB!

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  3. The Best Little Whorehouse in Chicago

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  4. Globus' expandable lateral cage sounds like a good idea, but don't believe the hype.

    The major problems with this new implant:

    1.) The graft material does not expand with the cage which minimizes contact between the graft and the endplates. Minimal contact = Minimal fusion

    2.) It has a very small graft window due to the bulky expansion mechanism.

    3.) The thing is about 80% titanium which makes the assessment of fusion nearly impossible post-operatively.

    4.) It is SUPER expensive. The materials manager at one of my hospitals told me it lists for more than $10k.

    5.) It is rumored that there have been numerous reported failures already and the thing hasn't even launched yet. Who knows if this is true, but I can say from handling the thing personally, that it feels pretty flimsy.

    Of course, the above caveats apply to the expandable TLIF cage as well since it is based on the same basic design/biomechanics as the lateral cage.

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  5. Mark Brunell, the 18-year NFL veteran QB, will take a job as a "medical sales representative" in Florida later this year when he retires from pro-football. Any idea which company he will be going to work for? Which specialty? Spine? Ortho? Geriatric supplies? Haha...

    Here's the link:
    http://www.thepostgame.com/blog/dish/201111/nfl-quarterback-will-have-work-9-5-after-18-year-career

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  6. Anyone know what happened with the Stryker reps in their federal trial involving OP-1? I heard they were arraigned again just yesterday. Off topic, I know, but just wondering if anyone has the scoop...

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  7. U.S. v. Stryker Biotech, LLC - Docket Number: 09‐CR‐10330‐ JGD

    Pre-Trial Motions Hearing- February 3, 2011, 2:00 PM Courtroom 9- Judge George O’Toole

    Trial- November 7, 2011, 9:00 AM Courtroom 9- Judge George O’Toole

    http://www.justice.gov/usao/ma/news/...d/stryker.html

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  8. 12:09 - Thanks but I was looking for something with a little more detail. I'm no lawyer but I don't think you typically go to trial just a week after your (2nd) arraignment. I think this looks more like a plea deal of some sort and wondered if any one out there has any recent info?

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  9. Any one hear about the dog and pony show in Chicago this week?

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  10. Brunell will prob end up at Stryker seeing as they are a bunch of jock sniffers. That's if he can pass the Gallup....losing $50 million? He prob won't

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  11. You got to be kidding me! Brunnel didn't pack enough cash away to retire on? Guy must have managed his money poorly and spent like crazy.

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  12. @9:15 not that you have every right to be worried but the lateral expandable can hold 80% the graft as your standard lateral cage. fusions are happens perfectly with the posterior expandable - all signs point to lateral having same success. While I haven't handled the device yet, I sincerely doubt there will be a single issue with the strength and mechanics with the device. As to your cost point - sorry your company hasn't launched something equivalent, that is the sweet reward of being first to market.

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  13. Lets get back to the Gabe Hyams and Dr. K. question in the previous post. Word on the street is that they are starting a company with M. Stromer. Anyone have insight into this and enlightenment on who this Stromer guy is? He claims to be an MD but appears to be a sales guy?????????? Another POD?

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    1. I don't know who you are...but this is this first comment that is 100 % accurate and right on. He believes he is God and no one can get to him, he doesn't care who he hurts, as long as he gets what he wants. His dishonesty is not just in his business life but his personal life as well...anyone that comes in contact with him ...beware he will squeeze everything out of you, use you abuse you and throw you away like garbage. He claims a lot of things but it's a cover for all his insecurities...he is in my opinion, very unstable mentally. Run..don't let him pull you in...companies beware he isn't the person he claims to be.

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  14. @9:15

    For that 10k for the Caliper Cage, what does that include? One cage? Two? Tools? What else goes in the 10k package??

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  15. It can be sold for less than 10K, I don't want to give away the absolute bottom price, becuase that would take all the fun out of it.

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  16. 6:35am fixed it for you...
    "You got to be kidding me! Brunnel didn't pack enough cash away to retire on? Guy must have managed his wife poorly."

    Sincerely,
    Abe Frohman

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  17. 7:07 re Merrill Stromer is indeed an MD. He was a vascular surgeon, but retired due to an injury. He has been in spine sales from nearly the beginning. Many on this blog will trash Merrill. But, I consider him a great guy who is often understood. A telling sign: Merrill has many long term friends. Although he has his share of warts (who doesn't?), he is the Merrill we know and love...

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    1. Your crazy he is NO surgeon!! He was a podiatrist in Michigan! Faked a hand injury and cheated his insurance company out of hundreds of thousands of dollars over 10 years! Where do you think his money started from...,true epitome of cheater, con man.

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    2. Anonymous...4/4/17 the first honest response of what Stromer is! Con man, cheater thinks he's all that and everyone is his friend...doesn't he realize he can't buy people...only people that are his friends are those he showers with gifts money and promises..a piece of work..the worst kind. Run don't walk if you ever encounter this crazy piece of work. Mentally not all there, anger issues and mentally unstable!

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    3. Agree and knew Strommer personally. He is a podiatrist and scammed insurance company to collect money which got him going in Arizona. An extremely slick con man who has glossed over his real self and created the lie that he is today! Wouldn’t rust him with anything! He had been at it so long he had a trail of bankruptcies and legal issues behind him. Talk about a Fake person!

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    4. Merrill buys everybody to be his friend but truth is he has NO real friends. Such a narcissistic con man. The women in his life are weak and bought into his crap because they want to live the good life. He has money hid in offshore accounts, in his ex-wife’s name, son, and live in woman friend. But not to worry his evil webs guarantee they have little access to any of it while he is still breathing!

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  18. Merrill is a podiatrist. He tells everyone he was stabbed in the ulnar nerve and it is a lie.

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  19. Abe Froman...., sausage king of Chicago ??

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  20. Hey fellow spinebloggers. I have a couple of surgeons looking for a good solid XLIF/DLIF cage and implants. Im a independent rep looking to pick up the line. Please email me at bryanfreeman23@gmail.com. Appreciate that help. Rock on!!

