I've watched key, core engineers and technical leaders work for US and European companies, develop their next generation products, then turn around and design and develop essentially the exact same thing for the Chinese market. They then build a company, in China, that makes essentially the same product, but for the Chinese Market, and with Chinese investors, etc.
Examples: Thoratec/Abbot Heartmate III & CH Biomedical
Auris/Verb/J&J Robotic & Digital Solutions & Renovo Surgical
The ironic thing, is that some of these companies after success in China are working to sell and be competitive in the US and Europe.
It's not even secret or under the table anymore, it's overt and largely accepted as the way it is in our industry. A brave new world.
The other factor, is that it is very very difficult for a foreign company to do business and protect their assets in China, so often the wise companies don't even try. They often just license their stuff for the Chinese market to a Chinese company. That way they at least have a chance of not having it all just stolen.