DOTmed Business News 03-12

76

Transcript of DOTmed Business News 03-12

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systems, and discover the ANDA Medical difference.

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Read all about it!

iPad owners, downloadthe free app for

DOTmed Business News magazine today.Get the current issue and

the entire archive.Search term: DOTmed

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Contents

38 AORN 2012 Update Q & A with AORN 2011-2012 president Anne Marie Herlehy

47 DOTmed 100

Find out who’s in for 2012

Features

Industry Sector Reports

20 OR Suites LED lights and hybrid rooms populate the sector

30 Endoscopy/Arthroscopy The start of endoscopy’s reign

40 Sterilizers

A hospital’s first line of defense against infection

58 Anesthesia Information management systems sales fuel market

MARcH 2012

Visit DOTmed.com/news for breaking news daily, to comment on stories in this issue, to participate in surveys and more.

38

Read all about it!

iPad owners, downloadthe free app for

DOTmed Business News magazine today.Get the current issue and

the entire archive.Search term: DOTmed

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20

58

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Departments

In Every Issue

Contents

6 Letter from the Editor – Alright, this is the last time . . .

8 Letter from the Online Editor – Budget battle

déjà vu 9 Top Stories from Our Daily Online News

15 Upcoming Events calendar

15 In the Next Issue

15 This Month’s Exclusive Online content

16 New Products Showcase

18 Hospital Spotlight – NewYork Presbyterian

63 Show and conference Spotlight – AORN 59th congress

66 This Month’s Featured Auctions

67 Marketplace & classifieds

72 Blue Book Price Guide

64 Medical Museum The Wales Endoscope

65 This Month in Medical History “coca-Koller” and the discovery of local anesthesia

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Philip F. Jacobus

Sean Ruck212-742-1200 Ext. [email protected]

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Sean Collins212-742-1200 Ext. [email protected]

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DOTmedbusiness news I march 2012 www.dotmed.com6

As you’re probably aware, during February’s American Medical As-

sociation’s conference in Washington D.C., the acting Centers for

Medicare and Medicaid Services administrator, Marilyn Tavenner,

announced that the government would consider extending the Oct. 13

2012 deadline for the upgrade to ICD-10. Since that announcement, the

deadline extension has been confirmed, although no firm date has been

set. The original deadline of October, 2011 was extended after providers

voiced concerns during a public comment period in 2008.

Although a second extension provides a welcome relief for practitio-

ners already burdened with a flood of developments delivered by health

care reform, one wonders if it would just be better to rip off the Band-Aid

now. Yes, more time gives the opportunity to get things in order. But more

time also provides the chance for further developments to crop up – in-

creasing the burden.

I would hope CMS takes a hard look at Europe’s adoption of ICD-10 to

determine how great the benefit would be to our own health care system.

As European health care practices have been using ICD-10 for years

already, there should be a wealth of information on its return. Obviously,

the greater the return, the greater the argument for pushing forward with current deadlines. Conversely, minimal benefit

should translate into possibly keeping the Band-Aid on and sticking to other deadlines with bigger payoffs. It should be

interesting to watch how this plays out.

In other developments to follow, DOTmed Business News is now available as a free app in Apple’s iTunes Store.

We’re very proud to offer the magazine to iPad users and

we welcome feedback on your experience with our maga-

zine in that digital format.

Of course, our print offering will continue to be delivered

and in this issue we deliver industry sector reports on en-

doscopy updates, the evolving OR suite, safer anesthesia

delivery devices and the latest on sterilizers. We also reveal

the DOTmed 100 for 2012 and have a chat with AORN

president Anne Marie Herlehy.

As always, feedback, story ideas and any other

suggestions are welcome.

Until next issue!

Sean Ruck

Editor-in-Chief

[email protected]

DOTmed Business News

LETTER FROM THE EDITOR

Alright, this is the last time . . .

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Download the free DMBN Magazine app in Apple’s iTunes Store.

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2012 CONFERENCE

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DOTmedbusiness news I march 2012 9DOTmedbusiness news I march 2012 www.dotmed.com8

hile the most-read story over the past 30

days is not a repeat, you should still be able

to recognize it. That’s because it’s about the fiscal year 2013 federal budget, which is similar to the 2012 federal budget, covered in these pages last year, in one important

regard. Namely, the new budget contains the same proposed plans for imag-ing that drew an outcry from radiologists last year: it calls for a bump in the assumed utilization rate (meaning lower Medicare payments to providers) and for doctors to get permission from some-body, probably a radiology benefits manager, before ordering an exam.

Just like in 2011, radi-ologists don’t seem happy about the proposals, and the American College of Radiology said it’ll work to get them stricken from the final budget, which is what happened in the last

go-around. It remains to be seen, of course, if the script plays out the same way this time.

If you have a news tip or comment, write to me at [email protected].

Brendon Nafziger Online Editor DOTmed Business News

Budget battle déjà vuLetter from the onLine editor

Read it online first: visit www.dotmed.com/news/

and sign up for our weekly news blast.

Subscribe now

Your e-mail here

Sign up for our exclusive weekly news e-mail.

Visit www.dotmed.com/newsand join our 45,000 + other subscribers

TOP STORIES FROM DOTmed ONLINE NEWS ExclusivE contEnt • uPDAtED DAilY At www.dotmed.com/news

• Obama FY ‘13 budget includes imaging cuts, prior authorization

• CyberKnife arrives in Mexico

• Nuance talks bringing Watson, Siri-like tech to medicine

• ‘Not safe’ X-ray unit sold online leads to FDA investigation

• Varian books $50 million Russia proton order

• Medical device user fee deal hailed as “game changer”

• PACS market to see double-digit growth

• AMA happy by ICD-10 delay; HIMSS, not so much

• McKesson acquires peerVue

• GOP freshmen take aim at med device tax

Top 10 online stories (from Jan. 17 – Feb. 10)

he Obama administration’s proposed $3.8 trillion federal

budget for fiscal 2013 includes a Medicare requirement that would make doctors get prior authoriza-tion before ordering an advanced imaging test. It also could slash millions in reimbursements to doctors, as it proposes lowering payments for advanced imaging equipment to account for “higher levels of utilization.”

“The rapid growth in the number and intensity of imaging services over the last decade raises con-cerns about whether these services are being used appropriately,” said a budget outline released in February by the Department of Health and Human Services.

The proposed budget was quickly slammed by medical imag-ing device manufacturers, who said it was “recklessly limiting access” to imaging for seniors and could slow down job creation in the industry. “Reducing seniors’ access to early disease detection by cut-ting imaging reimbursements and adding an unworkable prior au-thorization system will negatively impact health outcomes, lead to more health care spending and is contrary to the president’s goal of spurring advanced manufacturing in communities across our country,” Gail Rodriguez, the new executive director of OEM lobby the Medical Imaging & Technology Alliance, said in a statement.

In the proposed budget, the Centers for Medicare and Medic-aid Services said that although the growth of imaging has “mediated somewhat” in recent years, Medi-

care payments under the physician fee schedule have shot up dra-matically over the past decade. As a result, CMS said it was listening to MedPAC suggestions that imag-ing might be “mis-priced.” Starting next year, the agency proposes to cut payments for advanced imag-ing equipment to take into account higher rates of utilization, in a move it says will bring in $40 billion in sav-ings for fiscal 2013 and $820 million over the next decade.

In addition, under one of 16 anti-waste proposals, which aim to cut out about $3.6 billion in wasteful or fraudulent spending over the next 10 years, the agency is proposing to

set up a prior authorization scheme.“This proposal would adopt

prior authorization for the most ex-pensive imaging services to ensure that these services are used as intended and protect the Medicare program and its beneficiaries from unwarranted use,” the HHS budget outline said.

The CMS said that many private health insurers have already adopt-ed similar plans to “manage spend-ing growth,” and that the Govern-ment Accountability Office asked CMS to consider prior authorization plans among others to control the rise in spending. That said, the

provision was listed as having “no budget impact.”

Barriers to care While the specifics of the imag-ing proposals haven’t been fully released, American College of Ra-diology spokesman Shawn Farley said they appear similar to what was proposed in last year’s federal budget, and which was ultimately defeated.

“They were bad policy last year, and they’re bad policy this year,” he told DOTmed News.

If the payment cuts designed to take into account higher levels of utilization are an increase on

the assumed utilization rate, as it seems to be, the current rate, at 75 percent, is “already too high,” Farley said. ACR said a Radiology Business Management Association survey from 2009 suggests the ac-tual average utilization rate is closer to 54 percent.

“Basically, these cuts place bar-riers to care in front of seniors that don’t need to be there, and could result in dialing back the clock on advances made against cancer and other serious illnesses,” Farley said.• Online: dotmed.com/dm18065

Proposed federal budget includes imaging cuts, prior authorization scheme

$820 millionAmount the utilization rate changes are expected to save Medicare over the next decade.

DMBN March 2012 Online News.indd 8-9 3/1/2012 12:07:03 PM

Page 11: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 9DOTmedbusiness news I march 2012 www.dotmed.com8

hile the most-read story over the past 30

days is not a repeat, you should still be able

to recognize it. That’s because it’s about the fiscal year 2013 federal budget, which is similar to the 2012 federal budget, covered in these pages last year, in one important

regard. Namely, the new budget contains the same proposed plans for imag-ing that drew an outcry from radiologists last year: it calls for a bump in the assumed utilization rate (meaning lower Medicare payments to providers) and for doctors to get permission from some-body, probably a radiology benefits manager, before ordering an exam.

Just like in 2011, radi-ologists don’t seem happy about the proposals, and the American College of Radiology said it’ll work to get them stricken from the final budget, which is what happened in the last

go-around. It remains to be seen, of course, if the script plays out the same way this time.

If you have a news tip or comment, write to me at [email protected].

Brendon Nafziger Online Editor DOTmed Business News

Budget battle déjà vuLetter from the onLine editor

Read it online first: visit www.dotmed.com/news/

and sign up for our weekly news blast.

Subscribe now

Your e-mail here

Sign up for our exclusive weekly news e-mail.

Visit www.dotmed.com/newsand join our 45,000 + other subscribers

TOP STORIES FROM DOTmed ONLINE NEWS ExclusivE contEnt • uPDAtED DAilY At www.dotmed.com/news

• Obama FY ‘13 budget includes imaging cuts, prior authorization

• CyberKnife arrives in Mexico

• Nuance talks bringing Watson, Siri-like tech to medicine

• ‘Not safe’ X-ray unit sold online leads to FDA investigation

• Varian books $50 million Russia proton order

• Medical device user fee deal hailed as “game changer”

• PACS market to see double-digit growth

• AMA happy by ICD-10 delay; HIMSS, not so much

• McKesson acquires peerVue

• GOP freshmen take aim at med device tax

Top 10 online stories (from Jan. 17 – Feb. 10)

he Obama administration’s proposed $3.8 trillion federal

budget for fiscal 2013 includes a Medicare requirement that would make doctors get prior authoriza-tion before ordering an advanced imaging test. It also could slash millions in reimbursements to doctors, as it proposes lowering payments for advanced imaging equipment to account for “higher levels of utilization.”

“The rapid growth in the number and intensity of imaging services over the last decade raises con-cerns about whether these services are being used appropriately,” said a budget outline released in February by the Department of Health and Human Services.

The proposed budget was quickly slammed by medical imag-ing device manufacturers, who said it was “recklessly limiting access” to imaging for seniors and could slow down job creation in the industry. “Reducing seniors’ access to early disease detection by cut-ting imaging reimbursements and adding an unworkable prior au-thorization system will negatively impact health outcomes, lead to more health care spending and is contrary to the president’s goal of spurring advanced manufacturing in communities across our country,” Gail Rodriguez, the new executive director of OEM lobby the Medical Imaging & Technology Alliance, said in a statement.

In the proposed budget, the Centers for Medicare and Medic-aid Services said that although the growth of imaging has “mediated somewhat” in recent years, Medi-

care payments under the physician fee schedule have shot up dra-matically over the past decade. As a result, CMS said it was listening to MedPAC suggestions that imag-ing might be “mis-priced.” Starting next year, the agency proposes to cut payments for advanced imag-ing equipment to take into account higher rates of utilization, in a move it says will bring in $40 billion in sav-ings for fiscal 2013 and $820 million over the next decade.

In addition, under one of 16 anti-waste proposals, which aim to cut out about $3.6 billion in wasteful or fraudulent spending over the next 10 years, the agency is proposing to

set up a prior authorization scheme.“This proposal would adopt

prior authorization for the most ex-pensive imaging services to ensure that these services are used as intended and protect the Medicare program and its beneficiaries from unwarranted use,” the HHS budget outline said.

The CMS said that many private health insurers have already adopt-ed similar plans to “manage spend-ing growth,” and that the Govern-ment Accountability Office asked CMS to consider prior authorization plans among others to control the rise in spending. That said, the

provision was listed as having “no budget impact.”

Barriers to care While the specifics of the imag-ing proposals haven’t been fully released, American College of Ra-diology spokesman Shawn Farley said they appear similar to what was proposed in last year’s federal budget, and which was ultimately defeated.

“They were bad policy last year, and they’re bad policy this year,” he told DOTmed News.

If the payment cuts designed to take into account higher levels of utilization are an increase on

the assumed utilization rate, as it seems to be, the current rate, at 75 percent, is “already too high,” Farley said. ACR said a Radiology Business Management Association survey from 2009 suggests the ac-tual average utilization rate is closer to 54 percent.

“Basically, these cuts place bar-riers to care in front of seniors that don’t need to be there, and could result in dialing back the clock on advances made against cancer and other serious illnesses,” Farley said.• Online: dotmed.com/dm18065

Proposed federal budget includes imaging cuts, prior authorization scheme

$820 millionAmount the utilization rate changes are expected to save Medicare over the next decade.

DMBN March 2012 Online News.indd 8-9 3/1/2012 12:07:03 PM

Page 12: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 11DOTmedbusiness news I march 2012 www.dotmed.com10

A prototype of the as-yet-unnamed app will make its public debut at HIMSS 2012 in late February, but it will be a quiet one.

“We’ll carry a few of them around in our pockets,” Joe Petro, senior vice president of research and development with Nuance Healthcare, told DOTmed News.

Nuance made its name in speech recogni-tion software. And the product, which Nuance plans to release commercially later this year, takes advantage of what Petro calls the “next evolutionary step” in the technology.

“We think we have the speech dictation down. We’re chewing at the upper edge of ac-curacy, getting from 96 to 99 percent,” he said.

“Most of the stuff you see from an inno-vation perspective in 2012 will be about exploiting that understanding. From the understanding perspective, it’s almost untapped.”

Language processing In essence, the technology would work by breaking down spoken language, categorizing it and mapping the catego-ries onto a series of medically oriented databases - for instance, for drug inter-action (as in our antibiotic and antide-pressant example) - and then returning a context-specific result.

As it acts more like a reference book than a computer-aided diagnosis tool, the technology likely wouldn’t fall under the Food and Drug Administration’s pur-view. Still, the company hopes doctors can find it helpful. The drug interaction use case is, in fact, rather important here, as Petro said Nuance sees a lot of potential for this technology in helping doctors navigate the perilous waters of pharmacology.

“One of the big challenges [for doc-tors] is keeping up with all the phar-maceutical stuff,” he said. Treatment protocols and dosing information are frequently updated and quite complex, so having a ready reference to aid physi-cians in prescribing drugs to someone already taking others could be useful.

Of course, this feat, rapidly and intel-ligently finding answers to technical questions, bumps up pretty close to the turf of another much-ballyhooed techno-

Time to page Dr. Watson? Nuance looks to bring smart tech to medicineA doctor is about to prescribe an antibiotic, but is a bit worried it might interact with an antidepressant her patient is currently tak-ing, Wellbutrin. So, what does she do? It’s possible, in the near future, she might simply pull out her phone and ask it.

At the recently wrapped up 2012 Consumer Electronics Show, Nuance brought Android phone owners a program similar to Siri, the popular voice-command search feature released by Apple in its most recent iPhone rollout. The free app, Dragon Go!, is strictly for consumer use. But Nuance, which licenses some of its tech-nology for Siri (Nuance and Apple are pretty closed-lipped about specifics), also has a medical version in the works.

onLine neWS www.dotmed.com/news

Product develoPment850 w. Hind Drive #205 • Honolulu, HI 96821 • Phone 808.373.7048 • 808.373.7017

manufacturing/SuPPort3000 Church Road #102 • Oakdale, PA 15071 • Phone: 412.490.0891 • FAX: 412.490.0896

• arcHive, PrefetcH and forWard: FILEROOM AND FILECLERK

• BroWSer-BaSed WorKStation: CONNECTWEB

• client-Server WorKStation: VIEWBOX, MAMMO VIEWBOX

• Burn cdS, Print filmS: TECH WORKSTATION

• advanced StudY diStriBution: DICOM DISTRIBUTOR

• forWard from/to remote Site: DICOM FORWARD

• merge/SPlit StudieS: STUDY MANAGER

You’ve developed your workflow over time. You’ve fine-tuned it to suit your specific needs. You know how you want things set up. That’s why we start every job with a detailed workflow analysis. Your needs, not our PACS/RIS, will drive the configuration.

Unlike the big guys, we never expect you to make changes to accommodate our PACS/RIS. In eleven years, we haven’t met a workflow we couldn’t accommodate.

A C SPmodular

Productivity Tools for Imaging

connect imaginga neW generation of modular PacS/riS

How do you want PACS/RIS to fit into your operations?

Visit us at connectimaging.com or contact [email protected]

logical figure from last year that Nuance also is working on: Watson.

The Dr. Watson dilemma Watson, originally called DeepQA when developed by IBM, can rapidly browse through a vast store of infor-

mation. Like Johnny Five, the speed-reading robot in the 1980s comedy “Short Circuit,” Watson works fast, and can page through about 200 million pages of data in three seconds, according to a presentation Nuance gave at the Radiological Society of North America’s an-nual meeting last fall.

Using all the data at its electronic fingertips, plus its hypothesis-testing programming that helps it puzzle out a user’s “intent,” Watson can then provide answers to specific questions. Famously, this was done answering trivia on the TV show “Jeopardy.” But almost immedi-ately, people began wondering if there were medical applications for it.

It turns out Nuance has been working with IBM (again, the company is cagey about specifics), doing research on using a Watson-like technology in medicine. Petro said when they originally approached IBM about using Watson, the first idea bandied about was essentially “Dr. Watson”: having the software answer specific questions related to specific diagnoses. But Petro said they decid-ed it could be an “unnatural interaction” for physicians,

“Most of the stuff you see from an innovation perspective in 2012 will

be about exploiting [language] understand-

ing. From the under-standing perspective, it’s almost untapped.”

onLine neWS www.dotmed.com/news

DMBN March 2012 Online News.indd 10-11 3/1/2012 12:07:07 PM

Page 13: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 11DOTmedbusiness news I march 2012 www.dotmed.com10

A prototype of the as-yet-unnamed app will make its public debut at HIMSS 2012 in late February, but it will be a quiet one.

“We’ll carry a few of them around in our pockets,” Joe Petro, senior vice president of research and development with Nuance Healthcare, told DOTmed News.

Nuance made its name in speech recogni-tion software. And the product, which Nuance plans to release commercially later this year, takes advantage of what Petro calls the “next evolutionary step” in the technology.

“We think we have the speech dictation down. We’re chewing at the upper edge of ac-curacy, getting from 96 to 99 percent,” he said.

“Most of the stuff you see from an inno-vation perspective in 2012 will be about exploiting that understanding. From the understanding perspective, it’s almost untapped.”

Language processing In essence, the technology would work by breaking down spoken language, categorizing it and mapping the catego-ries onto a series of medically oriented databases - for instance, for drug inter-action (as in our antibiotic and antide-pressant example) - and then returning a context-specific result.

As it acts more like a reference book than a computer-aided diagnosis tool, the technology likely wouldn’t fall under the Food and Drug Administration’s pur-view. Still, the company hopes doctors can find it helpful. The drug interaction use case is, in fact, rather important here, as Petro said Nuance sees a lot of potential for this technology in helping doctors navigate the perilous waters of pharmacology.

“One of the big challenges [for doc-tors] is keeping up with all the phar-maceutical stuff,” he said. Treatment protocols and dosing information are frequently updated and quite complex, so having a ready reference to aid physi-cians in prescribing drugs to someone already taking others could be useful.

Of course, this feat, rapidly and intel-ligently finding answers to technical questions, bumps up pretty close to the turf of another much-ballyhooed techno-

Time to page Dr. Watson? Nuance looks to bring smart tech to medicineA doctor is about to prescribe an antibiotic, but is a bit worried it might interact with an antidepressant her patient is currently tak-ing, Wellbutrin. So, what does she do? It’s possible, in the near future, she might simply pull out her phone and ask it.