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  21. Has anybody seen Olie Burkhardt at NASS or is he steering the ship and driving the growth train at Olympus Biotech? Maybe he's playing Possum and staying away from all of the great news that they have been recieiving this past week! Don't fret my friends Uncle Olie will run it into the ground like OFIX!

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  22. @10:18

    Thanks, tho that was the first thing that popped up when I Googled his name. I'M NOT THAT CLEVER !!

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  23. 9:15pm

    If you were getting an XLIF, wouldn't YOU want that expandable cage? Or would you rather a static peak block pounded in there with a large mallet. Maybe into the endplate.

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  24. 7:07 Dr.K and Joe from X-Spine combined with Gabe Hyams and Merrill Stormer? Well, that's not what I would call the dream team. If anyone's ever been around Joe, then one would know he does not need a soapbox or megaphone to tell everyone about himself. I've heard several distributors and surgeons say that Joe really gets on their nerves. As one said, he's all telephone and no receiver.

    On the other hand, and in my humble opinion, Dr. K couldn't pour water out of a boot if the instructions were on the heel. That's pretty bad.

    Now, moving on to Gabe Hyams and Merrill Stormer. Again, and in my opinion, not a good combination for success. Instead, it's a combintion that sucks.

    I would guess that collectively, the four may have an IQ of 42. These four are definitely proof that evolution can go in reverse.

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  25. C'mon 3:11 whose' Bitch were you from the above? Sounds like it ended badly for you. Kicked to the curb?

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  26. Zimmer talks endlessly about Vision, Mission, Values. They have no values (what corporation does? It's ludicrous and insulting to everyone else that they even pretend), their mission is to make money (nothing wrong with that, but they wouldn't put it that way, oh heavens no), and the Vision thing? Don't make me laugh. Don't even try.

    The only really innovative thing they've even tried since they bought Centerpulse Spine-tech was Dynesys, and here's the dirty truth about that--it was 90% through the pipeline at time of purchase. It probably would have cost them as much to abandon it as to continue it, at that point. Well, anyway, we all know how Dynesys turned out.

    The spine division 4 years ago officially gave up on internal product development--even though they have some clever people and interesting patents--in favor of an acquisition-based business model. Trouble with an acquisition-based model is, there has to be something worth buying, i.e. something you can buy for less than it's worth. Or something that through your cleverness you can grow. Good luck with that plan, with the group of losers they've got in management in Warsaw (headed by Chief Loser DD, of course).

    The reason, the real reason, all this happened is because there are maybe only two people (not including sales people, who unavoidably learn stuff from the customers) in the entire spine division who actually know a damned thing about spine. The company is run by and for bean counters. And you expect innovation from this group? You expect risk taking?

    What did I say about making me laugh?

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  27. So what if NuVa doesn't have an expandable XLIF cage? The clinical data speaks for itself. XLIF (NOT LLIF) has been proven to work and it works extremely well. Why would a surgeon switch to some new gimmicky implant like Globus' expandable cage when the cage that he is already using is 1/3 the price and works like a charm?

    Don't fix it if it ain't broken.

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  28. Well, I must take my hat off to globus. They have just introduced their 1st innovative adaptation of somebody elses copy of an innovation. Way to go, boys!! What's next, screws with heads that move? Pshaw!!!

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  29. You all who claim to be friends of Stromer have it all wrong. He's a podiatrist by training. Hails from Detroit. Admits that he doesn't do business in Phoenix (where he lives), becasue "he's burned too many bridges. Claims EVERYONE is a "dear frined". Also claims that he "owns two private planes". He does not. He's a real sociopath. Lies at the drop of a hat.
    The only accurate statements about him above are that he is involved with many PODs. The man has no conscience. He does have many contacts. For ninty days. That's how long he gets involved with companies. "They're wonderful for that long". As long as he gets his 5% cut off of your sales. Or as long as they pay him a stipend.

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  30. You all are a bunch of hand jobs Corporate didols! U know who u are! Nerds! Bring it! Chicago true city boys want u! Faggots! We will fight u any day nerds

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  31. Love it! Chitown mob don't mess around! Faggots

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  32. http://www.healthcarefinancenews.com/news/dfine-pays-239m-settle-kickback-charges

    Dfine pays $2.39M to settle kickback charges

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  33. 6:35pm, Nuva rep

    "If it ain't broke don't fix it?". Sounds like the poster on the wall in the engineering room. Great concept for innovation.

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  34. It is Obvious that The NuVa train is at its last stop.
    Thier reps should be scared.

    All of the Globus bashing is out of Fear of the company as well as tremendous envy.

    I love reading the negative comments as my market share and product portfolio continues to expand.

    Good luck.

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  35. 7:35am

    Normally I would agree that the attitude of "if it aint broke don't fix it" is a bad idea when it comes to improving medicine.

    However in the case of 6:35pm the context was key. An expandable single level cage would be a good thing in TLIF/PLIF where the access constrains you. With the caveat that IF (and im not saying for sure it would) the cage itself drops the fusion rate then its quite a trade off. In a lateral case you can get something pretty massive in anyway without many issues. Damage to the endplates isnt really a major concern - the surgeon either has to be unlucky or a bit careless to have any problems from the cage insertion itself and regardless the stability from supplemental fixation should help avoid issues as well.

    Far more of a concern to me is what happens to the expanding mechanism in a small disc space when the surgeon pounds down on the cage with their mallet?

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  36. NUVA below 14. Trouble in paradise?

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  37. NASS invited Karl Rove as the presidential speaker. Is there any oher way they could better advertise their true nature and mission?

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  38. Outside looking in ...

    NUVA - 10.5% sales growth Q3 2011 over Q3 2010 tells me they are adding surgeons and taking share. It seems that if you want to develop another lateral sysystem, you first learn from these guys.

