Medtronic

Medtronic plc
Type	Public
Traded as	NYSE: MDT; S&P 500 component
Industry	Medical devices
Founded	29 April 1949, Minneapolis, Minnesota
Founder	Earl Bakken and Palmer Hermundslie
Headquarters	Dublin, Ireland, registered; Minneapolis, Minnesota, operational
Area served	More than 150 countries
Key people	Geoff Martha (chairman and chief executive), Thierry Piéton (chief financial officer)
Products	Pacemakers, defibrillators, heart valves, stents, neurostimulators, spinal implants, surgical staplers, insulin pumps, continuous glucose monitors, surgical robots
Revenue	Approximately US$33 billion (fiscal 2025)
Employees	Approximately 95,000
Website	medtronic.com

Medtronic plc is a medical device company incorporated in Ireland with operational headquarters in Minneapolis, Minnesota. It is among the largest medical technology companies in the world, employs approximately 95,000 people and supplies devices used in more than 150 countries, in areas including cardiac rhythm management, cardiovascular intervention, neuromodulation, spinal surgery, surgical instruments and diabetes management.

Medtronic invented the wearable and then the implantable cardiac pacemaker, and the cardiac rhythm business that resulted has remained its core for seventy years. It is now organised into four segments, cardiovascular, neuroscience, medical surgical and diabetes, the last of which it announced in 2025 would be separated as an independent company.

History

The garage and the pacemaker, 1949 to 1970

Earl Bakken, an electrical engineering graduate of the University of Minnesota, and his brother-in-law Palmer Hermundslie founded Medtronic on 29 April 1949 in a garage in northeast Minneapolis, repairing medical equipment for hospitals and laboratories. The business earned US$8 in its first month.

Its transformation came from a specific event. In October 1957 a power failure in Minneapolis cut electricity to the University of Minnesota hospital, where the surgeon C. Walton Lillehei was pioneering open-heart surgery in children, and a child dependent on a mains-powered external pacemaker died. Lillehei asked Bakken whether a battery-powered device could be built. Bakken adapted a transistorised metronome circuit he had found in Popular Electronics, produced a wearable pacemaker within about four weeks, and it was in use on a patient the following day.

The device was a small box worn on the body, connected by wires passed through the chest to electrodes on the heart. It was the first practical battery-powered wearable pacemaker and it made possible the survival of children whose hearts had been blocked during surgery.

The implantable pacemaker followed. Wilson Greatbatch and William Chardack, working in Buffalo, New York, developed a device small enough to be placed entirely within the body, and Medtronic licensed it in 1960 and manufactured it. The company grew rapidly on the product and nearly failed in 1962 through expanding faster than its finances permitted, being rescued by a loan arranged through the Minneapolis banker Thomas Holloran, who subsequently joined the company.

Bakken wrote the company's Mission in 1960, a statement whose first element is to contribute to human welfare by the application of biomedical engineering to alleviate pain, restore health and extend life. It is read to every new employee, who receives a bronze medallion depicting a rising figure, and the ceremony has been conducted for six decades. Bakken also founded the Bakken Museum of electricity in Minneapolis and remained associated with the company until his death in 2018.

Diversification, 1970 to 2010

The company extended from pacing into the adjacent areas that shared its technology: implantable cardioverter defibrillators, which detect and terminate life-threatening arrhythmias; heart valves, following the acquisition of Hancock and later of Hall; and, through the acquisition of Medtronic Neurological capabilities, into neurostimulation, in which electrodes implanted in the brain or spinal cord modulate neural activity.

Deep brain stimulation, approved for essential tremor in 1997 and for Parkinson's disease in 2002, has been among the company's most significant contributions. Electrodes placed in specific nuclei and driven by an implanted pulse generator suppress the tremor and rigidity of Parkinson's disease in a manner that can be adjusted and reversed, and the treatment has been extended to dystonia, obsessive-compulsive disorder and epilepsy.

Other acquisitions built the remainder of the portfolio: Sofamor Danek in 1999 for spinal implants, AVE for coronary stents, MiniMed in 2001 for insulin pumps, Kyphon in 2007 for vertebral augmentation, and CoreValve in 2009, which supplied the transcatheter aortic valve that became the Evolut system.

Covidien and the Irish domicile, 2015

In January 2015 Medtronic completed the acquisition of Covidien, an Irish-domiciled medical device and supplies company itself descended from Tyco Healthcare, for approximately US$49.9 billion.

