The Green Issue

Transcription

The Green Issue

Visit DOTmed at HIMSS, April 4-8, McCormick Place, Chicago, Booth #5711
APRIL 2009
SM
New and Used Equipment & Parts from www.DOTmed.com
The Green Issue
Special Feature: The Greening of Hackensack University Medical Center
Deirdre Imus and John Ferguson
INDUSTRY SECTOR REPORTS:
Ŷ CT Scanners
Ŷ C-Arm
Ŷ Arthroscopy
Ŷ Disposables
contents
april 2009
features
16DOTmed Clean Sweep
46
Even hospitals can do some spring cleaning.
31Greening Hackensack
University Medical Center
What’s big, green and doesn’t smell like a hospital?
42Recycling Used Equipment
It’s more involved yet more profitable than your household recycling.
45Green Construction
Green construction can lead to green in the bank.
17 CT Sales and Service
Check on the health of this segment of the industry.
27 Disposables
Even though they’re disposable, they’re still indispensable.
37Arthroscopy Sales and Service
DOTmed makes an exploratory report.
46C-Arm Sales and Service
C-arms continue to flex some muscle.
17
departments
2
Letter from the Editor
14 In the Next Issue
54 People & Companies
4
Feedback
14 Focus on Performance
57 Law & Order
6
Hospital & Health News
41 Spotlight on Service
60 Old Into Gold
10 Healthcare Chronicles
44 Shows & Conferences
62 Marketplace & Classifieds
12 What’s New
53 This Month in Medical History
68 Blue Book Price Guide
letter from the
editor
Green isn’t just for St. Paddy’s Day
Our April issue of DOTmed introduces a number of things
I’m excited about. First, it’s our “Green Themed” issue.
That means many of the features and even some of the Industry Sector Reports have been approached in a way that
highlights aspects dealing with the environment. You may
be surprised how much health care and the environment
do go hand-in-hand.
The second exciting event is hinted at on the cover.
DOTmed was invited by Deirdre Imus of the Deirdre Imus Environmental
Center for Pediatric Oncology at Hackensack University Medical Center and
John Ferguson, president and CEO of Hackensack to visit the hospital and
discover how they went about “greening” their facility. We bring that meeting
to you in this issue.
As promised last issue, there is more information about the Association
of Medical Service Providers (AMSP) and more will follow in the future.
This group offers a lot of benefits to those they do business with and it pays
to learn about them.
This issue also introduces a new regular feature called “Spotlight on Service.” We hope to hear from you on what direction you would like to see this
feature go so we can continue to improve upon the content we offer.
I hope you enjoy our first “Green” issue and keep an eye out for next
month’s themed issue “Women’s Health.”
As always, questions, comments and suggestions are always welcome.
Please email me at [email protected]
Until next issue!
Sean Ruck
Editor-in-Chief
DOTmed Business News
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DOTmed Business NewsSM
invites all medical industry
professionals who have unique
experience or knowledge in
any clinical or business area of
healthcare to submit an article
for publication.
On The Cover:
Deirdre Imus, philanthropist, and environmental and children’s health advocate,
with John P. Ferguson, President and CEO of Hackensack University Medical
Center, photographed in the lobby of the Donna A. Sanzari Women’s Hospital,
part of the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion — an
award-winning facility built with environmentally responsible materials.
DOTmedSM provides the DOTmed Business NewsSM to its registered users free of charge. DOTmedSM
makes no warranty, representation or guarantee as to the accuracy or timeliness of its content.
DOTmedSM may suspend or cancel this service at any time and for any reason without liability or
obligation to any party. All trade names, trademarks and trade dress contained herein belong to
their respective owners and are used herein with the intent to represent the goods and services
of their respective owners. If you think your trade name, trademark or trade dress is not properly
represented, please contact DOTmed.com, Inc.
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I april 2009
April 2009
Publisher
DOTmed.com, Inc.
President
Philip F. Jacobus
Executive Editor
Robert Garment
212-742-1200 Ext. 243
[email protected]
Editor-in-Chief
Sean Ruck
212-742-1200 Ext. 218
[email protected]
Associate Editor
Barbara Kram
212-742-1200 Ext. 251
[email protected]
Creative Editor
Bradley Rose
212-742-1200 Ext. 226
[email protected]
Copy Editor
Joan Trombetti
Editorial Coordinator
Kathy Mahdoubi
Design Director
Stephanie Biddle
Contributing Writers
Daniel Callahan, Wayne Webster,
Keith Loria, Astrid Fiano, Mark Klincewicz, BME
Advertising
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Account Executive: Rigo Smith
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Share Your Thoughts
feedback
Our upcoming issue is our “Women’s Health Issue.” So we
want to hear your thoughts: What is the biggest challenge facing health care in regards to women’s health?
Is FDA Creating a New Cardinal Rule?
I read your article about Cardinal Health’s consent decree
[Editor’s Note: See DM 8247] and it made me wonder if you
or the FDA have considered what a company like this would
do to guarantee their place in the market. Has anyone considered investigating whether their test procedures, processes
and quality assurance procedures are developed in such a way
as to yield the desired results that would guarantee them a
pass with the FDA? I too could write a test case that would
pass under the right conditions.
And what’s this about an independent auditor? How
could the FDA allow an “independent auditor” in-house who
becomes like one of the staff with the same things at stake?
Does this auditor then exist to help them create documents
and procedures that are solely for the benefit of getting a pass
from the FDA and maybe not to ensure that their product really works as expected by the consumer? How does the FDA
allow this type of behavior to happen when the company has
obviously failed with issues that cause a recall? The FDA’s
recommendations are supposed to represent the consumer not
the business, and the business is not supposed to get away
with circumventing that in any way.
Sincerely,
J. English
Submit responses to [email protected]
(please include “May Feedback” in the subject line)
Events for April 2009
ARNA National Radiology Nurses Day 2009,
April 10, Nationally-U.S.A.
Health & Rehab (Assistive Technology and Care
Products) 2009, April 12-14, Fredericia, Denmark
6th Annual World Health Care Congress 2009,
April 14-16, Washington D.C.
AHRA (Radiology Administrators) Leadership
Institute Spring Conference 2009, April 14-16,
New Orleans, LA
AONE (Nurse Executives) 44nd Annual Meeting
and Exposition 2009, April 15-19, San Antonio, TX
Japan Radiological Society (JRS) 68th Annual
Meeting 2009, April 16-19, Yokohama, Japan
ISMRM (Magnetic Resonance in Medicine) 17th
Scientific Meeting & Exhibition 2009, April 18-24,
Honolulu, HI
AACR (Cancer Research) 100th Annual Meeting
2009, April 18-22, Denver, CO
CMEF China International Medical Equipment Fair
2009, April 18-21, Shenzhen, China
ACEP (Emergency Physicians) Leadership
and Advocacy Conference 2009, April 19-22,
Washington, D.C.
The latest generation of Unfors Xi featuring
New Unfors Xi Survey Detector
BIOMEDevice Exposition & Conference 2009,
April 22-23, Boston, MA
New mammo beam quality - W/Ag
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AHA (Heart Association) Cardiovascular Disease
and Stroke Conference 2009, April 23-25,
Washington, D.C.
...and more than 20 enhancements.
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CAR (Canadian Radiologists) 72nd Annual
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ARS (Radium Society) Annual Meeting 2009,
April 25-29, Vancouver, Canada
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hospital & health news
CVS Pays $2.25 Million and Toughens
Practices to Settle HIPAA Privacy Case
Climate Change Threatens Health,
Reports Harvard Men’s Health Watch
The U.S. Department of Health and Human Services (HHS)
and the Federal Trade Commission (FTC) has announced that
CVS, the nation’s largest retail pharmacy chain, will pay the
U.S. government a $2.25 million settlement and take corrective action to ensure it does not violate the privacy of its millions of patients when disposing of patient information such as
identifying information on pill bottle labels.
The settlement, which applies to all of CVS’s more than
6,000 retail pharmacies, follows an extensive investigation by
the HHS Office for Civil Rights (OCR) for potential violations
of the Health Insurance Portability and Accountability Act of
1996 (HIPAA) Privacy Rule.
The Privacy Rule requires health plans, health care clearinghouses and most health care providers (covered entities),
including most pharmacies, to safeguard the privacy of patient
information, including such information during its disposal.
Online: dotmed.com/dm8267
Climate change can affect health in many ways. Heat-related illnesses and deaths will increase as the earth warms up.
Hurricanes, cyclones, floods, and wildfires are expected to increase, causing injury and death. Many insects thrive in warm
weather, meaning potential for more insect-borne diseases, including West Nile virus, viral encephalitis, and Lyme disease.
Tropical diseases such as malaria and yellow fever could also
spread to temperate zones like the United States.
Climate change is already producing health problems in
the United States. Ozone layer depletion has increased exposure to ultraviolet B radiation, which contributes to skin cancer and cataracts. Global warming has promoted the growth of
ragweed-another reason for the increase in asthma, as well as
hay fever and allergies.
•
Waiting for Biopsy Results May Adversely
Affect Health
Women who’ve had a breast biopsy know the anxiety of waiting for the results, but that stress may cause adverse health
effects, according to a new study published in the March issue
of Radiology.
•
Landmark Policy Report: Many Cancers
Could Be Prevented in the U.S. and Across
the Globe
A new global policy report estimates that approximately 45%
of colon cancer cases and 38% of breast cancer cases in the
U.S. are preventable through diet, physical activity and weight
maintenance. The report also sets out recommendations for
policies to reduce the global number of cancer cases.
The overall message of the report, Policy and Action for
Cancer Prevention, published by World Cancer Research Fund
(WCRF) and American Institute for Cancer Research (AICR),
is that all sections of society need to make public health, and
cancer prevention in particular, a higher priority.
It includes estimates on the proportion of many different
types of cancer that could be prevented through diet, physical
activity and weight management. In the U.S., about one third
of the most common cancers could be prevented. That figure
does not include smoking, which alone accounts for about a
third of cancers.
•
FDA Warns About Risk of Wearing
Medicated Patches During MRIs
“When women express how taxing it is to have to wait for
results, the medical establishment may dismiss their feelings as
psychological,” said the study’s lead author, Elvira V. Lang, M.D.,
associate professor of radiology at Harvard Medical School and
radiologist at Beth Israel Deaconess Medical Center in Boston.
“We were able to show that this state of not knowing the diagnosis goes along with biochemical changes which can have adverse
effects on wound healing and the immune system.”
