Monday, November 21, 2011

Nine Months: A Lifetime

High drama?  No fellow bloggers, this wasn't Judge Judy's courtroom.  Today at around 2:45 p.m. Judge Lagrome D. Davis sentenced Michael Huggins and Tom Higgins to nine months in prison with three months probation and a $100,000 fine for their roles in Synthes illegal promotion and clinical tests by spine surgeons resulting in the deaths of three patients.

Judge Davis said that Michael Huggins showed a "knowing disregard" for the safety of the patients. But one must ask the $21.3 billion dollar question, why didn't prosecutors seek any charges against one Hansjoerg Wyss? Huggins and Higgins must share responsibility for their conduct, yet, how is it that one individual named in the original legal documents as Person #7, not be held responsible for the actions of those that were employed by Sin-thes.  A miscarriage of justice?  Is this another case where the minions pay the price while the man pulling all the levers rides off into Big Sky country counting his billions.

Obviously there will be no joy in the Huggins or Higgins household this holiday season, but then what about the deceased families? Hopefully Wyss will have done the right thing and paid for everyone's legal fees, a small token for keeping his raggedy Swiss ass out of jail.  So fellow bloggers the next time someone asks you to do anything that potentially threatens your freedom, remember that at the end of the day, it's your ass that's on the line.  As for the three deceased patients, may you rest in peace, all for the love of the almighty dollar.

162 comments:

  1. As is the case in so many courtrooms, class justice. As the CEO at the time this all happened, he was the one ultimately repsonsible. With the divestiture of Norian it in the end the whole debacle did not cost Synthes or Wyss a single dime.

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  2. Wyss paid all the defendants's legal fees and fines. So they have the privilege of sitting in prison, the victims do NOT. Their families may be saddened that their greedy loved ones are behind bars, but at the end of the day it's just the price of business. Success at any cost. This is a despicable society we live in!!!

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  3. This was a joke. 9 months and 100k is not even a speed bump to these guys. Additionally Norian is divested, yet Synthes still can sell it in the OR. Wyss will hopefully have karma knocking on his door sometime soon.

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  4. Swiss jails are like American country clubs. That fossil Wyss doesn't have much time left on planet earth, anyway. W/ penalties as light as they are, why not do a little ghoulish experimenting on grandmother?

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  5. Are we sure the V-BROS had nothing to do with this!!!!!

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  6. So i get it, this was a terrible thing, and definitely a dark spot in the history of Synthes. Wait until the light is shed on medtronic and all of their questionable, under the table dealings with getting Infuse to market.... They should have learned from Sin-thes.

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  7. Funny thing is a few years back , when discussing it with a Synthes rep, he stated Norian was a superior product.... He has also stated ProDisc is a "superior" product. He also told me SynFix was a "superior " product... Synthes trains their reps to cackle the company line....

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  8. Legal Fees and Fines is a blip on Wyss's radar. He ought to be paying these guy's $1000/hr for sitting in the pen on his behalf.

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  9. Zimmer mention

    http://www.nytimes.com/2011/11/22/business/rash-to-some-stock-buybacks-are-on-the-rise.html?_r=1&adxnnl=1&ref=todayspaper&adxnnlx=1321974020-YP0zPiE0I4Tse6gsIKHuvw&gwh=727C040950776BA71993375EC5322293

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  10. A bit of correction is needed. While the other's legal fees were covered by Synthes, Huggin's was not. He was the first to admit guilt almost three years ago, was willing and prepared take the punishment, but the gov wanted to make sure it was a four ring circus, and they sure did. Which does not cover the seriousness of the situation ... people died and that sucks, deserving attention and punishment.

    But before everyone gets to sanctimonious, give this some thought. How many companies have done this - how many have pushed the un-approved use of a device for financial gain. Pedicle screws for years were labeled as a common bone screw and people were injured seriously. The first anterior cervical plates were bone plates, put in bicortical and people were injured and some died. How many interarticular screws, labeled bone screw have been put in and caused serious injury, and yes, death. How many interbody device labeled as a cement restrictor were implanted, and yes in the early days, people were injured seriously, and some died, how many anterior interbody devices labeled VBRs were implanted and yes, people died, and still do due to vascular injury. So, who is not at fault? Be careful throwing stones.

    Finally, Wyess is a micro-manager par excellance - he knew what was going on and he sits fat and happy, with a TON of cash, un-accused. The four execs at least had the balls to admit guilt. They have been thrown under the bus, not without justification or inappropriate reason, but these guys are just the ones scraficied, hung to be the example for others to heed.

    And, where is Wyess in all this? What a pussy!!!

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  11. Surgeon looking for a titanium TLIF cage. Could someone please point me in the right direction? Thank you!

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  12. The Swiss have always been known as a bunch of pussies

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  13. 8:59 - Stand Alone TLIF Ti Cage - wenzelspine.com

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  14. 7:26, a few corrections:

    Pedicle screws were originally submitted as such. It was FDA who suggested to the first company (AcroMed) which filed to change it to long bone screws, and then cleared them. What the screws were called had nothing to do with them causing more or less injury, that is a matter of surgical skills, which have improved with surgical navigation, neuro-monitoring and better mobile X-rays. Cement restrictors were essentially the same design and material as previously approved cages. It may not have been elegant, but a risk analysis would not have identified new and unanticipated risks. VBRs are 510(k)'d as such. Anterior corpectomies do carry a risk of vascular injury, which makes it paramount that they are done only for the right reason.

