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Boston Scientific stock crumbled Wednesday after the medical technology company posted a "rare, off-color performance" featuring lagging revenue and earnings, and lowered expectations going forward.XMeanwhile, shares of Thermo Fisher Scientific (TMO) dipped a fraction despite a solid first quarter. Thermo Fisher earnings and sales beat expectations, and the medical technology company raised its 2019 outlook.On the stock market today, Boston Scientific stock tumbled 1.3% to close at 35.44. Thermo Fisher stock slid 0.9% to close at 261.56. Shares of medical technology companies have been under pressure recently after a "Medicare-for-All" proposal from Democratic presidential candidate Sen. Bernie Sanders.Boston Scientific Earnings, Sales Lag EstimatesFor the first quarter ended March 31, Boston Scientific adjusted earnings of 35 cents per share rose 6.1% vs. the year-earlier period. But earnings lagged estimates from analysts polled by Zacks Investment Research by a penny.Sales rose 6.3% organically to $2.49 billion, but that missed predictions for $2.54 billion.The first-quarter report was key for Boston Scientific stock. Over the last month, the Food and Drug Administration told Boston Scientific and Danish company Coloplast to stop selling a medical device used to repair pelvic organ prolapse in women due to safety issues.Further, the FDA is also questioning the safety of medical devices coated in a drug called paclitaxel. A slew of medical technology companies including Boston Scientific, SurModics (SRDX), Medtronic (MDT) and Becton Dickinson (BDX) sell these devices to treat cardiovascular conditions.But what surprised Wall Street about Boston Scientific earnings was that revenue "came in light across the board," Evercore analyst Vijay Kumar said in a note to clients. The biggest miss came from cardiovascular sales, which were 2% below expectations at $972 million. Those sales grew 6.8% organically.RBC Capital Markets analyst Brandon Henry noted neuromodulation sales growth slowed more than expected. These devices from Boston Scientific, Medtronic and Abbott Laboratories (ABT) emit electrical signals to mask pain. In the quarter, $186 million in neuromodulation sales grew 12.4% organically.Boston Scientific Stock Suffers On Guidance CutThe medical technology company narrowed its guidance for 2019. On an adjusted basis, Boston Scientific earnings are expected to come in at $1.54-$1.58 per share. Previously, the company guided to earnings of $1.53-$1.58 a share. Analysts had called for $1.56 per share.Boston Scientific also guided to 7%-8% organic growth for the year vs. its prior outlook for 7.5%-8%. That would put sales around $10.5 billion to $10.6 billion for the full year, RBC's Henry said. Analysts projected $10.63 billion in sales. Henry noted the sales guidance was in line with his own estimates.For the second quarter, the medical technology company guided to 6%-7% organic revenue growth. Boston Scientific earnings are expected to be 37-39 cents per share, a penny lower than analysts polled by Zacks at the midpoint.What could help Boston Scientific, however, is FDA approval of the medical technology company's transcatheter heart-valve replacement system, Lotus Edge, for patients with severe aortic stenosis unable to undergo surgery. Boston Scientific grabbed that long-awaited approval late Tuesday.The Lotus Edge will rival TAVR systems from Medtronic and Edwards Lifesciences (EW). Late Tuesday, Edwards said its first-quarter TAVR sales grew 8%, or 10% on an underlying basis. That lagged the global procedure growth rate "due to a modest year-over-year share decline."Thermo Fisher Earnings, Sales Top EstimatesFresh off Waters Corporation's (WAT) earnings disappointment, Thermo Fisher earnings confirmed strength in the life science tools market, Evercore analyst Ross Muken said in his report to clients. Thermo Fisher earnings and sales beat estimates, and the medical technology company raised its 2019 outlook."Thermo Fisher's first-quarter beat and raise confirms our view that the tools end market remains healthy and they are still as dominant as ever," he said. "Core growth came in at 7%, which is below the second half of 2018 levels (as expected), but impressive given the comparable quarter was 300 basis points tougher."During the first quarter, Thermo Fisher earnings of $2.81 per share, on an adjusted basis, advanced 12% to top the average estimate of analysts polled by Zacks for $2.74. Sales for the quarter ended March 30, rose 4.6% to $6.13 billion, beating expectations for $6.02 billion.The medical technology company also raised its outlook for 2019. Thermo Fisher earnings are expected to be $12.08-$12.22 per share, vs. its prior estimate for $12-$12.20 a share. That outlook for Thermo Fisher earnings was a penny below the consensus at the midpoint.Thermo Fisher also sees $25.17 billion to $25.47 billion in full-year sales, up from its previous outlook for $24.88 billion to $25.28 billion. That would account for 3%-5% growth over 2018, the medical technology company said. Analysts estimated $25.21 billion in full-year revenue.Follow Allison Gatlin on Twitter at @IBD_AGatlin.YOU MIGHT ALSO LIKE:This Medical Supplier Toppled Below A Breakout On Its Earnings LagWhy This Migraine-Focused Biotech Stock Could Be The Next TakeoverMarketSmith: Research, Charts, Data And Coaching All In One PlaceWant More IBD Insights? 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