    Zimmer Spine - 12 consecutive quarters of negative sales growth? I'm sure they'll have an enormous booth at NASS but these guys are a retreads and trainwrecks run by people that don't have a clue. Seriously, does anyone take this loser organization seriously? Zimmer Corporate is a finance organization only concerned with buying back shares and keeping key shareholders happy. They could give a rip about Spine.

    NASS - another year and they still have their head in the sand regarding ethics, PODs, and accountability. Medtronic has run the committees for years which is why it took so long for the other side of the InFuse debate to be heard.

    Until this organization begins to address the obvious ethical lapses of their members, their proclamations will be viewed as a joke.

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  39. Any word on Synthes/Depuy merger? Are they sticking with Distr model?

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  40. They gonna mix it up, best boys may stay.

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  41. I couldn't agree with what is being said on here about ZS. After 9 years in sales with that company they have proven themselves as a bunch of guys that could care less about Spine. DD is one of them. Is a lawyer "trying" to do what's best....best for who David? You all in Warsaw have made the Spine division of Zimmer a laughing stalk of the biz. What a shame, what a shame.

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  42. Has any body seen Oliver Burkhardt at the Fair, wondering if he's in hiding this week with all the positives moves OLympus Biotech is taking?

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  43. Could anyone expand on the nature and terms of the typical "consulting agreement" If Surgeon A creates a cervical plate is he paid a fee for creation or "creative input" or is the typical compensation a portion of sales from the plate? If someone could expand on this or other means of surgeon compensation I would appreciate it.

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  44. Oliver is no where to be found at NASS.

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  45. Suregon agreements vary from a royalty if he designs the implant to more of a general consulting arrangement. In these arrangements, a surgeon is paid for his time to speak, teach, or educate on technology. It is usually an hourly fee. He is also paid for his travel time to an educational event etc. They are needed in this business and most are legit.

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  46. Process Expo at McCormick Place in Chicago - same venue as NASS this week.

    Process Expo badge - $0
    NASS - $1,000 and up

    Wake up NASS!!!!!

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  47. And the Process expo is chock full of machines that actually do what they claim! But there seems to be some poetic element to combining NASS with a butchers convention.

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  48. As a user of many different companies implants, I must say Globus' stuff is designed well, does what it's supposed to do, and I'm confused by comments that claim all their stuff is a copy of other stuff. That's just not true in my experience. Their SP-Fix locks unlike any other on the market, and is the easiest to insert compared to the other 3 companies I've used.

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  49. The sp fix was a copy of Nuvasive Affix II....Globus just copies other companies.

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  50. Anybody see Cappuccinno at the Lanx booth pimping Timberline lateral with his hot ex-Nuvasive rep now turned Lanx distributor?

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  51. Regarding Dvorak ... He was the Group President in charge of Spine prior to taking Ray's spot. Zimmer Spine's failures are partly based on his BS he's been spilling internally and externally (those analyst calls are a joke) Also didn't forget getting bent over by the Feds and agreeing to pay a ridiculous sum of money to enter the DPA. This guy is out of his league.

    Cappuccino ... looks like he took his rep and his partner into the scam that is Lanx. I was told Just 3 months ago he was crying at a Nuvasive meeting praising the company because of all the wonder mission work in Africa that he participated in. Times must be tough if he needs the cash that bad ... Seriously, I don't know of one surgeon ... not one ... who moves ALL of their business to Lanx WITHOUT getting paid a ton of $. They ALL leave when the $ stops flowing.

    Lanx is bleeding revenue. Aspen's are failing everywhere. The company knows it but they FAIL to report their device failures to the FDA (Aspen being the chief culprit). So who will Capp run to next when the FDA shows up at Lanx's doorstep (Yes Lanxophytes ... your ex-corporate folks are starting to talk) demanding to know why their MDR are so out of date or shredded?

    Within 18 months will Capp drag his rep and partner to K2M? Globus?

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  52. 4:43

    "Their SP-Fix locks unlike any other on the market." Strange, as the ratchet locking mechanism on the Globus SP Fix plate has come loose two times already with a surgeon I know, resulting in a revision each time. He switched to another plate and has not had the same problem since. Maybe, the Globus plate doesn't lock as good in Texas as it does in your state? I mean, everything is bigger in Texas, you know?

    The Globus ratchet mechanism reminds me of the old Synthes Synex VBR, but on a smaller scale, which I believe had a similar problem with the ratchet mechanism.

    By the way, 5:03 is right though because the SP Fix is very similar to Nuvasive's Affix II plate.

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  53. lanx has been fishing for a cover boy for a long time... Unfortunately, the economy is rough and Dr. Cappuccino has a private jet and wine cellar to keep up with.

    As far as I have heard, Lanx has been recruiting ex-globus employees.

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  54. Can we get a picture of Capp's Rep?

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  55. Where is Lanx getting money and why?

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  56. Yup pretty much all ex Globus hires. Likely because as one comes over, they then refer their buddies to HR.

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  57. Speaking of PODs, what's up with Alphatec?

    It couldn't have been any sleepier at the ATEC booth today.

    With demo stations empty, I wandered up to a guy with a beard wandering aimlessly around the corner of the booth to ask about the MIS system. He couldn't really demo the system or tell me what was so special about it. He then proceeds to tell me he's the Director of Marketing for MIS. Huh??

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  58. WOW, Medtronic is going for the jugular on Nuvasive by filing a move for a permanent injunction on the patents that they won on:

    "Medtronic Inc. (NYSE: MDT) sought a permanent federal court injunction barring NuVasive Inc. (Nasdaq: NUVA) from making, using or selling medical devices used in spinal surgery that infringed patents held by a Medtronic subsidiary.

    The filing in San Diego federal court Wednesday follows a Sept. 20 jury verdict in which Minneapolis-based Medtronic was awarded $101.2 million in damages after the jury found that San Diego-based NuVasive infringed three Medtronic patents.