    All this is different from studying a self setting calcium phosphate cement which uses free calcium ions in a situation where one of the most common issue is leaking of the material in vascular structures. It is common knowledge that these ions play a role in the coagulation cascade, and at the very least an animal experiment should have been done prior to starting any clinical study. The only animal study that I'm aware of was done later by Jens Chapman, who showed in pigs that the injection of the cement in the vena cava of pigs did cause thrombus formation.

    Your comments on Wyss seem dead-on.

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  15. 8:59, Depuy still has the Harms type Ti mesh cages.

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  16. ... and another correction for 7:26. Anterior cervical plates with bicortical screws were safe, effective, and quickly became standard of care for multilevel fusions for the right reasons. And they were on label, with both Aesculap and Synthes providing surgeons with technique manuals for their use. While being able to insert unicortical screws (Synthes Morscher plate) represented a huge advancement and was quickly adopted, it was mostly because of convenience, with no fluoro being needed while putting the screws in. So if you're suggesting that the type of medical advancement that led to the modern anterior cervical plate needs to be curtailed, I'll politely disagree with you.

    More importantly, not being familiar with the details of their actions, may I ask what you all see as the practical take home message for the rest of us? Surgeons use products in their practice off label routinely, and we're all familiar with the regulations. But it sounds like clearly they crossed the line by promoting an application illegally, but what exactly did they do? Anyone read the details?

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  17. Titanium TLIF Cage: Alphatec's Novel SD comes in Ti or PEEK. Biconvex, 9mm wide, 3 different lengths, heights begin at 8mm & increase in 1mm increments. Office 800-922-1356.

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  18. Hey Doc 8:59, seriously? you can't find a titanium cage? Have you ever heard of Google?

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  19. 2:08, the most objective way to find out what happened is to read the warning letter FDA sent Syntes in 2004: http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2004/ucm146924.htm

    They just didn't want to spend the time and money to do a proper study, nor did they any pre-clinical animal work. Cutting corners, it's called, and Wyss must have known about it.

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  20. Mike huggins a great man! Fall guy possibly? Possibly the man in charge? Great guy either way! I enjoyed your company! Frank W

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  21. New mexico was years ago w/rich and i i wish u the best! Ftt

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  22. Mr. Wyss was born in Switzerland, but a significant part of his life might take part in America. Synthes became more an more an today is part of an American company. Could it be possible that there is some American influence contributing to that mess, because I hardly can recognize some typical Swiss behaviour in this case? But a do recognize some very typical behavior of US money, sales and marketing driven spine companies... So if some of you like to do some Swiss bashing, move ahead if it makes you happy and helps to relieve some stress, you certainly have these days in your profession.

    Synthes went on the same wrecked train as almost all the other US spine companies, bypassing FDA by approving products through 510k for a use they never were developed for. Most of them did and do more or less directly promoting offlabel use afterwards, swimming in the grey zone, while in some cases putting patients health or even life at risk. My impression still is, that a lot of them havn't yet learned the lesson, so they redo their mistakes all over again...

    Let's look at a specific example - the Anulex XClose product. This is just to visualize the anatomy of a typical offlabel use 510(k) approved product, as they exist within many spine companies in the US....this is not to blame a specific company or a specific product...

    Most of you probably agree, that Anulex looks like a spine company (at least their homepage), so common sense for patients (and outsiders) would be that they develop spine products and approve it accordingly as spine products? No?

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  23. Here we go:
    FDA cleared Xclose under Premarket Notification Submission (510(k)) K062307 for the intended use of soft tissue approximation for procedures such as general and orthopedic surgery...

    Once more in this case, does itlook like a spine company CEO (or two of them) has again choosen the fastest way to market (or desaster)?

    So please tell me, does a spine doc has any significant, well paid for use for this product as it was approved but never developed for...? No? Is a standard spine doc without any ties to this company keen to use the product offlabel and solely take the risk if things go wrong? No? So what do you do as a company...?

    Phase 1: Ohh..., let's (co-developing) surgeons talk about their off label use as an annulus closure device.....they are free to speak about their experience...or publish on their offlabel use... So let's support or finance some personal markting efforts, publications etc. by these docs about our nice product, to show everybody how it is used off label. They get patients on their table and we sell our products... Win-Win. So after a while the internet gets flooded with non-company labeled information material.... Check for youtube movies, presentations, etc. on Xclose).

    Preliminary result: Wow, we were so fast to market with our very innovative products an sales are exponentially growing.... $$$$$$ cling, cling, cling! The clinical and legal risk is still under control, because most surgeries are performed by surgeons with ties to the company and good knowledge.....In this phase, it makes me smile to see how the company raises money in series a, b, c, d, e.. xyz. Impressive multimillion USD amounts are poured into the firm and honestly I am a bit jealous, because such a rain of venture capital would just be impossible on the old continent. By the way, this would be the ideal time to sell the whole company.....ups...time slot passed.

