Sign up for our daily briefing

Make your busy days simpler with the Axios AM and PM newsletters. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to the Axios Closer newsletter for insights into the day’s business news and trends and why they matter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios Pro Rata

Dive into the world of dealmakers across VC, PE and M&A with Axios Pro Rata. Delivered daily to your inbox by Dan Primack and Kia Kokalitcheva.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with the Axios Sports newsletter. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with the Axios Des Moines newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with the Axios Tampa Bay newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Nashville news?

Get a daily digest of the most important stories affecting your hometown with the Axios Nashville newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Columbus news?

Get a daily digest of the most important stories affecting your hometown with the Axios Columbus newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Dallas news?

Get a daily digest of the most important stories affecting your hometown with the Axios Dallas newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Austin news?

Get a daily digest of the most important stories affecting your hometown with the Axios Austin newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Atlanta news?

Get a daily digest of the most important stories affecting your hometown with the Axios Atlanta newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Philadelphia news?

Get a daily digest of the most important stories affecting your hometown with the Axios Philadelphia newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Chicago news?

Get a daily digest of the most important stories affecting your hometown with the Axios Chicago newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top DC news?

Get a daily digest of the most important stories affecting your hometown with the Axios DC newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Illustration: Aïda Amer/Axios

Several hospitals have mounted a legal battle against the company that makes the da Vinci surgical robot, alleging its monopoly position forces hospitals to buy its maintenance services and replacement parts at inflated prices even though cheaper options exist.

Driving the news: In one allegation, a hospital says Intuitive Surgical remotely shut down a hospital's surgical robot "in the middle of a procedure" which forced the surgeon "to convert the procedure to open surgery with the patient on the operating table," after the hospital said it was considering a service contract with a third party.

The big picture: Intuitive Surgical makes the da Vinci surgical robot, and sells them to hospitals for anywhere from $500,000 to $2.5 million each.

  • But a majority of Intuitive Surgical's $4 billion of annual revenue comes from instruments, accessories, and service contracts that are needed to keep the robots operating.

Where things stand: Franciscan Health headquartered in Indiana, Valley Medical Center in Washington and Kaleida Health in New York filed class-action lawsuits. They claim Intuitive Surgical has a monopoly on minimally invasive surgical robots, which gives the company a "near-stranglehold" on the market for all the parts and services the robots need after hospitals buy them.

  • One lawsuit alleges hospitals cannot have their da Vinci robots serviced by third parties because Intuitive Surgical forces hospitals to sign "multi-year, exclusive servicing agreements" at rates that are much higher than other vendors'.
  • Hospitals also allege Intuitive Surgical forces them to buy new, costly instruments and attachments for their robots (called EndoWrists) after 10 uses, even if the parts are in good working condition. Intuitive Surgical launched a program last year that now allows 12-18 uses for some of its instruments.
  • Engineers at Intuitive Surgical have threatened hospitals they will turn the machines into "paperweights" if hospitals turn to outside vendors for repairs or new parts, the lawsuit alleges.
  • Intuitive Surgical has faced antitrust lawsuits from third-party repair and service companies since 2019, but these hospital class-action lawsuits are new.

A spokesperson said Intuitive Surgical will not comment on the lawsuits.

By the numbers: Intuitive Surgical has a market cap of $113 billion — higher than companies like CVS Health or Lockheed Martin — and its executives are among the highest-paid in health care.

  • Wall Street has loved Intuitive Surgical for years because of the company's competitive moat and the high profit margins that result.
  • Last year, while discussing a possible surgical robot competitor from Johnson & Johnson that remains years away from federal approval, bankers at SVB Leerink told investors this market "has essentially been a monopoly for da Vinci over the past two decades."

Zoom out: It's worth remembering there is no evidence robotic-assisted surgeries lead to better outcomes than traditional minimally invasive surgeries.

Go deeper

5 mins ago - World

Scoop: Israel's "top priority" mission to discredit UN probe

Israeli Prime Minister Naftali Bennett addresses the UN. Photo: John Minchillo/Pool via Getty

Israel is planning a campaign to discredit a UN commission formed to investigate the violence in Gaza last May and the root causes of the protracted conflict in the occupied West Bank and Gaza, according to an Israeli Foreign Ministry cable seen by Axios.

Why it matters: Israeli officials say they are highly concerned that the commission’s report will refer to Israel as an "Apartheid state" and that its findings could damage Israel's reputation, particularly among progressives in the West. The report is expected in June.

Updated 6 mins ago - Politics & Policy

Liberal Supreme Court Justice Stephen Breyer to retire: reports

Justice Stephen Breyer. Photo: MANDEL NGAN / AFP via Getty Images

Supreme Court Justice Stephen Breyer will retire, NBC news first reported and multiple outlets confirmed on Wednesday, giving President Biden his first — and maybe only — chance to put a stamp on the high court.

What’s next: Appointing a new Supreme Court justice will be one of the longest-lasting pieces of Biden’s legacy — and could give Democrats a jolt of energy ahead of next year's midterms.

39 mins ago - Science

Blizzard likely to hit New England this weekend as "bomb cyclone" forms

Computer model projection of the precipitation and wind field from the weekend storm in the Northeast. (Earth.nullschool.net)

A powerful blizzard is likely to strike parts of New England and the Mid-Atlantic beginning Friday and lasting into the weekend, with snow totals that are likely to be measured in feet.

The big picture: The joining of weather systems embedded in both the polar, or northern branch, of the jet stream and the southern branch is projected to create a bomb cyclone. Such storms undergo a process known as bombogenesis, with their minimum central air pressure readings plunging at least 24 millibars in 24 hours.