•
6
DOTmedbusiness news
I april 2009
Certain adhesive patches that deliver medication through the
skin have been found to be a risk to patient safety. The patches,
if worn while undergoing magnetic resonance imaging scans
or MRIs, can cause skin burns, says the U.S. Food and Drug
Administration.
The patches of concern include both brand name and generic products and patches purchased over the counter without
a prescription.
•
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HHS Announces New Health Reform Website
The Department of Health and Human Services (HHS) has announced the implementation of a new web site dedicated to
health care reform, www.healthreform.gov. In an HHS press
release, HHS Spokeswoman Jenny Backus stated that the web
site and a new report on the web site, Americans Speak on
Health Reform: Report on Health Care Community Discussions, would “ensure that when we discuss health reform, the
American people will have an equal stake in the health reform
efforts.” Ms. Backus also stated, “Sky-rocketing health care
costs are creating enormous pressure on families, on businesses and our fiscal future. The Obama Administration is committed to taking action this year on health reform and is calling on
government, business, health care stakeholders and everyday
Americans to come together to make it happen.”
On the web site, visitors can access the video of the recent
White House Health Forum (reported in DM 8381) and the
event blog of the Forum. They can also submit an electronic
statement of support for health reform, submit questions for
Regional Health Forums scheduled for across the country in
the coming months, watch videos of Americans explaining
why they believe health care reform is needed, and review
details of the HHS budget. Visitors can also comment on the
issues in the web site.
•
FDA Recalls Selected Pediatric
Tracheostomy Tubes
A class 1 recall is being issued on selected lots of pediatric
tracheostomy tubes (Shiley 3.0PED Cuffless Pediatric Tracheostomy Tubes, Covidien Inc) manufactured from July 7,
2008, through December 9, 2008, and distributed from July
24, 2008, through December 23, 2008, the FDA says.
The recall is necessary due to complaints received about
the difficulty of inserting two instruments: the device used to
place the tracheostomy tube into the windpipe (the obturator)
and the catheter suction tube, which is inserted into the tracheostomy tube.
The company issued an urgent alert letter to customers
on January 14, 2009; a second letter issued on March 6, 2009,
recommends that healthcare professionals remove all remaining affected products and return them to the manufacturer for
replacement or credit. The manufacturer may be contacted by
telephone at 1-800-635-5267.
•
Metal Devices for Joint Replacement Are
Loosened by Immune System
Researchers at Rush University Medical Center have identified a key immunological defense reaction to the metals in
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www.dotmed.com
joint replacement devices, which leads
to loosening of the components and
device failure.
Over 600,000 total joint replacements are performed in the United
States each year. The majority are successful and last well over 10 years.
But in up to 10% of patients, the metal
components loosen, requiring the patient to undergo a second surgery.
The loosening is often caused by
localized inflammation, an immune reaction to tiny particles of debris from
the components themselves as they
rub against one another. No infection
is involved.
“As soon as joint replacement
devices are implanted, they begin to
corrode and wear away, releasing particles and ions that ultimately signal
danger to the body’s immune system,”
said Nadim Hallab, associate professor
at Rush University Medical Center and
the study author.
This is the first time that researchers have shown that debris and ions
from implants trigger this danger-signaling pathway.
•
Surgical Devices Coated
With Peptides Kill Bacteria
Researchers at the University of British Columbia have discovered a mimic
of one of “nature’s antibiotics” that
can be used to coat medical devices to
prevent infection and rejection.
The study, published in the journal Chemistry and Biology, found
that a synthetic form, short tethered
cationic antimicrobial peptides can
protect surfaces, like those of medical
devices, killing bacteria and fungi that
come into contact with them.
Medical devices such as surgical implants, catheters, hip replacements, and joint prostheses have the
potential to become infected with
bacteria, leading to many medical
problems including degeneration or
rejection of the implant. Currently,
silver is sometimes used to coat
medical devices because of its antimicrobial properties.
•
10 DOTmedbusiness news
Healthcare
Chronicles
Prescription for the Future: More Knowledge
By Dr. Henry Wagner
T
he health care system is likely to change dramatically. Politicians are working
feverishly to keep their constituents from the unemployment lines and every
avenue is being investigated for ways to cut government costs to free funds for
other expenditures. Health care has long been a target of cost cutting. Those
holding the purse strings are now reluctant to make big purchases at this time.
While it is understandable, it is also unfortunate. Few would argue that America is
an aging society. Baby boomers, among the largest generational representation of our society, have passed the halfway point and the demands placed on our health care system
will only increase. To meet this increase, it will be necessary to allocate more funds to
update existing technology and purchase the latest molecular imaging instruments.
Nuclear medicine - PET/CT, SPECT/CT together with CT and MRI represent an incredibly useful set of tools that can assist in providing the best possible health care that we
can offer. There is, however, a downside - the equipment is very expensive. This expense
means it is imperative for a machine to not only prove itself in clinical practice, but also
justify itself in basic economics. Even the most effective methods of identifying or treating
health problems need to be economically viable in order for them to be used in practice.
Efficient Use
Fortunately, nuclear medicine can be economically viable. The answer to the problem of
return on investment can be found in the value of the knowledge that nuclear medicine provides. Having a team trained to use the machines to their maximum efficiency reduces the
time spent on each patient study. Plus, the knowledge will decrease the overall cost of caring
for each patient. There will be decrease in the cost of care for each patient. Less time spent
does not mean a lower quality of care. It means the time spent will be used to maximum
benefit. An assessment of time used will take into account such things as the span of time
between onset of symptoms and the care of the patient.
Efficient Budgeting
Many of the people in control of budgets and finances for hospitals and clinics are troubled
by the thought of spending money for nuclear medicine. Right now, the big OEMs - GE,
Philips and Siemens are having problems because of the hospital administrators’ worries
about the economy. Although recent sales of PET/CT and SPECT/CT have decreased, I think
they will resume their growth as more people come into the health care system.
The Key to it All
I believe the cost per patient will decrease as equipment improves and training increases
for professionals operating the equipment. I believe overall expenditure for hospitals will
increase as well, with more equipment needed to handle the larger influx of patients. An increased number of patients with a decreased amount of time needed to give them the proper
care means hospitals stand to bring in revenue.
Further, education for professionals will lead to quicker diagnosis, better planning and
monitoring of treatments and ultimately, improved patient care. Ultimately, isn’t that what
we all want to provide?
• Online: dotmed.com/dm8549
Dr. Henry Wagner is an international authority on nuclear medicine. He is currently Emeritus Professor
of Medicine and Radiology; and Professor of Environmental Health Sciences at John Hopkins University. During his six decades with John Hopkins he has trained more than 500 radiologists. Dr. Wagner is a
member of the Institute of Medicine of the National Academy of Sciences and he is an honorary member
of both the British Institute of Radiology and the Radiological Society of North America.
www.dotmed.com
what’s new
Medical Imaging & Technology Alliance Statement on
Obama Budget
The Medical Imaging & Technology Alliance (MITA) expressed its support for
the health policy goals presented in the
President’s federal budget, and shares a
commitment to ensuring that all Americans have access to affordable, quality
health care.
However, the association said that
the budget’s proposed reliance on radiology benefit managers (RBMs) will
deny imaging services, and is an ineffective model that undermines the doctor-patient relationship in making health
care decisions. If the Medicare program
depends on RBMs, it will lead to further
reducing seniors’ access to life-saving
medical services.
•
NYM Offers Innovative
Solution to Treat Lumbar
Spinal Stenosis
A new minimally invasive surgical
procedure that relieves the symptoms
associated with lumbar spinal stenosis
(narrowing of the spinal canal) is now
available at New York Methodist Hospital (NYM).
The X-STOP IPD, the new procedure now being performed at New York
Methodist Hospital, involves placement
of an implant, called the X-STOP device,
between two bones in the back of the
spine to widen the canal and alleviate the
symptoms of spinal stenosis. Once the
implant is in place, the bone overgrowth
no longer comes in contact with the
nerves and the symptoms are alleviated.
This new procedure lessens the risks of
medical complications associated with
traditional surgery used to treat LSS and
can be performed in under an hour with
the use of local anesthesia.
•
Vapor Sensor May One Day
Whiff Disease
A future sensor may test a patient’s
breath for breast cancer, lung cancer,
diabetes or asthma.
A University of Missouri researcher
is developing a device that will analyze
breath and urine samples for volatile
markers inside the body that indicate
disease. These volatile markers, such as
alkanes, acetones or nitric oxide, give
doctors clues about what is happening
inside the body and can be used as a diagnostic tool.
•
Virtual Colonoscopies
Show Value for Some
Patients, But Polyps Will
Be Missed
The value of CT colonography, also
called virtual colonoscopy, is under debate as Medicare considers halting coverage of these procedures as a diagnostic
method for detecting colorectal cancer
and precancerous growths. Research
findings from meta-analyses performed
by ECRI Institute® suggest that CT
colonography appears most promising
for screening asymptomatic, averagerisk patients; however, it will miss some
important polyps and cancer that would
I april 2009
have been detected by colonoscopy. For
asymptomatic high-risk patients and
symptomatic patients, the percentage of
patients correctly identified as having
colorectal polyps or cancer may be too
low to be useful.
•
National Neurotechnology
Initiative Act Introduced in
Congress
The National Neurotechnology Initiative (NNTI) Act was introduced into
both houses of Congress on March 12,
by Rep. Patrick J. Kennedy (D-RI) in the
House, and Sen. Patty Murray (D-WA)
in the Senate. On her website, Sen.
Murray said the legislation was to “help
scientists advance their understanding
of the human brain and develop new
treatments and cures for the millions of
Americans who suffer from neurological diseases, conditions and disorders.”
The Neurotechnology Industry
Organization (NIO) has applauded the
legislation. “The huge numbers speak
for themselves: There are 100 million
Americans suffering from a brain-related illness, with an enormous economic
burden that continues to grow as the
population ages,” said Zack Lynch, Executive Director of the NIO, in a press
release. “For a modest investment, Congress has the opportunity to streamline
research efforts, accelerate the development of new treatments, promote innovation and job creation by small businesses and have a meaningful impact on
the lives of those suffering from devastating diseases and injuries.”
•
Latest IMV Market Report
on Mammography Centers
Shows a 16% Decline in
Mammography Procedures
An estimated 36.7 million x-ray mammography procedures were performed
in the United States in 2008, in 8,670
www.dotmed.com
hospital and non-hospital sites, according to a report just released by IMV Medical Information Division.