    The patents covered implants capable of being inserted between adjacent vertebrae, a plate and screw system used to stabilize vertebrae and a tissue retractor, according to court filings. The jury also found that Medtronic owes NuVasive $660,000 in damages for infringing a NuVasive patent for a nerve monitoring system for lateral spinal surgery.

    Medtronic lawyers said they also planned to seek post-verdict damages dating from June 10, 2010, the ending date on which the jury's finding was based, to the present. In Wednesday's court filings they said that NuVasive has failed to produce requested financial data upon which they would base those damages.

    The $101.2 million Medtronic damages verdict, which was awarded after a two-week trial, was the 14th-largest jury award in the United States in 2011 and the fourth-largest in a patent infringement claim, according to data compiled by Bloomberg. The largest patent jury verdict in 2011 was for $482 million in a lawsuit against a Johnson & Johnson (NYSE: JNJ) unit over stents.

    In its court filings NuVasive asked U.S. District Court Judge Michael Anello to either reject the jury award or order a new trial. NuVasive said the patents aren't infringed and the jury verdict wasn't supported by the evidence.

    The case is Medtronic Sofamor Danek USA v. NuVasive Inc., 3:08-cv-1512, U.S. District Court, Southern District of California (San Diego)."

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  59. Maybe MDT is going to make this personal with with Alex. Is Alex walking the floor with his 4 personal assistants entourage?

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  60. It's over Johnny......

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  61. 9:34 I know who are talking about. Can't believe got that gig, err...maybe I can. Has never launched a commercial product in his career (sitting on the sidelines with an IDE product for six yrs doesn't count). Then again, alphatec doesn't really do commercial launches do they. I keep hearing "beta" release.

    Disgruntled rep waiting for product.

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  62. 5:11AM Kinda harsh. Charlie is a nice guy. I know him from SpinalMotions.

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  63. Well fellow NASS folks. I know all of your booths are not busy. What is your overall feeling on NASS this year? Aren't you tired of standing in the booth and staying out late wining and dining the surgeons?

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  64. Too easy to bash Cappucino. I've worked with him over the years and he is someone you all wish you could spend time with in the O.R. His departure is all about nuva. The way they treat their people is shameful. The way alex flaunts his wealth is discusting. ed mayadag, brian cornwall and the rest of the mvp team actually represent themselves as surgeons and talk down to most docs except for pimenta, smith and rodgers. what goes around comes around and nuva now must pay for the ip they stole. koolaid is about to start taking its toll.

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  65. NUVA Nation:

    I believe Porky Pig said it best,
    "Th-Th-Th-Th-Th-... That's all, folks."

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  66. The richest one percent of this country owns half our country's wealth, five trillion dollars. One third of that comes from hard work, two thirds comes from inheritance, interest on interest accumulating to widows and idiot sons and what I do, steal IP and pad my stock options. It's BS. You got ninety percent of the American public out there with little or no net worth. I create nothing. I own. We make the rules, pal. The news, war, peace, famine, upheaval, the price per paper clip. We pick that rabbit out of the hat while everybody sits out there wondering how the hell we did it. Now you're not naive enough to think we're living in a democracy, are you buddy? It's the free market. And you're a part of it. You've got that killer instinct. Stick around pal, I've still got a lot to teach you. Love Alex.

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  67. A Cappuccino sounds delicious right about now...

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  68. So does Kim Kardasian.

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  69. This is not a surprising trend. This is why sales growth is not what it used to be:
    A new study published in the Archives of Internal Medicine sought to analyze changes in payments to orthopedic surgeons following five orthopedic manufacturers' 2007 settlement with the DOJ. What they found between 2007 and today was a decrease in the number of surgeons paid, an increase in the absolute dollar value of payments and a "need for clearer specific requirements for disclosure" from surgeons, companies and institutions.

    Available data from 2007 demonstrated that 1041 payments totaling in excess of $198 million were made to 939 orthopedic surgeons, A year later, the number of surgeons receiving payments dwindled to 526, though the absolute value of payments increased to $228 million. Contributing to this increase was $109 million in one-time royalty buyouts by a single firm, though similar patterns were seen in subsequent years: companies reporting data paid an average of $212,740 per surgeon in 2007, $193,943 in 2008, $246,867 in 2009 and $233,108 in 2010. Additionally, one trend since 2007 was that the proportion of surgeons receiving payments who had academic affiliations rose from 39% in 2007 to 45% in 2008, which may reflect more stringent reporting policies at academic centers.

    The researchers also addressed variability in the data; they only had complete reports from three companies for all four years, and the details available varied by company. The authors concluded that more specific and uniform disclosure requirements would make the data more valuable

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  70. the laughing policemanNovember 4, 2011 at 9:14 AM

    if nuva goes tits up, where will Roger "cross-eyed Mary" and Terry "how to win friends and influence people" end up? Baxano?

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  71. Who Framed Roger Rabbit, heard he has been having secret meetings with Baxano already. Crossed Eye Mary is next, just wait for the Big announcement next week they are leaving!

    I spied Olie Burkhardt at Alphatech begging for another shot to join Dirk "No Bullshit" Kuypher.
    I believe that he see's the end of the road at Olympus. He's been there for a few months now, its time to move on!

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  72. Orthofix, I walked by there booth yesterday and it was a ghost town. I thought that they were doing so well accordingly to some reports that they have been growing. Looks like to me they should roll up the store front and sell off spine totally! Who wants to hear about Trinity Plus, Plus, old story that has nothing behind the curtain. Cory Brenner looked like a scared little boy with no one's should to cry on!

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  73. Alphatec and Burkhardt deserve each other!

    Who gives a rat's &*&#%*!!

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  74. Orthofix another sinking ship, maybe they should make a few more executive changes, what's it been about 20 top managers gone in and out the door in the last three years!

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  75. No doubt! I have never seen so many upper executive changes in 2 years. Burckhardt, Masson, Unger, Milinazzo. Maybe they should bring back Ollie?