At the recently wrapped up 2012 Consumer Electronics Show, Nuance brought Android phone owners a program similar to Siri, the popular voice-command search feature released by Apple in its most recent iPhone rollout. The free app, Dragon Go!, is strictly for consumer use. But Nuance, which licenses some of its tech-nology for Siri (Nuance and Apple are pretty closed-lipped about specifics), also has a medical version in the works.

onLine neWS www.dotmed.com/news

Product develoPment850 w. Hind Drive #205 • Honolulu, HI 96821 • Phone 808.373.7048 • 808.373.7017

manufacturing/SuPPort3000 Church Road #102 • Oakdale, PA 15071 • Phone: 412.490.0891 • FAX: 412.490.0896

• arcHive, PrefetcH and forWard: FILEROOM AND FILECLERK

• BroWSer-BaSed WorKStation: CONNECTWEB

• client-Server WorKStation: VIEWBOX, MAMMO VIEWBOX

• Burn cdS, Print filmS: TECH WORKSTATION

• advanced StudY diStriBution: DICOM DISTRIBUTOR

• forWard from/to remote Site: DICOM FORWARD

• merge/SPlit StudieS: STUDY MANAGER

You’ve developed your workflow over time. You’ve fine-tuned it to suit your specific needs. You know how you want things set up. That’s why we start every job with a detailed workflow analysis. Your needs, not our PACS/RIS, will drive the configuration.

Unlike the big guys, we never expect you to make changes to accommodate our PACS/RIS. In eleven years, we haven’t met a workflow we couldn’t accommodate.

A C SPmodular

Productivity Tools for Imaging

connect imaginga neW generation of modular PacS/riS

How do you want PACS/RIS to fit into your operations?

Visit us at connectimaging.com or contact [email protected]

logical figure from last year that Nuance also is working on: Watson.

The Dr. Watson dilemma Watson, originally called DeepQA when developed by IBM, can rapidly browse through a vast store of infor-

mation. Like Johnny Five, the speed-reading robot in the 1980s comedy “Short Circuit,” Watson works fast, and can page through about 200 million pages of data in three seconds, according to a presentation Nuance gave at the Radiological Society of North America’s an-nual meeting last fall.

Using all the data at its electronic fingertips, plus its hypothesis-testing programming that helps it puzzle out a user’s “intent,” Watson can then provide answers to specific questions. Famously, this was done answering trivia on the TV show “Jeopardy.” But almost immedi-ately, people began wondering if there were medical applications for it.

It turns out Nuance has been working with IBM (again, the company is cagey about specifics), doing research on using a Watson-like technology in medicine. Petro said when they originally approached IBM about using Watson, the first idea bandied about was essentially “Dr. Watson”: having the software answer specific questions related to specific diagnoses. But Petro said they decid-ed it could be an “unnatural interaction” for physicians,

“Most of the stuff you see from an innovation perspective in 2012 will

be about exploiting [language] understand-

ing. From the under-standing perspective, it’s almost untapped.”

onLine neWS www.dotmed.com/news

DMBN March 2012 Online News.indd 10-11 3/1/2012 12:07:07 PM

Page 14: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 DOTmedbusiness news I march 2012www.dotmed.com12 13

and that it could “tread too closely on what is ultimately their clinical decision-making.” What doctors want, Petro suggests, is a consultative process, where they work with the software to get deeper and deeper levels of information about medical topics, such as common treatments for psoriasis.

“We call it spiraling,” he said. “You can imagine spiral-ing down and converging on a single body of information to provide final answers to support the conclusion the physician has made.” • Online: dotmed.com/dm17906

Medical device user fee deal hailed as “game changer”The Food and Drug Administration reached a tenta-tive deal with the medical device industry on user fees. The deal would let the FDA collect more than half a billion dollars from companies over the next five years, double what it got in the last user fee renewal, but in return would agree to a faster, more transparent device review process.

“We believe this agreement is a potential game changer for the FDA, for the industry and most impor-tantly, for patients and the American economy,” Stephen Ubl, president of the Advanced Medical Technology Association, one of the three trade lobbies that helped negotiate the deal, said on a conference call in Febru-ary. The other two lobbies involved in the deal were the Medical Imaging & Technology Alliance and the Medical Device Manufacturers Association.

The 10-year-old user fee system lets the FDA draw money from device companies to pay for its review of new devices, and has so far been renewed for two five-year blocks. However, the medical device industry has long complained that the agency is slow and inefficient, and that their businesses suffer as new devices languish in bureaucratic limbo while they await the agency’s approval.

But after a year of talks, and after the agency missed its self-imposed Jan. 15 deadline to submit a deal to Congress, the FDA and industry representatives have, hammered out a compromise: one that raises money for the FDA, while speeding up review times for industry.

And the effects of the deal could be felt by the imag-ing sector, too. Lindsay Morris, acting executive director of MITA, which represents manufacturers of CT and MRI scanners, among other equipment, said these changes could help bring radiation therapy and imaging devices to market quicker.

“The increase in resources to the agency under this agreement corresponds to a more timely approval pro-cess, which will benefit patients and the manufacturers

who develop these innovative technologies,” she said in a statement.

No device left behind The new agreement calls for the FDA to meet a variety of goals by fiscal year 2017, the last year of the pro-posed program, which is a reauthorization of a plan that first began in 2002 with the passage of the Medical Device User Fee and Modernization Act.

Among the new goals is what AdvaMed calls “leave no submission behind,” which requires the FDA to meet with companies if submissions run into trouble. The deal also requires the FDA to hire a third-party consulting or-ganization, as yet unnamed, to audit its review process. Also in the spirit of transparency, the agreement requires the FDA to provide quarterly and annual reports on prog-ress made towards meeting its review time goals.

Perhaps most important to the industry is the way those review time goals will now be handled. Previously, the FDA’s goals were centered on “FDA days” -- meaning the number of days the FDA spent reviewing the product, typically set at around 90 days for a device cleared in the 510(k) pathway, which includes much new imaging equipment. However, the 90 days only applies to the time

www.dotmed.com/newsonLine neWS

400 High Grove Blvd. • Glendale Heights, IL USA 60139 • +1.630.307.7200 • [email protected]

Are You Seeing Everything You Should?

© 2010 ETS-Lindgren

www.ets-lindgren.com/mri

The quality of an image is based on two things: MRI shielding and system technology.

ETS-Lindgren’s MRI shielding solutions have been helping doctors and technicians to see scans with more depth and detail at hospitals and clinics around the world for over 20 years. Visit our website and see for yourself. We welcome your inquiries and the opportunity to serve you.

Unfors Xi -Platinum Plus edition

The Unfors Concept

Accurate result Pocket sized10s to learn

www.unfors.com

Unfors Instruments, Inc.48 Anderson Avenue, Suite 1New Milford, CT 06776, USA

Phone: +1 (860) 355-2588Fax: +1 (860) 350-2664E-mail: [email protected]

The Unfors Xi, now in its Platinum Plus Edition, is the leading system for diagnostic x-ray multiparameter measurements on all modalities. Thousands of users have experienced the benefits of this high-capacity, pocket-sized instrument. With the Platinum Plus edition, the Unfors Xi takes another evolutionary leap in diagnostic QA systems.

Pocket sized – Easy to use – Accurate. We call it the Unfors Concept. You can call it productivity.

the FDA spends reviewing the data; if the agency asks for more information, which often happens, it pauses that countdown, even as the actual calendar days fly by.

Now, the new plan also calls for the agency to com-mit to a reduction in average total review time – that is, the time from the filing of the application to the final decision from the agency.

“We think that will have the net effect of reducing total review time, the most important measurement you can make,” Ubl said.

On the call, Janet Trunzo, AdvaMed’s executive vice president, technology and regulatory affairs, who helped lead the negotiations with the FDA, said the process would ramp up from fiscal 2013, when the new rules

take effect, to fiscal 2017, the end of the proposed pro-gram. By 2017, for instance, the final average total for a 510(k) would be 124 calendar days, she said.

More staff On the FDA’s end, the agreement gives the agency $595 million over the next five years, a boost over the $287 million it was earmarked through the program in the last reauthorization, although less than the $800 million or so the agency was originally asking, according to minutes of meetings hosted on the agency’s website.

One use of the money will be increasing staff: in an announcement, MITA said the agency would hire 200 new full-time-equivalent workers, including 140 device reviewers, with the aim of also lowering the ratio of man-agers to reviewers at the agency.

However, although the deal was approved in princi-ple by the trade groups and by the agency, details, such as fee structure, have to be worked out. The deadline for finalizing the agreement is Sept. 30, when the five-year program’s last reauthorization expires and needs to be renewed. • Online: dotmed.com/dm17981

www.dotmed.com/newsonLine neWS

User fee by the numbersFDA gets Medical device companies get

$595 million 124 calendar day average over 5 years total review time for 510(k) application by 2017

200 new full-time 140 device reviewers equivalent workers

DMBN March 2012 Online News.indd 12-13 3/1/2012 12:07:11 PM

Page 15: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 DOTmedbusiness news I march 2012www.dotmed.com12 13

and that it could “tread too closely on what is ultimately their clinical decision-making.” What doctors want, Petro suggests, is a consultative process, where they work with the software to get deeper and deeper levels of information about medical topics, such as common treatments for psoriasis.

“We call it spiraling,” he said. “You can imagine spiral-ing down and converging on a single body of information to provide final answers to support the conclusion the physician has made.” • Online: dotmed.com/dm17906

Medical device user fee deal hailed as “game changer”The Food and Drug Administration reached a tenta-tive deal with the medical device industry on user fees. The deal would let the FDA collect more than half a billion dollars from companies over the next five years, double what it got in the last user fee renewal, but in return would agree to a faster, more transparent device review process.

“We believe this agreement is a potential game changer for the FDA, for the industry and most impor-tantly, for patients and the American economy,” Stephen Ubl, president of the Advanced Medical Technology Association, one of the three trade lobbies that helped negotiate the deal, said on a conference call in Febru-ary. The other two lobbies involved in the deal were the Medical Imaging & Technology Alliance and the Medical Device Manufacturers Association.

The 10-year-old user fee system lets the FDA draw money from device companies to pay for its review of new devices, and has so far been renewed for two five-year blocks. However, the medical device industry has long complained that the agency is slow and inefficient, and that their businesses suffer as new devices languish in bureaucratic limbo while they await the agency’s approval.

But after a year of talks, and after the agency missed its self-imposed Jan. 15 deadline to submit a deal to Congress, the FDA and industry representatives have, hammered out a compromise: one that raises money for the FDA, while speeding up review times for industry.

And the effects of the deal could be felt by the imag-ing sector, too. Lindsay Morris, acting executive director of MITA, which represents manufacturers of CT and MRI scanners, among other equipment, said these changes could help bring radiation therapy and imaging devices to market quicker.

“The increase in resources to the agency under this agreement corresponds to a more timely approval pro-cess, which will benefit patients and the manufacturers

who develop these innovative technologies,” she said in a statement.

No device left behind The new agreement calls for the FDA to meet a variety of goals by fiscal year 2017, the last year of the pro-posed program, which is a reauthorization of a plan that first began in 2002 with the passage of the Medical Device User Fee and Modernization Act.

Among the new goals is what AdvaMed calls “leave no submission behind,” which requires the FDA to meet with companies if submissions run into trouble. The deal also requires the FDA to hire a third-party consulting or-ganization, as yet unnamed, to audit its review process. Also in the spirit of transparency, the agreement requires the FDA to provide quarterly and annual reports on prog-ress made towards meeting its review time goals.

Perhaps most important to the industry is the way those review time goals will now be handled. Previously, the FDA’s goals were centered on “FDA days” -- meaning the number of days the FDA spent reviewing the product, typically set at around 90 days for a device cleared in the 510(k) pathway, which includes much new imaging equipment. However, the 90 days only applies to the time

www.dotmed.com/newsonLine neWS

400 High Grove Blvd. • Glendale Heights, IL USA 60139 • +1.630.307.7200 • [email protected]

Are You Seeing Everything You Should?

© 2010 ETS-Lindgren

www.ets-lindgren.com/mri

The quality of an image is based on two things: MRI shielding and system technology.

ETS-Lindgren’s MRI shielding solutions have been helping doctors and technicians to see scans with more depth and detail at hospitals and clinics around the world for over 20 years. Visit our website and see for yourself. We welcome your inquiries and the opportunity to serve you.

Unfors Xi -Platinum Plus edition

The Unfors Concept

Accurate result Pocket sized10s to learn

www.unfors.com

Unfors Instruments, Inc.48 Anderson Avenue, Suite 1New Milford, CT 06776, USA

Phone: +1 (860) 355-2588Fax: +1 (860) 350-2664E-mail: [email protected]

The Unfors Xi, now in its Platinum Plus Edition, is the leading system for diagnostic x-ray multiparameter measurements on all modalities. Thousands of users have experienced the benefits of this high-capacity, pocket-sized instrument. With the Platinum Plus edition, the Unfors Xi takes another evolutionary leap in diagnostic QA systems.

Pocket sized – Easy to use – Accurate. We call it the Unfors Concept. You can call it productivity.

the FDA spends reviewing the data; if the agency asks for more information, which often happens, it pauses that countdown, even as the actual calendar days fly by.

Now, the new plan also calls for the agency to com-mit to a reduction in average total review time – that is, the time from the filing of the application to the final decision from the agency.

“We think that will have the net effect of reducing total review time, the most important measurement you can make,” Ubl said.

On the call, Janet Trunzo, AdvaMed’s executive vice president, technology and regulatory affairs, who helped lead the negotiations with the FDA, said the process would ramp up from fiscal 2013, when the new rules

take effect, to fiscal 2017, the end of the proposed pro-gram. By 2017, for instance, the final average total for a 510(k) would be 124 calendar days, she said.

More staff On the FDA’s end, the agreement gives the agency $595 million over the next five years, a boost over the $287 million it was earmarked through the program in the last reauthorization, although less than the $800 million or so the agency was originally asking, according to minutes of meetings hosted on the agency’s website.

One use of the money will be increasing staff: in an announcement, MITA said the agency would hire 200 new full-time-equivalent workers, including 140 device reviewers, with the aim of also lowering the ratio of man-agers to reviewers at the agency.

However, although the deal was approved in princi-ple by the trade groups and by the agency, details, such as fee structure, have to be worked out. The deadline for finalizing the agreement is Sept. 30, when the five-year program’s last reauthorization expires and needs to be renewed. • Online: dotmed.com/dm17981

www.dotmed.com/newsonLine neWS

User fee by the numbersFDA gets Medical device companies get

$595 million 124 calendar day average over 5 years total review time for 510(k) application by 2017

200 new full-time 140 device reviewers equivalent workers

DMBN March 2012 Online News.indd 12-13 3/1/2012 12:07:11 PM

Page 16: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 DOTmedbusiness news I march 2012www.dotmed.com14 15

iServiceQuality MRI service – the cool choice

MRI

For further information contact us directly:Tel: +1 732.850.9323 Email: [email protected] www.oxford-instruments.com/mri

Unbeatable international field service for magnets, cold heads and helium compressors – expertise you can trustChoose Oxford Instruments – our 50 years experience with magnets means you get the very best service and technical support available. Make the cool choice!

iServiceQuality MRI service – the cool choice

For further information contact us directly:Tel: +1 732.850.9323 Email: [email protected] www.oxford-instruments.com/mri

Unbeatable international field service for magnets, cold heads and helium compressors – expertise you can trustChoose Oxford Instruments – our 50 years experience with magnets means you get the very best service and technical support available. Make the cool choice!

For further information contact us directly:Tel: +1 877.434.4304 +1 732.850.9323Email: [email protected]/mri

iServiceQuality MRI service – the cool choice

www.oxford-instruments.com/mri

For further information contact us directly:Tel: +1 732.850.9323 Email: [email protected]

Unbeatable international field service for magnets, cold heads and helium compressors – expertise you can trustChoose Oxford Instruments – our 50 years experience with magnets means you get the very best service and technical support available. Make the cool choice!

See us at RSNA Booth #804 Hall D

iServiceQuality MRI service – the cool choice

www.oxford-instruments.com/mri

For further information contact us directly:Tel: +1 732.850.9323 Email: [email protected]

Unbeatable international field service for magnets, cold heads and helium compressors – expertise you can trustChoose Oxford Instruments – our 50 years experience with magnets means you get the very best service and technical support available. Make the cool choice!

See us at RSNA Booth #804 Hall D

www.dotmed.com/newsonLine neWS www.dotmed.com/newsonLine neWS

McKesson acquires peerVue

McKesson bought radiology workflow and communi-cations solutions provider peerVue Inc. in a move the Fortune 500 company said would extend its portfolio and address site-specific needs. Terms of the deal, announced in early February, weren’t disclosed.

Joe Biegel, vice president, product management and product marketing of McKesson’s enterprise medi-cal imaging division, said acquisition was partly driven by the growing market for a “flexible workflow solution” in diagnostic imaging. But he also hinted at plans of expanding Sarasota, Fla.-based peerVue’s technology outside of radiology.

“While peerVue’s team has a strong focus in the ra-diology segment, we believe the core technology devel-oped by the team could easily be applied into other clini-cal domains in the future and we are quite excited about the potential to build up solutions in some other domains closely related to radiology,” Biegel told DOTmed News. • Online: dotmed.com/dm18036

GE is the “leading player” in the PACS market with 16 percent market share, according to a recent GlobalData report. Forecasted value of PACS sector by 2017 is ex-

pected to be $5.4 billion, GlobalData says• Online: dotmed.com/dm17856

GE Healthcare’s sweet 16

coming in April:

Industry Sector Reports:• C-arm – Our

annual review of recent developments.

• Special Procedures: Cath/Angio – These rooms for improve-ment are expanding their specialties.

• Injectors & Contrast Agents – New technology, new concerns.

Features:• Nanomedicine

update – Cancer killers don’t come any smaller.

• IDN Summit Preview – We offer a glimpse at this year’s gathering.

INDUSTRYSECTOR

REPORTS

Apri l 2012

Your Industry Source for Health Care and Equipment Coverage

The C-Arm Issue

Upcoming EventsPITTCON Conference & Expo 2012March 11 – March 15Orlando, Fla.

Dubai Pharmeceutical & Technologies ExhibitionMarch 12 – March 14Dubai, U.A.E.

Medtec EuropeMarch 13 – March 15Stuttgart, Germany

MD&M Southern Regional SeriesMarch 14 – March 15Fort Worth, Texas

Biotech WorldMarch 20 – March 22Moscow, Russia

International Vision Expo & Conference East 2012March 22 – March 25New York, N.Y.

China MedMarch 23 – March 25Beijing, China

AORNMarch 26 – March 28New Orleans, La.

Arab Lab – The ExpoMarch 26 – March 29Dubai, U.A.E.

MedExpo KenyaMarch 31 – April 2Nairobi, Kenya

DMBN March 2012 Online News.indd 14-15 3/1/2012 12:07:19 PM

Page 17: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 15

PITTCON Conference & Expo 2012March 11 – March 15, Orlando, Fla.

Dubai Pharmeceutical & Technologies ExhibitionMarch 12 – March 14, Dubai, U.A.E.

Medtec EuropeMarch 13 – March 15, Stuttgart, Germany

MD&M Southern Regional SeriesMarch 14 – March 15, Fort Worth, Texas

Biotech WorldMarch 20 – March 22, Moscow, Russia

International Vision Expo & Conference East 2012March 22 – March 25, New York, N.Y.

China MedMarch 23 – March 25, Beijing, China

AORNMarch 26 – March 28, New Orleans, La.

Arab Lab – The ExpoMarch 26 – March 29, Dubai, U.A.E.

MedExpo KenyaMarch 31 – April 2, Nairobi, Kenya

Upcoming EventsIn a saga stretching nearly four years, the final chap-

ter of the STERIS SYSTEM 1 processor recall is set to

close on August 2, 2012. DOTmed News offers a look

back at the issues and a look at how STERIS is mak-

ing strides in replacing the SYSTEM 1 processor with

the SYSTEM 1E Liquid Chemical Sterilant Processing

System. We also look at how the new system has been

received by the market. Read the timeline and the latest

updates online at: www.dotmed.com/news/18224 or

type “DM18224” into any search window on the site.

Exclusively Online This Month

Industry Sector Reports:C-arm Our annual review of recent developments.

Special Procedures: Cath/Angio These rooms for improvement are expanding their specialties.

Injectors & Contrast Agents New technology, new concerns.

Features:Nanomedicine update Cancer killers don’t come any smaller.

IDN Summit Preview We offer a glimpse at this year’s gathering.

INDUSTRYSECTOR

REPORTS

Coming in April:

Page 18: DOTmed Business News 03-12

www.dotmed.com

to view the full product description, enter the online code following the story. Have a new product? Send your press release to [email protected].

CORENTEC CO., LTD., Launches CORENTEC AMERICA, INC.Corentec Co., Ltd., announced that the company is now offering its orthopedic products in the U.S. with the launch of Corentec America, Inc.

The portfolio of products include artificial hip and knee joint replacement products, and spine implants, for orthopedic Implant solutions.

Products available immediately, include Total Hip, and Bi-Polar Hip Joint Implants, and a Pedicle Screw System. A Total Knee Joint Implant solution is expected to receive FDA clearance in Q1, 2012. Additional products for Hip, Knee and Spine are in the FDA clearance process, and should be available in the U.S. in 2012.

• Online: dotmed.com/dm18054

NEW PRODUCT SHOWCASE

NPSNEW PRODUCTS SHOWCASE

NEW PRODUCT SHOWCASE

EW100-UVGI Ergonomic WorkstationS&S X-Ray/S&S RADX /dba S&S Technology has recently received a patent for its EW100-UVGI Ergonomic Workstation & Keyboard Sanitizer. A pullout drawer with UV lamps extends over the keyboard area to provide sanitizing that will eliminate the H1N1 virus and at the same time, lockout operation of the table mechanism. The table is available in single or dual elevating table configurations and numerous other options.