“This represents a slight 2% decline from 37.3 million
procedures in 2007, which is consistent with trends observed
by the CDC,” said Lorna Young, Senior Director, Market
Research. “Compared to 2000, the 36.7 million procedures
conducted in 2008 represents a decline of 16% from an estimated 43.9 million procedures in 2000, or about a 2% decline per year. This may be partially influenced by a 13% reduction in the number of MQSA certified sites in the United
States from 9,910 sites as of May 2000 to 8,670 sites as of
December 2007.”
•
Fraud Monitoring of Electronic Medical
Records Uncovers Identity Theft
In the health policy arena, information technology is seen as a
panacea to improve efficiency, reduce repeat testing, and save
billions. While those are some expected benefits of electronic
medical record-keeping, its greater money-saving potential
may lie in helping to uncover fraud.
The National Health Care Anti-Fraud Association (NHCAA.org) conservatively estimates that 3 percent of all health
care spending - about $68 billion - is lost to fraud. A more
jaundiced, or perhaps realistic estimate by the FBI and CDC
puts the rate at 10%, a crippling $226 billion loss yearly.
Suddenly the urgency for electronic medical record adoption is in sharp focus because the best way to spot fraud is by
using high-tech data mining tools.
•
DOTmedbusiness news
I april 2009
13
Industry Sector
Reports:
Ultrasound Sales
& Service
A probing report at this sector.
Digital
Mammography
Sales & Service
Mammography’s hi-tech ascent
continues.
Bone
Densitometer
Sales & Service
Get to the meat of the matter on
bone densitometers.
Analog
Mammography
Sales & Service
Even when it’s not digital, it still
proves invaluable.
I april 2009
“It’s not easy being
green”
Along with his association with Miss Piggy this
song made Kermit the Frog famous in the 1980’s.
When Kermit was belting this one out, it really
wasn’t so easy being green. Today, things are
easier. There are ways to help the environment
and your pocketbook at the same time.
For most, just reducing the carbon footprint
Wayne
won’t be enough incentive. To make greening
Webster
work in a medical imaging facility there needs
to be a financial reward for changing habits. Today’s medical imaging facility can do much to reduce the use of
consumables and the cost of capital goods. Imaging is transitioning
to digital and as it does, the film and the chemicals for processing
are greatly reduced. The dilemma faced by the facility manager
is balancing the long term environmental benefit with the shortterm capital budget. In any financial environment it’s difficult to
justify replacing equipment just to eliminate a disposable. Today’s
uncertain economy makes it even harder.
If you’re in the process of planning the replacement of old medical
equipment with new, give some thought to where the old equipment
will go. It’s often easier to trade-in the old equipment rather than try
to sell it yourself so that’s the route many take. But, just like when
you trade-in your car for a new one, you don’t know what you’re
receiving for your trade-in or where it’s going.
FOCUS ON PERFORMANCE
Coming in
May
Even if your equipment is still useable and in good condition,
depending on age there’s a good chance that once traded-in it will
just head for the scrap yard. With this equipment out of the inventory
another new medical device will need to be manufactured to replace
it. The outcome isn’t good for the environment or your wallet.
When considering the replacement of a piece of equipment with
new, contact a company that can buy your old equipment for
refurbishing and resale. I work with many of these companies.
They are anxious to work with you. You’ll most likely get a better
value for the old equipment and conserve resources by eliminating
the need to produce a new instrument to take its place.
If you don’t know who to contact, you can use DOTmed to list
the equipment and the requirements you have for purchase and
removal. The listing is free. A company dealing in pre-owned
medical equipment or someone wanting to acquire and make use of
your equipment will contact you.
Taking charge of the disposition of equipment you plan to replace
can help green the environment and put a little extra green into your
budget.
Wayne Webster is a consultant in Medical Imaging Business
Development. You can send your comments or questions to
[email protected].
www.dotmed.com
Just in time for Spring Cleaning
I
n this issue we have focused on
“going green,” or at least making choices that are better for
the environment and in turn, for
society.
One choice that meets both those
goals – of helping the environment and
directly helping society is to do some
spring cleaning. For hospitals and
medical centers, spring cleaning usually gets a bit more in-depth than just
putting away the winter clothes and
taking out the patio furniture.
If you have equipment that you
will no longer be using and it’s just
taking up room in storage, do yourself,
and others a favor and dust it off and
put it on the market. Medical centers
lacking the budget for new equipment
will thank you, their patients will thank
you, and those at your hospital trying
to make budgets stay in the black will
thank you.
I april 2009
Call in a DOTmed Clean Sweep Team
We make cleaning it all out a breeze!
We’ll come pick-up all that idle medical equipment you have in storage, we’ll sell
it — and you’ll pick-up some extra cash!
Every hospital – including yours – has plenty of equipment you can’t throw away, but
just won’t use. Now you can easily dispose of it. And make some money, too boot!
Call in a DOTmed Clean Sweep Team.
We’ll come to your facility, inventory, photograph, itemize, and remove all your old
equipment that still has value.
Then we’ll Auction it all on DOTmed.com. You can watch the Auction yourself.
We’ll deduct the cost of pick-up, storage, Auction Management, crating & shipping
from the total Auction results, and write you a check for the balance!*
All the old equipment you have in storage can be worth thousands of dollars to you.
Call DOTmed’s Clean Sweep Hotline. We make cleaning out your old used
equipment a breeze!
866-999-DOTmed (3686) Ext. 105
*Pick-up fees may be required for rural hospitals, or hospitals with less than 10 re-sellable items.
www.dotmed.com
CT Sales & Service
The market reflects broader health care technology stressors
By Barbara Kram
J
anuary 1, 2007 was an infamous day for the CT industry and in many ways the beginning of a new era.
That date initiated cuts in Medicare reimbursement for
imaging studies at free-standing radiology centers as a
result of the Deficit Reduction Act (DRA). Also at that
time, the reimbursement rate for cardiac computed tomography angiography (CTA) was slashed in half or more, depending on the rate and region. As a result U.S. sales of CT, which
had risen dramatically, came down from a spike of about $1.8
billion in 2006 to just over one billion in 2008.
“That’s a fairly significant drop but the market was very
highly accelerated before that. The stable range is probably $1.2
or $1.3 billion per year,” said Doug Ryan, Senior Director, CT,
Toshiba America Medical Systems. “You need to constantly be
flexible and change your business. In the U.S. there has not been
one year that is the same as another,” he observed.
This unpredictable climate is worsened by the economic
storm, uncertain federal regulatory shifts, concerns about the
overuse of medical imaging, clinical issues of radiation dose exposure, and the potential reform of the U.S. health care system.
These factors leave hospitals and imaging centers more focused on the bottom line than ever. Some practice models just
won’t make it. Others are postponing equipment investments.
“The way the economy is going right now, we’re seeing
a trend of more small imaging centers shutting down. Small
centers don’t fall under the same Medicare reimbursement arrangements that large hospitals do,” said Larry Knight, Chief
Operating Officer, Sunrise Medical Technology, Inc., Waxahachie, TX. Reimbursements that had been over $1,000 per
study a few years ago have been trimmed to about the $300
range. “So their entire business model was based on higher
numbers. CT in many cases is a loss leader, a device put in the
center not as a primary source of revenue, but as a device that
must be there to maintain their status overall.”
DOTmedbusiness news
I april 2009
17
Prices on new CT scanners have
come down and manufacturers have
come up with smaller systems that are
more affordable, as well as with scalable solutions. These don’t require as
great an up-front investment but can be
upgraded over time. An example is the
Philips Brilliance iCT flagship and its
offspring, the Brilliance iCT SP, priced
about 20% lower.
“The major difference is a smaller
detector size compared to iCT,” said
Peter Reimer, Vice President of Global
Marketing, Philips Healthcare. “The de-
A collimator on a GE LightSpeed 16 is
being checked at C&G Technologies
I april 2009
tector is an exchangeable unit that could
grow with future needs. iCT SP meets a
lower price point and meets the need for
a secure investment into the future so
the product is not outdated in two, three
or four years.”
The bottom line for CT is not just
its reimbursement rate but the growth
in procedures that now top 70 million per year. While the rate of growth
has slowed to about 7% from double
digits three years ago, that’s still not
too shabby. The OEMs told DOTmed
Business News that they anticipate the
markets should unfreeze in the second
half of this year.
Regarding access to capital,
which is a challenge of our current
economic crisis, it bears noting that
Philips Healthcare provides financing through Philips Medical Capital,
a joint venture with AAA-rated Dutch
bank De Lage Landen.
As for long-term trends, watch for
forthcoming clinical studies on the ef-
Trauma patient getting a
scan from a Brilliance CT
64-channel scanner
fectiveness of CT in applications such
as CT colonography, which suffered a
setback in February when Medicare said
it doesn’t want it covered. (Note that the
final rule was not out as of this writing.)
CT as a modality is in need of a
“killer app” like virtual colonoscopy that
is routinely used for widespread screening in the healthy population. Another
example might be screening symptomfree smokers to spot early lung cancer.
Meanwhile, cardiac and ER remain
important applications for CT and evidence of effectiveness is mounting.
www.dotmed.com
Mixed Signals on Third Party Impact
Fewer new scanners are being sold, and those that are sold
may suffer from a reversal of recent slice wars. “People are
being very cautious, measured and calculating,” said Greg
Kramer, President, C&G Technologies, Inc., Jeffersonville, IN
speaking of CT comparison shoppers. “People are asking - do
I really need a 64-slice CT? They may say a 16-slice is just
fine.” Providers may not be able to do a cardiac exam on a
16-slice machine, but for common applications like chest or
spine it does the job.
“There are also hospitals that never considered buying refurbished equipment before and are now doing it,”
Kramer said.
“People were waiting till after the election and to see what
happens with the economy,” said Robert Serros Jr., President
and CEO, Amber Diagnostics, Orlando, FL. “All industries
took their foot off the accelerator. Now people are revisiting
their capital expenses and looking at refurbished equipment
without a doubt because they have to.”
Conservatively, purchasers can save 30% and often much
more, by opting for used equipment. As an example, one independent company reported that a new 16-slice CT that goes for
$500,000 can sell for $175,000 used on the open market.
“Reimbursements always play a large role in driving the
market, but the recent economic downturn has only served to
make our business model more attractive,” said Greg Mullen,
Tips for Hospitals from Third
Party CT Service Providers
DOTmed Business News regularly polls independent service organizations (ISOs) about
medical technology trends. Here is some advice
from third-party companies about CT purchase
and service decisions.
