Spine Nation:
First off TSB would like to apologize for the crappy format that Google Blogspot has enacted as their means to a better comment section. If Larry Page and Sergey Brin are reading this, "it sucks." Our readers are not happy, neither is TSB. The people's voice has been heard. Money, Money, Money, the Almighty Dollar, it makes you do crazy things. With that said, you know what the Rolling Stones use to sing,
Ti.....me is on my side, yes it is.....Ti......ime is on my side yes it is
Now you always say, that you wanted to be free
But you'll come running back, You'll come running back, You'll come running back
To me e ee.
It seems that Time is on Mitchell Salzman's side. It seems back in December, Mitch pled guilty to making false declarations in front of a grand jury/ Salzman, a former sales director of a medical device company, lied about his involvement with a former territory manager in Tennessee who had been fired for forging medical records in connection with Medicare orders. Now TSB knows that old news is well......old news, but this does not bode well for the medical device industry. There must be some tainted water in Tennessee, must be dioxin, considering that the Volunteer State may be known also known as ground zero for POD's. But that's not what this blog is about.
It seems like old Mitch and others at this well known device company had concocted a scheme where the company continued to pay the former territory manager vis-a-vis a shell medical device distributorship. Looks like Judge Rya Zobel intends on sending the device industry a message, on June 12, 2012 the intends on sentencing old Mitch to a potential five year prison term followed by three years of supervised probation and a $250,000 fine (OUCH!). If that don't sting, TSB doesn't know what will.
Orange is a tough color ont he eyes.
Is anyone surprised that the combination of Orthofix and TN spine surgeons has resulted in a grand jury testimony? In the court case it talks about “fitting fees paid to surgeons for the fitting of a stimulator in which they never performed the actual fitting. Cut and dry violation of the anti-kickback statute.
ReplyDeleteI would think these fraud units would be able to stay in TN and probably round up 8-10 spine surgeons while they are at it.
I have heard stories of Spine Stim reps parking themselves at old folks homes and providers offices putting Stims on any and everyone that has a fracture. Sadly this type of stuff is not limited to Tennessee. Is their any good level 1 or 2.1 that proves that these types of devices do anything?
ReplyDeleteElectrical stimulation has been around for years. It does work and there have been several published papers on it including a double blinded study(Vert Mooney). It should be used for a difficult fracture or mulit level spinal fusion cases the patient has some risk factors( smokers, diabetic, etc). There would be really no need for a single level fusion case. To me that is overkill.
ReplyDeleteAnybody sell the implantable stims from Biomet Spine to improve fusion? Good product? Any feedback?
ReplyDeleteThe only thing electricity is good for is turning on the light - Sig Hansen, M.D.
ReplyDeleteSig is a dinosaur. He became one of the establishment that he fought so hard against in the seventies. His quota is tell-tale of this.
DeleteOrthofix, as in the "fix" is on. The Blackstone sleaze continues
ReplyDeleteAnybody know where to get a lateral plate? Not looking to work with the big box spine companies.
ReplyDeleteBiomet has something interesting coming. I don't work for them, but the surgeon in my area talked about a lateral cage with built in fixation. Interesting idea. Good luck.
Deletehttp://www.biomet.com/corporate/codeOfSupplierConduct.cfm
DeleteWhat Biomet has coming for it is interesting indeed! What company needs a code of conduct like this unless they're outsourcing their manufacturing to cheap third-world sweatshops.
Who are these guys doing business with that they need a code like this? Lead painted implants, look out.
Excerpts:
Child Labor Avoidance. Suppliers must not employ any person younger than the legal minimum age for working in the jurisdiction in which such person is employed and must comply with all applicable minimum legal age requirements and other applicable child labor laws. Biomet does support the use of legitimate workplace apprenticeship programs, but only if they comply with all applicable laws and regulations.
Slavery and Human Trafficking. Suppliers must not support, promote or engage in the practice of slavery or human trafficking, and suppliers must comply with the laws regarding slavery and human trafficking of the country or countries in which they are doing business. Additionally, the materials incorporated into Supplier's products must comply with the laws regarding human trafficking of the country or countries in which they are doing business.
Conflict Minerals. Biomet strictly forbids the use of conflict minerals in its products or by its Suppliers in the making of its products. Conflict minerals are defined as cassiterite, columbite-tantalite, gold, wolframite, or their derivatives from the Democratic Republic of the Congo or any adjoining countries. In addition, if any Supplier uses any other minerals from the Democratic Republic of the Congo, such Supplier must contact the United States Government to verify those additional minerals have not been added to the U.S. conflict mineral list.
Good point, they outsource production to China.
DeleteA lateral plate with built in fixation is an interesting idea????? Get with the program - Nuva has had them for 4 years. I hope I compete against you.
