Four stories this week, and they do not share a theme — which is itself a theme. Private equity keeps buying MedTech services assets. Costa Rica keeps eating into China's share of the global MedTech manufacturing pie. ResMed keeps expanding its sleep ecosystem via M&A. And Dexcom has a sensor recall that started with theft, not a manufacturing defect. Four different vectors. One newsletter. Welcome to Issue #28.
Top Stories
Story 01
Align Capital Partners, a private equity firm based in Dallas, has acquired Heritage Imaging, a mobile diagnostic imaging provider headquartered in Boise, Idaho, and founded in 1989. Financial terms were not disclosed. Heritage serves critical access hospitals, community clinics, and other local healthcare centers across 14 states in the Midwest and Pacific Northwest, operating fully staffed mobile solutions and leased equipment across PET-CT, MRI, nuclear medicine, ultrasound, and echocardiography. (Source: Radiology Business, June 4, 2026)
Heritage CEO Steve Coppess, MD, MBA, a former Radiology Business Forty Under 40 winner, will continue leading the company alongside the existing management team. Rob Langley, managing partner at Align Capital Partners, described Heritage as "a trusted imaging partner to hospitals operating in rural America." The company has closed three add-on acquisitions since 2024 and plans to continue pursuing M&A in adjacent markets while expanding into new modalities.
Why It Matters
Rural healthcare imaging has been structurally underserved for decades. The fixed cost of a permanent MRI or PET-CT suite does not pencil out for a 25-bed critical access hospital in rural Idaho. Mobile imaging services solve that problem. PE firms have taken note: the recurring revenue from multi-year hospital contracts, combined with the consolidation logic of add-on acquisitions, makes this a predictable cash flow story. Align Capital Partners is not buying a device — it is buying contracted service relationships with 14 states worth of health systems. That is a different asset class than a device company.
M&A
Diagnostics
Private Equity
Story 02
Costa Rica now exports more than $10 billion in medical devices annually — nearly half of its total goods exports — making it the world's largest per capita exporter of medical devices. The country is home to over 100 multinational life sciences companies, including 18 of the world's top 35 MedTech firms, and employs more than 60,000 people across 16 subsectors including cardiovascular, neurovascular, orthopaedic, and diagnostic systems. (Source: The European, June 3, 2026)
Marianela Urgelles, managing director of CINDE, the country's private investment promotion agency, said global MedTech foreign direct investment projects fell roughly 25% while U.S. outbound investment hit its lowest level in a decade. Despite that, Costa Rica attracted 48 reinvestment projects in 2025 against 19 new investment projects — companies expanding into higher-value work rather than leaving. "Companies that come to Costa Rica do not leave. They expand," Urgelles said. The shift mirrors a broader transition from basic disposables into Class II and Class III devices across the local MedTech cluster.
Why It Matters
The global MedTech supply chain story has been dominated by China-vs.-Vietnam-vs.-Mexico narratives. Costa Rica is rarely in that conversation. It should be. The country's $10 billion in MedTech exports puts it ahead of Vietnam, ahead of Malaysia on a per-capita basis, and ahead of most of Southeast Asia in device complexity. It is not making Band-Aids — it is making cardiovascular implants and neurovascular devices under FDA and EC standards. The reinvestment data is the most telling signal: when existing multinationals keep expanding capacity in Costa Rica rather than shifting to cheaper markets, that is a supply chain loyalty signal most Southeast Asian manufacturing hubs cannot replicate.
Global Markets
Supply Chain
Manufacturing
Story 03
ResMed has completed its acquisition of Noctrix Health, a medical device company developing wearable therapeutics for chronic neurological disorders, from Angelini Ventures in a transaction valued at $340 million. Noctrix's Nidra Tonic Motor Activation (TOMAC) Therapy holds FDA De Novo clearance and is a non-invasive, non-pharmacologic treatment designed for adults with moderate-to-severe Restless Legs Syndrome (RLS) who have not found sufficient relief with drug therapy. (Source: Investors in Healthcare, June 3, 2026)
The deal marks Angelini Ventures' first successful portfolio exit since launching in October 2022. Paolo Di Giorgio, CEO and managing director of Angelini Ventures, said the transaction "reaffirms our strategy of backing disruptive healthcare companies with the potential to address significant medical needs." Noctrix was founded in 2016. Its $40 million Series C in 2024 was led by Sectoral Asset Management with participation from ResMed itself, Asahi Kasei Corporation, OrbiMed, and Treo Ventures — ResMed's prior investment in the round made this a strategic acquisition at a known price.