Pre-owned equipment is always going to provide a cost
savings, and leasing versus buying offers the flexibility of
upgrading your equipment sooner rather than later. This allows a facility to provide current technology without significant capital expenditures.
-Greg Mullen, Vice President, ADM, Elmhurst, IL
Do not sign multi-year service contracts you can’t get out of.
Look for third-party service. Keep your equipment another
year. Don’t let doctors make decisions about spending your
money just because they want a new scanner. Make them
justify the purchase by ROI and patient care improvement.
-Bill Blackford, Vice President, CTronics, Stockton, CA
Hospitals and imaging centers should call their local colleagues before doing business with any company. Before
buying any equipment check to find out if what you are buying has a proprietary X-ray tube or requires proprietary software for servicing.
-Frank Pontillo, Imaging Director, Engineering & Network Systems, Inc., Pembroke Pines, FL
Ask how long a third party has been in business and get
referrals. Anybody can sell a piece of equipment. If you give
someone a warranty and in the last week of that warranty
a major part goes out, are they going to be there? Do a
background check.
-Robert Serros Jr., President and CEO, Amber Diagnostics,
Orlando, FL
Make certain that the company you are contracting to deinstall has experience not only in the deinstallation and rigging of CT but in the specific OEM type. For instance, you
may have a company with experience in Philips CTs but
if you have a Siemens that needs to be deinstalled, there
are specific differences and requirements. Due diligence is
the rule of thumb. Identify a good dealer that has a longstanding reputation of representing what they sell. DOTmed
can be a valuable resource here.
-Larry Knight, Chief Operating Officer,
Sunrise Medical Technology, Inc., Waxahachie, TX
Listen to more than talk. You are investing in something you
will have for a number of years and is a critical component.
Visit the service provider’s facility. It might take a day out of
your schedule but it is a day well spent. Can they do emergency repairs? Do they stock parts? What about tracking
and record keeping? Evaluate the support network.
If you have a major disaster with your machine and
whole gantry needs to be replaced, can they take care of it?
You reputation is riding on your CT.
- Greg Kramer, President, C&G Technologies, Inc., Jeffersonville, IN
I april 2009
www.dotmed.com
Vice President, ADM, Elmhurst, IL. “Our
primary market originally was more rural
areas or clinic settings but we are starting to receive more attention from larger
hospitals in urban locations.”
Nevertheless, the economy hurts everyone and most third party companies
report steady or somewhat slowing sales.
“The OEMs need to maintain a competitive advantage in the marketplace
and are dropping prices on those brand
new CTs installed with a warranty, driving prices on used equipment down even
lower,” Knight said. “To be competitive,
a used piece of equipment must be significantly lower in cost than what that
OEM can offer in new equipment. So
the OEMs are really bringing a competitive edge into the marketplace making it
tighter for third party market groups.”
Another challenge for independents is that, with fewer units sold,
fewer pre-owned scanners are coming
on the market, reducing inventory for
re-sellers.
“There is a tougher time sourcing. But some of the slack is taken up
by people going out of business,” explained David Denholtz, CEO, Integrity Medical Systems, Inc., Fort Myers, FL. It seems that imaging center
closings are a trend that off-sets the
demand for sales. “Centers are consolidating or not replacing equipment.
Some customers with three or four
centers are going down to two or three
centers. When nobody is buying new,
there are not as many used scanners,
but then again fewer people are buying used scanners, so it evens out.”
“The market has slowed down
somewhat. Many hospitals have frozen
their capital budgets for this year and
maybe longer depending on what legislation is forthcoming. Access to preowned scanners is becoming more of
a challenge,” noted Bill Adkins, President, National X-Ray Corporation,
Palmetto, FL.
What’s The Right Price For This Imaging Equipment?
Call Bay Shore. And Know For Sure.
We Are The Largest Buyer & Seller Of Pre-Owned
Imaging Equipment In The U.S.
Before you trade-in your current unit, sell
to a broker, or buy from a dealer, make one
more call: to Bay Shore.
1-800-471-1189
We will provide you with a free, up-to-date
market valuation and quotation for any
piece of imaging equipment you wish to
buy or sell.
Call Bay Shore.
And know for sure.
I april 2009
www.bayshore-medical.com
Service Dominates as a
Priority for OEMs, ISOs
In times when sales are suppressed, service becomes more important as providers
keep the installed equipment operational.
And service of this sophisticated technology doesn’t come cheap.
“The lifecycle costs over a piece of
equipment like a CT scanner is almost
half the price of a scanner. You are typically selling the [new CT] in the million
dollar-plus range and the service contracts can be $130,000 to $200,000 per
year,” said Ted Nemetz, Vice President
of Service, Toshiba America Medical
Systems. “Operating costs may not meet
that so we have to be more creative and
flexible on the service side to wrap the
deal together for the customer.”
Toshiba, with nearly a 90% capture
rate for service contracts on its equipment, enjoys an impeccable reputation
in the marketplace with top rankings
for service from major research firms.
Its line of Aquilion CT scanners has
not been in the market long so that
few third parties are servicing them
and few are available for re-sale. “We
don’t have that many out there,” Nemetz said. “It’s like a Toyota Corolla that
keeps running.”
While Toshiba would not tell us
how many service engineers it employs,
it was clear that the quantity and coverage they hold, as well as its quality are
big reasons for the high service ratings.
But hospitals are cutting corners
here, too.
“Many clients are choosing to
modify or reduce their service contract
coverage on CT to a bare minimum
and put greater focus on the [other]
modalities that generate the revenue,”
Knight said.
OEMs and service companies offer
a range of contracts from full parts and
service including the pricey X-ray tube,
to a partnership deal where the hospital biomedical staff assumes some risk,
down to a time and materials bare bones
contract.
Preventive maintenance is critical
and must not be skipped. ISOs suggest
that the OEM general requirement for
quarterly PM is a minimum standard.
“You MUST keep a good eye on
the rotate brushes and rings. X-ray tube
www.dotmed.com
dielectric oil must be checked; oil fans and filters cleaned. If a
PM is done only four times a year as many OEMs recommend,
the mechanical systems must be inspected,” urged Sal Aidone,
Vice President, Deccaid Services, Inc., Deer Park, N.Y.
used in imaging equipment to block radiation, but the X-ray
tube in the Brilliance iCT is the industry’s first “green” glassware since it contains no lead.
CT: A “Green” Machine?
You may not think of a CT scanner as part of the solution to the
world’s environmental challenges but the industry is doing its
part. Both ISOs and OEMs have programs in place. For
example, ISOs pride themselves on recycling equipment back into the marketplace, an inherently conservative business.
“Any reprocessing has a benefit,” said Serros. “We also chop up machines for parts and
scrap metal. A recycler separates the metals
by type after we take out the major components.”
But the best way to save the planet is by
design, which the OEMs are pursuing in their
equipment.
“A lot of our heritage comes from Western
Europe, which tends to be more progressive in
terms of sustainability and ‘green’ initiatives.
That has an impact in our product roadmap
today,” said Jason Plante, Director of CT
Product Marketing for Philips Healthcare.
He explained that lead is a common metal
GE Discovery
CT750 HD
DOTmedbusiness news
I april 2009
23
“We had a breakthrough in using more environmentally friendly material to safeguard the radiation inside
the X-ray tube. That is an area of focus and concern,”
Plante said. Outside the U.S., Philips must comply with
stiff global environmental standards to reduce hazardous substances. “The same products will be offered in the
U.S. so the U.S. will benefit from European trend-setting
in environmental policy.”
•
Read More Online
• Considering a portable CT?
Read clinical vignettes from leading OEMs
at www.dotmed.com/news/story/8476.
• Concerned about radiation dose? Calculate
your patients’ exposure risk using a new web
site. Read about it at www.dotmed.com/news/
story/8477.
DOTmed Registered CT Equipment Sales & Service Companies
For convenient links to these companies’ DOTmed Services Directory listings, go to www.dotmed.com and enter [DM 8551]
Names in boldface are Premium Listings.
Name
Carl Frank
Rick Stockton
Steve Foos
Mike Guthleben
Bill Blackford
Steve Gregson
Chris Ash
Scott Carson
David Denholtz
John Pereira
Alex Clavijo
Robert Serros, Jr.
Bill Adkins
Frank Pontillo
Len Spooner
Heather Funk
James Gallagher
Greg Mullen
George Webb
Mike Ghazal
Charles Gauthier
Ronald Moore
Greg Kramer
Davyn McGuire
Wayne Horsman
Jeff Rogers
Susie Vestevich
Jason Crawford
Jim O’Rourke
Robert Manetta
Joseph Jenkins
Sal Aidone
John Kollegger
Peter Reimer
Gilberto Mangual
Trey McIntyre
Marshall Shannon
Michael Webster
Courtney Lane
Larry Knight
Cliff Hess
Jon DeRoost
Company - Domestic
DBRS Medical Systems, Inc.
Atlas Medical Technologies
IMAG, Inc.
Radiology Oncology Systems
CTronics
Sage Point Transport, LLC
Scanworks
Med1Online
Integrity Medical Systems, Inc.
United Medical Technologies Corp.
Diagnostic Medical Equipment Solutions
Amber Diagnostics
National X-Ray Corporation
Engineering & Network Systems, Inc.
MagnaServ, Inc.
Dunlee, Inc.
LG Medical Technologies, Inc.
ADM
MobileScan Imaging
Zetta Medical Technologies, LLC
Imaging Services
R & D Imaging, Inc.
C&G Technologies, Inc
Med Exchange International, Inc.
Columbia Imaging Inc
Medical Imaging Resources, Inc.
Xoran Technologies, Inc.
Block Imaging International, Inc.
LJ Technologies
Nationwide Imaging Services, Inc.
International Imaging Ltd.
Deccaid Services Inc.
Bay Shore Medical, LLC
Philips Healthcare
ImageTek
City
Chino
Ontario
Redding
San Diego
Stockton
Upland
Centennial
Golden
Fort Myers
Fort Myers
Miami
Orlando
Palmetto
Pembroke Pines
Stuart
Aurora
East Dundee
Elmhurst
Kildeer
Lake Zurich
Streamwood
Evansville
Jeffersonville
Agawam
Columbia
Ann Arbor
Ann Arbor
Lansing
Brick
Brick
Las Vegas
Deer Park
Ronkonkoma
Highland Heights
Trujillo Alto
International Medical Equipment and Service, Inc. Fort Mill
Image Technology Consulting, LLC
DeSoto
Legacy Medical Imaging
Fort Worth
Innovative X-Ray Services, LLC
Friendswood
Sunrise Medical Technology, Inc.