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  24. Phase 2: Unless by some greenhorn marketing or sales employees, you won't see direct promotion of the product as an annulus repair device by the company in phase 1...however, the more and longer docs use a product offlabel and talk about it.. other surgeons are getting the impression that the product is approved as an annulus closure device... and at some point, the whole thing gets somehow out of control, especially when sale targets have to be met to fullfill investor expectations....In this stage you start to see presentations like this: http://www.slideshare.net/buddhaben/anulex-presentation-to-central-florida-case-manager-society-03242011
    Is this off label promotion? Off label use is shown combined with the surgical technique of Anulex products and original Anulex pictures (likely provided by someone) of the company within one presentation? At least we are now in the dark grey on not the light grey zone anymore. Maybe first investors are getting a bit nervous...

    Phase 3: Somewhere down the road, whatever reasons....event parts of the company stuff itself seem to be brainwashed enough and start to ignore what they originally approved the product for...they even might get the idea to enroll clinical studies on off label use without permission of uncle sam...because that use is anyway already reality out in the marketplace...but that doesn't make it approved that way, doesn't it?

    Phase 4: Finally, some of you might think 4 years late, but better late than neverever....someone at FDA gets really angry, because his job gets obsolete if things go on like this. It finally ends exactly the way some pighead Swiss engineering pussies may have predicted in the very beginning of the process....

    http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm243529.htm

    ....and finally ...

    http://www.minnpost.com/medcitynews/2011/04/19/27598/layoffs_at_anulex_follow_fdas_warning_letter

    I feel sad for all the good girls and guys who worked for this company and maybe lost their jobs. Especially for those I know personally - good luck in finding a perfect new job.

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  25. 5:44 - great set of posts. While the rationale for this approach is never as clear as black and white, you accurately portrayed this not uncommon course of events.

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  26. Anyone who believes the Norian experience represents "not uncommon" events is grossly mistaken!
    Synthes cancelled safety studies in primates and initiated studies in humans. They represented the product as approved for spine when it was not, and went as far as to rebrand (ie to use FDA language misbrand) it.
    The safety risks associated with injecting a reactive paste into the highly vascular vertebrae bear little resemblance to the risks of screwing some metal doo dad to a bone.
    Synthes was negligent in these acts. It seems highly implausible that "person of interest #7" was not aware or making the call.

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  27. Wyss sits back and sips Halter Wine while Huggins spends his first night in prison, Higgins has to find care for an ailing wife, while Walsh gets to spend the day with his daughter before reporting to the big house, all for the love of Sin-tez. Hopefully many of us will learn a valuable lesson, but then again, maybe not, all for the love of the Almighty $$$$$

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  28. OK, there are like 5 posts on here made by the same Swiss douche who thinks we have no idea he is commenting on his own posts. You're terrible English is a dead give away, Hans. You sound like my high school French teacher...

    "Is a standard spine doc without any ties to this company keen to use the product offlabel and solely take the risk if things go wrong?" ~5:43pm

    Nobody f*cking uses the word "keen" in the U.S. anymore. Good try though.

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  29. Spineology anyone off labor use and bribing doc try it off label.

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  30. While reading that whole post(s) about Annulex, I was thinking Spineology. How much $ flows from off label use in VCF? Lots. They conducted courses teaching surgeons how to use it off label. Has anyone heard of any fallout from this?

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  31. Why does Wyss escape prosecution? He either knew about it, or he didn't, in which case he should have. In either case he failed, and as CEO ultimately is responsible. It stinks.

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  32. November 22, 2011 9:34 PM

    Not really KEEN about your condescending immature attitude!

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  33. Hey Cheetahs and stock analysts NuVa is dropping like a rock WTF

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  34. 4:02PM you mean the same "ethical" company that hired a consulting surgeons son as territory Manager in PHX to cover his dad's cases. Or his buddy in NM that tried to squeeze his way into a distributor's good graces by gving him a three state territory even though he' sgot no coverage?

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  35. Austin Powers, Int'l man of mysteryNovember 23, 2011 at 11:27 AM

    Ohhhhhhh Behave!!!

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  36. @ 11:12

    Does this surprise you? Nothing like the "Billion Dollar Baby" start up sitting at an all time low. Boy or boy, what does Alex have on that BOD that they just allow him to remain in the seat and watch this baby get HAMMERED?

    Seriously, it reminds me of the pathetic captain in the wheel house of the Titanic just staring hopeless through the window as the ship goes slowly sinks under the sea.

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  37. Take a look at Alphatec's closing price - $1.85 !!!
    How are those PODs, bought surgeon consultants, the greasy NJ AVP and rabbit on speed RM working out for them? Not so well it would seem. When is their BOD going to make a clean sweep of management?

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  38. Penny stocks on the horizon.

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  39. be thankful for what you have today; tomorrow.... creeps in this petty pace from day to day,
    To the last syllable of recorded time;
    And all our yesterdays have lighted fools
    The way to dusty death. Out, out, brief candle!

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  40. Every stock I buy goes down, so I bought ATEC out of spite. Bought at $2.50, now $1.85 - works like a charm! NuVasive next...

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  41. Sounds like the POD thing has complicated things at ATEC. BOD's making changes?? Is Dirk K looking around? Do you sense changes coming?

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  42. November 23, 2011 1:05 PM --- This blogger is the epitome of sleaze. Must be a big 3 salesrep thinking he's the cats meow... what a joke! I just wish I could see him in person at one of the conventions..

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  43. ALL spine stocks down today, even beloved NUVA (under $12.50).
    Screw you bitch

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  44. Doesn't explain why ATEC has benn riding down since last Spring. Facts are facts - Alphatec can't make a profit. All those surgeons who bought at the $15 IPO amount are bailing. Paying too many surgeons to use their products.