• Online: dotmed.com/dm17826

DOTmedbusiness news16

Nvision VLE Imaging SystemNinePoint Medical, Inc., an-nounced it has received 510(k) clearance to market its Nvision VLE Imaging System. The system is indicated for use as an imaging tool in the evaluation of human tissue microstructure by providing two-dimensional, cross sectional, real-time depth visualization. The Nvision VLE Imaging System is the first volumetric optical coherence tomography (OCT) device cleared by the FDA for endoscopic imaging that uses a circumferential scanning technique and an automatic pullback to generate cross sectional and longitudinal images simultaneously in real-time.

• Online: dotmed.com/dm17795

Page 19: DOTmed Business News 03-12

NEW PRODUCT SHOWCASE

NEW PRODUCT SHOWCASE

Advancement-Assisted Single-Use Colonoscopy SystemLast month, invendo medical announced the company received 510(k) clearance for its C20 colonoscopy system including the SC20 single-use colonoscope. The invendoscope SC20 has several features that are new to the field of colonoscopy:* it is a single-use colonoscope with a working channel* uses a computer-assisted gentle drive technology* all endoscopic functions are performed using a handheld device and* it reduces forces on the colon wall

A clinical trial with the company’s colonoscope delivered convincing results with a >98% cecal intubation rate and lesions detected in 41% of screening subjects. No device-related adverse events were observed during the study.

• Online: dotmed.com/dm18180

Xper Flex Cardio Physiomonitoring system Philips Healthcare announced the release of the Xper Flex Cardio Physiomonitoring system, a hemodynamic cardiac monitoring solution used to facilitate invasive investi-gation of heart and vascular disease.

The Xper Flex Cardio Physiomonitoring system offers 12-lead interpretation of the resting ECG in addition to 16-lead analysis.

It also comes equipped with integrated Fractional Flow Reserve functionality and a DXL ECG Algorithm analysis capability that uses multiple steps to produce precise and consistent ECG statements. Additionally, the system has Culprit Artery Detection-a technology that provides suggestions on the probable site of an occlusion prior to a cath procedure, assisting with procedure planning-and patented ST Maps that provide a graphical indication of ST elevation.

• Online: dotmed.com/dm17876

DOTmedbusiness news I march 2012 17

PRIMA T CR Digtial X-ray Tabletop UnitFUJIFILM Medical Systems U.S.A., Inc. recently introduced the FCR Prima T, the latest addition to the FCR Prima family. The Prima T comes complete with a CR reader, an electronic viewing workstation and an archiving system.

“It’s one of the smallest table top system on the mar-ket (22” x 21.5” x 15”) enabling one person to install and transport,” says Eddie Massetti, Manager, Distributor Sales at Fujifilm. “This compact design eliminates the need for designated floor space and at just 86 pounds, it can be installed on nearly any desk or table top.”

• Online: dotmed.com/dm18037

Xpress CR Mammography Konica Minolta Medical Imaging USA announced on Feb. 19th that the FDA has cleared the Xpress CR Digi-tal Mammography upgrade for sale. The clearance specifically applies to the company’s CP1M 18 x 24 and 24 x 30 cassettes and the use of the CS 3 control station with the REGIUS 190 and 210 readers.

The upgrade utilizes a Cesium Bromide phosphor receptor.

The CS-3 Control station offers an imaging platform that includes specialized imaging tools for CR, DR and also Mammography imaging applications. Special-ized Mammography algorithms include advanced skin line detec-tion and chest wall masking.

• Online: dotmed.com/dm17871

Page 20: DOTmed Business News 03-12

HOSPITAL SPOTLIGHT

Year founded: 1998Number of beds: 2,409Number of Employees: 25,520Hospital: CEO Steven J. Corwin, M.D.

Noteworthy distinctions: In 1998, The New York Hospital (founded in 1771) publicly announced its full-asset merger with The Presbyterian Hospital (founded in 1868) to create NewYork-Presbyterian Hospital. Today, NewYork-Presbyterian Hospital is the nation’s largest not-for-profit, non-sectarian hospital. It is the number one hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including 12,797 deliveries and 195,294 visits to its emergency departments.

Affiliations: The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Medical centers: NewYork-Presbyterian Hospital/ Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork- Presbyterian/Morgan Stanley Children’s Hospital, NewYork- Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division.

CEO Steven J. Corwin, M.D.

NewYork Presbyterian/ Columbia University Medical Center operating room.

Neonatal Intensive Care Unit-Morgan Stanley Children’s at NewYork Presbyterian/Columbia

NewYork Presbyterian/ Weill CornellMedical Center operating room

Perleman Heart Institute at New York Presbyterian/Weill Cornell

DMBN March Hospital Spotlight.indd 2-3 3/1/2012 10:12:43 AM

Page 21: DOTmed Business News 03-12

HOSPITAL SPOTLIGHT

Year founded: 1998Number of beds: 2,409Number of Employees: 25,520Hospital: CEO Steven J. Corwin, M.D.

Noteworthy distinctions: In 1998, The New York Hospital (founded in 1771) publicly announced its full-asset merger with The Presbyterian Hospital (founded in 1868) to create NewYork-Presbyterian Hospital. Today, NewYork-Presbyterian Hospital is the nation’s largest not-for-profit, non-sectarian hospital. It is the number one hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including 12,797 deliveries and 195,294 visits to its emergency departments.

Affiliations: The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Medical centers: NewYork-Presbyterian Hospital/ Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork- Presbyterian/Morgan Stanley Children’s Hospital, NewYork- Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division.

CEO Steven J. Corwin, M.D.

NewYork Presbyterian/ Columbia University Medical Center operating room.

Neonatal Intensive Care Unit-Morgan Stanley Children’s at NewYork Presbyterian/Columbia

NewYork Presbyterian/ Weill CornellMedical Center operating room

Perleman Heart Institute at New York Presbyterian/Weill Cornell

DMBN March Hospital Spotlight.indd 2-3 3/1/2012 10:12:43 AM

Page 22: DOTmed Business News 03-12

INDUSTRY SEcTOR REPORT

DOTmedbusiness news I march 2012 www.dotmed.com20

LED lights and hybrid rooms populate the OR sectorBy Joanna Padovano

INDUSTRYSECTOR

REPORTS

Page 23: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 21

More and more, technologically advanced hospi-tals are implementing hybrid operating rooms — a mixture of catheterization lab and tradi-

tional OR suite. And advancements don’t come cheaply.In today’s market, a typical general surgery table is

going to set a hospital back around $40,000, estimates Charly Dalbert, director of vocational services, stable business and business development for TRUMPF Medi-cal Systems. Depending on the complexity of the table’s functions, the price could be closer to $120,000, says Cynthia Jefferson, marketing manager of lights and booms for MAQUET Medical Systems USA. Typical LED operating room light systems cost between $25,000 and $27,000 on average, says Steve Palmer, TRUMPF’s direc-tor of marketing.

According to “Operating Room Equipment - Global Op-portunity Assessment, Competitive Landscape and Market Forecasts to 2017,” a report published by Global Data in September 2011, the global operating room equipment mar-ket, valued at more than $770 million in 2010, is predicted to reach nearly $990 million by 2017. The U.S. operating

Beacon Surgical’s refurbished OR equipment

Page 24: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 www.dotmed.com22

room equipment market, which is the largest, was valued at $288.8 million in 2010. It is expected to increase at a compound annual growth rate of 3.9 percent to hit $377.2 million in 2017.

Much of this growth is driven by interest in hybrid ORs, the report says. But specifically, the market for OR tables will be fueled by rising de-mand for specialized surgical tables used for complicated operations, such as hip replacement surgeries. And the market for OR lights will see slight growth due to the transition from halogen to LED lights.

LED outshines halogenAs has been the case for some time now, the preference for halogen lights in the OR equipment has dimmed considerably since the technology’s heyday.

“Halogen is being phased-out,” says TRUMPF’s Palmer, who esti-mates that 95 percent of all major acute-care hospitals purchasing sur-gical lights are buying LED. “Prob-ably in about four, five years, you’ll be hard-pressed to see a new halogen surgical light being sold to the major hospitals.”

“For the past five years or so, we’ve seen a preference for LED surgi-cal lighting, especially as LEDs have become more efficient as the technol-ogy has evolved,” says Jake Isley, the product manager of Chromophare for Berchtold. “Surgeons appreciate the cool properties LEDs provide.”

There are several advantages to LED lights, with less heat generated being perhaps the most appreciated by those working under their shine. Older halogen lights, according to Palmer, generate more heat and have to filter out ultraviolet and infrared radiation, which is not always 100 percent effec-tive. “LEDs by nature do not have UV or IR characteristics to them,” he says.

Another benefit to LED lights is that they have an extremely long lifecycle. Halogen lights tend to last around 1,000 hours, meaning they typically need to be replaced on a monthly basis; LED lights, on the other hand, can last for more than 30,000 hours. “You’re going to get probably up to 10 years of life out of an LED, so you get rid of that reoccurring cost, which is always something that you have to take into consideration,” says Palmer.

A third favorable feature of LED lights is their ability to adjust color temperature in order to achieve supe-rior visualization based on the type of procedure being performed and/or what the surgeons prefer.

“When you talk about the sur-geon’s preference for a certain color temperature, you really have to put yourself in the position of the OR manager,” says Dave Rec-tor, TRUMPF’s director of marketing communications. “The OR manager is trying to satisfy different surgeons and obviously all the hospitals are competing for the best surgical talent. You can’t expect that all the surgeons at a given hospital are going to agree on what color temperature they pre-fer; it’s a subjective thing and it also has to do with what kind of surgery they specialize in. So the ability to change color temperature just changes the life of the OR manager in that now you have a light that every one of your surgeons can be happy with.”

THE POWER OF MAQUET:COMPREHENSIVE PRODUCTS

AND THERAPEUTIC SOLUTIONS

n VASOVIEW Endoscopic Vessel Harvesting

n CARDIOSAVE/Sensation Plus IAB Therapy

n CARDIOHELP System

n ACROBAT System for Off-Pump Cardiac

Surgery (OPCAB)

n YUNO OTN and MAGNUS Surgical Tables

n POWERLED Surgical Lighting

TRADITIONAL OR • CATHETERIZATION LAB • HYBRID ORMAQUET — The Gold Standard.

AT AORN 2012, VISIT MAQUET BOOTH #4523 www.maquetusa.com

n MODUTEC Ceiling Supply Units

n FLOW-i Anesthesia Delivery System

n SERVO-i and SERVO-s Ventilator Systems

n NAVA (Neurally Adjusted Ventilatory Assist) and

Edi Monitoring

n HEMASHIELD and INTERGARD Vascular Grafts

INDUSTRY SEcTOR REPORT

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Additionally, LED lights use lower power consumption, making them a more environmentally friendly alter-native to halogen.

Although LED lights are taking over on the new equipment side of the spectrum, halogen lights still have some shine in the refurbished market. “LEDs really haven’t hit the used mar-ket in a big way yet,” says Jerry Bur-ton, director of sales and marketing for refurbished surgical equipment dealer Beacon Surgical. “They’re start-ing to, but it’s slow and as they do, there’s a lot more cost involved, obvi-ously. They’re still in high demand, so it’s at a premium when they do hit the market.” Burton approximates that 98 percent of the refurbished lights he sells are still halogen.

The prices of refurbished OR lights, naturally, are significantly less than those of new. “[For] around $1,000 you could probably get a set of OR lights if they’re older and not in the best condition.”

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Some refurbished halogen lights could cost upwards of $8,000, he says, and refurbished LEDs are typi-cally twice that amount.

“Even though the halogens may not be quite what LEDs are, they’re still good lights that doctors have used for years,” says Burton. “If they can maintain those and keep them in good working order, then they can use that money for other areas of their budget that have been constrained.”

Burton says that most of his cus-tomers shopping for refurbished OR

lights are initially looking for LEDs, until they discover the cost; at which time they then decide to buy halo-gens instead.

New products at AORN CongressDuring the 2012 Association of periOp-erative Nurses’ Annual Congress being held in New Orleans March 26 -29, TRUMPF is going to launch the Tru-System 7000 mobile general surgical table. As mentioned by Rector, during the development stage of this product, the company collected a significant amount of clinician input for feedback on the design. “When this table is introduced, it is very much going to meet the market needs not because we say so, but because we let the market dictate it; the market says so,” he says.

Also at this year’s event, Berch-told will introduce the Chromophare F Class Surgical Lights, which use 104 customized LEDs and multiples that produce more than 650 over-lapping beams in the surgical field, according to Isley. “The F Class Sur-gical Lights use an energy efficient light source to power the light, while using reflection to create the depth of field and homogenous column of light that LEDs cannot produce on their own,” says James Townsend, Berchtold’s manager of research and development.

Homing in on hybrid ORsNowadays, more and more medi-cal facilities are offering hybrid OR solutions.

“More complex procedures, hy-brid procedures—involving several medical specialties, each with their own equipment and imaging needs—have given rise to the hybrid OR, where each specialty can perform their part of a complex procedure in a single room with all the products and functions that they would have in their own dedicated specialty room,”

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The U.S. operating room equipment market, which is the largest, was valued at $288.8 million in 2010. It is expected to increase at a compound annual growth rate of 3.9 percent to hit $377.2 million in 2017.

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DOTmedbusiness news I march 2012 27

says Walt Hoffman, group market-ing manager of hybrid OR therapy for MAQUET.

There’s a lot that goes into a hybrid OR installation; for starters, a facility needs to allocate a great deal of space in order to accommodate all of the bulky equipment that it requires. Dick Werner, product man-ager of vascular X-ray for Toshiba America Medical Systems, says that a hybrid OR is almost always bigger than a conventional OR and that it should be at least 900 square feet in size (traditional ORs are usually around 600 to 800 square feet).

Once a large enough room is designated for the construction of a hybrid OR, its infrastructure must be altered. “They have to put lead in the walls and ceiling, depending on what is in the adjacent spaces,” says Werner. “For instance, if there are offices above the room, then they have to protect the people sitting above that room from radiation just as they would adjacent wall space. So it makes the real estate more expen-sive because you have to prepare for the environment, not to mention the usual laminar airflow and clean sur-faces [standards] that any OR is held to these days.”

Not only does a hybrid OR need to be big; it also needs to have a well-conceived floor plan and easy-to-move equipment in order to maxi-mize workflow efficiency.

“The criticality is not room size, but the layout of the room, so that you create those paths for what we call ‘circulation,’” says Palmer.

“The most important things in any hybrid OR are patient access, anes-thesia access and room for operat-

ing,” says Sudhir Kulkarni, segment director of hybrid OR for Siemens Healthcare. “When necessary, the systems should be getting out of the way very quickly and very easily.”

There are many upsides to build-ing a hybrid OR, one of which is that it allows a hospital to attract high-end clinicians, who, in turn, bring in more patients.

The downside, of course, is the depths at which hospitals must reach into their pockets to fund the proj-ect. “The cost of equipping a hybrid

OR suite can vary from as little as $150,000 to up to several million, de-pending on how modern the surgical and imaging equipment is at the hos-pital,” says Hoffman. “New construc-tion can easily double that.”

According to Hoffman, although a hospital will need to dish out a large lump of cash to construct a hy-brid OR, they will most likely break even on their investment within the first few years. “By providing one operating room where more medi-cal specialties can

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perform procedures with all the specialized equipment and products that these surgical procedures require, the hybrid OR can actually reduce the demand for multiple specialty OR rooms,” he says. “By allowing medical specialty teams to treat the patient without the need to transport the patient, complications can be reduced and outcomes improved.”

Hybrids will continue to evolveThe popularity of hybrid ORs will continue to increase in the future, marrying the surgical and radiographic specialties in hospitals across the globe. “I believe that the hybrid operat-ing rooms [are] not only here to stay, but I think that’s going to grow,” says Siemens’ Kulkarni, noting that the company continues to see an increasing number of installations.

“The future of the OR suite sector is undoubtedly going to focus on integration and innovative technology,” says MAQUET’s Jefferson.

Jefferson says hospitals desire universal operating rooms to be utilized by all disciplines and surgery types. To make this happen, facilities want a versatile surgical workplace with products that can provide any type of surgeon with the lights, tables and devices they need. The goals of forward-thinking hospitals will be to incorporate the most advanced technologies, improve OR efficiency and improve patient outcomes.

Robert Popilock, manager of strategic alliances and hybrid OR for STERIS gets to the heart of the matter. “The potential of hybrid ORs is still in its adolescence,” he says.

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One Facility’s OR Story In any given OR suite at the NYU Langone Medical Center in New York, there are TRUMPF, KLM or STER-IS lights; Leica or Zeiss microscopes; and Skytron, STERIS, Osi, MAQUET, Berchtold or Jackson tables, depending on the type of procedure being performed.

“Our preference is to purchase or lease new equip-ment, but we are open to looking at refurbished equipment as it can be cost effective if the product meets our high clinical standards,” says Maureen Fitzpatrick, the hospital’s vice president of periopera-tive services.

“We will look at key factors including the age of the equipment, its current condition and its history of repairs. We also work closely with Clinical Engineer-ing and our department chairs to forecast what our new OR equipment needs will be.”

At the facility there is a designated Department of Biomedical Engineering worker who periodically evalu-ates OR equipment in order to determine whether or not repairs are necessary. If so, the equipment is either fixed by a third-party vendor or the OEM, depending on the existence of a service contract.

NYU Langone Medical Center features a Robotic Surgery Center, which provides robot-assisted mini-mally-invasive procedures in the areas of gynecology and urology, as well as general and cardiothoracic surgery. The center uses the da Vinci Si Surgical System, considered the most sophisticated robotic surgical technology to date.

In addition to the Robotic Surgery Center, the state-of-the-art facility offers a hybrid operating room, introduced last year. “The [hybrid] OR, located on the sixth floor of Tisch Hospital at NYU Langone, is comprised of a large operating room, control room, stationary X-ray technology, high-tech surgical table, three large high-definition plasma monitors, video cameras and three computer systems,” says Zaida I. Jacoby, the hospital’s director of periopera-tive services and director of the surgical technology program. “Physicians in the hybrid operating room can leverage its built-in X-ray imaging and video-integrated technology for minimally invasive surgical procedures on organs, arteries and veins. These high-powered images of the surgical field are visible in 3-D on high-definition plasma monitors.”

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Page 31: DOTmed Business News 03-12

DOTmed Registered OR Suite Sales & Service CompaniesFor convenient links to these companies, go to www.dotmed.com and enter [DM 18160] Names in boldface are Premium Listings.

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DGA Medical,LLC Doug Anderson Phoenix AZ enBio, Corp. Arthur Zenian Burbank CA Green Cross Medical/ GOMED G. John Oggel Camarillo CA •Ready Medical Lisa Vanesco Paramount CA JTec Surgical, Inc. Kevin Jones Santa Ana CA Toshiba America Medical Systems Dick Werner Tustin CA Asset Equip Store Debbie Rice Bradenton FL •Quest Medical Supply, Inc. Clinton Courson Longwood FL • Sunnex Inc Anders Utter St Petersburg FL Inex Surgical Camera & Power Repair, Inc. Danny Tipei Niles IL • • Beacon Surgical Jerry Burton Churubusco IN PRN Bob Gaw Fall River MA • Saffire Medical Alda Clemmey Taunton MA • •Action Products Janet Kaplan Hagerstown MD Medical Service Solutions, LLC Jacqueline Michaud Waldorf MD • Midbrook Medical Jamie Crowley Jackson MI MedRepair LLC Jerry Gebauer Portage MI Clinical Imaging Systems, Inc. Ryan Gilday Manalapan NJ • MAQUET Medical Systems USA Walt Hoffman Wayne NJ STS North America James Graham Hauppauge NY Biodex Medical Systems, Inc. Richard Schubert Shirley NY STERIS Corporation Robin Baum Mentor OH MedSource CES, Inc. Bob Adair Oklahoma City OK NUVO, Inc. Brett Mesina Erie PA Berchtold James Townsend Charleston SC TRUMPF Medical Systems Steve Palmer Charleston SC Monterrey Medical Equipment Juan Sandoval San Antonio TX Strategic Surgical Solutions, LLC James Volbracht New Berlin WI • Company - International Contact Name City State Certified DM100

ANDA Medical David Lapenat Ontario Canada • •Deans Medical Equipment Nasir Khan Peshawar Pakistan

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INDUSTRY SEcTOR REPORT

The start of endoscopy’s

reign Endoscopy at the

top of the market with arthroscopy following suit

By Diana Bradley

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DOTmedbusiness news I march 2012 31

When faced with surgery, it goes without say-ing that patients favor the most minimally invasive route. This is why physicians now

regard new and innovative endoscopic devices as the primary method of diagnosis and treatment ahead of imaging scans. Enabling access to hard-to-reach regions of the body, endoscopic procedures enhance patient outcomes and reduce hospital stay and recov-ery times. So it comes as little surprise that endos-copy is among the top growing sectors in the medical device industry.