Waxahachie
Texas Medical Mobile Services
Waxahachie
Beacon International
Edmonds
Name
Horacio Jose Gomez
David Lapenat
Abdelrahim Khalil
Paulos Hailu
Florian Dickopp
Bippon Gupta
Abdul Radjak
Rami Marom
Fusako Hashimoto
Borhan Kalash
Imad Muati
Ahmet Guner
Ralph Childs
Jose Morillo
Company – International
VCG Imagen SRL
ANDA Medical, Inc.
Besisc
Diverse Electromedical
Medicopex GmbH
Masters Medical Equipment Pvt Ltd.
PT Alkeslab Primatama
ElsMed Ltd. & Relaxation, Inc.
Fair Medical
Memco
IMC
Ekolab Lab ve Bilgi SisTic Ltd.
G-Tech Medical Services
J Morillo Sistemas Biomedicos
I april 2009
City
Buenos Aires
Ottawa
Cairo
Addis Ababa
Oberasbach
New Delhi
Jakarta
Holon Matsudo
Damascus
Damascus
Ankara
Abu Dhabi
Cabimas
State
Certified
CA
CA
CA
CA
CA
CA
CO
CO
FL
FL
FL
FL
FL
FL
FL
IL
IL
IL
IL
IL
IL
IN
IN
MA
MD
MI
MI
MI
NJ
NJ
NV
NY
NY
OH
PR
SC
TX
TX
TX
TX
TX
WA
•
•
DM100
•
•
Country
Certified
Argentina
Canada
Egypt
Ethiopia
Germany
India
Indonesia
Israel
Japan
Syria
Syria
Turkey
United Arab Emirates
Venezuela
DM100
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
www.dotmed.com
“Building a Legacy
One Customer at a Time”
Engineering & Network
Systems, Inc.
MRI, CT, and X-Ray Sales & Service
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Siemens Siremobil
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Disposable Medical
Devices Painting a
Greener
Picture
By Joan Trombetti
T
here is a broad range of disposable medical
products and devices in the health care industry.
With “disposable” as part of the description, it
might not seem that these medical devices and a
friendly “greener” environment could go handin-hand, but the industry segment is moving in a greener
direction and trying to help reduce the millions of tons of
medical waste generated each year — a portion of which is
considered biohazardous.
A report by the Hospitals for a Healthy Environment
(H2E) states that hospitals in the U.S. produce approximately
6,600 tons of waste per day. As much as 80% to 85% of this
waste is non-hazardous solid waste like paper, cardboard,
food, metal, glass and plastics. H2E believes that recycling
would substantially reduce waste volume.
“Green disposables” begin with the design
Chris Kadamus, Principal Design Engineer at Cambridge Consultants, Inc, believes that with the introduction of new regulations, rules and purchaser preferences, many of the waste disposal methods of hospitals and ultimately the design decisions
of medical device manufacturers will soon be changing. “True
sustainable design considers the social and financial effect on
a product as well as its effect on the environment,” says Kadamus. From a designer or engineer’s perspective, sustainable
design takes the entire product life cycle into account, from
creation to disposal, during the initial design of the product.
Regulations for waste reduction and minimization or elimination of hazardous substances have already been in place for
the European Union (EU) for several years for everything but
medical devices, and it is believed that medical devices will be
included sometime between 2010-2012 in the EU.
These regulations include: the Waste Electrical and Electronic Equipment (WEEE); Restriction on Hazardous Substances (RoHS); Registration, Evaluation and Authorization of
Chemicals (REACH); and the Energy Using Products (EuP)
regulations. The WEEE Directive is environmental legislation
that hopes to reduce the amount of waste dumped into landfills.
It encourages recycling and reusing electrical and electronic
equipment. The RoHS applies to end-user electrical and electronic equipment (EEEE) and has in place maximum acceptable
levels of six substances within the composition of the product
including lead, cadmium, mercury, hexavalent chromium, polybrominated biphenyl (PBB) and polybrominated diphenyl ether
DOTmedbusiness news
I april 2009
27
Some of the
disposables
offered by
Precision
Surgical Supply
(PBDE) flame retardants.
Kadamus says that although similar
legislation does not yet exist in the U.S.,
there is pressure from a non-domestic
customer base that has already forced
many American companies to comply
with WEEE and RoHS.
“Many health care facilities are
embracing sustainable practices as a
smarter way to do business,” according
to Kadamus. To save on spending, they
are purchasing and using eco-friendly
products that are PVC-free, mercuryfree and lead-free. This, in turn, will allow the medical device industry to cut
back on packing materials, design products for disassembly and recyclability
and support end-of-life product reclamation programs.
Kadamus says, “many of the key
tenants of sustainable product concept
of product life cycle design stem from
understanding and developing a product
life cycle, not just a product.”
The product life cycle
design concept
The concept of product life cycle design
considers all stages of product existence,
including concept development, material
selection, design and engineering, manufacturing, packaging, transportation,
sales, use and end-of-life disposal during
I april 2009
the initial product planning stages. Each
stage is evaluated from the perspectives
of energy efficiency, environmental impact, material usage, human effort and
cost. “Performed correctly, product life
cycle design can lead to significant improvements in manufacturing efficiency,
and improve time to market, risk reduction, efficient material and energy usage, safety and regulatory compliance,
and packaging and transportation costs,”
says Kadamus. Designing products for
easy disassembly, minimizing bulky or
nonessential packaging, reducing part
count, moderating the use of dissimilar
injection-molded materials and eliminating toxic or hazardous materials (lead and
PVC, for instance) help to meet the goals
for sustainable design as well as those for
efficient, low-cost design. “With respect
to disposable medical products, choosing
materials that limit environmental damage during disposal and incineration can
reduce toxic air emissions and reduce
waste processing costs,” he says.
Reprocessing
single-use-devices
Single-use-devices (SUDs) reprocessing
has been evaluated for safety and cleaning efficacy by various groups within the
health care industry including The Association of Perioperative Registered Nurses,
The American Hospital Association, The
American Society for Gastrointestinal
Endoscopy, and The American College of
Cardiology. Among these groups, several
have introduced Industry Statements that
support the use of SUDs based on reports
issued by the U.S. Government Accountability Office (GAO). The GAO concluded that FDA oversight has increased since
2000, and available information does not
indicate that the use of SUDS presents an
elevated health risk.
Brian Sullivan, President and CEO
of SterilMed, Inc. says that using reprocessed devices has become a standard practice for most hospitals in the
United States, as well as most of the
leading teaching and research hospitals
in the country. “Using at least some reprocessed devices is a standard practice
in 70% of US hospitals,” says Sullivan.
“While over 3,000 hospitals currently
have a reprocessing program, and over
93% of the US News’ “Honor Roll”
Hospitals use reprocessed devices, there
are still some hospitals that have yet to
fully integrate reprocessing as a standard practice at their facility.”
Reprocessing medical devices
positively impacts the environment by
maximizing the use of existing devices,
decreasing the volume of devices that
are sent to landfills and reducing the
production of methane gas required
to make new products. The American
Hospital Association and the U.S. Environmental Protection Agency have
entered into a Memorandum of Agreement which called for a number of action steps for hospitals to reduce medical waste. “Hospitals face the challenge
of meeting the goal of a 50% reduction
in medical waste volume by 2010. With
US hospitals producing more than 6,000
tons of waste each day, this is a significant challenge. Recycling is one important step in reducing that impact on our
environment,” says Sullivan.
Association of Medical Device Reprocessors (AMDR) president Daniel
Vukelich says, “As the U.S. Government Accountability Office indicates
– medical device reprocessing is stringently regulated by FDA.” With that
assurance, it makes financial sense for
hospitals. “Reprocessing saves hospitals millions of dollars,” says Vukelich.
www.dotmed.com
He also pointed out that of all the disposable medical devices
available – only 2% to 3% can be considered for reprocessing. That brings up the question, “What happens to the 97%
to 98% of the disposables that can’t be reprocessed – where
do they go?”
Recycled disposables
Vukelich explained that when the AMDR can no longer reprocess a medical device, it is usually stripped down and its
components sold to third parties. For example, some plastics
can be melted down and put into cinderblocks used for weatherproofing– the aftermarket for plastic is valuable. Other
components, like titanium and carbon used by orthopedics for
external fix bolts – can be sold, melted down and reused in
certain consumer products. “This is a very exciting time for
the reprocessing and recycling industry,” says Vukelich. “The
AMDA and other organizations and companies are working
very hard to clean up and keep the environment clean.”
Sullivan of SterilMed explains that if a device cannot be
reprocessed, the company reclaims and recycles the metal and
plastic. During 2008, more than 20,000 pounds of material
was recycled at SterilMed. The reclaimed plastics and metals
were refined and used to create other products.
Time limits on reprocessing
Robert Copeland is a consultant in the North Carolina region
with more than 25 years of experience in the industry. He says
that disposables fall into several categories, and if they are
candidates for reprocessing, they can usually only be reprocessed a certain amount of times – particularly those made of
plastic. “The sterilizing process of plastics has to be carefully
managed because if the temperature is too high, or an incorrect sterilizing method is used – chemical changes could cause
damage to the composition of the plastic. “There is a time/
temperature/method relationship that must be adhered to,”
says Copeland. He believes that hospitals must weigh the cost
versus risk when it comes to deciding whether or not to go
forward with reprocessing certain single use devices.
“SterilMed limits the number of reprocessing cycles according to the specific construction and material composition
characteristics of each device,” says Sullivan. To assess this,
the company performs an analysis that determines the structural integrity of a device, and then performs validation testing. Based on the results of the validation testing, Sullivan
says, “We will determine the number of cycles a particular
device can be reprocessed. The number of reprocessing cycles
for devices ranges from one to five.”
damage to the environment with mercury and dioxin being the
main culprits. Dioxin is produced from materials like plastic
that react at high temperatures with materials like PVC and
chlorine. Accumulating dioxins released into the environment
have been proven to have an effect on the endocrine systems
of humans and animals. The EPA has regulations to control the
emissions from medical waste incinerators and include stringent
air emissions guidelines for states to use in developing plans to
reduce air pollution from medical waste incinerators built on or
before June 20, 1996; and final air emission standards for medical waste incinerators (MWIs) built after June 20, 1996.
The EPA’s MWI standards and guidelines have caused many
health care facilities to use alternative technologies for treating
waste including microwave technologies, steam sterilization
like autoclaving, electropyrolysis and chemical mechanical
systems. Many states have regulations requiring medical waste
treatment technologies to be certified, licensed or regulated and
individual states have their own requirements. Several Federal
agencies also have regulations that cover the waste stream.