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  76. Where did Rusty McArver land? How about that guy with the blue tooth in his ear all of the time? I think his name was Earlright?

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  77. 8:42 & 8:43 - I think you'll find that they're both a little bitter right now.

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  78. @914 & 935:

    Didn't T. Rich recently move to San Diego? Perhaps he needed to be THAT close to Jeff Rydin? As for Yapp, Recupero wouldn't make the same mistake twice.

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  79. 7:07 Dr.K and Joe from X-Spine combined with Gabe Hyams and Merrill Stormer? Well, that's not what I would call the dream team. If anyone's ever been around Joe, then one would know he does not need a soapbox or megaphone to tell everyone about himself. I've heard several distributors and surgeons say that Joe really gets on their nerves. As one said, he's all telephone and no receiver.

    On the other hand, and in my humble opinion, Dr. K couldn't pour water out of a boot if the instructions were on the heel. That's pretty bad.

    Now, moving on to Gabe Hyams and Merrill Stormer. Again, and in my opinion, not a good combination for success. Instead, it's a combintion that sucks.

    I would guess that collectively, the four may have an IQ of 42. These four are definitely proof that evolution can go in reverse

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  80. can some of us homegamers get a good meaty post from something going on @NASS??

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  81. Anything from Synthes or Medtronic - i.e., anything new being released product-wise?

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  82. Hey Nov 4, 3:42pm. You posted this same post on Nov 2 at 3:11pm. You mo mo! Is this the best you got??

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  83. @349

    Globus did not go public. Does that work?

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  84. Now THAT was funny.

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  85. Nuvasive Booth was packed at Nass......

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  86. Too bad that NUVA booth had 50 NUVA employees. Next time look at the badge holders and you won't get fooled so easy. They even did the lame pep-rally clap after each day.

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  87. Unbelievable, a pep rally clap?

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  88. i thought NASS sucked.. it was 90% reps. It was the same crap, its a marketing show. ALthough there wasnt too much to show this year. every company comes up with a fancy booth then fills it with their employees to make it look happening. I thought it was a waste of time and I will not be going next year for sure. Companies should demand that surgeons will actually be there.. Pathetic....

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  89. 7:53 is spot on. I think the number was closer to 100 purple nurple metrosexuals with funny gelled mohawks, emphasis on 'mo!

    Stryker was relegated to a dark distant corner. Probably by design to avoid having to show their new product line up.

    MDT had a huge showing once again...outside of there booth in the form of ex employees, that is.

    A very unimpressive NASS overall. Its sad when the odd shaped chick in the silver body suite and the headlight was the brightest spot on the floor!

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  90. 3:42 on 11/4/11

    It's been almost three years since the inception of TSB and you my friend receive our first literary award, we have never had anyone write as prolific a comment as yours, we may have to hire you on our team. Thank you for making everyone's night. We're outta here

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  91. Anybody have information on how DS plans to roll out new sales force? Is there distr model strong domestically? I hear northeast is locked down to stay status quo.

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  92. Zimmer booth had crickets. Their reps all have the deer in the headlight looks on their faces. Chris Ryan is a great guy, but you can only put so much lipstick on a pig. Nuva floods their booth with thier reps, and it's pathetic to watch they all applaud when a surgeon does a presentation. Exhibit hall filled with half wit sales reps..sad to see the dumbing down of our industry!

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  93. Your right, Zimmer booth looked nice but nothing. I looked over and see the biggest crook in this industry standing there Jim Matteola. That makes Zimmer a big joke even more so then lack of products.

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  94. Nov.3 5:43, just a typical competitor bashing. Aspens failing everywhere? if that is true, so are all of the other spinous process systems in place now, as aspen is clearly the leader in the group, not withstanding life spines shameless knock-off facilitated by Don Freeman, when his sorry ass got booted from lanx. Sell as many of the aspen knock-offs as you can, life-spine to generate revenue to pay off the lawsuit that your going to lose. Cappuccino "pimping" timberline? Cappuccino is at Lanx because they, are still small enough to address the need for custom instruments, & tweaking product to meet his needs. Don't get me wrong I'm sure that Lanx paid this guy, & the reps he dragged along wiht him huge $$ to jump on board. But I am just as sure that Nuvasive countered with considerably more money than Lanx could ever dream of having to get him to stay, so say what you will he was probably tired of Nuvasives b.s. ex corporates starting to talk? Don't make me laugh. Reading through this blog is very entertaining. I'd be willing to wager a large sum of $$ that 95% of the contributors are nothing but whore reps working for the pimps. All you guys (reps)are nothing but a group of non-value added (with the exception of the really hot babes) ex physical therapists, or whatever you were before you hopped on to the spinal gravy train who add cost to a product at the expense of all others involved. I'd also be willing to wager that you've all bounced from company to company, trashing your formers to no end. I have always found this blog to be extremely entertaining. Please don't ever stop!!

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  95. 7:09 Would love to hear what value you feel that you bring to this industry?

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  96. Did anyone get the chance to stop by the Vertiflex venture capitalist booth?
    "For better or worse."
    Thanks again TSB for the free plug!

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  97. I make the stuff that you sell, 7:34

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  98. Nuvasive's booth was packed with company people and reps --- all purple lanyards

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  99. I heard some earth shattering news. Amedica is taking it up a notch by bringing in ousted Jim Enright from Orthofix. This industry is in incestuous, cauldron of retreads.

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  100. 9:38am, you make the stuff that nobody sells if you work for Lanx. And how pathetic are you if you're bitching about Life Spine stealing your ideas? Who cares? They have zero market share. You are wasting your time.

    And by the way, Lanx was not the first company to develop an interspinous process fixation device. You did not "invent" sh*t!!

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  101. Where was Spine Aliign at NASS? Is that what you mean by re-treads? As the Musical chairs continue to change. Meeting was a farce. Synthes reps beware!