The transaction was the largest medical device acquisition in history and was structured as an inversion: the combined company was incorporated in Ireland, which reduced its tax rate substantially and, more significantly at the time, allowed it to use the very large cash balances it held outside the United States without incurring the American tax then payable on repatriation. It was among the last and largest of a wave of such transactions, and the United States Treasury introduced rules during the process to restrict them, which Medtronic's structure survived and which prevented several others.

The deal attracted political criticism in the United States and produced legislative proposals to prevent inversions. Its commercial logic was independent of the tax arrangement: Covidien brought surgical stapling, energy devices, ventilators and hospital supplies, businesses that sold to hospital procurement departments rather than to individual physicians and which diversified Medtronic away from implantable devices.

The Tax Cuts and Jobs Act of 2017, which reduced the American corporate rate and changed the treatment of foreign earnings, removed much of the inversion's original advantage.

Recent history, 2020 to 2026

Geoff Martha became chief executive in April 2020, succeeding Omar Ishrak, at the start of the COVID-19 pandemic, which suspended a very large proportion of the elective procedures on which the company's revenue depends while simultaneously producing extraordinary demand for its ventilators; Medtronic increased ventilator production several-fold and released the design of one of its older models publicly so that others could manufacture it.

His tenure has been directed at improving growth, which had lagged competitors for a decade, by reorganising the company from four groups into twenty operating units each accountable for its own performance, by increasing research spending, and by disposing of businesses without adequate prospects.

Product difficulties have been a recurring feature. The HeartWare HVAD ventricular assist device was withdrawn from the market in June 2021 after the company concluded that a competing device performed better and after problems with pump restarts and neurological events, a withdrawal affecting several thousand patients living with an implanted device that could no longer be replaced with the same model. Insulin pump components were recalled between 2019 and 2021, and the Food and Drug Administration issued a warning letter concerning the diabetes business in 2021 that constrained new product approvals for a period.

The company has also achieved significant approvals. The Micra leadless pacemaker, small enough to be placed inside the heart without leads or a chest incision, was approved in 2016 and has been implanted in very large numbers. The Hugo robotic surgery system received American approval in 2025 after being available internationally since 2021. PulseSelect, the first pulsed field ablation system approved in the United States, was cleared in December 2023, entering a field that has grown very rapidly.

In May 2025 the company announced that it would separate its diabetes business, comprising the MiniMed insulin pumps and the associated continuous glucose monitors, as an independent public company through an offering and subsequent separation, on the reasoning that the business competes with different companies, sells to different customers and requires different investment from the rest of the portfolio.

Business segments

Cardiovascular

The largest segment, comprising cardiac rhythm management, structural heart, coronary and peripheral intervention, and cardiac surgery.

Cardiac rhythm management includes pacemakers, implantable cardioverter defibrillators, cardiac resynchronisation devices and insertable cardiac monitors. Medtronic holds a leading position in a market it created and shares principally with Abbott and Boston Scientific. The Micra leadless pacemaker, placed directly inside the right ventricle through a catheter in the femoral vein, eliminates the leads and the subcutaneous pocket that are the sources of most pacemaker complications.

Structural heart comprises the Evolut transcatheter aortic valve, delivered through a catheter to replace a diseased aortic valve without opening the chest, a procedure that has largely displaced surgical replacement in older patients and is expanding into younger and lower-risk populations. Medtronic competes here principally with Edwards Lifesciences, whose Sapien valve holds the larger share.

Cardiac ablation treats atrial fibrillation by destroying the tissue conducting abnormal signals. Pulsed field ablation, which uses electrical fields rather than heat or cold and which spares adjacent tissue including the oesophagus and phrenic nerve, has transformed the field since 2023, and Medtronic's PulseSelect and Affera systems compete with those of Boston Scientific and Johnson and Johnson.

Neuroscience

Comprises cranial and spinal technologies, specialty therapies and neuromodulation.

Spine supplies implants, instruments and the Mazor robotic guidance and StealthStation navigation systems used to place screws accurately. Neurosurgery supplies cranial fixation, navigation and the instruments used in tumour resection. Neurovascular supplies coils, stents and thrombectomy devices for stroke, a field in which mechanical removal of clots has produced among the largest improvements in outcome achieved in any area of medicine in the past decade.

Neuromodulation comprises deep brain stimulation, including the Percept system which records brain activity as well as stimulating it, permitting therapy to be adjusted to the patient's own neural signals; spinal cord stimulation for chronic pain; sacral neuromodulation for bladder and bowel dysfunction; and targeted drug delivery.

