Trucks choke boulevards lined with factories, many bearing the names of American-born companies: Medtronic, Hill-Rom, DJO Global and Greatbatch Medical. Inside, Mexican workers churn out millions of medical devices each day, from intravenous bags to artificial respirators, for the global market.

Nearly all Americans with pacemakers and people worldwide walk around with parts from here.

When President Donald Trump threatens to redo trade deals and slap steep taxes on imports, he focuses largely on car companies and makers of air conditioners. But the medical devices business makes a particularly revelatory case study of the difficulties of untangling global trade.

America imports about 30 percent of its medical devices and supplies. The trouble is, there are barriers to importing the jobs tied to making them. To ensure the safety of products that often end up inside the human body, medical devices are strictly regulated and require lengthy approvals from the Food and Drug Administration and other inspectors.

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