Ratchet is an Autobot in the Universe conflict.
"All life is precious."
Unlike his Generation 1 alternate universe counterpart, Ratchet's patients have a problem relating to him outside of his role as a doctor. Quiet and modest, he's not much of a social animal. However, he's the best there is at what he does. You'd have to look long and hard to find a better surgeon than Ratchet. He often performs this duty at the risk of his own personal exhaustion. Ratchet is dedicated solely to his work.
Fiction
3H Universe Comics
Ratchet is one of countless Transformers who had been pulled from his timestream and imprisoned within the Cauldron arena inside the shattered remains of Unicron. When Trailbreaker and Silverbolt managed to arrange a prison break, Ratchet was part of the group that managed to flee. But instead of being transported back to his home dimension, he found himself on the technorganic Cybertron that Silverbolt called home.
Though distressed and confused at this turn of events, Ratchet quickly got to work on Sideswipe, attempting to find a way to remove the Unicron virus that had infected the Transformers who had been sent into combat within the Cauldron.
Toys
Ratchet is a redeco of the Robots in Disguise X-Brawn toy, transforming into an emergency-response Mercedes-Benz ML320 SUV. He has a spring-loaded missile launcher in his right arm. He is technically named "Autobot Ratchet" to better protect the trademark on the name "Ratchet".
He and Inferno were released with the "sub-line" name "Machine Robot Rescue" printed on their cards in a fairly blatant attempt by Hasbro to prevent rival toy company Bandai from marketing one of their Japanese transforming robot toy lines in the US under that name. Whether or not this was ultimately neccessary is debatable, as the line was never brought to the US.