When Ramsay Health Care boss Craig McNally got a phone call in the middle of the night last Monday while asleep in his Norway hotel, it could only be one thing: suitor KKR & Co was playing hardball again.

It was meant to be the biggest M&A deal of the year, valuing its equity at $20 billion, or nearly $30 billion including debt, but has turned into a train wreck. After the better part of two years stalking the nation’s largest private hospitals operator, the global PE firm is still empty-handed.