Generating sales of $23.3 billion in 2010, the global market for endoscopy devices will rapidly grow to $49 billion by 2017 and $75.8 billion by 2022, forecasts business information provider visiongain’s Jan. report, “Endoscopy Devices: World Market Outlook 2012-2022.” The leader in the global rigid endoscopes market is Karl Storz, with a market share of 36 percent, followed by Olympus Medi-cal Systems Corp. with a 32 percent market share. Richard Wolf GmbH, Stryker Corporation and B. Braun Melsungen AG also have significant presence in the market, according to research firm GlobalData’s July report, “Rigid Endo-scopes - Global Pipeline Analysis, Competitive Landscape and Market Forecasts to 2017.” As of 2010, companies that accounted for 90 percent of the global market share for the flexible endoscopes market were Olympus, with a market share of 67 percent; followed by Fujifilm and Hoya, says GlobalData’s July report, “Flexible Endoscopes - Global Pipeline Analysis, Competitive Landscape and Market Forecasts to 2017.”

On the refurb side, Olympus has continued to triumph, with the most sought-after products being the Olympus Q160 series of scopes, according to Harvey Buxbaum, president of HMB Endoscopy Products.

“These scopes produce excellent full screen images with magnificent resolution, so the demand for the Q series is high,” he says. “However, supply is relatively low, thus keeping the prices from trending downward as the equipment ages.”

The endoscopy industry has also seen much consolida-tion in the past year. Mark Waite, CEO of the Portland, Maine-based Lighthouse Imaging Corporation, says one of the biggest stories was in September when scope repair company SterilMed was acquired by original equipment manufacturer Ethicon Endo-Surgery, a division of John-son & Johnson. He notes that a big chunk of the market’s consolidation is due to increased OR integration.

“A company like Karl Storz can go into a hospital and say, ‘We can outfit the whole OR with beds, lights, en-doscopy equipment and scopes,’” says Waite. “If you’re a company only focused on endoscopy equipment, you are probably not going to get designed into some of the bigger hospitals; you’re going to have to focus on a certain niche.”

Arthroscopic advantagesThe U.S. arthroscopy device market — a major contributor to the endoscopy market — is also set to experience mod-

erate growth through 2016, according to the Millennium Research Group, Inc.’s November report, “US Markets for Arthroscopy Devices 2012.” The market will double to over $4.2 billion by 2017, adds iData’s June 2011 report series on the markets for “U.S. Arthroscopic Devices” and “U.S. Soft-Tissue Repair.”

In 2010, knee and shoulder procedures dominated the over 4 million arthroscopies performed in the U.S.; how-ever, the hip arthroscopy segment is the fastest growing, according to the report. Small joint and hip arthroscopy procedure volumes have increased, along with shoulder arthroscopy procedures, says Dr. Simon Moyes, consultant orthopaedic surgeon at the Wellington Hospital in London.

“I perform a lot of ankle arthroscopy and suspect that instruments designed for accessing the posterior

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INDUSTRY SEcTOR REPORT

compartment of the ankle joint will evolve as will curved arthroscopic instruments to access the dome of the talus together with the evolution of the radio frequency probe,” he says. “In the hip, I see the evolution of more and more arthroscopic suturing techniques for labral repairs.”

In the U.S., an increasing number of sports-related in-juries and advancements will fuel the arthroscopy device market, according to Millenium’s report.

“Certainly more and more people indulging in sports are sustaining sport related injuries and the natural evolution of arthroscopic surgery means more and more arthroscopies are being performed,” says Moyes. “This is also fuelled by generally increased longevity of people in the west.”

Moyes cites radio frequency probes (probes which are more powerful and produce fewer bubbles in the joint therefore affording better visibility with less risk of thermal damage) from companies like Mitek; and Smith & Neph-ew’s platinum, multi-functional blades, as being the hottest commodities of the moment among arthroscopic surgeons.

Within the soft tissue and sports medicine market, com-panies such as Arthrex, ArthroCare, ConMed Linvatec, DePuy Mitek, Smith & Nephew and Stryker lead the mar-ket. Smith & Nephew and Arthrex lead the hip arthros-copy market, while Stryker recently launched its platform in a bid to gain market share in this growing segment.

Endoscopy utilization increases as cancer and obesity rates escalateThe U.S. represents the single largest regional endos-copy market worldwide and the market, along with American citizens, is growing. Demand for gastrointes-tinal endoscopy is rising, with many turning to gastric bypass and gastric banding to aid in their weight-loss as obesity rates soar.

Asia-Pacific represents the fastest growing regional market displaying a compound annual growth rate of 8.3 percent over a six-year historic analysis, according to research firm Global Industry Analysts, Inc.’s October report, “Endoscopy Systems - Global Strategic Business Report.”

With economies in Brazil, Russia, India and China on the rise, Visiongain’s report predicts that increased wealth will lead to a hike in health care spending, medical insur-ance coverage and adoption of westernized lifestyles — particularly diet. Consequently, obesity and cardiovascular disease instances will ramp up, resulting in an increase of laparoscopic weight-loss procedures.

But the major force driving the endoscopy equipment market will continue to be colonoscopy screenings, accord-ing to Buxbaum. With more than 1 million new cases of colorectal cancer reported each year worldwide, cancer is one of the leading reasons for surgery.

“Speaking for flexible endoscopy, it seems as if colon cancer awareness has increased the number of colonos-copy screenings and therapeutic colonoscopy procedures,” says Buxbaum. “In addition, the development of newer, less invasive endoscopic procedures for other gastrointes-tinal medical conditions, have also added to the number of procedures being performed.”

50 percent of Americans who should be screened for colon cancer avoid a colonoscopy, according to the Centers for Disease Control and Prevention’s most recent statistics. But the mortality rate can be reduced by up to 90 percent by colonoscopies and capsule endoscopies.

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annually growing 12.9 percent since 2007, notes research firm Kalorama Information’s January report.

Approved in the U.S. in 2000, capsule endoscopy is a way to see what is going on in the middle of the small in-testine, which scopes for colonoscopy and upper endosco-py cannot reach. A single capsule endoscopy costs around $1,000 and produces about 50,000 images for doctors to read within 30 to 90 minutes, which elevates the risk of missing something.

Brigham and Women’s Hospital in Boston and Tel Aviv University’s researchers are currently creating an MRI-guided capsule that provides images of the digestive tract. This technology may help ease fears associated with colonoscopy screenings. Researchers say the new device would improve upon current technology, combining the en-doscopes control and real-time imaging with the safety and ease of a pill. Steered with wireless and MRI technologies, the new capsule can swim with the magnetic current, with tails made out of copper coils and flexible polymer. It is still early days for the device, which still needs to undergo ani-mal testing and trials before entering mainstream treatment.

The tiny cameras on current capsule endoscopy technol-ogy only capture images at random intervals, rendering the technology ineffective in cancer screening. To confirm diagnosis, it is common for patients to require a second pro-cedure. Although the procedure is considered low-risk, about one percent of the time, the capsule has a chance of becom-ing lodged in the digestive tract, which may require removal with a scope or through surgery. But aside from obstacles with capsule endoscopy technology, human error is also a major issue. In a study published in the American Journal of Gastroenterology in January, researchers found that doc-tors who read results from pill cameras often fail to catch abnormalities. Doctors in the study were only able to detect between 43 percent and 47 percent of abnormalities, when looking at images in three of the four most commonly used reading modes. With the fourth reading mode, doctors only detected 26 percent of abnormalities. Researchers recom-mended that to counteract this issue, a second doctor should look at capsule endoscopy images to help avoid misses.

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INDUSTRY SEcTOR REPORT

Regardless of risks, the technology’s benefits to patients are considerable. As a non-invasive approach to diagnos-ing conditions in the small bowel and detecting small pathologies, the technology is also cost-effective, adminis-tered on an outpatient basis.

“As far as diagnostic equipment goes, I think pill cams are a big advancement,” says Chris Leman, senior vice president of refurb company, Scope Connection. “A pill can go virtually through the whole GI tract, providing images for diagnoses that were only accessible in the past through surgery.”

Major endoscopic capsule suppliers include Given Imaging – with its PillCam Capsule; and Olympus – who in September 2007, as part of the EnteroPro brand of products, launched the Endo Capsule for visualizing small bowel mucosa. Olympus’ product uses six LEDs, which offer automatic lighting, two images per second transmis-sion and an eight-hour recording time.

“There is talk that they are working on pill cameras with therapeutic capabilities,” Leman says. “Maybe small biopsies and things like that.”

New techniques and technologiesThere has been an increased development and interest in improving core imaging technologies through contrast enhancement, optical biopsy technologies and endoscopic ultrasound, explains Kurt Cannon, the vice president of

sales and marketing for Fujifilm Medical Systems U.S.A., Inc.’s Endoscopy Division.

“Two specific areas that come to mind are ablative therapies for Barrett’s esophagus, and device-assisted deep small bowel enteroscopy such as double balloon enter-oscopy,” adds Dr. Stephen Heller, associate professor of medicine at Temple University’s Division of Gastroenterol-ogy at Fox Chase Cancer Center, Philadelphia, Pa. “Double balloon enteroscopy has opened a new frontier of mini-mally invasive access to the small intestine, with the ability to diagnose and treat diseases of the small bowel which were previously directly accessible only via surgery.”

Another major development in endoscope technology has been the emergence of 3D high definition imaging. HD – previously only really known as a consumer term for TVs – has now crossed over into the medical technology industry. LED sources or bulbs are also more common-place in the market today. But these advancements come with higher price tags.

“In the case of a light source that is now using an LED source or bulb, the cost is justified because an LED source is going to last much longer, will stay brighter for longer and consumes a lot less power,” says Waite. “If you are able to pay slightly more at the purchase point and your savings are realized on an ongoing basis, that’s good business.”

The growing preference of disposable instruments over conventional re-usable instruments will also be a great aid to the endoscopy systems market.

“Disposables are in many ways easier to manage, as they cut down on disinfection costs and the specter of transmitting infection in the endoscopy unit,” says Heller.

As for the future of flexible endoscopic procedures, nat-ural orifice transluminal endoscopic surgery – a minimally invasive surgical procedure allowing access to internal organs using a flexible endoscope –is expected to extend flexible endoscopes’ capabilities for use in more advanced interventions and surgical procedures, enabling more sophisticated diagnosis and therapy options.

Safety and quality concernsA red flag has recently been raised regarding quality as-surance in endoscopy – and not just in the U.S. In October, it was discovered that a non-hospital clinic in Ottawa was not following proper cleaning and infection prevention procedures with its endoscopic equipment. Public health officials sent out more than 6,800 letters to residents indi-cating that patients might have been exposed to hepatitis B, hepatitis C or HIV due to the clinic’s carelessness. As of January, the Canadian Association of Gastroenterology has new Consensus Guidelines on Safety and Quality Indica-tors in Endoscopy, developed by a group of 35 Canadian, European and U.S.-based participants.

The quality of colonoscopy reporting and performance in daily clinical practice was also recently assessed by research-ers in the Netherlands, in a study printed in the January issue of “GIE: Gastrointestinal Endoscopy,” the American Society for Gastrointestinal Endoscopy’s scientific journal. While

DOTmedbusiness news I march 2012 www.dotmed.com34

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DOTmedbusiness news I march 2012 35

colonoscopy performance met the sug-gested standards, researchers found it varied considerably between endosco-py departments. The study highlighted the importance of implementing and monitoring quality indicators and guidelines to improve both colonos-copy reporting and performance.

In 2010, the Joint Commission (in their Elements of Performance for EC.02.04.01, EC.02.04.03) stated that endoscopes are to be tested before use. But according to Waite, many are not. He believes this glaring omission needs to be addressed.

“At the moment, a lot of atten-tion is being paid to endoscopes in general and how they are being used, now that they need to be tracked in the hospitals,” he explains. “And so that’s raised a lot of awareness in the hospitals’ clinical and biomedical engineering departments. They have started to look for tools to be able to track the scopes to measure quality, but there hasn’t really been anyone monitoring quality of endoscopes in the hospital.”

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scopes – the EndoBench Endoscope Image Quality Tester. The Endo-Bench measures a scope’s image quality using image processing or a

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machine vision system. Historically, instead of a com-puter, the human eye was relied upon to look at a target through the scope and make a qualitative or subjective assessment regarding the quality of the scope. Compa-nies making non-medical optics, including photography equipment have been using quantitative measurement metrics for years, according to Waite. But his company is the first to bring those measurement metrics to the medi-cal optics industry.

“What a technician sees at 8 a.m. is different than what the same technician sees at 4 p.m.; after 8 hours their eyes get tired,” says Waite. “That’s not really a repeatable assessment. But the EndoBench makes repeat-able measurements.”

Better-managing scopes and using quantitative means for measuring quality, Waite adds, also enables hospitals to save a significant amount of money.

Challenges: Regulations and legislationsThere is a “perfect storm” with regards to health care reform in the endoscopy market, according to Fuji’s Can-non. He notes that while health care reform has provid-ed easier access to colonoscopy screenings for patients, potential health care legislation drives down the reim-

bursement for performing colonoscopy screenings. There is an industry-driven demand for quality outcomes and benchmarking, but historic Centers for Disease Control and Prevention data indicates that the market demand that will exist for future colonoscopy screenings can-not be met by the current supply of product, room time and procedure time. Further to this, increasingly strict FDA regulations are slowing the clearance process for endoscopic equipment, which could impact the sector’s technological advancement. In addition, the proposed 2 percent tax on medical devices may begin to show an impact on the industry’s ability to support education, fund research and development and develop new tech-nologies in the U.S.

“In general, increasing regulations at the FDA are impacting the entire device manufacturing industry,” says Cannon. “Overall summary is that an increase in patient population with a potential decrease in reimbursement will certainly have an impact on the market sector.”

Despite these challenges, the future of the endoscopy devices market appears promising and has significant potential for growth and investment with the increasing demand for safer, less invasive therapies.

• Online: dotmed.com/dm18166

INDUSTRY SEcTOR REPORT

Page 39: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 37

DOTmed Registered Endoscopy/Arthroscopy Sales & Service CompaniesFor convenient links to these companies, go to www.dotmed.com and enter [DM 18166] Names in boldface are Premium Listings.

Company - Domestic Contact Name City State Certified DM100

Zgrum Medical Alberto Voli Tucson AZ • •Advanced Endoscopy Devices, Inc. Gayle Butler Canoga Park CA

Scope Connection Chris Leman Inglewood CA

Global Medical Sales and Repair Mark Charaf Long Beach CA •

Mediflex, Inc David Weiss Rancho Cucamonga CA

Requests International Ramon Manalo, Jr. Stevenson Ranch CA

SH Medical Corp Marcelo Salvade Doral FL • •American Medical Endoscopy Carolina Olivera Doral FL •

HMB Endoscopy Products Harvey Buxbaum Hollywood FL •

Quest Medical Supply, Inc. Clinton Courson Longwood FL • SH Medical Corp Marcelo Salvade Miami FL • •Danan Medical Systems Daniel Finerman Ormond Beach FL • • Advanced Endoscopy Solutions Bruce Mason Ormond Beach FL •

West Coast Medical Resources Randy Ware Seminole FL

MTM Medical Matt McRoberts Tequesta FL

PMR Medical Devices Tony Anzalone Wellington FL •

RRC Rigid Repair Center Todd Abrams Wellington FL

Authorized Acquisitions Scott Mattfeld Mokena IL

Alternative Source Medical Monte Montain Buffalo Grove IL •

Kingsbridge Healthcare Mike Solot Lake Forest IL •

Inex Surgical Camera & Power Repair, Inc Danny Tipei Niles IL •

Coast To Coast Medical Kevin Blaser Fall River MA

PRN Bob Gaw Fall River MA •

Medical Device Store Christine Marley Southbridge MA

Saffire Medical Alda Clemmey Taunton MA • •MedServ International - EndoCure Technologies Wendell Haight Beltsville MD

OEM Medical Solutions Dave Reier Towson MD

Lighthouse Imaging Corporation Mark Waite Portland ME

Medstar Dina Helmi Dearborn MI

Medical Recovery Company Inc. Kurt Nierengarten Burnsville MN

Endoscopy Development Company Marcus Rosenberg Bridgeton MO

Life Systems, Inc. Lori Morrison Chesterfield MO

Sterilmed Eddie Soto Greensboro NC

Pro Scope Systems Stuart Jackson Cincinnati OH • • Spectrum Surgical Jim Rygiel Stowe OH

US Medical Systems Tom Boston Fort Mill SC

Surgical Device Repair Inc. Sean McCauley Maryville TN •

Pilot Medical Addam Arrington Nashville TN • • Dobbs Medical Pamela Dobbs Colleyville TX •

Company - International Contact Name City State Certified DM100

Endosource, Inc. M. Ashfaq Ontario Canada •DODODO Medical Equipment Welshen Gao Guangdong China

AGITO Medical Patrick Chapus Strasbourg France •All 2 Med Sharon Liran Holon Israel

M-Cast INC Hiroyoshi Miyama Tokyo Japan •

SaikrupaEnterprises Sunil Kanjwani Pune Maharashtra

DEANS MEDICAL EQUIPMENT Nasir Khan Peshawar Pakistan

Endoscopy Solutions Notwen Cardozo Rio de Janeiro RJ

TEPA, Inc. Mehmet Er Ankara Turkey

Page 40: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 www.dotmed.com38

Keeping current and providing a safer practice

AORN president Anne Marie Herlehy, DNP, RN, CNOR

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DOTmedbusiness news I march 2012 39

DMBN: So your term as president of AORN is drawing to a close, but getting appointed had to be a long journey. How did you get interested in health care as a career?

Herlehy: In part, it stemmed from having ill family members that we took care of. So I always wanted to be a nurse, I was just unsure of the specialty. In nursing school, I did clinical rotations and the team-oriented nature of the OR drew me. During my time working there, I had a nurse supervisor, Joan Uebele, who became my mentor. She encouraged me to work toward my masters’ and doctorate and also introduced me to AORN. It was intriguing to see fellow nurses gather and share information about the things that were impacting their careers.

DMBN: How long have you been in health care and has there been an achievement that stands out?

Herlehy: I graduated nursing school and went directly into the operat-ing room in 1993, close to 20 years. While I was in nursing school, someone asked me what my career goals were. I said I wanted to be able to influence the practice of every perioperative nurse in the U.S. So, my greatest achievement has been the realization of that goal when I became the president of AORN.

DMBN: And during your time as president, what initiatives have you championed?

Herlehy: The association as a whole has come up with initiatives, rather than the individual. So we’ve pushed tech-nology including making access easier for our members. Another standout is our recommended practices. We’ve created links and ranked the practices, qualifying and quantifying our work – making it appropriate for nurses to use. It’s offered in Word and pdf. formats, giving nurses the ability to edit the lists to suit their needs. Our immediate past president, Charlotte Guglielemi, was a real driver on that tool.

DMBN: What achievements are you most proud of from your time as president?

Herlehy: I would have to say moving along the recommended practices, moving the perioperative practice to be very safe.

DMBN: Revisiting an earlier response you offered, how can and does AORN help to shape the country’s health care?

Herlehy: There is an estimated 160,000 perioperative nurses in the U.S. — our goal and desire is to tie the interest of those nurses, whether through practices, being the voice and giving the what, when and why of our practice and being

that influence. AORN membership is roughly 41,000 members, or a little over a quarter of that 160,000. The privileges of being a member allows them to be privy to educa-tional offerings, but more impor-tantly, helps them to partner with those in the industry.

DMBN: What will your involvement be with the association post-presidency?

Herlehy: I will automatically become a liaison for our nominating commit-tee. Beyond that, my role will be de-pendent on the incoming president. AORN serves on 30 professional as-sociations and committees to shape safe surgical practices, I will partici-pate in any committee the president wants me to be a part of.

DMBN: What suggestions can you offer for those interested in learning more about the association?

Herlehy: I recommend they attend local chapter meetings. We’ve also worked hard to deliver ways for members and potential members to access a lot of information online, so that’s a great tool as well.

I also want to make a recommen-dation beyond AORN membership involvement: be knowledgeable and work to keep current. Don’t con-tinue to do something because it’s a sacred practice – do it because it’s relevant, because it works.

• Online: dotmed.com/dm18225

Representing more than one quarter of all the perioperative nurses in the country, AORN steers nursing practices for the better.

On the eve of the Association of periOperative Registered Nurses’ annual show and conference, current association president Anne Marie Herlehy took some time to speak with DOTmed News about the associa-tion’s goals, the evolving roles of perioperative nurses and a little bit about how she came to be the president of the prestigious group.

Check out the AORN Show and Conference Preview on page 63.

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DOTmedbusiness news I march 2012 www.dotmed.com40

INDUSTRY SEcTOR REPORT

Sterilizers: A hospital’s first line of defense against infectionBy Joanna Padovano

lthough the public seldom thinks about steril-izers, they are one of the most important parts of maintaining a safe medical facility. Without a properly functioning sterilizer, patients are at risk of contracting poten-

tially life-threatening infections.Depending on the type, manufacturer and size, a new

sterilizer can cost anywhere from $50,000 to well over $300,000.

Mount Sinai Hospital in New York currently uses five steam and eight low-temperature sterilizers, all of which were purchased new, says Binchu John, the hospital’s sterilizing processing department director. Each unit typically runs between 11 and 15 loads per day. When one of the systems malfunctions, the facility utilizes its service contract and calls the manufacturer to come in

and fix it. “Do not replace sterilizers unless [they’re] be-yond repair,” says John.

With proper maintenance, health care facilities will have over a decade to make a return on their investment. There are many ways an end-user can extend the life of their sterilizer equipment. But one of the most important is to regularly perform preventive maintenance, such as cleansing every sterilizer with a liquid cleaner.