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  102. Not bitching about anything, 12:43, just stating facts. And I know that Lanx didn't invent the spinous process device. They just had a better design, & marketed it better than the rest of you clowns. Parts that I make are for little known companies like Biomet, & Du Pont to name a couple. Lanx may not have invented sh*t, but apparently you don't know sh*t!!!

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  103. 2:26. No, I would not say spine align is made up of re-treads. Some good people there but they ran into FDA issues.

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  104. The more pedicle screws and peek cages I look at the more I realize $400 pedicle screws will be here sooner than later...Probably late 2012.

    while clouded with "new tech", the majority of industry's revenues are derived from pedicle screws....Globus expandable cage for 10k, who gives a shit....can't afford it.

    can anyone share their experiences in a similar boom industry that experienced such rapid deflation and hyper competition?

    tb

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  105. James Robinson MD developed the first spinous process device in 2004. He worked with Reggie Haid in Atlanta.

    If he was smart he would sue Lanx for IP infringement.

    tb

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  106. For all of the bitching & complaining on here,, How many of you were interviewing while you were at NASS?

    C'mon, be honest, I know that I saw a lot of 1 on 1 conversations taking place around the convention center & surroudning hotels.

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  107. touche 7:32!!! I'll bet most of them were, that's all spine is anymore...reps going from company to company, & taking whatever business they can with them & 6:44, it's medtronic that should sue lanx, since the spire was the inspiration for aspen

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  108. @6:44 and @4:28 you should understand how patens work. you have to have a paten to protect your self. there is a reason why there are 15 sp devices on the market and they all look and act the same. No one was smart enough to lock down a great paten. Things will change moving forward. The problem with NASS and everyone there is that we have not had any new evidence in a long time. Does any one think its interewsting that WE (spine) has only had 13 PMA approvals in spine? all that money, all the new products, and 13 PMA's. We all want to talk about how great our company is or how awful another are. In reality we all copy each others system. I am sorry to offend but a screw is ascrew and a plate is a plate. a D-lif is an X-lif and Stryker your new lateral will be the same. Spend some time at a booth during NASS and it has be come a surgeons dream to pitch their IP. I am concerned as a rep how we will continue to not look more and more like whores. There are a select few that dont, but most just chase the next gaurentee. So if your at Globus 2 years from now you will probably be at Nuva. Medtronic reps are going to Zimmer and Stryker? Really that makes sense. Smell the money and your understanding of the spine market and products goes out the window.

    Just Sayin

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  109. 6:44- Might want to check your history on spinous process devices...XSTOP was finishing up their IDE study in 2004...

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  110. 5:24 consider spell check occasionally.

    Just sayin.

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  111. Ummmm, We should understand how "patents" work yet you can't even spell it correctly?!?! I'm sure you meant well but it's a bit hypocritical to tell us to do our homework without you doing your own. You don't look more and more like a whore...with spelling and grammar like you displayed, you look like an fool. It bothers me that folks criticize and get on a soap box when they are just as guilty of something as the next guy. We're not perfect, none of us...the sooner we stick to what's going on instead of slinging mud every other post, the better off we'll be. Carry on.

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  112. Sorry to add to the confusion about spinous process fixation, but X-stop is not a fusion device. The discussion was around fixation, not stabilization, and there are numerous plate systems invented prior to Lanx to include one developed in the late 90"s, and FDA cleared in 2001 called Tandem. It was predicated by use of bone fixation plates used in ISP fixation from the late 80's. Interspinous fixation has been around forever, popularized by Dr. Bowman with a technique named for him, primarily used in cervical fusion, but also used in lumbar for "Chance" fractures. So, least you think any of this is a new thought or an idea, most are certainly not. They are just methods to make the technique a bit easier, and by the way, have not changed outcomes and in a number of cases, made them worse.

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  113. They are just methods to make the technique a bit easier, and by the way, have not changed outcomes and in a number of cases, made them worse.


    Something we all on the way to the bank could stand to think about.

    If payment to the doc or instrument company was dependent upon outcome, my how this industry would be different!

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  114. Closing remarks at NASS:

    I remember those cheers / They still ring in my ears / After years, they remain in my thoughts. / Go to one night / I took off my robe, and what'd I do? I forgot to wear shorts. / I recall every fall / Every hook, every jab / The worst way a guy can get rid of his flab. / As you know, my life wasn't drab. / Though I'd rather hear you cheer / When I delve into Shakespeare / "A horse, a horse, my kingdom for a horse", I haven't had a winner in six months.

    And though I'm no Olivier / If he fought Sugar Ray / He would say / That the thing ain't the ring, it's the play. / So give me a... stage / Where this bull here can rage / And though I could fight / I'd much rather recite /... that's entertainment!!

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  115. 7:09 said: "Sell as many of the aspen knock-offs as you can, life-spine to generate revenue to pay off the lawsuit that your going to lose."

    Typical spine rep dumbass. There has to be an issued patent to sue over, which Lanx doesn't have. Damages don't begin until the time of issuance of the patent. At which time Lifespine can choose to stop selling their "knockoff," or come to a licensing agreement, or go ahead and go to trial over it. They'll probably just introduce the novel one they are working on at that time. But this is all grown folks talk...

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  116. 12:14

    "Damages don't begin until the time of issuance of the patent."

    You are a f-n moron.

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  117. Be on the look out. Eminent Spine looking to take over the industry. Haha! Are they for real with the "camo" booth?

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  118. I kept over hearing some looser at the Alphatec booth talk about playing college football in Boston........no one cares Al Bundy!

    Who had the best booth at the show? Did any company stand out?

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  119. K2 & Lanx seemed to have decent traffic. Heard a lot of good things regarding Baxano. Walked by their booth, was pretty busy both times I went by. SI-Bone seemed to be generating interest as well.

    Eminet Spine's booth was ridiculous.

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  120. I was near Lanx booth the whole week and it was not any busier than other booths next to the show-hoes from SpineSmith!

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  121. ATEC has lost a lot of biz in the South East. I noticed Kenely didn't show his face at NASS. Probably busy having tea!

