Intended for healthcare professionals

Feature The Implant Files

What happens when the world’s biggest medical device maker becomes a “health services provider”?

BMJ 2018; 363 doi: (Published 26 November 2018) Cite this as: BMJ 2018;363:k4917

Spanish translation

¿Qué sucede cuando el fabricante de dispositivos médicos más grande del mundo se convierte en un “proveedor de servicios de salud”?

Read all The BMJ's investigations

  1. Jeanne Lenzer, associate editor, The BMJ
  1. jlenzer{at}

A new cardiac suite with state-of-the-art equipment is developed for a cash strapped hospital in Mexico by the world’s leading medical device maker. What’s not to like? Jeanne Lenzer reports from Tijuana, Mexico, on a new public-private model that is being rolled out across the world amid criticism such deals introduce commercial concerns into clinical decision making

A cluster of men stand on a corner near a home improvement store in Tijuana; several hold rough cardboard signs advertising their skills in hopes of being picked up for a day labour job. Across from the corner is a sanctuary for the sick and injured, the Red Cross Hospital.

Two years ago, the hospital faced a $3m pesos (£117 000; €132 000; $150 000) shortfall and was forced to lay off 16 staff.1 Today, Alberto Quintanar Hernández, director general of the Red Cross in Tijuana, shows off some of the hospital’s bright new facilities: a cardiac suite with the latest equipment for cardiac computed tomography, balloon angioplasty, implanting stents and pacemakers, and open heart surgery. The hospital built the suite through a partnership with Medtronic, the world’s biggest medical device manufacturer.

The partnership has allowed the Red Cross to equip 13 of its ambulances with electrocardiographs that can transmit a patient’s heart tracing in real time to a doctor’s mobile phone.2 Quintanar opens the door to an immaculate private room. Nodding towards a massive flat screen TV mounted on the wall, he says, “It has wi-fi and Netflix,” adding with a smile, “We like to give patients a spa-like experience.”

Under a five year contract, Medtronic is donating staff to the cardiac suite, helping to devise clinical protocols, providing training to doctors on how to implant various medical devices, and managing the suite’s inventory. The contract doesn’t restrict the hospital to …

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