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  45. Interestimgly, a business built on SLEAZE is calling TSB a sleaze what a dick head, is that you Keith Valentine, or is that Alex "billion dollar baby" Lukianov?

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  46. This comment has been removed by a blog administrator.

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  47. Heard xspine vp and nsm are taking over for BOD and lube. Step in right direction

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  48. Spine industry ride...as we know, has come to an end. Move on to other green pastures while you can!!!

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  49. Lube and Bag of Donuts are on their way out??? I don't believe it...

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  50. Everyone should stop all the bitching & chastizng for one day & fins somtheing to be thankful for today.

    Go have some turkey, Go Lions & Niners,, Happy Thanksgiving!!

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  51. 1:05.....who is the rabbit on speed RM and who is the bag of donuts?

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  52. BOD is the business acronym for Board of Directors. If you don't know who the rabbit is, ask someone who works for Alphatec in the South.

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  53. Lube is good. Billy (bag of donuts) not good. Kenley (rabbit) with mid life crisis.

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  54. November 23, 2011 8:22 PM reread the post.....

    i didnt call TSB a sleaze... was referring to the drop out who posted on Nov 23, and again on Nov 24 at 2:36pm. --troll he hates his life ...

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  55. Nov 24, 2011 9:11PM
    I posted the Nov 23rd 1:05 post. Someone else posted the Nov 24th 2:36 post. More than one person who feels the same about the Alphatec management. What part of my post offended you the most? Can't imagine why you would take such offense at a statement that is based on public stock quotes, public announcements showing the start of management changes from the top down, and personal observations and opinions of an AVP and RM.
    Me thinks one doth protest too much.

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  56. I posted the Nov 24 2:36
    I stand by it

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  57. if you are so proud of your opinion and observations stop being a coward and post under your name. If I were making such statements about someone by name....I would have the courage to post my name. Your anonymous cheap shots tells the world you're a coward.. end of story

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  58. NJ AVP uses grease in his hair - hence "greasy" adjective. The RM that acts like a rabbit on speed - descriptive adverbs. Get over yourself 2:51PM. The only dropout here is you for defending a company that is well known to engage in the worst behavior within our industry.

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  59. So 2:51PM. Why do you post under Anonymous yet demand to know who you are responding to? Lead by example you putz.

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  60. im surprised atec even gets mention on this blog.. c'mon man. nobody really cares about the company whose stock closed at a buck eighty, and has never been above nine dollars. Of course everything facet of that company sucks. Im not wasting any more breath or brain power on them. you all shouldnt either

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  61. hey 3:57 if you cannot differentiate someone posting an anynomous attack vs my post pointing out that a "child" would use a blog to secretly throw stones.... then you are the putz. loser...

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  62. You are all a bunch of fags. I hate all of you. Hey...I heard the little gremlin RJ is no longer w/ ATEC. Out.

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  63. 5:09PM You are correct he claims he resigned right before NASS. Claims "they begged him to stay".....Isnt he the one that got them in the big ruckus with PODs?

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  64. Who's RJ? Be careful though. Mr 4:58PM is really sensitive to anyone who may not speak kindly about those associated with Alphawreck. Someone must have eaten his piece of pumpkin pie. I haven't heard crying like his since Flounder got his ass paddled on Animal House.

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  65. Where did RJ end up going? I want to make sure I short their stock and never work with the company. He was by far the worst person I have ever worked with. He should join the Dbags at Phygen.

    I heard Phygen is asking the docs for more money! Can you confirm this Kyle?

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  66. When's ATEC going public?

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  67. Why so few comments about the Nuvasive stock crash? Are they going to make it? Will they be acquired at that price? Do they have something in the pipeline they can pull out?

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  68. @ 6:46. Be careful about using the term short in the same paragraph as RJ. He's real sensitive about that..."word". BTW...To answer the question as to where he is working...I saw him at the mall working for Santa. Just say'n.

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  69. Funny. Hell, just last month he was so fussy at my office I picked him up to burp him. Worked. He then napped all day.

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  70. I thought he was more sensitive about being called fat ass. There is not a more unqualified person in all of spine. Every time he spoke to me all I could think is "how did this dipshit get this job?". He reminds me of pig vomit from the Howard Stern movie.

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  71. I am thinking about buying some NUVA stock. The company has been beat down hard. Based on the quality of the products and solid sales force it looks like a good deal. I know about the recent lawsuit awarded to MDT and slowing growth. What is the story on the debt? Is it too much? Is management capable of getting this once wall street darling back on track? Or, is this a sucker bet?

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  72. Let's see... In the game with their own lateral devices are Synthes, DePuy, Danek, Globus, OrthoFix, K2M and another 3 or 4 very small players. Nuva's market share is in decline. Danek wins a huge lawsuit that will increase Nuva's debt by 25%. If Danek wins their injunction of XLIF you can say bye bye to 85% of sales. Tack on issues with reimbursement and continuing downward pricing pressure from hospitals.
    In review, declining market share, inflating debt, more legal problems, reimbursement problems and a decline in average selling price. You will have more fun losing your money on a suckers bet in Vegas.