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  122. The commercial side of spine is in obvious decline. Exhibition with again fewer companies and smaller booths. They still were too large to hide the fact that very few surgeons showed their face. Felt more like an undertaker conference. Baxano and SI-bone were the only ones with some traffic. Eminent spine offered free tattoos. Ken Horton showed how much diamonds you can stick in one ring if you work with PODs. Otherwise, booooooring...

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  123. 1:10, Why do you say 12:14 is a f-n moron? 12:14 is exactly correct. This is directly from West's 2011 text on patent law:

    "As the patentee has no rights until the date the patent is granted, there can be no award of damages for activities prior to issuance. After issuance, the patentee is entitled to collect damages from the date that the patented product is marked with a patent number."

    As Dirty Harry said, A man's got to know his limitations.

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  124. 9:15

    Damages go back to patent publication, not issuance. An infringement suit can't be brought until issuance, but damages can predate that.


    The statute that governs the damages starting at the publication date, is 35 U.S.C. 154 - Contents and terms of patent; provisional rights.
    (d) PROVISIONAL RIGHTS.-
    (1) IN GENERAL.- In addition to other rights provided by this section, a patent shall include the right to obtain a reasonable royalty from any person who, during the period beginning on the date of publication of the application for such patent under section 122(b), or in the case of an international application filed under the treaty defined in section 351(a) designating the United States under Article 21(2)(a) of such treaty, the date of publication of the application, and ending on the date the patent is issued-

    Now your know your limitations!

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  125. A lot of lawyer wanna be's on here. 4:47, I think you are wrong and 9:15 is right based on the excerpts you provided. Damages and royalties are two different things.

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  126. As Keith Jackson would say "yes indeedee dooddee...it's a fumble" (speaking of the NASS show and lack of innovation).

    Any chance on getting my $$ back for the $1k badge I bought????

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  127. Just to add two cents to the SP historical compilation, the first device I recall that specifically and solely used the spinous process as an anchor point was the alligator plate from Japan, introduced over 15 years ago.

    And yes, ISP wiring has been common for many years, and just for clarity I think it's Henry Bohlman's (not Bowman) "triple wire technique" you're thinking of.

    More importantly, what was missing at NASS, this year more than ever was spine surgeons! Seemed like a lot of the big names didn't go. Curious what the attendee numbers looked like. Will be interesting how NASS positions itself going forward if the surgeons continue their exodus. While spine surgeons have questioned their relevance over the years, at least meetings like AAOS and AANS/CNS have their role as the home of the medical specialty to secure their existence. NASS has no such legitimization.

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  128. As royalty and consulting agreements proceed down the slow path to extinction, those big names (you say) will need to find another place to land. What is your guess? Do they need to come visit the booths? We are nothing more than the local rubes teasing the tourists on the beach with beads and local knick-knacks. We have become pathetic. Let others bring the next step in our life or should we walk out gracefully! You make the call.

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  129. I lost my job because of of J Matti, was with a smaller size company and brought him on board. He promised millions and did nothing

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  130. Anybody have any comments on what was presented during the scientific sessions?

    First time outside of AMPLIFY panel meeting that InFuse increasing cancer risk was publicly presented.

    Anyone... Anyone... Buehler...

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  131. So, I brought a friend to the exhibit hall this past week so he could see what we do and sell. As we were walking out, he said and I quote, "This is like a bunch of Ford dealers lining up to tell you why their Ford is better than the Ford next door. It's no wonder it looks like a salesman's convention." He sells cars, needless to say. Thought it was appropriate.

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  132. "He sells cars, needless to say"

    Do you know if his store has any openings?

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  133. I thought the Globus booth was very busy. From what I over heard on the CALIBER corner, none of the listed issues above were a concern. Oh and how could something fail if it hasn't been implanted yet? You people...must be shitting purple.

    On a lighter note, I really digged their navy sweaters. Hhehehehe

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  134. In regards to the Caliber, why in the hell would you design a lordotic implant to be implanted unilaterally. Wouldn't you be putting the patient in scoliosis?

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  135. 7:09 We need more competition like you, please come to my area.

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  136. 7:55 - thank you.
    7:09 - think before you type (and speak)

    side note-has anyone heard of a company out there that regrows finger tips/heals horrific wounds with a porcine derived xenograft?

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  137. side note-has anyone heard of a company out there that regrows finger tips/heals horrific wounds with a porcine derived xenograft?

    ACELL (www.acell.com)

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  138. Wow...talk about a diverse, AND tough group...it is sad to see how jaded many of us have become. This industry used to be pretty professional--now we have peeps, (and perps). Is there such a thing as a truly good company anymore? How would we define? Innovation? (Don't they ALL 'borrow' ideas from each other?) Good marketing? What is 'good' marketing these days? Sound management teams? Tell me one company who actually respects and treats their people truly well--with respect and by empowering with 'ownership' in day to day? In my mind, there is a huge centrifuge with being being flung off--remarkably many land elsewhere only to take incompetence to the next level. It seems there are only a few 'good' guys left. How about some submissions to that end. We all know the zebras and snakes. Nuvasive is an easy mark these days. What goes around, comes around. I can't believe it didn't happen sooner, but legal processes take time. As a strategy, it also makes sense to allow a company who stepped on your patent to gain sufficient traction. Damages easier to assess on revenue. Many companies made it a calculated business strategy by blatantly copying a design and then flying under radar as long as possible. Alphatec started this back in the early 90's...how did Globus start at all? Where will it end? What about outcomes? Does anyone truly care? Thanks tsb for the forum. You were a visionary. Wanna run a company?