The Maine Hospital Association, which represents 29
community-governed Maine area hospitals generate about
190,000 pounds of waste per month. The Maine Medical
Waste Facility utilizes 2H-1000 Hydroclase Vessels, which
process 500 to 800 pounds of waste per day. The technology from Hydroclave Systems Corp (SC) of Canada has a
patented treatment process that utilizes steam heat to sterilize
waste and subsequently shred it making it acceptable material for landfill disposal. This is a positive move for the environment. Previously, medical waste was hauled to landfills
in unmodified form.
Landfills and incineration for medical
disposables that cannot be reprocessed or
recycled
Hospitals and other health care facilities have been trying to
deal with medical waste for years. Incineration is one strategy
that many facilities have adopted because it reduces waste in
landfills and saves health care facilities money. Still, incineration has its drawbacks.
Known emissions of organic pollutants and metals cause
Disposable imaging
catheter testing at
SterilMed
DOTmedbusiness news
I april 2009
29
Kate Flynn, FACHE, president of
The Health Care Improvement Foundation (HCIF) – a Philadelphia-based nonprofit dedicated to building partnerships
for better health care in Southeastern
PA, says, “Hospitals’ commitment to the
‘green revolution’ is a critical objective
for the Delaware Valley.” She says that
the 20 hospitals in her region have been
working together since mid-2007 to reduce the impact on the environment by
reducing regulated medical and general
waste, managing pharmaceutical and
toxic waste and developing environmentally preferred purchasing. “A prominent
achievement has been reducing the volume of infectious waste among the region’s hospitals by more than 40% in the
aggregate,” says Flynn. “Best practices
are being compiled and, along with case
studies, will be posted on HCIF’s web
site as a resource for other hospitals and
health care providers.”
Disposables in the home
health care environment
Disposable needles, syringes and lancets
represent the lion’s share of home health
care SUDs. It is estimated that over three
billion disposable needles and syringes
and an additional 900 million lancets (collectively called “medical sharps”) are used
outside of health care facilities in the U.S.,
and two-thirds of these are used by those
managing their own (or their pet’s) health
care at home. Self-injectors are known to
discard medical sharps in trash containers
in homes and public places and in other
public settings such as hotel rooms, airports and toilets. These disposal methods
create potential dangers for the transmission of infectious diseases. Sierra E.
Fletcher, Associate – Policy and Programs
at the Product Stewardship Institute, Inc.
in Boston says that over the past year, PSI
has facilitated meetings with pharmaceutical companies, device manufacturers,
government officials, pharmacies, public
health groups and other key stakeholders
to recommend the development and implementation of a “model state program
for Massachusetts” based on a modified
producer responsibility system, the details
of which remain to be negotiated. “The
goal of the project is to maximize the safe
collection and disposal of used medical
sharp devices,” says Fletcher. “The project is in-line with other PSI initiatives
to directly involve the manufacturers of
products that create challenging waste issues in creating solutions.”
DOTmed users express
their opinions
Jennifer Westbrook, CEO of Precision
Surgical Supply has firsthand knowledge as a former phlebotomist of many
disposables on the market. She said that
for her company, sales of disposable
products have remained strong despite
current economic conditions. As far as
the environment goes, Westbrook says,
“I find the biggest challenge is finding
a balance between having an environmental conscience and awareness with
providing supplies that will be of the
most benefit to our clinics, hospitals and
– ultimately the patients.
Westbrook is confident that the
SUD market will continue to grow.
There continues to be a great need for
these products,” she says. As the world
market grows, so will the need for reprocessing.” Wetsbrook says that she
can understand both sides of the reprocessing issue. When it comes to legislation in the works requiring patients to
be informed about reprocessed singleuse-devices, she says, “In most cases,
patients are more comfortable knowing
that they are getting items that have never been used before – especially when
considering an invasive procedure”
Scott Townsend, owner of
Townsend Surgical relates that his disposable business has been average to
slow and his biggest challenge has been
finding precisely what customers want
amongst the enormous variety of medical disposable devices available. He
anticipates that business will continue
as usual with “steady slow growth over
the next six months, especially in markets outside of the U.S.” Townsend sells
and repairs equipment to hospitals, surgery centers, clinics and dealers, nationally and internationally. He said that he
sometimes will sell disposables outright
or on consignment from a medical facility, but he will not touch certain products
that are injectable or contain liquids.
Another company, SONOTECH,
has a product in unit dose packets that
is designed to prevent cross contamination. Marian Larson, Marketing and
Sales Manager at SONOTECH says,
“57% less plastic waste is generated
by the average hospital when it used
Clear Image Singles rather than 250 ml
bottles. It’s not only cost effective for
health care facilities – it’s also kind to
the environment because it reduces
waste.” When the ‘average’ hospital
performs around 20,000 scans per year,
that waste reduction is significant.
•
DOTmed Registered Disposables Equipment Sales & Service Companies
Name
Jenny Westbrook
Dan Vukelich
Juan Cortes
Robert Copeland Ralph J. Pesant
Dawn Nightshade
Scott Townsend
Marian Larson
Company - Domestic
Precision Surgical Supply, LLC
AMDR
Sensor Medics Corp.
Consultant
RJP International, Inc.
Medequip Engineering Service, Inc.
Townsend Surgical
Sonotech, Inc.
Name
Jorge Martinez
City
Laboratorio De Tecnologia Electronica En Medicina, LTEM SA DE CV
I april 2009
City
Westminster
Washington
Homestead
Winston Salem
Baldwin
Central Point
Knoxville
Bellingham
State
Certified DM100
CO
DC
FL
NC
NY
OR
TN
WA
•
•
•
Country
Certified DM100
Mexico City Mexico
www.dotmed.com
How the Country’s 4th Largest Health Care Facility Became #1 In
Being Green
By Robert Garment
H
ackensack University Medical Center (HUMC)
is an impressive complex of 14 buildings spread
over several acres. At its heart is a 775-bed
teaching and research hospital affiliated with
the University of Medicine and Dentistry of
New Jersey – New Jersey Medical School.
HUMC has more than 7,200 employees and an annual
budget of over $1 billion. There are more than 1,400 physicians and dentists on staff. HUMC is the largest provider of
inpatient and outpatient services in the state of New Jersey, and
it’s a very busy place. For example, in 2008 alone at HUMC
there were more than:
Photography by Titus Kana
• 6,200 babies born
• 76,000 inpatient admissions
• 77,000 CT scans performed
• 105,000 visits to the emergency room
• 5,347,000 pathology procedures performed.
This award-winning facility that has just about everything
is missing the one thing most other hospitals have in abundance: that pervasive, not-so-pleasant “hospital smell.” And
for that, the patients, visitors, and staff alike have environmental advocate Deirdre Imus to thank.
DOTmedbusiness news
I april 2009
31
How fast can you turn
around an ocean liner?
To get a facility the size of HUMC to
make any large-scale change — such
as revamping their entire housekeeping
process — is a daunting undertaking.
It’s somewhat akin to turning around an
ocean liner steaming at flank speed.
So what kind of person would approach HUMC’s President and CEO to
convince him to “green” such a bustling
facility — particularly given the rigorous standards for cleanliness a hospital
must maintain?
Greening The
Cleaning products
are so safe to
use, they’re used
inside the nursery
full of newborns at
the Women’s and
Children’s Pavilion
at Hackensack.
Meet Deirdre Imus, and
learn what makes her tick
Deirdre Imus began to take a serious
interest in the correlation between
the environment and an individual’s
health when she was attending college at Villanova. “Because I was involved in athletics at school, I wanted
to be as fit as possible. I learned how
variations in my diet could affect my
performance on the track. I paid attention to the food I ate, and it was
easy to extend that concept to all the
things that could affect my health,
and of course, that’s everything you
come in contact with on
a daily basis,” Mrs. Imus
observed. “From what I
learned, I became a vegetarian, and have been for about
25 years now.”
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The Imus Cattle Ranch
for Kids with Cancer
The Imus Ranch is an authentic, 4,000 acre cattle
ranch located near Ribera, NM, approximately 50 miles
northeast of Santa Fe. Ten times a year for two-week
sessions, the Ranch welcomes children suffering from
cancer, serious blood disorders, and those who have
lost siblings to Sudden Infant Death Syndrome. The
Ranch is a 501(3)(c) charity financed by Don Imus’
fundraising efforts, and by 100% of the profits from
Deirdre Imus’ retail Greening The Cleaning (GTC)
product line and Imus Ranch food products.
The Imuses make sure that parents and their children understand the Ranch’s fundamental philosophy. It is not your typical summer camp — at all.
Or as Don Imus, in his own eloquent, understated
way puts it, “This is not Camp Happy Face.” The
children work from dawn to dusk doing the jobs of
real cowboys and cowgirls. They round up horses
and Texas Longhorns, herd and feed sheep, buffalo,
chickens, goats and donkeys, and also learn to rope
and tie a calf.
Don and Deirdre Imus personally spend each day
with the children at the Ranch. They say their objective is to encourage the children to experience
a sense of achievement, responsibility and selfesteem through hard work and fun, while restoring
their pride and dignity. Many children are convinced
that because they are sick they are not normal, but
at the Imus Ranch they quickly discover they can do
anything any other kid can do.
Meanwhile, back at the Ranch…
In 1992, Deirdre met Don Imus, the noted radio talk show personality. The two soon married, and because they were both
committed to helping children battle cancer, they started the
Imus Cattle Ranch for Kids with Cancer in 1998.
“The concept behind the Ranch was to create a pristine
environment for the children — from all-natural building
materials, to growing our own organic food without insecticides. We also teach them that they’re normal children, who
happen to be sick, and that they can do pretty much what
any kids do, given the right environment and encouragement,” Mrs. Imus shared. “At one point during the second
year we were at the Ranch, a question occurred to me: was
the typical hospital environment — where many of these
kids spent a lot of time being treated — healthy, particularly since they are cleaned 24/7? That well-known ‘hospital
smell’ made me think not, and further research proved that
was definitely the case,” Mrs. Imus concluded. And she set
out to do something about it.
The moment of truth
Mrs. Imus went to the President and CEO of Hackensack
University Medical Center, John Ferguson, with a thick
folder filled with facts documenting the toxic ingredients
in conventional cleaning products. She also made the case
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DOTmedbusiness news
I april 2009
33
During our tour of Hackensack, we came across a typical
housekeeper’s cart, which, as Mrs. Imus proudly displays,
is full of Greening The Cleaning products.
able areas. That’s a great deal of real
estate. And all of it is cleaned with
GTC products.