Medical Surgical

Derived largely from Covidien, comprising surgical stapling, energy devices including the LigaSure vessel sealing system, hernia mesh, wound closure, patient monitoring, respiratory interventions including ventilators, and the Hugo robotic-assisted surgery system.

Robotic surgery is the segment's principal opportunity and its principal difficulty. Intuitive Surgical's da Vinci system has been the dominant product for more than two decades, has a very large installed base and a surgeon population trained on it, and Medtronic's entry, delayed repeatedly, competes with an incumbent whose position resembles that of a platform rather than a device.

Diabetes

Comprises the MiniMed insulin pumps, the Guardian continuous glucose monitors and the algorithms connecting them. The MiniMed 780G is a hybrid closed-loop system that adjusts insulin delivery automatically in response to glucose readings, an approach usually described as an artificial pancreas.

The business has been the company's weakest for a decade. Its continuous glucose sensors have been regarded as less accurate and less convenient than those of Dexcom and Abbott, whose Libre system has been sold in enormous volume, and the pump business has lost share to Tandem and to Insulet's tubeless Omnipod. The regulatory constraints following the 2021 warning letter compounded the position. The announced separation in 2025 reflects a conclusion that the business requires a focus the parent has not given it.

Research and regulation

Medtronic spends approximately US$2.7 billion a year on research and holds tens of thousands of patents. Its development is constrained and shaped by regulation of a kind that does not apply to pharmaceuticals in the same way.

Class III devices, which include pacemakers, defibrillators and heart valves, require premarket approval supported by clinical evidence, a process comparable in demand to a drug approval. Lower-risk devices may be cleared through the 510(k) pathway on a demonstration of substantial equivalence to an existing product, a route that has been criticised because a device may be cleared by reference to a predicate that was itself cleared by reference to an earlier one, with no clinical data at any stage. The European Medical Device Regulation, applying from 2021, tightened the comparable European arrangements substantially and has had the effect of removing some older devices from the market because recertifying them was not economic.

Post-market surveillance is a further difficulty peculiar to devices. A medicine can be withdrawn; an implanted device cannot, and the decision whether to explant a device that may fail is a clinical judgement weighing the risk of the device against the risk of surgery. The HeartWare withdrawal illustrated the problem directly, since several thousand patients were living with a pump the manufacturer had concluded was inferior and which could not be exchanged.

Controversies

Infuse

Infuse is a recombinant human bone morphogenetic protein used to stimulate bone growth in spinal fusion, approved in 2002 for a specific procedure.

A sequence of investigations found that it had been used extensively outside its approved indications, that complications including uncontrolled bone growth, male sterility and cancer risk had been under-reported in the published literature, and that the physicians who authored the favourable studies had received very large payments from the company. A 2011 issue of The Spine Journal was devoted entirely to the matter, concluding that the original publications had understated adverse events by a substantial margin.

The Senate Finance Committee conducted an investigation and reported in 2012 that Medtronic employees had participated in drafting the studies. The company commissioned independent reviews by Yale University researchers, which were published in 2013 and which found modest benefit and higher complication rates than the original literature had described. It paid US$85 million in 2012 to settle shareholder claims and substantial further sums to settle personal injury litigation.

Device recalls and consent decrees

The SynchroMed implantable drug infusion pump was the subject of a consent decree in 2015 requiring the company to halt manufacture of most units until manufacturing deficiencies were corrected, following repeated recalls over battery, motor and dosing faults.

The HeartWare HVAD was withdrawn in 2021. MiniMed insulin pump retainer rings were recalled in 2019 and remote controllers in 2018 and 2021, the latter over a cybersecurity vulnerability permitting unauthorised control of insulin delivery. Sprint Fidelis defibrillator leads, withdrawn in 2007 after fractures caused inappropriate shocks and a small number of deaths, affected approximately a quarter of a million patients and produced extensive litigation, in which the Supreme Court held in Riegel v. Medtronic in 2008 that federal premarket approval pre-empts state law claims, a decision that substantially limited patients' ability to sue manufacturers of approved devices and which has been criticised ever since.

Payments to physicians and marketing

The company has settled several False Claims Act actions concerning payments to physicians who used its products, including US$23.5 million in 2011 over payments disguised as post-market study fees, and has been the subject of scrutiny under the Physician Payments Sunshine Act, which requires disclosure of such payments and which was enacted partly in response to practices in the device industry.