“If you run six cycles a day, then you should clean it once a week; if you run three cycles a day, you should clean it every two weeks,” says Shlomo Savyon, president of Alfa Medical, a sterilizer refurbishing, sales and service company. “You should run a cycle without any instru-ments—just with the liquid cleaner—and that will clean the pipes, the valves [and] it will coat the internal compo-nents to avoid rust and scaling.”

AAlfa Medical refurbished Pelton & Crane sterilizer

INDUSTRYSECTOR

REPORTS

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DOTmedbusiness news I march 2012 41

Sterilizer market moving againAccording to “Sterilization Equipment and Supplies - Global Strategic Business Report,” published by Global Industry Analysts in October 2011, the growth of the global sterilization equipment and supplies market slowed in 2009 due to the economic recession, which caused many hospitals to postpone buying new medical equipment. In 2010, however, the market experienced growth, driven largely by the increasing demand for infection control.

Moving forward, the report predicts that the global sterilization equipment and supplies market will be fueled by the necessity to replace or upgrade old equipment in order to stay technologically up-to-date. In addition, the anticipated increase in surgeries will create more of a de-mand for sterilization equipment in the future.

Low-temperature in high demandOut of all the different methods available, gas plasma sterilization—a type of low-temperature sterilization—was determined to be the fastest growing segment of the market with yearly sales at a compound annual growth rate of nearly 9 percent, according to the Global Industry Analysts report.

The popularity of low-temperature sterilizers is in part due to the equipment’s ability to sterilize a wide array of materials, including items that wouldn’t tolerate high heat sterilization. Within the realm of low-temperature, some changes have taken place.

“Ethylene oxide sterilizers were the standard for devices requiring low-temperature processing,” says Renee Brown, product manager of low temperature sterilizers for STERIS, a sterilizer manufacturer, “but recently, there has been a shift away from ethylene oxide to other low temperature modalities such as hydrogen peroxide sterilization, which offers short cycle times and increased productivity.”

Low-temperature sterilizers include the Amsco V-Pro, launched by STERIS toward the end of 2011, which offers three different cycle options—25, 35 and 55 minutes—de-pending on the type of instruments that are being sterilized and a line of Sterrad Systems by Advanced Sterilization Prod-ucts (a Johnson & Johnson company), which use low-temper-ature hydrogen peroxide gas plasma sterilization technology.

Refurbished keeps hospitals hummingFor many facilities with tight budgets, shopping for refur-bished units has become an attractive alternative. When a ster-

ilizer is in the process of being refurbished, it must be returned to the operating characteristics that were set by its original manufacturer. Without FDA approval, a refurbisher cannot add any new features onto a system. With that reassurance, dealing with a reputable refurb company can save big money.

“Versus new, you’re going to see a savings of about 30 to 50 percent,” says Clay Morris, sales manager of Auxo Medical.

ASP STERRAD 100NX low temperature sterilizerIn a saga stretching nearly four years, the final chapter of the STERIS SYSTEM 1 processor recall is set to close on August 2, 2012. DOTmed News offers a look back at the issues and a look at how STERIS is mak-ing strides in replacing the SYSTEM 1 processor with the SYSTEM 1E Liquid Chemical Sterilant Processing System. We also look at how the new system has been received by the market. Read the timeline and the lat-est updates online at: www.dotmed.com/news/18224 or type “DM18224” into any search window on the site.

Page 44: DOTmed Business News 03-12

1.888.888.3433 sustainability.stryker.com

Protect your bottom line

n Leading provider of medical device reprocessing/remanufacturing

n Comprehensive financial and evironmental sustainability

n Embraced by most U.S. News & World Report “Honor Roll” Hospitals

n Enables hospitals to reclaim and redirect resources

Stryker Sustainability Solutions:

protectoursavings.com

Stryker_DOTmed_Buyers_Guide_Full_Pg.indd 1 1/9/12 4:07 PM

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DOTmedbusiness news I march 2012 43

A provider of remanufactured sterilizers, Auxo Medical says its customer base consists of mainly surgery centers, although it also sells to hospitals, medical facilities and labo-ratories. Jay Crabtree, the company’s president, says he saw “significant growth” in sales last year.

“In the past couple years, even some smaller medical centers that typically wouldn’t consider refurbished equip-ment have really given remanufactured and refurbished equipment—especially in sterilization—a second look and a lot more consideration,” says Morris.

“Surgery centers have typically looked at return on capital, but now even some of the smaller regional hospitals are starting to say that they might be able to get a better return on their investment as well,” Crabtree says.

Digitalization and terminal sterilizationSimilar to many other sectors, with radiography being the prime example, sterilizers are trending more and more toward digital technology.

According to Alfa Medical Savyon, the first digital/automatic sterilizer was the Validator, created by Pelton & Crane approximately two decades ago. Automatic steril-izers, as opposed to manual ones, are often equipped with high-tech features such as self-diagnostic software, display codes for troubleshooting assistance, water guards to avoid leaking condensation, and extra valve ports to speed up the venting process.

Another trend, according to Barbara Trattler, ASP’s director of clinical education, is that an increasing amount of medical facilities are using terminal sterilization, as op-posed to immediate-use sterilization (previously known as flash sterilization). The former refers to the process of instruments being sterilized within some sort of packag-ing, enabling them to be stored for future use. The latter describes when unwrapped instruments are exposed to a steam sterilization cycle and then used right away.

“Sterile processing leaders are taking responsibility for ensuring their facility has the processes in place to meet current standards for best practices in sterilization,” says Trattler. “This has resulted in a focus on minimizing ‘immediate-use sterilization,’ which, as the name suggests, requires the immediate use of the processed device. Termi-nal sterilization allows health care facilities the flexibility of having dry, packaged devices delivered to the OR for use in a scheduled procedure or stored for use at a later time.”

Steady growth to comeIn the coming years, Savyon forecasts that sterilizer tech-nology’s move to digital will drive prices up. “The smarter you make the sterilizer, the more expensive it’s going to be,” he says.

Trattler feels that the need for better sterilization documentation methods will increase in the future. “For purposes of traceability and protection for both the patient and health care facility, documentation and record-keep-

ing are essential, as they provide the data you need should an infection occur,” she says.

Michael Cain, senior product marketing manager of N.A. Sterilization for Getinge USA—a sterilizer manufacture—is

certain that although low-temperature sterilizers are on the rise, their steam counterparts are here to stay. “The steam sterilization segment looks stable for years to come, despite increases in low-temperature processes,” he says.

According to Crabtree, steam sterilizers are not ex-pected to introduce any new groundbreaking technology in the future. “It’s a pretty mature market in a lot of ways, the technology and the science behind steam steriliza-tion hasn’t changed a great deal, and there’s not too many ‘gee-whiz’ features you can add to a steam sterilizer these days,” he says. “Like in lights, you can go from halogen to LED, which is a big change. You’re not going find that sort of change when you’re talking about sterilization.”

• Online: dotmed.com/dm18108

1.888.888.3433 sustainability.stryker.com

Protect your bottom line

n Leading provider of medical device reprocessing/remanufacturing

n Comprehensive financial and evironmental sustainability

n Embraced by most U.S. News & World Report “Honor Roll” Hospitals

n Enables hospitals to reclaim and redirect resources

Stryker Sustainability Solutions:

protectoursavings.com

Stryker_DOTmed_Buyers_Guide_Full_Pg.indd 1 1/9/12 4:07 PM

Quality assuranceOne of the ways to check if a sterilizer is working properly is by running a biological spore test, during which a non-pathogenic spore is placed inside part of a sterilizer’s chamber that is least likely to be penetrated. After running a cycle, a sample is cultured for 72 hours to determine if the spore was killed. If it was not, the sterilizer should be taken out of service until it is fixed.

Page 46: DOTmed Business News 03-12

Answering Questions Regarding the FDA Announcement on the STERIS System 1® Transition Deadline

By Barbara Trattler, RN, MPA, CNOR, CNA

On December 22, 2011 the U.S. Food and Drug Administration (FDA) announced that STERIS can continue to provide support on the STERIS System 1® (SS1) through August 2, 2012. However, this only applies to customers who have completed the following:

This is important for healthcare facilities that rely on the SS1 to process critical devices and must purchase a replacement option. At Advanced Sterilization Products (ASP), we have received many questions from customers regarding the December 22 FDA announcement on the SS1 transition deadline.

Q. Do I have another six months to purchase an alternative to my SS1?A. No. The deadline to purchase a legally-marketed

alternative remains February 2, 2012. However, healthcare facilities that have open orders to replace their SS1(s) and have completed the STERIS “Certificate of Transition” by February 2, 2012, may continue receiving support for their SS1(s) through August 2, 2012.

Q. What do I need to do by the February 2, 2012 deadline?A. If you have not already, place your order for an

alternative technology and fill out the “Certificate of Transition.” If you have ordered a replacement system that will not be installed prior to February 2, 2012, you should also complete the“Certificate of Transition” so that there is no disruption to device processing at your facility.

Q. What alternatives to the SS1 does ASP offer? A. The ASP STERRAD® NX® System uses a hydrogen

peroxide gas plasma sterilization process that provides the sterility assurance level (SAL) of 10-6 that you require for processing heat-sensitive critical devices. The STERRAD® CYCLESURE® 24 Biological Indicator (BI) provides evidence of proper sterilization conditions in accordance with AAMI, AORN †, and CDC guidelines.

For high-level disinfection, we offer the EVOTECH® Endoscope Cleaner and Reprocessor (ECR), the first commercially available system that both cleans* and high-level disinfects endoscopes. The system makes labor-intensive and time-consuming manual endoscope processing a thing of the past.

Q. If I have placed an order for an ASP system, when will I receive it? A. We have ample supply to help you transition in advance of the August 2, 2012 deadline. The date you receive your system will depend on the readiness of your facility and when you ordered your system. Your ASP representative will contact you with an installation date for your system. For more information, please contact your local ASP representative, visit www.aspjj.com/alternatives or call 888.783.7723.

To date, we have successfully helped thousands of facilities upgrade to ASP terminal sterilization and high-level disinfection systems. Using a team approach, our sales associates, service engineers and clinical educators are here to provide world-class service and clinical education support to help your facility make a smooth transition.

ASP currently offers a variety of purchase programs, including financing and deferred payment options, designed to help you elevate the standard of care for your patients. ASP currently offers trade in incentives for your STERIS System 1® and STERIS System 1E™ against the purchase of an ASP system. Please contact your local representative or call 888.783.7723 for complete terms and conditions.

AD-12002-01-US_A

For more answers to your pressing questions, please visit www.aspjj.com for the ongoing ASP Video Webisode series that will address issues that your facility faces every day. You may also Like Us on Facebook.com/aspjj or Follow Us on Twitter.com/aspjj.com

• Placedanorderforalegally-marketed alternative technology to replace all SS1s

• Completeda“CertificateofTransition”

• Returnedthecompletedcertificateto STERIScorporation

ADVERTISEMENT

© Ethicon, Inc. 2012. STERIS System 1 and System 1E are registered trademarks of the STERIS Corporation.AORN is a registered trademark of AORN, Inc. AORN does not endorse any commercial company’s products or services.

* Does not eliminate bedside precleaning. Manual cleaning of medical devices (endoscopes) is not required prior to placement in the EVOTECH® ECR when selecting those cycles that contain a wash stage. † Recommended practices for sterilization in the perioperative practice setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2012:561-566

Page 47: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 45

Answering Questions Regarding the FDA Announcement on the STERIS System 1® Transition Deadline

By Barbara Trattler, RN, MPA, CNOR, CNA

On December 22, 2011 the U.S. Food and Drug Administration (FDA) announced that STERIS can continue to provide support on the STERIS System 1® (SS1) through August 2, 2012. However, this only applies to customers who have completed the following:

This is important for healthcare facilities that rely on the SS1 to process critical devices and must purchase a replacement option. At Advanced Sterilization Products (ASP), we have received many questions from customers regarding the December 22 FDA announcement on the SS1 transition deadline.

Q. Do I have another six months to purchase an alternative to my SS1?A. No. The deadline to purchase a legally-marketed

alternative remains February 2, 2012. However, healthcare facilities that have open orders to replace their SS1(s) and have completed the STERIS “Certificate of Transition” by February 2, 2012, may continue receiving support for their SS1(s) through August 2, 2012.

Q. What do I need to do by the February 2, 2012 deadline?A. If you have not already, place your order for an

alternative technology and fill out the “Certificate of Transition.” If you have ordered a replacement system that will not be installed prior to February 2, 2012, you should also complete the“Certificate of Transition” so that there is no disruption to device processing at your facility.

Q. What alternatives to the SS1 does ASP offer? A. The ASP STERRAD® NX® System uses a hydrogen

peroxide gas plasma sterilization process that provides the sterility assurance level (SAL) of 10-6 that you require for processing heat-sensitive critical devices. The STERRAD® CYCLESURE® 24 Biological Indicator (BI) provides evidence of proper sterilization conditions in accordance with AAMI, AORN †, and CDC guidelines.

For high-level disinfection, we offer the EVOTECH® Endoscope Cleaner and Reprocessor (ECR), the first commercially available system that both cleans* and high-level disinfects endoscopes. The system makes labor-intensive and time-consuming manual endoscope processing a thing of the past.

Q. If I have placed an order for an ASP system, when will I receive it? A. We have ample supply to help you transition in advance of the August 2, 2012 deadline. The date you receive your system will depend on the readiness of your facility and when you ordered your system. Your ASP representative will contact you with an installation date for your system. For more information, please contact your local ASP representative, visit www.aspjj.com/alternatives or call 888.783.7723.

To date, we have successfully helped thousands of facilities upgrade to ASP terminal sterilization and high-level disinfection systems. Using a team approach, our sales associates, service engineers and clinical educators are here to provide world-class service and clinical education support to help your facility make a smooth transition.

ASP currently offers a variety of purchase programs, including financing and deferred payment options, designed to help you elevate the standard of care for your patients. ASP currently offers trade in incentives for your STERIS System 1® and STERIS System 1E™ against the purchase of an ASP system. Please contact your local representative or call 888.783.7723 for complete terms and conditions.

AD-12002-01-US_A

For more answers to your pressing questions, please visit www.aspjj.com for the ongoing ASP Video Webisode series that will address issues that your facility faces every day. You may also Like Us on Facebook.com/aspjj or Follow Us on Twitter.com/aspjj.com

• Placedanorderforalegally-marketed alternative technology to replace all SS1s

• Completeda“CertificateofTransition”

• Returnedthecompletedcertificateto STERIScorporation

ADVERTISEMENT

© Ethicon, Inc. 2012. STERIS System 1 and System 1E are registered trademarks of the STERIS Corporation.AORN is a registered trademark of AORN, Inc. AORN does not endorse any commercial company’s products or services.

* Does not eliminate bedside precleaning. Manual cleaning of medical devices (endoscopes) is not required prior to placement in the EVOTECH® ECR when selecting those cycles that contain a wash stage. † Recommended practices for sterilization in the perioperative practice setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2012:561-566

DOTmed Registered Sterilizers Sales & Service CompaniesFor convenient links to these companies, go to www.dotmed.com and enter [DM 18108] Names in boldface are Premium Listings.

Company - Domestic Contact Name City State Certified DM100

Biomedical Professional Services Mitchell Dailey Clanton AL Veterinary Products Distributor Elry Phillips Pine Bluff AR LANCER Medical Services, Inc Ray Smith Azusa CA ASP Jedrix Aquino Irvine CA Ready Medical Lisa Vanesco Paramount CA PES Medical George Perez Seal Beach CA Plazza Medical Steve Rice Denver CO • Asset Equipment Store Debbie Rice Bradenton FL Mercury Medical James Ruggiero Clearwater FL Alternative Source Medical Monte Montain Buffalo Grove IL • Coast To Coast Medical Kevin Blaser Fall River MA PRN Bob Gaw Fall River MA • Saffire Medical Alda Clemmey Taunton MA • •Medical Device Depot John Gladstein Ellicott City MD • Midbrook Medical Jamie Crowley Jackson MI SterilMed Darren Wennen Maple Grove MN Mediquip Parts Plus Dave French St. Louis MO Eichenauer Heating Elements Robert Gorsuch Newport NH Integris Equipment Lawrence Maroney Elma NY • STS North America James Graham Hauppauge NY Getinge Jim Gabalski Rochester NY DURALINE SYSTEMS Darren Walker West Nyack NY • • Alfa Medical Shlomo Savyon Westbury NY STERIS Corporation Robin Baum Mentor OH MERCO Krista Kalweit Portsmouth VA Auxo Medical Clay Morris Richmond VA • • World Medical Equipment Rich Cram Marysville WA •Strategic Surgical Solutions, LLC James Volbracht New Berlin WI •

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DOTmedbusiness news I march 2012 47

The peer-review rankings without equal in the health care industry.Based on the DOTmed 5-Star Rating System

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DOTmedbusiness news I march 2012 www.dotmed.com48

Company State Company Type Parts 100 PRN MA Dealer •UltraSolutions, Inc. CA Dealer •International Medical Equipment, Inc. MI Dealer •Complete Medical Services MI Dealer Quest Medical Supply, Inc. FL Dealer Advanced Imaging Solutions, Inc. AL Dealer Doctors Depot, Inc. FL ISO Green Cross Medical/ GOMED CA Dealer R Ventures Medical, Inc. GA Dealer Bayland Technologies TX Broker GTS Medical, Inc. CA Dealer NorthWest Supply WA Dealer Alternative Source Medical IL Dealer X-Stream Medical, Inc. TX Dealer American International Medical CA ISO •Absolute Medical Equipment NY Dealer •Bay Shore Medical NY Dealer C&G Technologies, Inc. IN ISO •Elite Medical NY Other Medical Equipment Dynamics, Inc. MA Dealer •The Laser Warehouse FL Dealer •Block Imaging International MI Broker •Image Technology Consulting, LLC TX Dealer •Monet Medical UT Dealer Quest Medical Equipment, Inc FL Dealer Adam Imaging Parts, Inc. NY Dealer •Integrity Medical Systems, Inc. FL Dealer •King Equipment Services, Inc. IL Dealer Zgrum Medical AZ Broker Integrated Medical Systems International, Inc. AL Dealer KPI Ultrasound CA Dealer •Nationwide Imaging Services, Inc. NJ Broker OMED of Nevada NV Dealer •Mid-America Medical TN Dealer Realtime Medical Equipment, Inc. NY Dealer Saffire Medical MA Dealer TH. Medical Equipment (Total Health) FL Dealer Venture Medical ReQuip, Inc. FL Dealer Crumpton Medical Sales TX Dealer Pilot Medical, Inc. TN Dealer C&C Medical Solutions Inc. IN Dealer •Medeco ID Dealer Medical Equipment Solutions TX Dealer Viable Med Services, Inc. CA ISO •All Imaging Systems, Inc. CA Dealer American Radiology Resource MD Broker BMX Medical, Inc. MN Dealer Express Systems & Parts Network, Inc OH Dealer •Radiology Solutions LLC MI Dealer Southwest Medical Corporation OK Dealer •Alaka Medical Systems, Inc. NY Dealer Dobbs Medical Sales, Inc. TX Dealer SH Medical Corp FL Dealer AllParts Medical TN Dealer •Clinical Imaging Systems, Inc. NJ Dealer Colossus Medical GA Dealer DMS Topline Medical ND Dealer

Welcome to this year’s DOTmed 100! This year, our honorees span the health care industry

from A to Z – literally in the case of OEMs. If you’re in the market for services pro-vided by these companies, the following list should provide a good starting point to identify a company dedicated to providing a good purchasing experience – with the feedback to prove it.

The lists presented for Equipment Sell-ers, International Equipment Sellers and Parts Sellers still rely on number of ratings and then the average of those ratings. Meanwhile, the list of Original Equipment Manufacturers is comprised of publicly traded companies with multi-million to multi-billion dollar yearly sales numbers. The OEM list was built off of last year’s list with facts and figures updated.

With the exception of the OEMs, which we’ve provided web site addresses for, companies found on these lists can be contacted via the DOTmed service direc-tory, with many companies also maintain-ing DOTmed virtual webstores.

We hope you find these lists useful and we welcome your feedback. And remember, if you’ve had a transaction with a company listing on DOTmed, be sure to rate them. DOTmed is a community and by offering feedback and participat-ing in the community, you help to make it stronger, creating a better experience for you and your peers.

Look for 5-Star Ratings when you visit DOTmed.The DOTmed 100 designation is awarded to the top 100 users with the highest number of positive 5-Star Ratings. But virtually every DOTmed user has a rating – most are very positive, but some are not, which is why it has value, because it is an honest peer review system. So look for it when you visit DOTmed, and please rate those people and companies you do business with.

DOTmed 100 Equipment SellersThe following list is based on number of ratings and the average score companies received from individuals who made transactions with them through DOTmed during the 2011 calendar year. The order of the list is based on positive feedback, with those receiving the most positive feedback at the top. Those at the bottom of the list didn’t necessarily receive any negative feedback, rather, they just received less feedback overall. A top international listing follows at the conclusion of this list. A red dot in a company’s column indicates that they are also listed on the DOTmed 100 Parts Companies list.