It’s the job of Alan Lee, Administrative Director of Information and Guest
Services, Environmental Services, and
Operator Services for HUMC, to oversee housekeeping. He says, “HUMC is
totally committed to the GTC program.
I came on board about a year after the
transition to GTC products was made
and from that day to this, when you
come to Hackensack University Medical Center, it doesn’t smell like you’re
in a hospital. To me, that is the sweet
smell of success.”
While most of HUMC’s buildings
are cleaned by on-staff employees,
some cleaning services are provided by
outside contractors. “It’s stipulated in
those contracts that the outside vendors
must use GTC products. And not surprisingly, they’re happy to do so,” Mr.
Lee noted.
Yes, disinfectants are used,
as needed, in conjunction
with the GTC Program
that housekeeping tends to overuse
harsh disinfectants to clean just about
everything and anything. “I was ready
for a whole lot of skepticism on his
part. He could have said, ‘You’re crazy, go away,’ but about five minutes
into our discussion he essentially said
‘Deirdre, you’re right, these products
are noxious, and if you can deliver
a natural solution that’s as effective,
then do it.’ And that’s how ‘Greening
The Cleaning’ was born,” Mrs. Imus
recalled.
Getting the go-ahead to ‘green the
cleaning’ was one thing. Developing a
new line of cleaning products that would
meet the high standards within a hospital
was an even bigger challenge. “When we
came in with the formulations we devel34 DOTmedbusiness news
I april 2009
oped from all-natural, non-toxic ingredients, they were put through Hackensack’s
rigorous efficacy testing. The results of
those tests were extremely satisfying to
me because our Greening The Cleaning
(GTC) formulations not only exceeded
the necessary standards, they actually did
better than many of the harsh chemical
cleaners which were in daily use,” Mrs.
Imus noted with pride.
Cleaning more than 3.4
million square feet on a
regular basis
The 14 buildings on HUMC’s campus
contain approximately 3.4 million sq.
ft. of floor space — not to mention all
the windows, walls, and other clean-
“I want people to understand that the
GTC products are not the only cleaning products we use,” Mr. Lee observed.
“There are situations in the hospitals that
call for the use of a disinfectant. Many
hospitals use bleach-based disinfectants,
which are very harsh. The one we use
at HUMC is TBQ from Steris, an EPAapproved quaternary-ammonia based
product. We use TBQ, as a disinfectant,
in concert with GTC products in all patient rooms during terminal cleaning,
so we do both a thorough and environmentally responsible job. Since HUMC
has had one of the best outcome records
for any hospital over the last five years,
that’s proof using GTC products does not
compromise our patients’ health. In fact,
GTC has helped contribute to those better outcomes, so the products are timetested and proven,” Mr. Lee added.
2006 U.S. Environmental
Protection Agency
Region-2 Quality Award
HUMC has received many awards for
excellence in healthcare. The GTC program has added to that total. In 2006,
www.dotmed.com
the regional office of
the U.S. Environmental Protection
Agency recognized
both Hackensack
University Medical Center and The
Deirdre Imus Environmental Center for
Pediatric Oncology for their
contributions to environmental health.
And in April, 2008 the New Jersey
Chapter of the U.S. Green Building
Council (USGBC) bestowed its first
Green Product Award on the Greening
the Cleaning line of non-toxic commercial cleaners.
Changing the long-held
notion of what “clean”
smells like
Mrs. Imus noted that, “one of the ironic
challenges we face when convincing
people they should use GTC products
is that one of their greatest benefits, the
lack of a noxious odor, goes against the
commonly-held perception that cleaning products should have a bleach-like
or ammonia-like odor. What ‘clean’
should smell like should be the absence
of odor, and not the smell that comes
from harsh detergents and the other
products we typically clean our homes
and businesses with,” she added.
A facility can go green in
just 7 to 14 days
Transitioning to the GTC program
is quite easy. HUMC was the first
hospital to do it, and since then, approximately 500 business enterprises
have gone GTC green. This includes
over 70 health care facilities, including multiple hospital systems, more
than 100 schools and school systems,
and hundreds of other businesses and
corporations.
“Since the housekeeping personnel are essentially replacing offending
cleaners with benign GTC products,
their training period is short and easy,”
Mrs. Imus said. “Our GTC Team comes
in to do the training. And basically, that
involves showing housekeeping personnel which GTC product is best for
a given job.”
The Deirdre Imus Environmental Center
for Pediatric Oncology
The Deirdre Imus Environmental Center
for Pediatric Oncology was founded in
2001. Its creation was inspired by Mrs.
Imus’ concern for children’s health and
the success in the greening of Hackensack University Medical Center.
In Mrs. Imus’ own words, the mission of
the Center is, “to identify, control, and
ultimately prevent exposure to the environmental toxins that are causing
children to become sick – that’s the bottom line.”
Deirdre and the staff strive to bring about fundamental health improvements in the lives of children today and in generations to come. Through
their education and outreach programs, they help disseminate information for parents and the community. They formed a task force to investigate the reported high incidence of autism and other learning disorders
among children born to teachers working at a school in New Jersey.
They are also leading a clinical study to investigate a pesticide-free alternative to traditional head lice treatments.
The Center also has a dedicated Greening The Cleaning (GTC) Team
that helps hospitals, schools, and other facilities transition to the awardwinning GTC program — which typically can be achieved in 7 to 14 days.
Marketing for the GTC program includes an array of new distributor and
customer support initiatives. Their evolving network has global reach.
Towards this end, The Deirdre Imus Environmental Center has recently
partnered with a number of organizations that employ the disabled, blind
and visually impaired. These business partners provide complete customer service and order fulfillment activities for GTC’s growing list of
institutional clients.
Contact the Center to talk about environmental issues or concerns, or
inquire about the Greening The Cleaning program.
HOW TO CONTACT THE CENTER:
The Deirdre Imus Environmental Center for Pediatric Oncology
Hackensack University Medical Center
Research Building, Room 240
30 Prospect Avenue • Hackensack, NJ 07601
Phone: (201) 336-8071 • Fax: (201) 336-8161
www.dienviro.com • Email: [email protected]
DOTmedbusiness news
I april 2009
35
Going green can save up
to 30% or more on housekeeping products
Sunrise Medical
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situations significant savings are realized on an annual basis,” she adds.
For instance, Ray Garcia, Director
Environmental Services, Silver Hill
Hospital, New Canaan, CT, said they
save about 20% annually using GTC
products. And Luann DeFalco, Manager Environmental Services, St. Vincent’s Hall-Brooke Behavioral Center,
Bridgeport, CT, said they are realizing
an annual savings of 33%.
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All profits from sales of institutional
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with Cancer.
Find out more about Greening
the Cleaning: Contact the
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Oncology – See page 35
A safer environment and
better morale for staff
One of the common problems with the
harshness of standard cleaning products is that housekeeping staff sometimes have allergic reactions to the
products. “Since the GTC program was
instituted, staff is no longer exposed to
toxic chemicals that could potentially
cause reactions,” says Mr. Lee, “this
lets all our employees enjoy a better
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36
www.dotmed.com
A microtechnology
becomes a
major business
By Keith Loria
J
ust about everywhere you look
arthroscopic procedures are on
rise, attributed to their mounting
scope and usage in the diagnosis
and treatment of ankles, elbow,
wrists, hips and knees. Shoulder procedures are also expected to increase with
the introduction of advanced knotless
fixation systems by some of the OEMs.
When you are dealing with the
business of arthroscopy equipment, you
need to look into more than just the arthroscopes themselves, as a typical arthroscopy system can include camera,
camera cables, light source, sheath,
color monitors, printers, fiber optic
cable and accessories. Accompanying
instruments include shavers, cannulas,
blades, burrs and forceps. All of these
components make up what the Arthros-
copy Association of North America now
calls a billion dollar industry.
Advancements in endoscopes, fluid
management systems, cameras, powered instruments, displays, and hand
tools are encouraging surgeons to prefer the use of arthroscopic devices to
open procedures. Some believe the arthroscopy market is driven by increased
utilization in sports-related injuries, as
a majority of orthopedic surgeons find
arthroscopic surgeries to be less risky.
In a recent marketing report created
by Global Industry Analysts, Inc., they
cite arthroscopic visualization instruments as representing the largest as well
as the fastest growing segment of the
field in both the U.S. and abroad. In fact,
it is expected to reach more than $515
million in the U.S alone by next year.
The Players
While OEMs such as Stryker, CONMED
Corp, Storz and Olympus continue to
see sales rise yearly, companies such
as Advanced Endoscopy Devices, Inc.
have graduated from service and refurbish sales to manufacturing their own
new arthroscopic equipment and are
seeing success.
“It’s pretty competitive out there.
One thing that has really helped us is
the fact that we don’t have many players, like Storz or Stryker. We don’t have
to do the big mark-ups so our prices
are typically 60% below what the other
manufacturers sell them for,” says the
company President John Dawoodjee.
“For independent distributors and people from other countries wanting to buy
product, our price advantage is so much
DOTmedbusiness news
I april 2009
37
Cut-away view of an arthroscope
(Image courtesy of Rigid Repair Center)
greater and we have seen an increase in
sales.”
Then there’s the refurbished market,
which has also been thriving according
to the companies who sell, service and
deal in this equipment.
“Our company sells refurbished arthroscopes from all the manufacturers
and we’ve seen sales increase steadily
over the years,” says Cornel Cacuci, Office Manager for Apex Endoscopy Inc.
in Lawrenceville, Ga. “We’re refurbishing about 40 a month and we haven’t
seen any change with the downward
trend in the economy. The refurbished
market is still strong here.”
Arthroscopes have evolved to bring
brighter, sharper images to the physician
and there seems to be a “latest and greatest” piece of new equipment coming to
market every other month. Of course, as
more applications evolve for using this
equipment and the OEMs continue to
roll out advancements on a regular basis
to fill the need, some of the older equipment may not hold its value.
“One of the biggest challenges is
trying to gauge the future value of equipment that is on the secondary market. As
the OEM’s continue to bring new products to market and with high frequency,
equipment that was once in high demand
can lose a large portion of its value due to
newer generations continually showing
up on the secondary market,” says Philip
Mothena, President of Simple Solutions,
Inc., a pre-owned dealer based in Virginia. “Another hurdle recently has been
facilities being very reluctant to spend
the capital on upgrading their existing
equipment, or expanding their current
arthroscopy set-ups.”
