Why Intuitive Surgical, Inc. (NASDAQ: ISRG) stock is under pressure

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Intuitive Surgical, Inc. (NASDAQ: ISRG) stock under 4% on 24th January, 2020 (as of 10:31 am GMT-5; Source: Google finance) despite decent fourth quarter of FY 19 update.

The company has reported the net income for the quarter of $358 million compared to $293 million in the prior-year quarter. The company has ended the fourth quarter with cash and investments of $5.8 billion compared to $5.4 billion at September 30, 2019.

Meanwhile, the company is in the Phase 1 launch of da Vinci SP and the company is working to expand its clinical clearances and build SP products at scale. In the fourth quarter, the company has installed six systems to bring the installed base of SP to 44. Going forward for SP, the company is in discussion with FDA regarding data requirements for a colorectal indication. ISRG expect this to require an IDE trial that includes follow up analysis, which means the company do not expect the third indication for SP in the U.S. in 2020.

ISRG in the fourth quarter of FY 19 has reported the adjusted earnings per share of $3.48, while the adjusted revenue growth of 22 percent to $1.28 billion in the fourth quarter of FY 19

Moreover, during the fourth quarter 2019, the procedures has increased about 19% compared with the fourth quarter of 2018 and increased about 11% compared to the last quarter. Procedure growth is due to the growth of the general surgery in the U.S. and urology worldwide. Fourth quarter system placements of 336 systems rose 16% compared with 290 systems last year and rose 22% compared with 275 systems last quarter. The company has expanded the installed base of da Vinci systems by 12% to about 5,582 systems. This growth rate is compared to 12% in the last quarter and 13% last year.

Instrument and accessory revenue increased 24% to $671 million compared to last year, which is higher than procedure growth, mainly due to customer buying patterns and increased usage of the advanced instruments. Systems revenue for the fourth quarter of 2019 grew 22% to $416 million, compared to the fourth quarter of 2018 and an increase of 23% compared with last quarter

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