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  73. What about Life Spine's latest business debacle....Glad they have a VP of Strategic Planning....In bed with PhyGen no less....First Trans1, then getting rid of loyal longterm distributors, then PhyGen....Nice move....

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  74. "Let's see... In the game with their own lateral devices are Synthes, DePuy, Danek, Globus, OrthoFix, K2M and another 3 or 4 very small players..."

    Exactly, and why are all these companies even wasting money with their launches of lateral systems in the face of Medtronic's patent win vs Nuva? If upheld, MDT's lawyers will plow down Globus next, and then the others will have no choice but to scale down rather than continue to put money at risk.

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  75. 8:55AM
    You need to read the patent based lawsuit and understand how the XLIF device violates the patent. The other companies did their homework and do not blatantly violate MDT's patent.

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  76. Wasn't the device description very broad, to cover almost any type of implant that spans far across the vetebral body?
    Is so, that certainly would cover the other lateral devices too, no?

    If not, and you have read the patent based lawsuit, please share your anaylsis with us details as to why you think the others will not be affected.

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  77. You are correct in the broad language of the patent. However, the specific violation which sank Nuvasive is the cross sectional support. If you look on their website you will see their newest design without the cross beam. The other companies mentioned above do not have the cross beam as well. The patent would be too broad as you detailed above and any IBF could be defined as violating MDTs patent. Of course, any company can bring a patent lawsuit with or without cause.

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  78. 7:22 - you're a couple months too late.
    I'll give this blog big props as it's due to all of you that I almost shorted 20K of Nuvasive stock in September. Should have used my cajones and gone for it. Would be sitting pretty on that move right meow.
    I've heard the statement "there's gold in them hills, you just have to dig for it" a couple times on this blog and it's true.
    Don't let the children fighting on the faceless internet playground detract from what any of you can take away from our resource here.
    Sincerely,
    Mr. my $500 pedicle screw is coming to your territory soon.

    I'm saddened that product choices are being taken away from surgeons and put into the hands of MM. However, I won't whine about it - I will adjust.
    and yes, I am aware I have a very long last name.

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  79. 12.13 There are hospitals on the east coast getting well under $500/screw. Being the cheapest does not always win. Your strategy may work short term but will fail unless you have a real vision. Smart people will innovate you right out of a job. Maybe you can sell shitty lemonade cheaper than the kids acros the street.

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  80. MDT has a pretty good chance to win that injunction vs. NUVA, but NUVA can just re-launch their cage as a copy of the Globus or Synthes cage. It will cost them a bunch of money, but they'll keep the doors open. Barely.

    Until they bring in some real earnings, though, the street will continue to punish the stock price. If $500 pedicle screws hit a bunch of their territories..or $1000 lateral cages, for that matter, everybody may as well go short on it. It can't absorb that pricing hit. They can't go back for more debt, as the last offering just paid off the prior offering. They are have gotten onto the mousewheel of ever-increasing debt placements.

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  81. ATEC closed at $1.80 on Friday. Looks like they are headed for Penny stocks land. Can't be too much longer before Health Point Capital unloads this dog. Or they can sell another 10 million shares to pay their debt as they have done in the past. This one is going to ride into the basement due to failed management.

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  82. ATEC is still living like it's 10 years ago when valuation was just sales sales sales. Nowadays the street wants to see good old fashioned profits and cash flow. The industry is rapidly maturing and the speculative play of "let's get the market share and worry about profit later" is OVER. I don't think anyone has told that to ATEC management. Perhaps when the stock is delisted they'll figure it out.

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  83. 8:36 said: "What about Life Spine's latest business debacle....Glad they have a VP of Strategic Planning....In bed with PhyGen no less....First Trans1, then getting rid of loyal longterm distributors, then PhyGen....Nice move...."

    Sounds like you are one of those "loyal longterm distributors" they got rid of. Quit whining and go find another line. You are overdoing the three dots thing.

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  84. Heard Alphatec has only done about 60 GLIFs in a year and a half. Anyone heard when they are supposed to re-release their zero profile ALIF device? Was considering picking up their line but by the looks at their stock price and balance sheet doesn't appear they will be around for the long haul.

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  85. Here's an interesting stat to consider for Alphatec. The insiders have sold 44,000 more shares than they have purchased over the last 6 months. Are the rats jumping from the ship and trying to minimize their losses? Data is available through Yahoo Finance.

    Net Share Purchase Activity
    Insider Purchases - Last 6 Months
      Shares Trans
    Purchases 6,000 1
    Sales 50,000 1
    Net Shares Purchased
    (Sold) (44,000) 2
    Total Insider Shares Held 35.07M N/A
    % Net Shares Purchased
    (Sold) (0.1%) N/A
    Net Institutional Purchases - Prior Qtr to Latest Qtr
      Shares
    Net Shares Purchased
    (Sold) (13,707,400)
    % Change in Institutional Shares Held

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  86. ATEC VP rat fink in engineering will milk the loot as long as he can. There's nowhere else to run- Panjabi is retired.

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  87. What about the CEO?

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  88. The GLIF is a bust as there are re-enineering it now. The docs that have used it don't like it. The other device (ALIF) is also a bust. Not being well received at all. This company is basically on the ropes. It really needs a reboot from several levels. The real issue here is to rep this companies products with all the associated baggage. Most (not all) of their distributors have been a bit shady. With the other options out there, I don't think it is worth it. It's hard enough to sell in this space as it is. why complicate it further? JMHO

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  89. 1:17PM
    What are your thoughts on the East Coast management team of ATEC?