DeleteTheir instruments say "made in Biomet China".
DeleteNuva rep trash talking. Say it ain't so, lol! They've had 6 reps in my 12 years. The cheetahs run away fast.
DeleteWhat about Spine news. Anyone interested in the study that came whose results suggests that, "Although BMPS are clinically safe BMPs only increased costs with no apparent improvement in results." Both groups (Control and BMP group for those that don't want to read the article or study) had a three percent repeat surgery rate at one year and a six percent repeat surgery rate at two years. Hmmm, and why does it justify the costs again? I would like to thank Medtronic and Infuse for the nice metal costs reductions I face today for no apparent benefits to the patient and I am still convinced years from now it will be shown that putting in a billion synthetic proteins was probably no the smartest idea. Can anyone say steroids? ... that apparently don't work.
ReplyDeletePreface, I haven't read the article yet. Is the repeat surgery rate really only 6% at two years out? I'd be interested to see results at 5 years.
Deletewhat study?
DeleteYawn...
DeleteDude the only reason your metal goes down is because there are 145 companies with screws just like yours. Overcapacity breeds lower costs.
ReplyDeleteAnyone looking for any advances in lateral cages should look in the only place with any advancement in the genre......Globus.
ReplyDeleteThey have Cages like eveyone else, +Zero profile, expandable, and soon, Zero profile/expandable. Anyone else in this market have anything that cam compete with that?
All you Nuva idiots that want to think your market share in this segment is untouchable, I give one example.
Spine Tech and thier dominance of cages....
You may want to wipe off your koolaid mustache.
DeleteYep, it seems they have some unique stuff... for now, at least, until they bust, or are bought out cheap, their reps and distibutors let go. Too many strikeouts (failures) per homerun.
ReplyDeleteWe are cleaning up after their messes.
The docs ask me " Who are their engineers, teenagers? Wish I hadn't bought their hype".
But they do have a private jet....
DeleteCurrently sitting in the OR playing with my iPAD. Not much to do... Damn that scub is hot. Pretty sure I can get a hummer from her today. She loves my biceps. Hum...should I get a hair cut today. No...damn..I need to go work out. I can't believe this doc is taking so long. I need to get on with my day. Damn that scrub is hot. Let see..two level cervical...needs 5 cc bio. I open a 10 cc 'cuz I have a car payment due. Damn...I need to go work out. You think she'll give me a hummer?
ReplyDeleteThe thoughts of an idiot useless spine rep....
I got a hummer...I got a hummer. Damn I love Florida spine.
DeleteMust be Stryker. How much hair gel do you massage in?
DeleteNeed 5cc? Thats wasteful. 10cc is criminal
DeleteWhen did "the situation" start selling spine??
DeleteListen...I love my hair get. I have a ton of hair. The scrubs love my hair and biceps. I'm like a Latin God at the hospital. And I needed to make my car payment so i opened a 10 cc. Opps.
DeleteI'm off today as my doc is gong fishing in the Keys. I will be getting laid by happy hour. Of course I have to get my workout in.
P90X ??
DeleteWorkout? Haircut? Gel? Damn, I need to pick up my Range Rover from the detail shop, which is next to the place where I spray tan...the chick at the front desk DIGS my scrubs. I told her I was a doc. She's "hella" cute, 19 years old. Man, I am the king of the world. Wish my surgeon would hurry up a finish. I got things to do
DeleteIf you were a smart rep ud b at the gym or massage parlour gettin a hummer while ur asr covered the case.
ReplyDeleteTrans1 Lateral System on the market. Any good?
ReplyDeleteDamn...sorry about the typo. damn iPhone auto-correct.
DeleteSucks. I talked to s design surgeon in my area. He said he would not even use it.
ReplyDeleteSpeaking of awful...surgeon that attended an Alphatec lab email me after saying great hanging out but that was by far the worst lab he has ever been to in his career! Imagine that! Not some good things some bad things...the worst ever and that is a quote. Wow! I need to find another line apparently.
ReplyDeleteThe company definitely makes some mistakes but don't throw the baby out with the bath water. They have great products for being such a small company. They are hamstrung by a senior management that is known for not being very good. It would not surprise me to hear that they administered a poor lab.
DeleteIt's the indian, not the arrow.
Yes, I am sure it was senior managements fault the lab was poor. They should never teach the lab alone. Try hiring a an MD next time, maybe even a spine surgeon. Damn senior management! They're always in the way!
DeleteMaybe your "Indian" had a dot on his head. Don't think they carry arrows.
Delete4:58 am
DeleteWho hired the people who ran the lab? Who signed off on the Venue? The format? The rubric?