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DOTmedbusiness news I march 2012 49

Company State Company Type Parts 100 DR’S TOY STORE FL Dealer JLS MedEquip FL Dealer •Laproman Endoserv LLC MI Dealer 2D Imaging CA Broker A+ Medical Company, Inc. SC Dealer •Bemes Inc. MO Dealer •Medical Concepts FL Dealer Medical Imaging Resources Inc. MI Dealer Soma Technology CT Dealer •Amber Diagnostics FL Dealer •Danan Medical Systems FL Dealer DCSP Medical OH Dealer Med Exchange International, Inc. MA Dealer MedCorp FL Dealer Metropolis International NY Dealer Midwest Imaging MO Dealer MRSBioMed GA ISO Mylin Medical Systems Inc IL Broker BMX-RAY INC. FL Dealer Cameron Medical LLC NC Broker Dura-Med Endoscopy, INC FL Dealer East Coast Medical NY Broker FHL Services, Inc. MN ISO Foremost Equipment NY Broker Global DSR FL Dealer Imaging Associates Inc. NC Dealer Kelley X-Ray Company TN Dealer Longevity, LLC NY Broker •Med-E-Quip Locators, Inc. MO Dealer •Pro Scope Systems OH Dealer Shared Medical Services, Inc. WI Dealer •tekyard Medical MN Dealer Artec Group Services, LLC FL Dealer Didage Sales Company, Inc. IN Dealer Dixie Medical TN Dealer HealthWare Inc. IL Broker KMA Remarketing PA Dealer Medimtech LLC CA ISO •Medisales Latinoamerica CA Dealer Northeast Medical Sales, Inc MA Dealer RD Medical IL Broker RJP International Inc. NY Exporter •US Med-Equip TX Dealer Xplore Medical Sales,Inc. NY Dealer International Company Country Company Type AGITO Medical Denmark DealerIndia Ultrasound India ExporterADN-Medical Ltd. Israel DealerANDA Medical Inc. Canada DealerJean Medical South Korea DealerMides Austria DealerLBN Medical Denmark DealerLogic S.r.l. Italy DealerLviv Ukraine DealerMedinet Korea. co. ltd South Korea Dealersitwat medical Pakistan DealerOrigin Industries Australia BrokerRaynor Shine Ent Canada DealerSonos Europe srl Italy OtherBIG SEA MEDICAL United Arab Emirates DealerDODODO Medical Equipment Service Co., Ltd. China ISOMedtec GmbH Germany Germany ISOBazzimed Lebanon DealerEndosource Inc. Canada DealerMED & IT Trading Germany DealerMedical Network Imaging South Africa ISOMedivit Ltd. Ukraine ISOTransducers-International Netherlands BrokerEverX Pty Ltd Australia Dealer

Page 52: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 www.dotmed.com50

Company State Type Specialty

PRN MA Dealer Operating Room

American International Medical CA ISO Cardiology

C&G Technologies, Inc IN ISO CT Scanner, X-ray Tube, PET/CT

Medical Equipment Dynamics, Inc. MA Dealer Anesthesia Monitor, Anesthesia Machine, O/R Microscope

The Laser Warehouse FL Dealer Laser - Co2, Laser - Yag, Liposuction Unit

Image Technology Consulting, LLC TX Dealer MRI Scanner, MRI Mobile, MRI Coil

Adam Imaging Parts, Inc. NY Dealer CT Scanner, Cath Lab, Angio Lab

Ultra Solutions IN Dealer Ultrasound

Absolute Medical Equipment NY Dealer EKG, ECG unit, Ultrasound General

Integrity Medical Systems, Inc. FL Dealer Bone Densitometer, MRI Scanner, CT Scanner

C&C Medical Solutions Inc. IN Dealer Ultrasound Transducer, Shared Service, OB / GYN - Vascular

Viable Med Services, Inc. IN ISO MRI Scanner, MRI Coil, PET Camera / Scanner

A+ Medical Company, Inc. SC Dealer Rad Room, Rad/Fluoro Room, Rad/Tomo Room

Bemes Inc. MO Dealer Ventilator, Oxygen Monitor, Stress Test

Express Systems & Parts Network, Inc OH Dealer CT Scanner, MRI Scanner, C-Arm

Longevity, LLC NY Broker Imaging/Radiology

Med-E-Quip Locators, Inc. MO Dealer Pump IV Infusion, Pump PCA, Pump Controller

OMED of Nevada NV Dealer Exam Room Suite, EKG, Defibrillator

Shared Medical Services, Inc. WI Dealer CT Mobile, MRI Mobile, PET Mobile

Medimtech LLC CA ISO Ultrasound Transducer, Shared Service, OB / GYN - Vascular

RJP International Inc. NY Exporter Oximeter - Pulse, Scope Accessories, Fetal Monitor

Advanced Ultrasound Electronics OK Dealer Ultrasound Transducer, Cardiac, Cardiac - Vascular

AllParts Medical TN Dealer CT Scanner, Rad/Fluoro Room, Rad Room

Duraline Systems NY Dealer Autoclave Tabletop, Sterilizer, Dry Heat Sterilizer

J&M Trading, Inc. TN Broker X-ray Generator, Rad/Fluoro Room, Rad/Tomo Room

Nova Technologies, Inc. CO Dealer Ultrasound Transducer, Ultrasound General, Vascular - Small Parts

Amber Diagnostics FL Dealer C-Arm, MRI Scanner, Mammo Unit

Block Imaging Parts & Service, Inc. MI ISO Imaging/Radiology

DOTmed Top100 Parts Companies The DOTmed top 100 Parts Companies list is compiled based on a combination of number of ratings and the average score these companies received from individuals who made transactions with them through DOTmed during the 2011 calendar year. Some companies on the list have thousands of parts listed on DOTmed, some just a few. We’ve included a “specialty” column to help you find what you’re looking for.

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DOTmedbusiness news I march 2012 51

Company State Type Specialty

KPI Ultrasound CA Dealer Cardiac - Vascular, Ultrasound Transducer, OB / GYN - Vascular

MedSurg Equipment, LLC. TX ISO Defibrillator, EKG, Electrosurgical Unit

Anamika Medical NY Dealer CR

Biomedix Medical PA ISO Pump IV Infusion, Pump PCA, Pump Lymphedema

Choice Medical Systems Inc FL Dealer Ultrasound

Classic Diagnostic Imaging OH Other C-Arm, Chest X-ray, Mammo Unit

Gale Medical, LLC GA Dealer Ultrasound

Townsend Surgical TN ISO Endoscope, Cystoscope, Light Source

Associated Imaging Services KS ISO Molecular Imaging

Grand Medical Equipment, Inc. PA Dealer Mammo Unit, Mammo Accessories

Radiology Equipment Sales & Service, LLC TX ISO Nuclear Gamma Camera, Nuclear Computer, CT Scanner

Radon Medical Imaging Corp.- WV WV ISO Radiology

International Medical Equipment and Service, Inc. SC Dealer CT Scanner, MRI Scanner, Rad Room

IV Technologies, Inc. PA Dealer Pump IV Infusion, Pump PCA

Medical Technic,LLC NJ Dealer Miscellaneous

Pan Am Imaging NJ Dealer MRI Scanner

Soma Technology CT Dealer C-Arm, Oxygen Analyzer, Defibrillator

Technical Prospects LLC WI Dealer CT Scanner, X-ray Tube, Rad/Fluoro Room

Advantage Medical Systems MO Dealer Respiratory

Better Imaging Solutions, Inc. AZ Dealer Ultrasound

MedPro, Inc. NJ Dealer Ultrasound

Oxford Instruments Service NJ ISO MRI Coldhead, MRI Compressor, Magnet

Radiology OneSource, Inc. TN Dealer MRI Scanner, CT Scanner, Shared Service

ReMedPar TN Dealer Imaging/Radiology

Southwest Medical Resources CA ISO MRI Scanner, MRI Mobile, CT Scanner

Transamerican Medical Imaging UT Dealer C-Arm, C-Arm Table, X-ray Image Intensifier

Alpha Source Inc. WI Other Light Source, Exam Light, Defibrillator

Calscan Medical Enterprises, Inc. CA Dealer Modular Building MRI, MRI Mobile, MRI Scanner

GERMAN ELECTRONICS FL Dealer X-ray/Radiology

HealthCare Imaging, LLC NC Exporter Imaging/Radiology

LaserTeks Services Inc. TX Dealer Cosmetic/Surgical Lasers

Ultimate Imaging Solutions TX ISO CT/Mri

Dietz Healthcare, Inc. AZ Dealer Ultrasound Transducer, OB / GYN, Vascular - Small Parts

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DOTmedbusiness news I march 2012 www.dotmed.com52

Company Name Stock Ticker Employees Sales last Sales growth Web Address 12 months last 12 months

General Electric Company GE 301,000 147.30 Billion -1.50% www.ge.com

Hewlett Packard Company HPQ 349,600 124.98 Billion 1.00% www.hp.com

McKesson Corporation MCK 36,400 119.89 Billion 3.10% www.mckesson.com

Hitachi, Ltd. HIT 372,360 116.56 Billion 3.90% www.hitachi.com

Cardinal Health, Inc. CAH 31,900 106.70 Billion 4.20% www.cardinal.com

Panasonic Corporation PC 348,028 99.39 Billion 17.20% www.panasonic.net

Siemens AG SI 363,000 98.9 Billion 6.60% www.siemens.com

SONY Corporation SNE 168,200 80.38 Billion -0.50% www.sony.net

Toshiba Corporation TOSBF 212,000 75.02 Billion 1.70% www.toshiba.co.jp

Johnson & Johnson JNJ 117,000 65..03 Billion 5.60% www.jnj.com

Bayer AG BAYZF 113,200 48.88 Billion 12.60% www.bayer.com

Canon Inc. CAJ 198,307 44.17 Billion -4.00% www.canon.com

Abbott Laboratories ABT 91,000 38.85 Billion 10.50% www.abbott.com

Koninklijke Philips Electronics N.V. PHG 121,888 30.25 Billion 1.30% www.philips.co.uk

3M Company MMM 84,198 29.61 Billion 5.66% www.3m.com

FujiFilm Holdings Corporation FUJIY 78,862 27.15 Billion 1.60% www.fujifilmholdings.com

Fresenius SE & Co KGaA FSNUF 145,118 21.84 Billion 12.80% www.fresenius.se

Medtronic Inc MDT 45,000 16.39 Billion 0.70% www.medtronic.com

Baxter International, Inc. BAX 48,500 13.89 Billion 8.20% www.baxter.com

Covidien Public Limited Company COV NA 11.7 Billion 11.00% www.covidien.com

Konica Minolta Minolta Holdings, Inc. KNCAF 35,204 9.44 Billion -3.30% www.konicaminolta.com

Owens & Minor, Inc OMI 4,800 8.63 Billion 6.20% www.owens-minor.com

Henry Schein, Inc. HSIC 15,000 8.53 Billion 13.30% www.henryschein.com

Stryker Corporation SYK 21,241 8.31 Billion 13.50% www.stryker.com

Becton, Dickinson and Company BDX 29,369 7.87 Billion 6.20% www.bd.com

Boston Scientific Corporation BSX 24,000 7.62 Billion -2.40% www.bostonscientific.com

St. Jude Medical, Inc. STJ 15,000 5.61 Billion 8.70% www.sjm.com

Teruma Corp. TRUMF 14,761 4.61 Billion 3.90% www.terumo.com

Zimmer Holdings, Inc. ZMH 8,000 4.45 Billion 5.50% www.zimmer.com

Smith & Nephew plc SNN 11,000 4.27 Billion 7.80% www.smith-nephew.com

Agfa-Gevaert NV AFGVF 11,766 4.07 Billion 7.00% www.agfa.com

Hospira, Inc. HSP 15,000 4.06 Billion 3.60% www.hospira.com

CareFusion Corporation CFN 14,000 3.59 Billion 1.60% www.carefusion.com

C. R. Bard, Inc. BCR 11,700 2.9 Billion 6.50% www.crbard.com

Varian Medical Systems, Inc. VAR 5,700 2.64 Billion 10.20% www.varian.com

Hologic Inc HOLX 5,019 1.83 Billion 6.50% www.hologic.com

Invacare Corporation IVC 6,300 1.80 Billion 4.60% www.invacare.com

Intuitive Surgical, Inc. ISRG 1,924 1.76 Billion 24.40% www.intuitivesurgical.com/

Top Medical Equipment OEMsThe following list was created based sales figures. The list provides some key numbers for publically traded medical equipment manufacturers. In some cases, larger companies producing products outside of the health care field don’t have separate income reported for different industry sectors, so the numbers presented may indicate one company with a smaller health care division as being more robust than a company with larger health care related sales. When possible, the information utilized company health care sales. Some privately held companies may bring in more than some businesses represented on this list, but the following information is based on sales as reported through stock ticker feedback.

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DOTmedbusiness news I march 2012 53

Company Name Stock Ticker Employees Sales last Sales growth Web Address 12 months last 12 months

Edwards Lifesciences Corporation EW 7,000 1.68 Billion 16.00% www.edwards.com

Hill-Rom Holdings, Inc. HRC 6,230 1.60 Billion 8.30% www.hill-rom.com

Barco NV BCNAF 3,500 1.40 Billion 16.10% www.barco.com

STERIS Corporation STE 5,000 1.39 Billion -4.00% www.steris.com

The Cooper Companies, Inc. COO 7,400 1.33 Billion 14.90% www.coopercos.com

Mindray Medical International Limited MR 6,700 827.59 Million 11.10% www.mindray.com

Carl Zeiss Meditec AG DE:AFX 2,430 783.89 Million 12.10% www.meditec.zeiss.com

Integra Lifesciences Holdings Corp. IART 3,000 780.08 Million 6.60% www.Integra-LS.com

CONMED Corporation CNMD 3,300 725.08 Million 1.60% www.conmed.com

NuVasive, Inc. NUVA 789 540.51 Million 13.00% www.nuvasive.com

Analogic Corporation ALOG 1,500 487.63 Million 14.20% www.analogic.com

Masimo Corporation MASI 2,548 438.99 Million 8.30% www.masimo.com

Thoratec Corporation THOR 773 422.71 Million 10.40% www.thoratec.com

ArthroCare Corporation ARTC 1,600 354.89 Million -10.00% www.arthrocare.com

Volcano Corporation VOLC 1,144 343.55 Million 16.80% www.volcanocorp.com

Accuray Incorporated Aray 1,100 336.84 Million 0.30% www.accuray.com

Sonosite, Inc. SONO 878 308.82 Million 21.10% www.sonosite.com

ICU Medical, Inc. ICUI 2,216 302.20 Million 6.20% www.icumed.com

Omnicell, Inc. OMCL 753 245.54 Million 10.40% www.omnicell.com

Merge Healthcare MRGE 750 232.43 Million 65.60% www.merge.com

Syneron Medical Ltd. ELOS 580 228.32 Million 20.50% www.international.syneron.com

AngioDynamics, Inc. ANGO 722 223.40 Million -10.00% www.angiodynamics.com

Exactech, Inc. EXAC 553 204.12 Million 7.40% www.exac.com

Given Imaging Ltd. GIVN 742 177.96 Million 12.80% www.givenimaging.com

Conceptus, Inc. CPTS 304 126.98 Million -9.70% www.conceptus.com

CardioNet, Inc. BEAT 754 119.02 Million -0.80% www.cardionet.com

Atrion Corporation ATRI 437 117.10 Million 8.40% www.atrioncorp.com

Cynosure Inc. CYNO 259 110.6 Million 35.30% www.cynosure.com

MEDTOX Scientific, Inc. MTOX 633 108.15 Million 11.40% www.medtox.com

Palomar Medical Technologies, Inc. PMTI 213 103.44 Million 62.30% www.palomarmedical.com

Vascular Solutions, Inc. VASC 355 89.96 Million 14.70% www.vascularsolutions.com

HeartWare International, Inc. HTWR 206 82.76 Million 50.00% www.heartware.com

Synovis Life Technologies, Inc. SYNO NA 82.36 Million 20.10% www.synovissurgical.com

Prism Medical, Ltd. PSDLF 5 72.67 Million 1.40% www.prismmedicalltd.com

MAKO Surgical Corp MAKO 315 66.40 Million 29.50% www.makosurgical.com

IMRIS Inc. IMRS 139 62.25 Million 78.10% www.imris.com

Zoll Medical Corporation ZOLL 1,908 544.3 Million 18.00% www.zoll.com

DGT Holdings Corp. DGTC 212 54.97 Million 20.90% www.delglobal.com

Digirad Corporation DRAD 261 53.75 Million -4.30% www.digirad.com

Fonar Corporation FONR 214 35.37 Million 4.20% www.fonar.com

iCAD, Inc. ICAD 143 28.41 Million -12.60% www.icadmed.com

Vasomedical, Inc. VASO 109 25.58 Million 289.30% www.vasomedical.com

Bovie Medical Corporation BVX 143 25.48 Million -10.10% www.boviemedical.com

Positron Corporation POSC 27 8.58 Million 219.70% www.positron.com

GenMark Diagnostics, Inc. GNMK 79 3.82 Million 156.60% www.genmarkdx.com

Vasamed, Inc. VSMD 31 3.43 Million 0.30% www.opsi.com

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DOTmedbusiness news I dotmed 100 2012 55DOTmedbusiness news I dotmed 100 2012 www.dotmed.com54

TOP STORIES

IntegrIty MedIcal SySteMS, Inc.13831 Jetport Commerce ParkwayFort Myers, FL [email protected]: (239) 454-9555phone: (800) 722-3646fax: (239) 454-9599integritymed.com

consecutive years of experience

23consecutive years

in the DOTmed 100

8

Buy-Sell-Rent-Repair

www.prnwebsite.com * email: [email protected]

PRN, Inc218 Shove StFall River, MA 02724508-679-6185

Certified

Certified

Top 100

Top 100

We BUY/SELL all used Endoscopy equipment• Huge inventory of equipment• Most equipment in Stock, not brokering equipment.• Visit us www.intmedicaleq.com• Full Endoscope repair services• Fast repair turn around

International Medical Equipment Inc.Phone: 734-422-7700

email: [email protected]

Top 100

Top 100

800.607.2115www.aismedical.com

Sales, Installation, Service, Applications Training and Parts

Call Now! We Take Trade-Ins800-449-7077 • 407-389-1311

Quest Medical Supply, Inc.600 Sweetwater Club CircleLongwood, FL 32779-2133

Ph: (407) 389-1311, Fx: (407) 389-1692

THINK PHILIPS. THINK QUEST MEDICAL SUPPLY. Sales and Service of:

• Anesthesia Machines• Anesthesia Vaporizers• Patient Monitors• ECG• Anesthesia Monitors

Contact: 800-979-4993

Doctor’S Depot

Certified

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• Track record of helping our customers find the part they want at the price they need

• Real-time inventory searching on our website• The only parts we offer are parts we own and

stock on-site

714 Atkins AveBrooklyn, NY 11208

347-985-1679www.adamimagingparts.com

Find us on Facebook &

LinkedIn

Certified

CertifiedINDUSTRYSECTOR

REPORTS

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Just Posted

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Top 100

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VirtualAuction House

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ServiceTech

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www.nationwideimaging.comSales: 732-262-3115

[email protected]

The Leader in Professional Pre-Owned

Imaging Equipment Sales

MRI • CT • PET/CT • Ultrasound • X-ray/CR • Nuclear Cameras • Mammo • Laser Printers • C-arms

ExpEriEncE MakEs thE DiffErEncE

WE GUARANTEE OUR SERVICE OUR TEAM WORKS WITH YOU AND FOR YOU.WE PROVIDE YOU WITH THE BEST PRICES

Lilly Echazabal VP/NCCI/PSGTDEALER/EXPORTING

Total Health Medical Equipments and Supply., Inc.Miami, FL 33165http://www.dotmed.com/webstore/137241/786-600-8442

WE SPECIALIZE IN THE SLEEP WORLD OF POLYSOMNOGRAPHY AND HOME SLEEP STUDYPSG,CPAP,BIPAP ETC, BUT WE ALSO SELL HOMEHEALTH PRODUCTS.

WE SERVICE YOU ON SHIPPING AND HANDLING, OUR TEAMS ALSO WORK CLOSELY WITH CUSTOMS.

Total Health

[email protected]

Dealers Welcome

flexibleendoscoperepairs and sales

Whether you’re buying or selling call or email BMX Medical, Inc. 888-553-2300 [email protected]

BMX Medical, Inc.1301 Cambridge St . #111AMinneapolis, MN 55343 Certified

CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

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• In business for 15 years• DOTmed certified; DOTmed 100• Offering the highest quality of used medical

equipment available in today’s marketplace. • Buy quality pre-owned medical

equipment at a fraction of the cost of new equipment.

• We buy and sell used and surplus medical equipment from hospitals, clinics, and surgery centers.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

DOTmed 100 Resource SectionAll the companies in this special section are part of the DOTmed 100 for 2012.The information presented will help you to get ac-quainted with the services and products offered by some of the companies in this elite group. If you already do business with them, be sure to share your experience with DOTmed users by rating your expe-rience. If you plan to do business with them in the future, be sure to tell them DOTmed sent you!