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  139. Kudos to 5:57. AMEN. Its amazing what some competition will do to people. This industry is cutting off its nose to spite its face. The continual undermining of every competitor, technology, rep, and surgeon is pathetic. The constant selling on price alone is going to destroy all of you not just some of you. The lowest cost provider is almost always to largest so awesome for JNJ and MDT. Where does that leave the rest of you? Certainly not treading a path of least resistance. NUVA failing, or even them losing the battle with MDT at the end of the day is a major loss for everyone on this blog and patients everywhere. MDT wins that patent lawsuit and all lateral systems are open season. Since lateral is the only area with sustained growth that is not controlled by the largest companies, where does that leave all of the mid-tier players? How do smaller companies grow to compete? Where does more money come to finance innovation? Be careful what you ask for through your words and actions, because all you are doing is cutting off your own legs.

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  140. Karl Rove speaking makes a lot of sense. So did what he said. Anyone in that exhibit hall should have blinders on when it comes to which level you pull on election day next year. Voting for the current administration is pink slipping yourself.

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  141. This whole industry sucks! I have never met a bunch of bigger douche bags in my life....this includes surgeons, reps, and the bottom of the pit...manufacterer executives. What really disgust me is the fact that patient care is the least of everyone's consideration. I guess this is where all the second tiered people end up. Here is a word and definition you all should know, especially scum surgeons; ALTRUISM: The principle or practice of unselfish concern for or devotion to the welfare of others (opposed to egoism).

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  142. 12:08- Agreed- nothing else in all of device as bad as spine. Too many shotty people rising to postions with companies, they are not capable of filling well. Too many little companies with no sales outside of their "deals" with surgeons and too many surgeons that are greedy and won't even look at a product based on merit- especially MOST of the young guys just getting started. see ya spine- I have had enough.

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  143. 5:57AM, 12:08 & 1:17

    Agreed;sounds like you worked for globus.

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  144. What is wrong with Nuvasive and the Management....Im in the interviewing process....I would like to know

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  145. Now you've done it! TSB servers are about to crash!

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  146. 12:08 said: "I have never met a bunch of bigger douche bags in my life...."

    You are one of us, so you are a douche bag by definition. But do not fret. Douche bags perform a valuable function, so there is hope for you yet.

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  147. Come on people...stop the name calling. I earn a really great living for my family; and I hope you all do as well. Let us consider ways that bring value to our Physician customers; ie Coding help, Facilitating peer:peer meetings/surgeries, to help usher in more MIS techniques that help all of us, & most notably the unsuspecting patient. We are the absolute last subspecialty to fully embrace & employ quality MIS approaches to the surgeries we observe everyday. Even the CV surgeons are doing MIS CABG's ahead of most Spine surgeons.....I'm telling you...there's still gold in dem der hills...but u gotta no where to look! Good Selling!!

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  148. 10.47, Karl Rove is the ultimate douchebag, the personification of cold calculated manipulation and evil. Given the moral state of our industry many members should be pink slipped anyhow. It would also help reduce costs. So on election day I know which lever I will pull, you can remain at the level of Rove.

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  149. Anybody hearing of this possible new new Stryker Spine purchase many of us are hearing of?

    Many think the reason they sold 750mil in sept. was to help fund.

    Any real details out there?

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  150. No question about it, Stryker is shopping.

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  151. I heard Stryker is interested in SI bone, might just be wishful thinking from si reps. Anyone hear anything?

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  152. @4:51

    Who specifically are you referencing at Nuvasive? Do you like Broadway musicals?

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  153. "Oh and how could something fail if it hasn't been implanted yet?"

    It has been. I know two surgeons who have used it and I don't even work for the Glow Bus.

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  154. Nuvasive people keep drinking purple koolaid. When a case goes to the appellate court they can only look at technical matters of the lowers court's proceedings. They cannot look at content or facts of the case. For Alex to say that the jurors were unsophisticated, and did not understand the cases content, and the appellate court will reverse the lower court's decision is incorrect, and absurd. Medtronic will ultimatily gain an injunction. Then what my little purple friends???

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  155. What's going on at Osseon? Those goofs are just about of of money. Medtronic..please buy them!!!

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  156. Rick Simmions should stop eating. I'm not sure they make a orange jump suit that big in a small man's size! He must be really concerned with the investigation of TranS1 for improper coding recomendations. That was the reason for firing Eric Ray..right Rick?

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  157. NASS will do what it must to pay its six figure staff salaries, and 12 million in debt. They will also try to keep their board out of jail- for one more year..

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  158. 7:25 I hope you are not a lawyer. God help your clients if you are.

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  159. I hope nuvasive wins the injunction. If not, many quality people will be looking for jobs...

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  160. "As far as I have heard, Lanx has been recruiting ex-globus employees."
    November 3, 2011 6:43 PM

    "Yup pretty much all ex Globus hires. Likely because as one comes over, they then refer their buddies to HR."
    November 3, 2011 8:17 PM

    Yep...and LOTS of Synthes people!

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  161. 2 questions

    What smaller spine company has a nice low profile cervical plate?

    Also, is pioneer's lateral worth anything?

    Thanks in advance

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  162. The Pioneer lateral retractor is very good and while comsidering Pioneer, their Slimfuse plate is very nice. That said, nothing much to say about their other systems with exception of the biologic which has some merit.

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  163. Heard the whole NE NuVa team is going with Cappuccino to Lanx!! Looks like NuVa is falling apart up there-amazing. Anything to that?

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  164. Stryker is looking at the real new comer at Nass

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  165. I found it interesting that since no one had any new innovative products that the only way to bring people into the booths was to offer coffee and cookies.

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  166. Why is it even worth mentioning if a company has a new lateral system, like Pioneer, or now Trans1? What a waste of time and money to develop, now that Medtronic's patent rights have been supported.
    I would expect Medtronic to next go after Globus's lateral system, since they have a fair share of business yet dont have the deep pocket legal defense abilities of J & J.

    Next!

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  167. How many different lateral systems are there? What are the differences and advantages?

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  168. hate to say "i told ya so"...but remember, I even went as far as to say this company could totally fold...

    no one lestened...

    NUVA has been a con game since day 1.

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  169. Zimmer, near 52 week low, takeover? Any thoughts?

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    ReplyDelete