When you are the janitor you are allowed to make mistakes. When you are the VP or C-level you can't have an excuse. You have to execute on every opportunity. If you don't, then someone else will. Thats how it works.
Shit may roll downhill but responsibility rolls up.
Hey 11:22 forget lateral plates, they're so last year. Gamechanger: Stand-alone lateral from LDR, zero profile, fast, sexy, expensive
ReplyDeleteYou are a f'n idiot. LDR stand-alone's should have never been approved. The revisions are criminal.
DeletePlease stop saying that.. Not true. I've revised two cervicals personally and if distract with Kasparov pins and burr down the very minimal peek it comes right out and now u have a "virgin" vertebral body. You guys are soo goofy when u keep saying this careful. U may just have a surgeon call your bluff and then our credibility is gone. Wait it was already!
Delete@ 9:01.. Bullshit. That my work well in the lab but not in the situation where a revision is being called for. Either you are a rep passing yourself off as a doc OR you are a paid off douche bag doc for LDR.
DeleteWhat is the pricing for SurgLine. Chinese company out of Cali
ReplyDeleteThe retractor for Trans1 rocks. Radiolucency, less iatrogenic psoas injury, di$posables, and you can buttscrew at 5-1!
ReplyDeleteButt, will anybody get paid for the butt screw? Yes, I meant to spell "butt" for all you grammar police out there. You know who you are.
DeleteSpineWave stackable is gamechaging as well, no sizing, and you don't have to jam a giant 16 through the psoas or damage endplates with a sledgehammer.
ReplyDeleteif your using a retractor i would hope that you wouldnt be jamming anything through the psoas.
DeleteSpinewave is the dumbest implant in years. It is simply not good. Good concept, but implant is a far cry from being good.
DeleteCould all you boring reps go away with your company blah and actually learn something about anatomy, physiology, pathology and biomechanics? That way this blog has a chance of becoming interesting again. It could for example discuss what the impact will be that insurance companies from now on will reimburse only an anterior or a posterolateral fusion, but not both. Or, what the significance is of the JBJS article that shows that hips and knees introduced over the last 5 years perform at best equal but often worse than older designs. Could this be true for spine as well? Or would this be hidden by the fact that at least half the patients getting spine surgery don't need it, and therefore only get to enjoy the complications, and experience no benefits? Just some food for thought...
ReplyDeleteMay I ask that you provide the author and title of the JBJS article? That is significant, indeed. Thank you.
DeleteAlthough, not a article about Spine. I find this article to be relevant regarding implants and "new technologies." The author describes THA and the procedure volume and pricing increase related to both. It is a fair leap to extend these concepts to Spine Implants, as it pertains to the implants that add very little clinical or procedural increase in effectiveness. Personally, I would say the expandable TLIF cages/Lateral Cages/ would be a prime example of this. If we are to be a profitable industry again, we must look outside these types of devices and more into Biologics/New Materials that allow for bone remodeling/Growth Modulation etc..
DeleteCost drivers in total hip arthroplasty: effects of procedure volume and implant selling price.
http://www.ncbi.nlm.nih.gov/pubmed/19238268
Speaking of blumpkins...that is so 2011. The "Angry Pirate" is the new way to go.
DeleteI find it interesting that the subject of this thread is one of our collegues pleading guilty to a crime and is facing prison time and NO ONE comments on it. TSB, it seems that it is a waste of your time to write about what is going on in the industry because the comments turn into a bitchfest, reps beating their chests that the shit the are pushing is the best or berating someone or something. Why are people not interested in commenting on the thread? I always enjoy reading what you write, but I could do without the comments, they add nothing.
ReplyDeleteWelcome to "The Spine Blogger." Where the lead story thread lasts until the first "blumpkin" reference and soon devolves into what you describe, "reps beating their chests," which is the standard bill of fare here. One of MSM's lead articles here feature talk about the desire to see surgeons who participate in PODs raped in prison by "Bubba." Not an exact quote from MSM, but pretty close. This is not your forum if you are looking for continuous serious discussion about the spine business.
DeleteSpeaking of blumpkins...that is so 2011. The "Angry Pirate" is the new way to go.
DeleteSo back to the subject. Is 'Mitch' the guy from Orthofix? On his linkedin picture he looksmuch younger than 55, so maybe it is not him..
ReplyDeleteAre Stryker spine reps allowed to sell competitive spine companies products line? Shady rep in my area has all kind of side business stuff going on.
ReplyDeleteStryker, shady, side business....hmmmmm. I think I know that rep.
DeleteJosh Maloney?
DeleteIf stryker didnt allow their reps to push other products, they would have no reps. Stryker is on vacation.
ReplyDeleteGene-X... There's a concept
ReplyDelete