The structural issue, which applies across the sector, is that a device's adoption depends on a small number of physicians who select it, that those physicians are frequently involved in its development and are legitimately compensated for that work, and that the boundary between paying for expertise and paying for use is difficult to police.

Taxation

The 2015 inversion was lawful and was criticised heavily in the United States as an abandonment of tax obligations by a company whose products are paid for substantially by American public health programmes. The company's position was that the arrangement was necessary to compete with rivals already domiciled outside the United States and that it would not reduce its American employment or investment, which it has not.

Corporate affairs

Mission and culture

Earl Bakken's Mission, written in 1960 and unchanged since, consists of six tenets beginning with the contribution to human welfare through biomedical engineering. Every employee receives a bronze medallion and attends a ceremony at which the Mission is explained, a practice that has continued for six decades and which the company regards as central to its identity.

The annual Medtronic Holiday Programme, at which patients whose lives have been changed by the company's devices address the employees who made them, has been held since the 1960s and is among the more unusual corporate traditions in American business.

The company's culture has been described as engineering-led and comparatively conservative, and its Minnesota location has made it the centre of a medical device cluster that includes Boston Scientific's operations, Abbott's former St. Jude Medical business and a very large number of suppliers and start-ups, an agglomeration comparable in its field to what Silicon Valley is in computing.

Leadership

Chief executives have been Earl Bakken, Dale Olseth, Winston Wallin, William George, from 1991 to 2001, who wrote extensively on authentic leadership and became a professor at Harvard Business School, Arthur Collins, Bill Hawkins, Omar Ishrak, from 2011 to 2020, who came from General Electric Healthcare, and Geoff Martha since 2020.

Employees and locations

The company employs approximately 95,000 people. Its operational headquarters and largest concentration are in the Minneapolis area, with substantial operations in Ireland, principally Galway, which has become a centre of medical device manufacture; in Puerto Rico; in Mexico; in Switzerland; in Singapore; and in China, where it operates manufacturing and where the government's volume-based procurement programme, which requires very large price reductions in exchange for guaranteed volumes, has substantially reduced margins across the industry.

Finances

Medtronic reported revenue of approximately US$33 billion in fiscal 2025. Its growth has been slower than that of its principal competitors for much of the past decade, in the low single digits, which has been the central criticism of its management and the motive for the reorganisation into operating units and for the separation of the diabetes business.

Its margins are high by the standards of most industries and moderate by those of medical technology, and it has increased its dividend annually for more than forty consecutive years.

Competition

Medtronic competes with Abbott Laboratories in cardiac rhythm, structural heart, diabetes and vascular; with Boston Scientific in rhythm, ablation, structural heart and endoscopy; with Johnson and Johnson MedTech in surgery, orthopaedics and electrophysiology; with Edwards Lifesciences in heart valves; with Stryker and Zimmer Biomet in spine and orthopaedics; with Intuitive Surgical in robotics; with Dexcom, Abbott, Tandem and Insulet in diabetes; and with a very large number of specialist companies in individual product categories.

The industry's competitive dynamic differs from pharmaceuticals in important respects. Devices are not protected by a single patent whose expiry is known, but by a combination of patents, manufacturing process, clinical evidence, surgeon familiarity and hospital contracting, which makes positions durable and displacement slow. A surgeon trained on one company's instruments will not change without reason, and the company's training programmes and clinical support exist to reinforce that.

The pressures on the industry are hospital purchasing consortia, which have consolidated and bargain accordingly; national procurement programmes, of which China's is the most severe; and the general constraint on health expenditure in every developed country.

Assessment

Medtronic invented an entire category of medicine. Before 1957 a person whose heart's conduction system failed had no treatment; the pacemaker is among the small number of devices that reliably converts a fatal condition into a manageable one, and several million people are alive because of it.

Its subsequent record is that of a very large, technically serious company that has grown more slowly than its competitors for a decade and whose management has been occupied with correcting that. Its difficulties have been specific rather than systemic: a diabetes business that fell behind on sensor technology, a robotic surgery entry that arrived late against an entrenched incumbent, a series of recalls that constrained approvals, and an organisational structure that had become too centralised for the number of markets it served.

Its strengths are the cardiac rhythm and neuromodulation franchises, in which its position is long established and its technology genuinely advanced; the Micra and Evolut products, which represent real clinical improvement; and an organisation whose stated purpose, read from a bronze medallion to every new employee, is more closely connected to what it actually does than most corporate mission statements manage.