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DOTmedbusiness news I dotmed 100 2012 55DOTmedbusiness news I dotmed 100 2012 www.dotmed.com54

TOP STORIES

IntegrIty MedIcal SySteMS, Inc.13831 Jetport Commerce ParkwayFort Myers, FL [email protected]: (239) 454-9555phone: (800) 722-3646fax: (239) 454-9599integritymed.com

consecutive years of experience

23consecutive years

in the DOTmed 100

8

Buy-Sell-Rent-Repair

www.prnwebsite.com * email: [email protected]

PRN, Inc218 Shove StFall River, MA 02724508-679-6185

Certified

Certified

Top 100

Top 100

We BUY/SELL all used Endoscopy equipment• Huge inventory of equipment• Most equipment in Stock, not brokering equipment.• Visit us www.intmedicaleq.com• Full Endoscope repair services• Fast repair turn around

International Medical Equipment Inc.Phone: 734-422-7700

email: [email protected]

Top 100

Top 100

800.607.2115www.aismedical.com

Sales, Installation, Service, Applications Training and Parts

Call Now! We Take Trade-Ins800-449-7077 • 407-389-1311

Quest Medical Supply, Inc.600 Sweetwater Club CircleLongwood, FL 32779-2133

Ph: (407) 389-1311, Fx: (407) 389-1692

THINK PHILIPS. THINK QUEST MEDICAL SUPPLY. Sales and Service of:

• Anesthesia Machines• Anesthesia Vaporizers• Patient Monitors• ECG• Anesthesia Monitors

Contact: 800-979-4993

Doctor’S Depot

Certified

CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

Alerts

Honest/Dishonest

Honest/Dishonest

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CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

Alerts

Honest/Dishonest

Honest/Dishonest

ServiceTech

Service Tech

CleanSweep

Clean Sweep

• Track record of helping our customers find the part they want at the price they need

• Real-time inventory searching on our website• The only parts we offer are parts we own and

stock on-site

714 Atkins AveBrooklyn, NY 11208

347-985-1679www.adamimagingparts.com

Find us on Facebook &

LinkedIn

Certified

CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

Alerts

Honest/Dishonest

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Service Tech

CleanSweep

Clean Sweep

Certified

CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

Alerts

Honest/Dishonest

Honest/Dishonest

ServiceTech

Service Tech

CleanSweep

Clean Sweep

www.nationwideimaging.comSales: 732-262-3115

[email protected]

The Leader in Professional Pre-Owned Imaging Equipment Sales

MRI • CT • PET/CT • Ultrasound • X-ray/CR • Nuclear Cameras • Mammo • Laser Printers • C-arms

ExpEriEncE MakEs thE DiffErEncE

WE GUARANTEE OUR SERVICE OUR TEAM WORKS WITH YOU AND FOR YOU.WE PROVIDE YOU WITH THE BEST PRICES

Lilly Echazabal VP/NCCI/PSGTDEALER/EXPORTING

Total Health Medical Equipments and Supply., Inc.Miami, FL 33165http://www.dotmed.com/webstore/137241/786-600-8442

WE SPECIALIZE IN THE SLEEP WORLD OF POLYSOMNOGRAPHY AND HOME SLEEP STUDYPSG,CPAP,BIPAP ETC, BUT WE ALSO SELL HOMEHEALTH PRODUCTS.

WE SERVICE YOU ON SHIPPING AND HANDLING, OUR TEAMS ALSO WORK CLOSELY WITH CUSTOMS.

Total Health

[email protected]

Dealers Welcome

flexibleendoscoperepairs and sales

Whether you’re buying or selling call or email BMX Medical, Inc. 888-553-2300 [email protected]

BMX Medical, Inc.1301 Cambridge St . #111AMinneapolis, MN 55343 Certified

CertifiedINDUSTRYSECTOR

REPORTS

JustPosted

Just Posted

Auction

Auction

Top 100

Top 100

VirtualAuction House

Vitrual Auction House

Alerts

Alerts

Honest/Dishonest

Honest/Dishonest

ServiceTech

Service Tech

CleanSweep

Clean Sweep

Top 100

Top 100

• In business for 15 years• DOTmed certified; DOTmed 100• Offering the highest quality of used medical

equipment available in today’s marketplace. • Buy quality pre-owned medical

equipment at a fraction of the cost of new equipment.

• We buy and sell used and surplus medical equipment from hospitals, clinics, and surgery centers.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

systems, and discover the ANDA Medical difference.

DOTmed 100 Resource SectionAll the companies in this special section are part of the DOTmed 100 for 2012.The information presented will help you to get ac-quainted with the services and products offered by some of the companies in this elite group. If you already do business with them, be sure to share your experience with DOTmed users by rating your expe-rience. If you plan to do business with them in the future, be sure to tell them DOTmed sent you!

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DOTmedbusiness news I dotmed 100 2012 57DOTmedbusiness news I dotmed 100 2012 www.dotmed.com56

TOP STORIES

Danan Medical Systems, Inc.(386) 868-5185

Cell: (386) 383-2593www.dananmed.com

Email: [email protected]

Specialists in Endoscopy ProductsRepairs

We specialize in repairs of Flexible fiber and video endoscopes, including Olympus, Pentax and Fuji-non, that meet or exceed manufacturer’s specifica-

tions without paying manufacturer pricing.

Danan Medical Systems guarantees honesty, quick turn around and excellent

customer service!

All the companies in this special section are DOTmed 100 for 2011.

Please browse these display ads to learn more about each company’s products and services; and if you choose to do business with any of them now or in the future, you can be assured of a quality buying experience.

DOTmedbusiness news I march 2011 www.dotmed.com52

• Specializing in I.V. Infusion Technology• Sales, service, Rentals• We support what the manufacturer’s

do not anymore• Service, parts, and accessories• Baxter AS50, Infus OR, Medfusion

2000 series, Alaris Medsystem III’s

Jason Ragazzo, sales managerBiomedix Medical

1153 Newark Rd, PO box 324Toughkenamon, PA 19374 USA

Phone: (610) 656-5851Email: [email protected]

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DMBN 3.2012 DOTmed 100 Special Section.indd 56-57 2/29/2012 10:31:41 AM

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DOTmedbusiness news I march 2012 www.dotmed.com58

INDUSTRY SEcTOR REPORT

Information management systems sales fuel market By Diana Bradley

Despite these improvements, as many as one in four patients postpone surgery due to lack of understanding and apprehension about anesthesia, according to the ASA’s Vital Health Report from 2010. And on its web-

site, the National Institute of General Medical Sciences says that for elderly patients and those with certain chronic, systemic diseases like diabetes, general anesthetics are still among the most dangerous drugs used by doctors.

To counteract this, in October, the Anesthesia Quality Institute pioneered the Anesthesia Inci-dent Reporting System, the first nationwide system that collects data including anesthesia-related issues from real, individual cases. As a means of improving patient safety, AQI aims to use this data to educate those in the industry and identify emerging trends in anes-thesia patient safety, including the introduction of new drugs or devices.

nesthesia is now safer than ever. Over the past 25 years, anesthesia-related mortality rates have dramatically decreased from one death per 5,000 anesthetics administered, to one death per 200,000-300,000 anesthetics administered, according to the American Society of Anesthesiologists. In

layman’s terms: a person is 40 times more likely to be struck by lightning than they are to die from anesthesia.

A

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Anesthesia’s device market: Companies battle for market shareBetween 2009 and 2010, the value of the U.S. anesthesia, respiratory and sleep-management device market in-creased 3.7 percent to more than $2.5 billion. Fueled by an-esthesia information management system sales, the overall market is estimated to grow at a midlevel, single-digit rate, reaching $4 billion by 2017, according to iData Research’s May report, “U.S. Market for Anesthesia, Respiratory and Sleep Management Devices.”

But emptier wallets are driving providers to demand more cost-effective products. An increasing number of sicker patients are being admitted to the hospital, placing a greater strain on health care resources, according to Kelly Barritt, senior market analyst in clinical care for research group InMedica.

“Following from the economic recession, clinicians are starting to make more informed purchasing decisions to ensure they get the best return on investment; demand for anesthesia devices is expected to decrease as a conse-quence,” she explains.

The anesthesia delivery unit market, in particular, is also getting more competitive. Picis, GE Healthcare, Drae-ger, IMDsoft, Merge and Philips are now releasing low-cost, low-acuity models to compete with Mindray Medical International Ltd., MAQUET and Penlon and other firms that have recently entered the market. Unit sales are fore-casted to increase through 2017 as a result of these lower cost devices coming out, adds iData’s report.

Across the industry and on a promotional level, OEMs are knocking down prices to levels never before seen, notes Ashish Dhammam, regional sales director, for refurb company Soma Technology. But buying secondhand still remains a much cheaper option.

“In general, if you were to buy a new piece of equip-ment from us, you would save up to 60 percent — I’m talking list price savings,” he says.

Barritt notes that beyond cost, the big focus for most anesthesia device manufacturers is getting a complete solution in place for hospitals.

“Products that provide a total solution for anesthesia care, including integrated decision support, intelligent alarms, and enhanced monitoring and visualization sys-tems are in most demand,” she explains.

AIMS: What’s driving the driverAnesthesia information management systems, or AIMS, is the big talk in the sector today. The systems, which track vital information about anesthesia being delivered dur-ing surgery, are being increasingly recognized as a vital link in patient care. “They will help us by harnessing the computational power to better control care we deliver dur-ing surgery, much as advanced avionics systems make complex and safer aircraft possible,” says ASA president, Dr. Jerry Cohen.

This year, the AIMS market is predicted to skyrocket, growing by more than 50 percent. The growth can largely

be attributed to U.S. legislation that requires hospitals to automate data collection in their anesthesia departments by 2015 as part of the implementation of electronic medical records, according to iData’s report.

AIMS are thought to help decrease malpractice claims by streamlining workflow. Yet, in a report last April, market research group KLAS found more optimism than actual adoption in the AIMS market. Between 2007 and 2010, the number of surgery departments using AIMS increased from 6 percent to 26 percent, with 63 percent of hospitals using only surgery systems stating they plan on purchasing an AIMS.

Vendors claiming the largest share of the AIMs market include Cerner, Draeger, GE, Philips and Picis, according to KLAS’ report.

Hospitals using AIMS designed for the perioperative market realized big savings. The average hospital saved $584,000 a year using such systems, and the hospital’s three-year investment of $1.3 million generated a positive ROI in 8 months, according to a 2008 white paper by finan-cial research firm Hobson & Co.

For the anesthesia sector in particular, meaningful use requirements highlight the need for improved connectivity between the various devices in the patient care environ-ment, including those in the OR, according to Risto Rossi, global anesthesia segment leader, premium life care solu-

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DOTmedbusiness news I march 2012 www.dotmed.com60

tions, for GE Healthcare’s Helsinki branch. In the next five years, as sophisticated AIMS and EMR

technology drives the market, equipment must keep up, as well as offer cost saving advantages and time effi-ciency. Devices such as MAQUET Medical System USA’s Flow-i Anesthesia Delivery System — which received FDA 510(k) clearance in June of 2011 and is the newest anesthesia system on the market — are designed with this in mind, including a communication port for remote diagnostic and repair services. Nancy Werfel, MAQUET’s marketing manager for anesthesia, notes that Flow-i’s comprehensive service, availability of parts and reduced downtime are important components.

Low-flow anesthesia: Another cost-effective routeBack in 1996, a European Journal of Anesthesiology paper noted that the reduction in fresh gas flow offered opportu-nities for significant cost savings and reduced workplace environmental impacts. Rossi notes that this observation is probably even timelier right now as providers are con-stantly tasked to provide high quality care while simulta-neously lowering costs.

“We in GE Healthcare have definitely seen an increased awareness among anesthesiologists for low-flow anesthe-sia,” Rossi says. “Globally, we have seen our customers responding positively to our low-flow enabled anesthesia systems and Advanced Breathing System platform prod-ucts—Aisys, Avance and AespireView.”

Although low-flow anesthesia is currently used more frequently in Europe, more and more U.S. clinicians are administering flows close to 2L and below, according to Werfel. Products like the Flow-I system have the capability to support low-flow anesthesia with settings as low as 0.3L.

“I think that there are definite advantages to low-flow anesthesia, such as less pollution, less patient heat loss, and fewer anesthetics used,” says Dr. Ashley Ryan, an anesthesiologist at Oconee Regional Medical Center in Milledgeville, Ga.

Low-flow gasses are especially useful because they re-lease less exhaled volatile anesthetic into the atmosphere, which reduces the environmental imprint anesthesiolo-gists make as they care for their surgical patients.

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DOTmedbusiness news I march 2012 61

“In addition, low flow uses less an-esthetic, thereby saving cost without compromising safety,” Cohen says.

In demand: Products, fea-tures and new technologies everyone’s talking aboutOn the used market side, some deal-ers are reporting that buyers now want newer models. Historically, 10- to 20-year-old Ohmeda Excel 110 Anesthesia Machines and Draeger Narkomed 2A and 2B anesthesia systems were in demand, according to Dhammam, a dealer. But today,

GE’s Aestiva/5 and Aespire systems, and Draeger’s Fabius products, are probably the most popular anesthesia machines in the U.S., he adds.

“I attribute that to obsoletion of equipment,” says Dhammam. “Many hospitals switch to a different prod-uct every time a manufacturer de-cides to stop supporting equipment with parts, even if their equipment still has a lot of life left in it.”

Aside from reassurance that the technology they purchase will not become prematurely obsolete, hospitals prefer equipment that is compatible with other vital equip-ment and electronic medical records. Because of this trend, new equipment offers regular software updates and enhanced features via USB.

In addition, the patient popula-tion’s continuous trend towards sick-er, older, younger or more morbidly obese patients undergoing surgical procedures is also having an effect on the anesthesia market.

“There is a greater need for advanced ventilation capabilities to support the ventilatory challenges of these patients,” Werfel says.

Ryan, who uses MAQUET’s Servo-i ICU ventilator, the company’s Kion-i anesthesia machine and the new Flow-i anesthesia machine, notes that the biggest trends include regional anesthesia, as well as implementing transthoracic echocardiography into the practice of the general anesthe-siologist, video laryngoscopy, and continuous CO2 monitoring for all patients, including sedation cases. He believes that the market has a lot of room for improvement.

“I think that the market for anes-thesia where we will potentially see

quite a bit of advancement will be in the improvement and implementa-tion of noninvasive cardiac output measurements as well as the contin-ued development in the electronic charting programs for anesthesia providers,” Ryan says.

Ryan also believes China may flex its manufacturing muscle, flooding the market with products that may be “average to below average anesthesia machines and other products, but [nonetheless] appealing because of the difference in cost.”

The global anesthesia market will continue growing and demanding new solutions to address issues such as cost pressures, care quality focus and affordable, accessible solutions, according to Rossi.

“It seems that the anesthesia market will see faster growth in the developing world as buying power increases,” he says. “Developed markets will focus on ensuring that information in their systems is put to good use, by continuing to link de-vices to each other and the electronic medical record.”

• Online: dotmed.com/dm18178

Although low-flow anesthesia is currently used more frequently in Europe, more and more U.S. clinicians are administering flows close to 2L and below, according to Werfel.

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DOTmed Registered Anesthesia Sales & Service CompaniesFor convenient links to these companies, go to www.dotmed.com and enter [DM 18178] Names in boldface are Premium Listings.

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The Association of periOperative Registered Nurses—formerly known as the Association of Operating Room Nurses—held its first yearly national conference in

New York in 1954. Based in Denver, Colo., the non-profit organization ’s membership currently boasts approximately 40,000 registered nurses.

AORN will be hosting its upcoming Annual Con-gress—the continent’s largest surgical products trade-show—from March 24-29 in New Orleans, La. The event, which spans six days with the first two days considered Pre-Congress, will allow attendees the opportunity to connect with thousands of perioperative pro-fessionals while visiting over 100 education sessions and sharpening their career-building abilities.

More than 5,200 professionals from over 2,200 different facilities attended last year’s show, which housed 515 exhibiting companies in Philadelphia, Pa. This year, the association expects an even bigger turnout in the Big Easy during its 59th annual gathering.

“Based on early bird registra-tion, we anticipate 6000 profession-als representing an equal increase in facilities,” Gayle Davis, AORN’s corporate communications manager wrote to DOTmed News in an email. “New Orleans is always popular for Congress and it’s a good location for those people who want to drive into the city to attend the conference for just a day or two.”

Each year, the theme is selected by the association’s president—a title currently held by Anne Marie Herlehy, who will be replaced by Deborah Spratt at the end of the event. Herlehy’s theme for this year is, “We Care. Influence Safe Perioperative Practice.”

“For the perioperative nurse, [AORN’s Congress is] an opportunity to learn the most up-to-the-minute, evidence-based information on safe surgical practices from well-known speakers,” said Davis. “The week gives them time and opportunities to talk to their peers about challenges, share experiences, and explore or challenge old and new ideas. Nurses come in from across the country and some from around the world. They come from large and small facilities, a wide variety of geographic settings and every different specialty area. They use this time to build their knowledge and skills from sessions and networking.”

Scheduled speakers and awardsThe opening keynote speaker of the Congress will be

Newark, N.J., Mayor Cory Booker, who will deliver a speech titled, “How to Change the World with Your Bare Hands.” Other speakers will include Cheryl Dellasega (“Spite in White: Do Nurses Really Eat Their Young (And Other Folks They Don’t Like)?”); Bob and Lee Woodruff (“Surviving Together: A Personal Journey”); Michael R. Bleich (“Every Nurses Commitment: What the IOM Future of Nursing Report Needs from You”); and Walter Bond

(“No One Can Stop You But You!”).During the event there will be

several awards presented, including Outstanding Achievement awards in the areas of Perioperative Clinical Nurs-ing Practice, Mentorship, Public Policy

Advocacy, State Council Leadership, and Volunteerism.

Exhibitions and education sessionsOver the course of three days, the Congress will be hosting more than a dozen hours worth of exhibition time, during which visitors can learn about new products, services and career development opportunities.

Also at this year’s show, attendees will be able to choose from 12 educa-tion tracks: Ambulatory, Clinical, Educator, Ethics/Legal, Evidence-Based/Research, Infection Control/Infection Prevention, Informatics,

International, Leadership/Management, Professional Development/Issues, Quality, and Sterile Processing. Hot topic sessions will touch upon issues such as extreme posi-tioning for MIS, OR environmental hygiene and validating competencies for perioperative nursing.

“New technologies continue to influence how we run the event and how we present our education sessions,” said Davis. “The attendees can document their earned CE credits while they’re still at the conference, exhibitors can track their leads electronically, and we have rooms where attend-ees can watch multiple sessions, live, on large screens.”

Virtual CongressSimilar to the annual conferences hosted by RSNA and HIMSS, the 2012 AORN Congress will be offering virtual features such as live and on-demand sessions, a network-ing lounge and a virtual exhibit floor.

“After the conference, the virtual Congress will offer ten recorded, edited, online education sessions with CE credits that can be accessed anytime from the AORN web-site,” said Davis.

• Online: dotmed.com/dm18211

AORN Congress in the Crescent CityBy Joanna Padovano

AORN Fast FactsHeadquarters: Denver, Colorado

Previously known as: Association of Operating Room Nurses

Vision: “AORN will be the indispensable resource for evidence-based practice and education that establishes the standards of excellence in the delivery of perioperative nursing care.”

First Annual Congress: 1954

Professional attendees in 2011: 5,235

Anticipated attendees in 2012: 6,000

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MEDICAL MUSEUM

Category: UrologyEstimated Date: 1868Name: Wales EndoscopeManufacturer: Horatio G. KernDescription: 12” x 6“x 2” wooden box with leather cover embossed Wales Endoscope. Contains red velvet lining with four 9” tubes of varied diameter, one with right angle and 1”

extension, as well as obturators. There is a 3.5” mirror on a brass stand with an attach-ment for a lens and a clamp to go on the end of the urethroscope. Two lenses are missing. There is a knife and possible caustic holder. Tiemann in the catalog listed as a reference illustrates the Otis endoscopic tube. One of the tubes in the Wales outfit is virtually identical.

• Online: dotmed.com/dm18210

WalesEndoscope

The picture and description appear courtesy of Dr. M. Donald Blaufox, M.D., Ph.D, from his website: www.mohma.org.

ach month we visit Dr. Blaufox’s Museum of Historical Medical Arti-facts to take a look back at the medical equipment that cleared the way for what patients encounter in the doctor offices and operating rooms of

today. Some equipment may be recognizable, while other inventions featured here have since become obsolete or have had their usefulness discredited.

Medical_Museum V2.indd 2 3/1/2012 12:06:02 PM

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DOTmedbusiness news I march 2012 65

This month marks 68 years since the death of Dr. Carl Koller. A mere suggestion from colleague Sigmund Freud would lead Koller to discover

that cocaine could numb the prickly problems asso-ciated with eye surgery. Green with envy at Koller’s quick success, Freud crowned the surgeon with the unfortunate nickname “Coca-Koller.” Although it is now extremely rare for cocaine to be utilized as an anesthetic, due to its addictive qualities and damag-ing effects on the cornea, Koller is still considered the founder of local anesthesia in ophthalmology.

Picturing 19th century surgery is enough to make anyone’s eyes water. But those doomed to undergo cataract surgery were particularly out-of-luck. 40 years prior to Koller’s discovery, ether and chloroform had been introduced as a general anesthetic. But even with these agents, eye surgery was akin to get-ting a red-hot needle in your eye for 45 minutes. To top this off, patients usually had to be fully conscious and responsive during this traumatic ordeal. To make the procedure more challenging, this method was known to induce severe vomiting in patients. All in all, not the most efficient means for conducting delicate eye surgery, which was why Koller’s discovery was all the more important.