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  90. The east coast is same as the Central, SW, SE, and West

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  91. Should Wyss be indicted? Will he?

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  92. Ok. Does anyone know about the Eastern based managers for ATEC? The good and the bad. Do they have credibility and ethics?

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  93. ATEC lives on PODs around the country. Life will be short lived for any sales person. Nuff said.

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  94. New thread please.

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  95. Did Globus xx xxxxxx ?

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  96. No wonder so many of you are out of work. All you do is sit around and complain.

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  97. Comedy!!! How about a thread on what everyone is gonna do for a living when it's just not worth the money anymore to do this job? Say 75-90k per year...time to dust off those cover rep resumes boys and gals.

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  98. Please pass the Carrot's.

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  99. So as the high paid reps begin the slow inevitable decent in income and parity sets in across the spineosphere. One must ask where does it stop? Will there be a place for them to go? Will they leave for greener pastures or graze in the well manicured fields amongst the herd? Is the end really near as so many love to post on TSB or is it just their fears of ineptitude manifesting in print? As Pink Floyd once sang:

    You say the hill's too steep to climb,
    chiding.
    You say you'd like to see me try
    climbing.

    You pick the place and I'll choose the time.
    And I'll climb
    that hill in my own way.
    Just wait a while for the right day.
    And as I rise above the tree line and the clouds,
    I look down, hearing the sound of the things you said today.

    Fearlessly the idiot faced the crowd,
    smiling.
    Merciless, the magistrate turns 'round,
    frowning.

    And who's the fool who wears the crown?
    Go down,
    in your own way.
    And every day is the right day.
    And as you rise above the fear-lines in his brow,
    you look down, hearing the sound of the faces in the crowd.

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  100. The end is nigh if you rep Alphatec, Trans1, XSpine or Life Spine. Sooo embarrassing for Alphatec who only has 25 cents per share cash on hand while Trans1 has $1.76 per share cash on hand. Alphawreck - the guppy in the fish bowl gulping for air. Health Point should put them out of their misery. Might actually help clean up this industry.
    What do you think will happen to Alphatec's cash on hand when they settle the class action lawsuit brought against them by their own shareholders? How on earth are they going to meet their financial obligations to all their surgeon consultants?

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  101. There is plenty of opportunity in this industry for skilled sales professionals. Spine is not the only specialty out there, if you hit your magic low number and decide to get out then simply move on to the next big thing or something you enjoy.

    Enough of the gloom and doom, some of you dopes need to head back home you are depriving your village of its idiot.

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  102. 6:17 said: "What do you think will happen to Alphatec's cash on hand when they settle the class action lawsuit brought against them by their own shareholders?"

    That's what a class action lawsuit is. Some pirate law firm finds a shareholder and brings an action. The lawyers run down the road until they are bleeding the Company dry, then they settle. The shareholders get bupkus, and the lawyers get mega-millions. Its a racket that ought to be illegal. Its a risk of doing business in the good old USA, and will continue to be that way until we get tort reform here. Alphatec has plenty of reasons to get slammed, they can't run a profitable business, and they are a dysfunctional organization at the mercy of the geniuses at HPC who don't know how to run a company. But the class action suit is not the fault of that braintrust. Its the fault of the American Bar Association.

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  103. I guess you missed all the rosey earnings reports and forecast that Dirk "Diggler" reported to Alphatec shareholders. How could he and/or Alphatecs accounting have so badly forecast sales? The lawyers are simply making the most of a gross misrepresentation of revenues and earnings. The real question is - was the misrepresentation intentional or just pure ignorance.

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  104. Dear Santa TSB,
    I've tried not to cry and pout this year cause I know your comin to town.
    I was thinking of asking for that special gun but Dad says "careful kid you'll put an eye out!"
    What I really want for Christmas is hope (not the Obama kind) of longevity for us all.
    Can u help us Santa TSB? Please oh please Santa TSB

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  105. Any fine NASS educators they were...

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  106. Does anyone know whether Dr. K Lee in Houston is a good surgeon? Does anyone know who he works with?

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  107. btw... anyone else find the message by Kerlan-Jobe on the previous post hilarious? It's clearly a cut and pasted canned thing they stick on the many spine patient blogs out there. I wonder if they realize that posting it here to spine insiders that know the field looks cheezy at best.

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  108. Just shorted NUVA at $12.90. Late but not too late.

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  109. KL is a good doc but all about business. Andrew Hillman and rep is Heath Lovel in Woodlnds. They must be paying the doc. Using Verticor.

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  110. 11:26 , nobody cares.

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  111. No need to short Alphatec. There's barely any room for them to fall before hitting ZERO.

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  112. 12:14, there is plenty of room to fall. Short 200,000 shares at 1.90. If it goes to .50 (which is entirely possible) you make almost a quarter million. Of course, if it goes to 2.75 (also entirely possible) you get the squeeze and lose almost 200 grand. Guess it depends on how sure you are its going to zero, and whether you have $400K liquid to place that bet. But there's plenty of room to fall.

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  113. You obviously have never bought options and/or know little about them. The actual dollar loss of a stock does not correspond to an identical increase in that stocks shorted option. Options are incredibly complex and rely as much on the time value of a given option as the actual stocks price. Amateur!

