UNITED STATES DISTRICT COURT
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`SOUTHERN DISTRICT OF CALIFORNIA - SAN DIEGO DIVISION
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`NUV ASIVE, INC. , a Delaware corporation,
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`Plaintiff,
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`V.
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`Defendants.
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`______________ )
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`ALPHATEC HOLDINGS, INC., a Delaware
`corporation, and ALPHATEC SPINE, INC., a
`California corporation,
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`Case No. 18-cv-00347-MDD-CAB
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`EXPERT REPORT OF JIM YOUSSEF RE DAMAGES
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1061, p. 1 of 3
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`I also considered the features that Alphatec touts on Alphatec’s website and in
`25.
`its surgical guides for the accused products. I addressed each in detail in my Opening Report at
`¶¶ 1372-1380. Consistent with my opinions there, and above, the features that Alphatec touts
`on Alphatec’s website provide minimal, if any, impact on the three primary demand drivers.
`4.
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`SURGEON CHOICE OF PLATFORM
`26.
`Based on my experience, surgeons base their usage/adoption decisions for
`lateral procedures at the platform-level versus the component-level. This is primarily based on
`the fact that lateral platforms such as NuVasive’s MAS platform include integrated components
`such as a neuromonitoring system, access system (including MaXcess retractor),
`neuromonitoring disposables, MaXcess disposables, and implants, each of which have been
`specifically designed to operate collectively as a functional unit in order to achieve a safe and
`reproducible, minimally invasive, and successful lateral spinal fusion. The three main
`components necessary for performance of an XLIF procedure – (1) access tools; (2) implants;
`and (3) neuromonitoring – collectively function in such a way that allows surgeons to achieve
`safe and reproducible, minimally invasive, and clinically successful interbody fusions.
`Additionally, because the absence of any one of these components would dramatically impair
`surgeons’ ability to achieve these objectives, it is my opinion that each of these components
`contributes equally but in different ways to the adoption and continued use of the XLIF
`procedure and platform. For example, the implant, by itself, is of little value without
`neuromonitoring and access systems as the surgeon would have no safe and reproducible way
`to place the implant in the targeted disc space. Similarly, the retractor and/or neuromonitoring
`components would provide significantly reduced value without an implant, which are required
`for fusion, restoring the disc height, and providing stability to the spine. Therefore, it is my
`opinion that no one of these three key components of XLIF has more clinical value to a surgeon
`than any other.
`27.
`In Section 21 of my Opening Report and Section 1 above, I have compared the
`features and components of NuVasive’s MAS platform and Alphatec’s Battalion platform and
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`14
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1061, p. 2 of 3
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`Dated: November 8, 2019
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`JiSc:
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` _________________________
`Jim A. Youssef, M.D.
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`17
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`ALPHATEC HOLDINGS, INC., ALPHATEC SPINE INC. v. NUVASIVE INC.
`IPR2019-00362, Ex. 1061, p. 3 of 3
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