The Czech-born Koller was a 26-year-old intern and house surgeon at the Allgemeine Krankenhaus (or General Hospital) in Vienna. This is where he began his experi-ments with cocaine as a local anesthetic in eye surgery, moving from a frog to a rabbit to a dog. Koller’s colleague, Dr. Joseph Gaertner, describes the “historic” moment he witnessed a frog’s eye being touched with a needle after a drop of the cocaine solution had been administered.

“The frog permitted his cornea to be touched and even injured without a trace of reflex action or attempt to pro-tect himself — whereas the other eye responded with the usual reflex action to the slightest touch,” he explained.

After this, Koller took his experiments to the next level and began testing his newfound local anesthetic on hu-mans – in particular, his colleagues. The scientists trickled the cocaine solution into their eyes and then touched pins to their corneas, making dents without the slightest feel-ing or reflex. And with that, the discovery of local anesthe-sia was completed, according to Gaertner.

News of Koller’s experiments spread worldwide. Other surgeons soon began testing cocaine as a local anesthetic. Koller prepared a formal address on cocaine for the international Ophthalmological Congress, held in Sept. 1884 in Germany. However, with the travel expense too steep for the poor surgeon, a 49-year-old ophthal-mologist, Dr. Josef Brettauer, was chosen as a surrogate to present Koller’s findings at the meeting. As part of his presentation, Brettauer demonstrated the effect of the

cocaine solution on a canine’s eye. Koller’s discovery was verified when, after touching the dog’s eye with a forceps, no whimper-ing, barking or even flinching occurred. The only sound that followed was the audience roaring with applause.

But Koller’s dream to obtain an academic career in Vienna, with a position in the hospital’s eye department, was never real-ized. In 1885, after being called an “impu-dent Jew” by colleague Fritz Zinner, Koller responded with a face-slapping. This led to an illegal duel with sabers, which left Zinner with two deep cuts, while Koller walked away unharmed. Forced to emigrate, New York eventually became Koller’s new home in 1888, where he set up a successful prac-tice as an ophthalmologist. Four years later,

he discovered the use of subconjunctival cocaine in eye surgery, refining his technique – particularly in the areas of cataract surgery and procedures involving the iris.

In his lifetime, Koller received a number of distinctions. He was nominated several times for the Nobel Prize in Physiology and Medicine. In 1922, Koller became the first ophthalmologist to receive the American Ophthalmologi-cal Society’s Lucien Howe Medal. It was even speculated in Derek Vail’s biography of Howe that the award might have been established specifically to honor Koller’s work. Further to this, the Austrian Academy of Cosmetic Surgery initiated the Karl Koller Award to be presented for out-standing contributions in the field of local anesthesia. Be-cause of Koller’s work, pharmaceutical companies thrived by marketing cocaine and later, safer local anesthetics like Novocain and Xylocaine.

Koller died on March 21, 1944 in New York, N.Y. he was 86.

• Online: dotmed.com/dm18209

“Coca-Koller” and the discovery of local anesthesia By Diana Bradley

THIS MONTH IN MEDIcAL HISTORY

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Tingle Rad RoomAuction 24041DOM: 1995This is a Private Sale Auction

LINEAR ACCELERATORS

Siemens Mevatron KD2 Linear AcceleratorAuction 21875DOM: 1993Starting Bid: $5,000

LASERS

Coherent Versa VP Select Laser – HolmiumAuction 23244Starting Bid: $3,000

NUCLEAR – MOLECULAR IMAGING

Elscint Millenium VG Nuclear Gamma CameraAuction 24015DOM: 1995Current Bid: $1,100

GE Millennium MPS SPECT CameraAuction 24150DOM: 2002This is a Private Sale Auction

CAMERAS

Kodak Dryview 8100 Dry CameraAuction 20539DOM: 2001This is a Private Sale Auction

Kodak CR 900 Multi-LoaderAuction 23896This is a Private Sale Auction

PORTABLE X-RAY

OREX PCCR 1417 Portable X-RayAuction 24156This is a Private Sale Auction

STERILIZERSAMSCO Century V116 SterilizerAuction 24195Current Bid: $1,500

STERIS Amsco Eagle 3017 SterilizerAuction 23039DOM: 2004Current Bid: $1,175

ALL OTHERS

Datex-Ohmeda ADU S/5 Anesthesia MachineAuction 23443Current Bid: $3,000

Marquette Mac 15 Stress System Stress TestAuction 24111Starting Bid: $1,500

Surgical Design 742 R2 PhacoemulsifierAuction 24190Starting Bid: $1,000

Burdick Medic 5 DefibrillatorAuction 23753This is a Private Sale Auction

Biomerieux Vitek Microbiology AnalyzerAuction 24187This is a Private Sale Auction

Johnson & Johnson Vitros 350 Chemistry AnalyzerAuction 22943DOM: 2006This is a Private Sale Auction

Featured Auctions on www.DOTmed.comThese are just a sample of the more than 250,000 listings on DOTmed on any given day.

PRIVATESALE

OEM Webstores www.DOTmed.comA unique way to shop and compare a wide range of new products.

DOTmed WebStores are hardworking virtual stores with infinite shelf & showroom space. There is nothing quite like a DOTmed WebStore for showcasing and selling new products online. Companies can post selected products, or post their entire inventory in a WebStore – giving customers a chance to see everything at once. Each listing can be a snapshot of a product with a link back to the OEM’s website where the full sell-story resides.

Each listing in a WebStore is also listed in the equipment category on DOTmed where it belongs – so the OEM is actually getting double exposure.

Easily sent by emailIt’s easy to email an entire WebStore to anyone anytime. And every time the owner updates a listing, it’s updated in the WebStore too – so it’s always up-to-date.

Links to the owner’s Virtual Trade Show boothIf the OEM has a DOTmed Virtual Trade Show booth – which most do – the header to their WebStore is the header section of the VTS booth. This gives the customer the opportunity to easily get more information about the company and their sales team.

Visit these leading OEM WebStores today

To see actual WebStores in action, “search” for these

company names in DOTmed’s Virtual Trade Show and you’ll find a link to their WebStore.

BiodexDunlee

GE HealthcareShimadzu

Varian

The WebStore for STeriS

12345A Search Equipment

All auctions were running at time of publication. Enter the Auction number in the search box on www.DOTmed.com.

The WebStore for Biodex

Both companies have additional listings on

multiple pages

Yes – Anyone can buy equip-ment posted in a Private Sale Auction. Private Sales are commission-free auctions for healthcare providers. Even though it’s a “Private Sale” – the bidding is limited to pre-screened DOTmed Gold Service Dealers – anyone can buy one of these auctions with the help of a friendly Gold Service Dealer. Just visit any Private Sale to learn how. The GSD will bid for you and act as your purchasing agent. This can be a significant benefit because your GSD will handle the deinstallation, crating and shipping. You will also find many standard auctions listed below, and find many more on DOTmed.com.

DMBN March Featured Auction OEM Webstore Spread.indd 66-67 3/1/2012 12:04:20 PM

Page 69: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 67DOTmedbusiness news I march 2012 www.dotmed.com66

About DOTmed

Private Sale Auctions

MRI SCANNERS

Esaote MRI ScannerAuction 24183DOM: 2005This is a Private Sale Auction

Philips Quad Gyroscan T.5NT MRI ScannerAuction 18808This is a Private Sale Auction

ULTRASOUNDSiemens Antares Shared ServiceAuction 24164Current Bid: $1,100DOM: 2001

Siemens Antares OB/GYN UltrasoundAuction 24163Current Bid: $1,200DOM: 2002

Acuson Cypress Cardiac UltrasoundAuction 24153DOM: 2006This is a Private Sale Auction

Sonosite M-Turbo Shared ServiceAuction 24028DOM: 2008This is a Private Sale Auction

BioSound MyLab 30 CV Portable Cardiac Vascular UltrasoundAuction 24005This is a Private Sale Auction

RAD – RAD/FLUORO ROOMS

Siemens Multix FD Rad RoomAuction 23920DOM: 2001Current Bid: $2,000

Den-Tal-EZ E-2000 Dental ChairAuction 22566Current Bid: $1,000

Tingle Rad RoomAuction 24041DOM: 1995This is a Private Sale Auction

LINEAR ACCELERATORS

Siemens Mevatron KD2 Linear AcceleratorAuction 21875DOM: 1993Starting Bid: $5,000

LASERS

Coherent Versa VP Select Laser – HolmiumAuction 23244Starting Bid: $3,000

NUCLEAR – MOLECULAR IMAGING

Elscint Millenium VG Nuclear Gamma CameraAuction 24015DOM: 1995Current Bid: $1,100

GE Millennium MPS SPECT CameraAuction 24150DOM: 2002This is a Private Sale Auction

CAMERAS

Kodak Dryview 8100 Dry CameraAuction 20539DOM: 2001This is a Private Sale Auction

Kodak CR 900 Multi-LoaderAuction 23896This is a Private Sale Auction

PORTABLE X-RAY

OREX PCCR 1417 Portable X-RayAuction 24156This is a Private Sale Auction

STERILIZERSAMSCO Century V116 SterilizerAuction 24195Current Bid: $1,500

STERIS Amsco Eagle 3017 SterilizerAuction 23039DOM: 2004Current Bid: $1,175

ALL OTHERS

Datex-Ohmeda ADU S/5 Anesthesia MachineAuction 23443Current Bid: $3,000

Marquette Mac 15 Stress System Stress TestAuction 24111Starting Bid: $1,500

Surgical Design 742 R2 PhacoemulsifierAuction 24190Starting Bid: $1,000

Burdick Medic 5 DefibrillatorAuction 23753This is a Private Sale Auction

Biomerieux Vitek Microbiology AnalyzerAuction 24187This is a Private Sale Auction

Johnson & Johnson Vitros 350 Chemistry AnalyzerAuction 22943DOM: 2006This is a Private Sale Auction

Featured Auctions on www.DOTmed.comThese are just a sample of the more than 250,000 listings on DOTmed on any given day.

PRIVATESALE

OEM Webstores www.DOTmed.comA unique way to shop and compare a wide range of new products.

DOTmed WebStores are hardworking virtual stores with infinite shelf & showroom space. There is nothing quite like a DOTmed WebStore for showcasing and selling new products online. Companies can post selected products, or post their entire inventory in a WebStore – giving customers a chance to see everything at once. Each listing can be a snapshot of a product with a link back to the OEM’s website where the full sell-story resides.

Each listing in a WebStore is also listed in the equipment category on DOTmed where it belongs – so the OEM is actually getting double exposure.

Easily sent by emailIt’s easy to email an entire WebStore to anyone anytime. And every time the owner updates a listing, it’s updated in the WebStore too – so it’s always up-to-date.

Links to the owner’s Virtual Trade Show boothIf the OEM has a DOTmed Virtual Trade Show booth – which most do – the header to their WebStore is the header section of the VTS booth. This gives the customer the opportunity to easily get more information about the company and their sales team.

Visit these leading OEM WebStores today

To see actual WebStores in action, “search” for these

company names in DOTmed’s Virtual Trade Show and you’ll find a link to their WebStore.

BiodexDunlee

GE HealthcareShimadzu

Varian

The WebStore for STeriS

12345A Search Equipment

All auctions were running at time of publication. Enter the Auction number in the search box on www.DOTmed.com.

The WebStore for Biodex

Both companies have additional listings on

multiple pages

Yes – Anyone can buy equip-ment posted in a Private Sale Auction. Private Sales are commission-free auctions for healthcare providers. Even though it’s a “Private Sale” – the bidding is limited to pre-screened DOTmed Gold Service Dealers – anyone can buy one of these auctions with the help of a friendly Gold Service Dealer. Just visit any Private Sale to learn how. The GSD will bid for you and act as your purchasing agent. This can be a significant benefit because your GSD will handle the deinstallation, crating and shipping. You will also find many standard auctions listed below, and find many more on DOTmed.com.

DMBN March Featured Auction OEM Webstore Spread.indd 66-67 3/1/2012 12:04:20 PM

Page 70: DOTmed Business News 03-12
Page 71: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 69

www.TechnicalProspects.com

New 60,000sqft Headquarters

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Email: [email protected]

Masimo Authorized Distributor

We sell and support the “gold standard” Masimo SET pulse oximetry, as well as all of the Rainbow TechnologyTM parameter measurements.

We stock all sensors available all the time — any quantity.

Marco Systems LLC888.425.5763 • 330.677.4025

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PROTONSERVICES INCORPORATED

776 Jernee Mill Road, Suite 120Sayreville, NJ 08872

1 800 793-0190 Fax 732 238-1225www.prosvcs.com [email protected]

We want to thank all our satisfiedcustomers for choosing Proton

We install, sell and service all types of whole body diagnostic imaging scanners in New Jersey, New York, Connecticut, Florida, and Eastern Pennsylvania.

We now directly repair and asset manage the following modalities:

MRICT

X-RayR&F

Bone DensitometryMammography

Ultrasound(we cover most manufacturers, please call for details)

We also service:Chillers, Cameras, Processors,

and MRI Coils

We correct chronic and intermittent imaginghardware problems, software problems,

application problems, and assist with ACR Accreditations.

Page 72: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 www.dotmed.com70

• Inside Pick Up and Delivery• Rigging• Packaging and Crating• Blanket Wrap Logistics• Air Ride Trucks• Full Value Insurance• Import/Export• Import/Export

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Magnet Services and First Class Replacement Parts for the Cryogenic and MRI Industries

Sumitomo, Leybold, Balzers & APD

24 Hour Response Time

Cryogen Sales & Filling

PM & Maintenance Agreements

Coldheads

Compressors

Cryocoolers

Flex Lines

Adsorbers

Page 73: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 71

Medical Equipment Specialists

When your medical equipment needs the utmost care in rigging, removal and installation, F. Ambrose Rigging

is your one-stop shop for medical excellence!

● De-installations● Installations● Removal of Old Rooms● New Deliveries

● Relocations● Cold MRI Storage● 44,000 sq. ft Warehouse

www.ambroserigging.com215-674-9232

F. Ambrose Rigging

ADVERTISER INDEX

Altima Diagnostic Imaging Solutions 10 www.altimadis.com

Amber Diagnostics 43 www.amberusa.com

ANDA Medical 1 www.andamedical.com

ASP 44 www.aspjj.com

Bemis Health Care 26 www.bemishealthcare.com

C&G Technologies, Inc. 45 www.cgtscan.com

Complete Medical Services 41 www.completemedicalservices.com

Connect Imaging, Inc. 11 www.connectimaging.com

Dobbs Medical Sales, Inc. 31 www.dobbsmedicalsales.com

Doctors Depot 61 www.doctorsdepot.com

Dunlee, Inc. Inside front cover www.dunlee.com

ETS-Lindgren 13 www.ets-lindgren.com

HCP 7 www.hlthcp.com

IDN 46 www.idnsummit.com

Image Technology Consulting, LLC 21, 59 www.imagetechnology.net

International Medical Equipment, Inc. 36 www.intmedicaleq.com

Lighthouse Imaging Corp. 33 www.lighthouseoptics.com

MAQUET 23 www.maquetusa.com

Medical Imaging Resources, Inc. 62 www.medimagingsales.com

Medicall 4 www.medicall.in

MedStar Equipment 34

MTM Medical 32

Nationwide Imaging Services, Inc. www.nationwideimaging.com Inside back cover

Numed 15 www.numedinc.com

Owen Kane Holdings, Inc. 68 www.owenkane.com

Oxford Instruments 14 www.oxford-instruments.com/mri

PulseConsultants 60 www.pulseconsultants.com

Physicians Resource Network, Inc. 24 www.prnwebsite.com

Quest Medical Supply, Inc. 25 www.questmedicalsupply.com

SH Medical Corporation 35

STERIS 29 www.steris.com

Stryker Sustainability Solutions 42 sustainability.stryker.com

Sunnex, Inc. 27 www.sunnexmedical.com

Unfors Instruments, Inc. 12 www.unfors.com

Varian Medical Systems, Inc. Back cover www.varian.com/interay

Viable Med Services, Inc. 28 www.viablemed.net

Ziehm Imaging 22 www.ziehm.com

DOTmed 100 Resource Section 54

ADVERTISER ADVERTISER ADVERTISERPAGE PAGE PAGE

ASSOCIATED IMAGING SERVICES

SMV and G.E. PartsFull-Service ContractsEquipment Relocations

Camera Sales/Purchases

800.607.2115www.aismedical.com

AIS_DotMedMktplace_Ad_01_AIS_DotMedMktplace_A

Affiliated with Viking Rigging & Logistics, Inc "NATIONWIDE RIGGING AND LOGISTICS SERVICES COMPANY"

Page 74: DOTmed Business News 03-12

DOTmedbusiness news I march 2012 www.dotmed.com72

IMAGING

ATL Shared Service HDI 5000 Auction #18463 – sold for an exporter in Japan, $2,750.

GE CT Scanner 2003 GE HS QXI H2 + Performix Tube with 5.3 MHU Auction #19198 – sold for a broker in Ill., $75,000.

SUMMIT Rad Room E7242X Auction #18341 – sold for a medical office in Kan., $4,500.

SIEMENS Nuclear Computer SyngoMI-Mobile2006A Auction #8623 – sold for an ISO in Ohio, $3,000.

MILLER Empty Trailer 1992 and 1990 Auction #18650 – sold for an ISO in Va., $8,000.

SIEMENS MRI Mobile Impact Magnetom Auction #15415 – sold for a hospital in N.Y., $17,500.

SURGICAL

STERIS O/R Table ASC 2000 Auction #17594 – sold for a charity in Conn., $9,000.

BURTON O/R Light AIM-100 Auction #19283 – sold for a manufacturer in N.J., $3,200.

OHMEDA Anesthesia Machine Plus II Auction #19273 – sold for a hospital in N.Y., $6,200.

AMSCO O/R OB Table 2080 Auction #18858 – sold for a hospital in N.J., $2,700.

VALLEY LAB Electrosurgical Unit Force 1 C Auction #16011 – sold for a hospital in NY, $2,000.

GE Mammo Unit Senographe DMR Auction #10427 – sold for an imaging center in Hawaii, $4,500.

HOLOGIC Bone Densitometer 4500C with QDR Auction #19322 – sold for a medical office in Mich., $5,500.

GE CT Scanner 2003 GE HS QXI H2 Auction #19198 – sold for a broker in Ill., $75,000.

OEC C-Arm 9600 Auction #18921 – sold for a medical office in Calif., $27,000.

MILLER Empty Trailer 1992 and 1990 Auction #18650 – sold for an ISO in Va., $8,000.

AGFA CR ADC Solo Auction #17449 – sold for a dealer in Texas, $2,200.

NEUROLOGY

NEURAL-SCAN Other Neural Scan Auction #19000 – sold for a clinic in Tenn., $15,000.

LABORATORY

MICROM Microtome HM 315 Auction #18500 – sold for a hospital in N.C., $4,200.

UNKNOWN Disposables - General Various Auction #17323 – sold for a dealer in Ind., $14,000.

IDEXX Blood Gas Analyzer Vetstat Auction #17815 – sold for a veterinary clinic in S.C., $1,800.

TECAN DNA Related Genesis 200/8 Auction #17029 – sold for a dealer in NY, $1,000.

OPTHAMALOGY

ALCON Phacoemulsifier Series 2000 Auction #17297 – sold for a broker in N.Y., $1,000.

DENTAL

ZURICH DENTAL Hand Instrument High Speed Dental Handpiece ST-Torque Mini 100 Units Auction #11640 – sold for a manufacturer in N.Y., $4,000.

FURNITURE

HAUSTED Stretcher 800 Series Unicare I Auction #17451 – sold for a hospital in Ore., $1,000.

Recent equipment and parts auctions on DOTmed with actual sale prices.

BLUE BOOK PRIcE GUIDE

Want to auction equipment on dotmed.com? Contact an auction specialist.

212.742.1200, ext. 252 or [email protected].

DOTmed Auctions

Page 75: DOTmed Business News 03-12
Page 76: DOTmed Business News 03-12

A replacement for:

Philips MX-8000 and Brilliance® CT scanners.

For more information contact us or your preferred dealer

www.varian.com/interay

GS-532B / AKRON B: for Philips MX 8000 - Dual(2) and Quad(4)• Metal Ceramic Technology• Replaces Philips S532B• Dual focal spots: 0.5 x 0.7, 0.8 x 1.2• 5.3 mHU• Prorated warranty matches OEM 12 months / 150,000 scan seconds

USA Contact InformationVarian Interay1-800-INTERAYTEL 843.767.3005FAX 843.760.0079E-mail [email protected]

Europe Contact InformationVarian X-ray Products Germany TEL 49-2154-924-980FAX 49-2154-924-994E-mail [email protected]

All trademarked terms are property of the respective manufacturer.

Brillance® is a registered trademark of Koninklijke Philips Electronics N.V.

GS-532Q / AKRON Q: for Philips MX 8000 6, 10, or 16, Brilliance® 6• Metal Ceramic Technology• Replaces Philips S532Q• Dual focal spots: 0.5 x 0.7, 0.8 x 1.2• 5.3 mHU• Prorated warranty matches OEM 12 months / 120,000 scan seconds

New from Varian...MX-8000