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  114. Why are we all not talking about NUVA and what is going to happen to this company in the short / long term?

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  115. A hostile takeover is brewing over NUVA.

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  116. Hostile take over? Do tell!
    Is it too late? It is remarkable to see this giant fall... but, how far will they go? Recoverable, I don't think so, they will be anemic forever going forward. Too much posion, not enough cure...

    Sales force- gone
    Wall St. appeal- gone
    Market for XLIF- going- many compeititors/expandables
    confidence/appeal to surgeons- destroyed

    TIMBER!

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  117. Ya, what is this hostile takeover? From what I know if they loose Medtronic Suite they are done for as they are not a IP rich company. Did a great job marketing and bringing XLIF to market but we all know they are a one trick pony with a great deal of market share. That being said, who really wants them? My gut is that Medtronic will beat them down so hard they will be absorbed... thoughts? deatails? Lets hear it!

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  118. What do you all think about Michel Orsinger being appointed Global Chairman of the Global Orthopedic Group for JNJ. Should we Depuy consultants/distributors be concerned how he might influence the sales force direction? Obviously we received a hint a couple a months ago when several didn't get there contracts renewed.

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  119. "...Michel Orsinger being appointed Global Chairman of the Global Orthopedic Group for JNJ..."

    Heck, they should just buy Globus then? The names fit in....

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  120. Michel Orsinger will fit in perfectly w JNJ. He was a drug company CEO that ran Synthes into the ground with his idea that device reps should only make 80k just like drug reps, because, "Zis iz de vay ve do it in Europe". Loser.

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  121. bye bye depuy distributors. that is the ones that are not the top 5.

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  122. You can take this to the bank. Alex wil drive the stock price to $5.00 and fire his entire sales force before he gives up even one of his administrative assistants. How many nuva "shareowners" still do not have any idea how to calculate the value fo their wothless stock options? A little hint - you are not a share owner if the strike price is $.01 higher than market price. How many of you wish you had sold your RSU's about a year ago. Keep walking towards the cliff you bunch of lemmings.

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  123. 10:26
    You should have received more than a few hints from corporate activity just last week. JnJ rolled up into NC and axed the distributor and took all the reps direct. the Synthes reps have this to look forward to in the near future. Yes I know, Synthes reps are already direct, what's the big deal. The big deal boys and girls is the comp package. The new commission structure will have the Synthes reps earning 35% less commissions. On top of that we are all dealing with pricing pressures - they could easily see a 40 - 50% reduction in income once the new comp plan takes full effect. I won't even get into the complexities and gamesmanship that will take place where a market is crowded with too many Synthes and DePuy reps. LET THE GAMES BEGIN!

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  124. I can hear the thump, thump, thump of the helicopter blades and the smell of napalm. Who amoung the managers of Synthes and DePuy Spine will be left standing to command the day. I heard the bugle sound and a voice cry out "I will lead SynPuy".

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  125. Or will it be DeNthes?

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  126. What I want to know is, when is Globus going public?

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  127. The Laughing PolicemanNovember 30, 2011 at 6:56 AM

    @5:39..you mean? they got rid of whitey? but he was so.....competent

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  128. 11:26, Nice short at 12.90! I can't wait for your margin call. Might as well pick a bridge and jump now.

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  129. 6:56, Who is Whitey? Please elaborate.

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  130. Any idea who the top 5 distributors are?

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  131. Predictions for 2012:
    1. JnJ will take a $20B acquisition of Synthes, merge it into DePuy Spine and 1 +1 = 1/2. Winner: Hansjorg Wyss. Loser: 5,600 employees and thousands of JnJ shareholders. This is going to be an epic debacle.
    2. JnJ will dump the bulk of their distributors to take as many direct as they can .... some of which will pick up NUVA ... just in time to see ...
    3. MDT drive NUVA into the pavement with the legal settlements and DADDA part of that settlement will be NUVA being acquired by Medtronic for pennies on the dollar. $500M revenue with a $500M market cap, that's a buck for a buck. If there is more bad press from the legal world for NUVA, that will be a $10 stock - part of the settlement will be the terms and conditions for an acquisition with some modest premium on the stock that shareholders will be thrilled with.
    4. Stryker will beat Zimmer to the punch and acquire LDR for a fat old premium and bring some life into the spine division.
    5. A pre-packaged sterile interbody implant will show up in a PIXIS through Owens and Minor ...

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  132. Hansjorg Wyss should be indicted....

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  133. @2:19 #5 iiis the most relevant remark -and scariest- I've yet to see on here
    I happen to agree.
    But, who will manufactur it for Owens-Minor AND, how will it be inserted.

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  134. 8:15 said:
    "You obviously have never bought options and/or know little about them. The actual dollar loss of a stock does not correspond to an identical increase in that stocks shorted option. Options are incredibly complex and rely as much on the time value of a given option as the actual stocks price. Amateur!"

    8:15,You are a moron. The post was regarding short sales, not options. Options may be "incredibly complicated" for a guy like you, but not to most adults. Here's a quick primer on stock short sales:

    Shorting a stock (or selling short) works like this:

    When you think a stock is going to go down...
    1. You borrow shares of stock you don't own, typically from your broker.
    2. You sell those shares at today's price.
    3. You wait for the stock to go down.
    4. You buy the same number of shares back at a lower price.
    5. You return the borrowed shares.
    6. You pocket the difference between the buying and selling price.
    Steps 1 & 5 are done automatically when you issue a short sale order with a broker.