Why It Matters
ResMed built its business on CPAP machines and AirView cloud monitoring. The Noctrix acquisition extends the clinical sleep health portfolio into a condition — RLS — that affects an estimated 7% of the U.S. population and has historically been treated pharmacologically. A non-drug, non-implant wearable device for RLS fills a gap in ResMed's portfolio and leverages the same prescriber base: sleep specialists and neurologists who are already writing ResMed device prescriptions. The pre-investment in the Series C is a bonus — ResMed knew the asset and negotiated from an informed position.
M&A
Sleep Health
FDA
Story 04
Product Recall
Dexcom has notified potentially impacted users after discovering that two lots of Dexcom G7 continuous glucose monitoring sensors originally designated for destruction were stolen by a third-party vendor during the destruction process and subsequently sold into the market. The affected lots are 1725204004 and 1725069002. Dexcom traced sales of the stolen product to Pharmsource LLC, which is not an authorized Dexcom distributor but supplies some independent pharmacies and DME distributors in the United States. (Source: Business Wire, May 26, 2026)
Lot 1725204004 carries an elevated risk of skin infection due to improper sterilization. Lot 1725069002 has an elevated internal testing failure rate, carrying a risk of absent sensor readings. No severe adverse events have been reported. Dexcom CEO Jake Leach called the situation "a matter of the utmost seriousness" and said the company is working closely with the FDA and other authorities. Users with sensors from affected lots should not use them and can call 1-844-478-1600 for replacement.
Why It Matters
The unusual part of this recall is not the product issue — it is the supply chain origin. Dexcom's quality control process requires certain sensors to be scrapped. The third-party destruction vendor then stole them before completing the process and sold them through an unauthorized distributor. Dexcom caught it through internal quality reviews, not a customer complaint. That is the kind of supply chain exposure that does not show up in a product quality audit — it shows up in an accounting review. The company deserves credit for detection speed, but the incident raises a structural question: who is auditing the third-party destruction vendors that handle medical device scrap?
Recall
FDA
CGM
Industry Shift
Four stories. Four different pictures. PE is buying service-layer assets like Heritage Imaging — contracted, recurring, rural. Costa Rica is building the manufacturing infrastructure that China built 20 years ago, only with higher-complexity devices. ResMed is executing the classic platform-play M&A: buy an asset your own investors already funded, at a price the co-investment relationship made transparent. And Dexcom has a supply chain security problem that is not about manufacturing — it is about vendor accountability. None of these are the same story. Together they illustrate a sector that is being rebuilt simultaneously at the asset level, the geographic level, the product level, and the operational level. If that feels like a lot happening at once — it is. The capital is moving in four directions at the same time.
Market Movers
| Ticker | Company | Price | Wk Change |
|---|
| ISRG | Intuitive Surgical | $468.20 | ▲ 0.8% |
| SYK | Stryker | $304.50 | ▲ 0.6% |
| DXCM ★ | Dexcom | $79.40 | ▼ 3.2% |
| BSX | Boston Scientific | $79.10 | ▲ 0.2% |
| BDX | Becton Dickinson | $237.80 | ▲ 0.4% |
| JNJ | Johnson & Johnson | $226.70 | ▲ 0.2% |
| ABT | Abbott Laboratories | $113.20 | ▲ 0.5% |
| ZBH | Zimmer Biomet | $98.80 | ▼ 0.1% |
| GEHC | GE HealthCare | $65.10 | ▲ 0.9% |
| RMD | ResMed | $240.30 | ▲ 1.4% |
★ Biggest Mover: Dexcom (DXCM) fell 3.2% following the announcement of a G7 sensor recall tied to two stolen and improperly sterilized lots. No severe adverse events reported; management is working with the FDA. Sorted by stock price, highest to lowest. Prices reflect approximate close, week of June 2–4, 2026. For illustrative purposes only.
⏳ That's your 5-minute briefing. Below: extras if you want to go deeper.
Fun Fact
💡 Fun Fact — Costa Rica MedTech by the Numbers
Costa Rica exports $10 billion in medical devices annually, employs 60,000 people across 16 subsectors, and is home to 18 of the world's top 35 MedTech firms. It exports 164 different device types to 88+ markets.
Trivia
MedTech Trivia
What specific mechanism did Dexcom use to detect that two lots of scrapped G7 sensors had been stolen and sold into the market by an unauthorized third-party distributor?
If you're building, hiring, or investing in MedTech, reply and tell me what you're seeing. I read every response.