    The advantage of shorting is that you can make money when stocks are going down. (With a normal stock purchase, you only make money if the stock goes up.)

    The disadvantage is that in theory, you could lose an unlimited amount of money. For example, if the stock goes up to five times its original value, you've just lost four times your investment. (With a regular stock purchase, the most you can lose is the amount you originally invested.)

    You are lucky these are anonymous posts, otherwise you would be exposed as just another spine rep who thinks he's smart because he made good money in a rigged game... but he (you) is actually a real dumb ass who doesn't know squat about "securities and such" but likes to run his mouth about it as if he does. Face it, you are an overpaid moron.

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  135. Whitey is the DePuy distributor in North Carolina. DePuy is going direct all over the USA, just a matter of time.

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  136. Orsinger will definitely try to implement more and more pharma ways with the new outfit. One of the best ways to increase profit is decrease sales and marketing expenses, the largest part being commissions and salaries that he feels are too high

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  137. 5:55, you'd be surprised at some of the changes that Orsinger approved for commissions and incentives recently.... A major change over his past M.O. I was shocked to hear what Synthes is offering as incentives for growth. Maybe he recognizes a few things.

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  138. 5:08: going direct all over the USA ? Please lay out your plan on how this takes place. There are Depuy distributors who have large market share. Seems they have leverage.

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  139. No distributor has leverage over DePuy. Just ask one sometime.

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  140. Wow, this thread made a comeback!
    Great conversation, good insight, a little mudslinging but all in all this is what TSB is all about. Good job Anonymous!

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  141. 6 Spine Company Leaders Discuss the Future
     
    http://www.beckersorthopedicandspine.com/orthopedic-spine-device-implant-news/item/9936-success-in-the-spine-market-5-spine-company-leaders-discuss-the-future

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  142. interesting selection of companies to represent the spine market

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  143. I realize most of you Nuva-bashers holed up in a cubicle would love for us to go under or get bought. Sorry ladies, this company isn't going anywhere. We are growing share, hiring talent, launching innovative products and acquiring new technologies - all in a down market. You can laugh about the stock price and the Medtronic lawsuit all you want, but my business is booming. Our products are great and surgeons have noticed. Lately, surgeons are approaching me to get trained, not the other way around. PT Barnum once said, any PR is good PR. I tend to agree. See you in the OR

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  144. 1:04, you're a little uptight and I guess I can understand, given the bashing NUVA is experiencing here (and elsewhere) and also the adversity your organization is currently facing. I am not a NUVA supporter in any way, in fact I have competed against them for over 10 years, but I tend to agree with you except on one point, it wouldn't surprise me a bit to see the company purchased. But that aside, from where I sit, the company will plow on and will rise up again, despite the current bumps in the road. Much of the bashing is professional jealously in my opinion. I haven't always agreed with NUVA's approach, but they have accomplished a great deal...many prefer to take shots at those on the pedestal, particularly when wounded. btw, I posted 10:42 just above, and I should have omitted NUVA in my curiosity about the companies selected to represent the spine market, as NUVA clearly has earned an opinion and to some extent, K2M has as well

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  145. In process of hiring new VP of Sales anyone know anything about todd fanning

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  146. todd fanning is a great guy. worked with him at spinal concepts.

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  147. He was fired from Lifespine and IST.

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  148. Word is Orsinger approved huge growth incentives for reps. That doesn't sound pharma. Distr reps would love to see these kinds of commissions he's throwing down.

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  149. 3:14. What company ?

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  150. Don't forget his stints at Fziomed and Biomet-think he's out of business now-probably the smartest move he's made.

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  151. Here's a question for the alleged Orsinger Growth incentives. Did he put those incentives in place before or after the JnJ announced merger? He had cut expenses to the bare bones in the 4 years leading up to the merger. He also made it very clear at the national sales meetings that he didn't value the sales reps and would continue adding feet on the street regardless of sales force morale.

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  152. 6:43. how so? very interesting...

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  153. If you were at the 2008 and 2009 NSM you would have heard and understood the back handed slap Orsinger laid on the salesforce when he responded to complaints of territory cuts - to paraphrase - "Get used to seeing new faces. This is a trend that is not going to stop".
    If you work for Synthes or used to, you are well aware how difficult it is to get necessary inventory and sets now versus 10 years ago.
    Enough said.

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  154. From the Synthes indictment, quote, "...get a few sites to perform 60-80 procedures and help them publish their clinical results...". This from Wyss (Person # 7). How he is not heading to jail is a travesty of travesties.

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  155. As someone who quit Synthes a long time ago because I could not stomach working for Tom Higgins, I have to say upon reading that he is in or headed to jail, "Couldn't happen to a nicer guy!"

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  156. 1:02

    Instant Karma's gonna get you. Of course everyone blames someone else for their misdeeds and poor judgement. One has to wonder whether Gennett's influence, aka his sociopathic personality permeated this organization a long time ago. Tricky Ricky should have been cut at the knees a long time ago, he's just a psycopath

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  157. Nice insights shared. Keep posting more information on spine surgery.

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  158. Thank you for sharing this informative post. Great job. laser spinal surgery Houston, TX

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