I april 2009
Refurb process
Over at Knoxville, Ten.-based Townsend
Surgical, owner Scott Townsend deals
in refurbishing all types of arthoscopic
equipment, from scopes to shavers to
cameras. The amount of work needed
on each varies from piece to piece.
“An all OEM scope that passes the
function tests perfectly and survives the
autoclave with no moisture intrusion
will be re-sold without doing anything
but the testing,” says Townsend. “Conversely, a camera may be entirely rebuilt
including the prism and the cord.”
Danny Tipei, Owner of Skokie, ILbased Inex Surgical, Inc., believes that
reverse engineering the new equipment
is the best way to know how to refurbish
the equipment to peak specifications.
Arthroscopic instruments that come
in get inspected, taken apart, cleaned,
have bearings and seals replaced, and
put through a performance test. Then
they measure the motor coils, test the
sensors, the shavers, repair the consoles,
and look at the power supply.
“The only blue prints we have are
the ones we made on our own, and we
understand how the different components
and parts work,” Tipei says. “Everything
that has to do with arthroscopy from small
shavers to video cameras to scopes we repair, refurbish and service here.”
By The Numbers
When you look at a new arthroscopic
system from an OEM such as Stryker
or Olympus, you are dealing with prices
in the tens of thousands of dollars. A
camera can run upwards to $50,000 by
itself, scopes average around $7,000,
while sheaths average a little under
$1,000. When you start comparing those
prices to those of a refurbished system,
you understand why business has been
booming for most.
“They can save a lot of money on
a refurbished unit and we can duplicate
the functionality and can save a surgeon
more than 70% on a lot of this,” says Tipei. “One Stryker shaver can be $7,000
but we can refurbish it and bring it back
to life and sell it for under $1,000.”
Same holds true for the camera systems which can run from
$20,000-$50,000. A refurbished camera
can go on the market for anywhere from
$1,000-$10,000.
Fixer Uppers
The popularity of arthroscopic procedures comes from a surgeon’s ability to
examine joints through small incisions
and it is that sensitive, micro-technology
that often leads to equipment damage.
Tipei offers up a laundry list of
things that can go wrong with these delicate instruments as the miniature cameras, lenses, light source and the fiber
optics inside the scope are all vulnerable. Things are dropped, bent, sliced
by other instruments or they get dirty or
simply are overused and are susceptible
to normal wear and tear.
“With scopes going down very frequently—due to, for example, a doctor
who doesn’t maneuver a shaver or laser
very well and cuts the tips off scopes or
a facility where they don’t have enough
scopes in inventory and resort to overusing the scopes that they have, it’s important to have everyone prepared,” he says.
“My technicians know how to search
blind and repair to the component level.”
www.dotmed.com
Michael Lay, Principal of Chesterfield, Mo.-based Life
Systems, Inc., also understands the importance of having experienced service people when fixing arthroscopic equipment
to make his company stand out.
“For flexible scopes we have a senior technician with previous OEM experience. We have a head technician in rigid
that was also previously with a major OEM. Our camera lead
technician has 15 years camera repair experience with three
major repair companies,” Lay says. “This is delicate equipment and you need the best people if you are going to provide
the best service.”
Todd Abrams, President of Rigid Repair Center in Wellington, Fla., repairs on average, 350-400 scopes a month.
“What we do is a-z repairs on 99.9 % of the rigid endoscopes
that are out there,” he says. “We do a three-level system here.
Level 1 would include a basic cleaning, opening up of the scope,
evaluating what’s wrong with it, replacing one rod lens, cleaning the scope and putting it back. Level 2 would be replacing the
objective lens system, the working end glass piece, which is the
expensive part. Level 3 is a complete rebuild. We will replace the
inner and outer tubing, fiber-optic bundle, and any and all parts
necessary to bring it back to factory specifications. If it’s run over
by a bus we can fix it.”
Perhaps that’s why service companies have seen their
business continue to grow over the years, even in today’s economic climate.
“We are doing more than usual. I am seeing the future for
repairs, at least in terms of the next year or two as the economy
picks back up,” says Abrams. “The hospitals are not getting
the budgets they used to get so they can’t buy those new toys
with the bells and whistles and need to fix their old toys, which
is our niche market. Business has been very good, especially
since October.”
“There are way too many people doing repairs and
sales these days. I have been doing repair business for over
15 years now and have seen the cost of the repair go up
and the price I can charge my customers go down,” says
Adam Rudinger, President of Lex-Tech, Inc., which deals
in refurbished arthroscopes. “This is due to a glut of repair
companies that have popped up over the past few years. The
new guy tries to undercut the existing guy and then a price
war ensues.”
This could affect the industry in the years to come.
International Market
Economic growth, corresponding increase in living standard,
and aging population would continue to create a greater demand for arthroscopic procedures throughout the world.
Global Industry Analysts, Inc. reports that the United
States, Europe, and Japan account for more than 85% of the
global market for arthroscopy. Meanwhile Asia-Pacific and
Latin America, each at about 10%, constitute the two fastest
growing markets during the last decade.
Those numbers have opened up the eyes of Advanced Endoscopy Devices, Inc. as they look to sell their new equipment
overseas.
This arthroscope’s tip was
hit by a shaver during a
procedure and the tip was
particially shaved off.
(Image courtesy of
Rigid Repair Center)
But when so much business exists, that opens up the door
for more businesses to try and take a stab at the market. Abrams
says there are at least 275 arthoscopic rigid repair shops that he
knows of, but many are operating out of their garage with little
experience, no insurance and not much to stand behind their
business except for slightly lower prices.
DOTmedbusiness news
I april 2009
39
DOTmed Registered Arthroscopy Equipment Sales & Service Companies
Name
John Woods
David Bello
Todd Abrams
Cornel Cacuci
Danny Tipei
Sam Kanaan
Asif Bhinder
Marcus Rosenberg
Michael Lay
Jason Eden
Edward Soto
Adam Rudinger
Roger Katona
Scott Townsend
Stephen Rousset
Philip Mothena
Robert Overmars
Company - Domestic
Advanced Endoscopy Devices, Inc.
Endoscopy Replacement Parts, Inc.
Rigid Repair Center
Apex Endoscopy, Inc.
Inex Surgical, Inc.
Laproman
tekyard
Endoscopy Development Company LLC
Life Systems, Inc.
Bio Basics Global
SterilMed’s Scope Exchange
Lex-Tech, Inc.
Zoi Surgical, Inc.
Townsend Surgical
Medical Equipment Solutions
Simple Solutions, Inc.
BPI Medical, Inc.
City
Canoga Park
Newberry
Wellington
Lawrenceville
Skokie
Dearborn
Burnsville
Bridgeton
Chesterfield
Park Hills
Greensboro
Greenwich
Chesterland
Knoxville
Beaumont
Blacksburg
Fife
State
Certified DM100
CA
FL
FL
GA
IL
MI
MN
MO
MO
MO
NC
NY
OH
TN
TX
VA
WA
Name
Kashif Saleem
Ansari Medical
City
Karachi
Country
Certified DM100
Pakistan
“The international markets such as Asia and South America are very much in demand for arthro equipment right now,”
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says Dawoodjee. “Our international market is only 20% right
now but we are hoping to increase that number, because more
and more countries are demanding that they get new products
and we can supply them with what they need.”
Obviously, the pre-owned equipment is attractive for foreign markets since they don’t often have the same budgets as
U.S. hospitals.
Cacuci has seen his company increase refurbished equipment to places like Taiwan and Brazil, because they are interested in getting the most for their money.
What lies ahead
In the next few years, the most obvious advancement that is
starting to already come into play from the OEMS, concerns
clearer imaging with HD video systems and wireless technologies being introduced.
Scopes, cameras, fluid management systems and power
instruments are all being seamlessly integrated into customizable OR systems, alongside high-definition monitors and
wireless camera heads, which offer greater data capturing
flexibility and enhanced image viewing. This helps to maximize space, reduce procedure and turnover time and enhance
surgeon control.
“It’s a strong industry and you have to keep things state
of the art and have the ability to offer things that other people can’t,” Dawoodjee says. “I think a way the business will
change is more and more hospitals will not want to do business with people coming to them, realizing the savings of purchasing on-line.”
When you have a billion dollar industry where the momentum doesn’t seem to be waning, there seems to be plenty
of business out there for everyone right now.
•
www.dotmed.com
A
Spotlight
on Service
re you willing to lose
thousands of dollars due
to an unforeseen problem? Are you willing
to gamble on a patient’s
well-being or your livelihood?
Most people attempt to avoid the
types of problems that could cost them
majorly. In the medical industry, one of
the best ways to avoid problems or to
at least minimize them is to make sure
your equipment is being serviced in a
time-efficient and cost effective way.
DOtmed realizes this is a concern
for many of our readers and that is why
we will be bringing you information on
servicing equipment in future issues of
the magazine. We will feature different modalities in each issue and spotlight service issues you may encounter
along with the expense (or savings) you
should anticipate depending upon how
you address the needs of that machine.
We will highlight the full spectrum
of equipment, from the high-end to the
low. We will offer feedback on the servicing of all this equipment from the
perspective of the Original Equipment
Manufacturers (OEMs), to Independent
Service Organizations (ISOs) to 3rd Party
and even in-house servicing. Get the information you need to know to make the
best decisions for your servicing needs.
Additionally, we want to hear your
service questions. Let us know what’s on
your mind and we’ll introduce your questions to those who have the answers.
Keep watch in upcoming issues of
DOTmed Business News for more information that you can’t afford to ignore!
Have a service
related question?
Contact us by email today.
[email protected]
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Special introductory set-up fee is just $50.
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DOTmedbusiness news
I april 2009
41
Green Machines
Recycling Used Medical Equipment
By Kathy F. Mahdoubi
E
verything moves in reverse at Newtech Recycling’s
computer and electronics recycling facility in Somerset, NJ. Technicians operate in much the same way
as you might see in a manufacturing video played
backwards. Each piece of equipment is processed
and broken down: first the casing and the circuit boards, the plastics and metal components and the wires, until there is nothing
left except the individual components used to manufacture them.
Jim Entwistle is President of Newtech Recycling,
Inc. He encounters defunct diagnostic X-ray equipment
regularly, and it’s his business to know exactly what to
do with it. For the most part, there is no guesswork.
“It comes in and we take it apart,” says Entwistle. “I
am truly the end-of-life person in this process. I’m the
end of the line.”
A push toward environmental health and regulation
has increased recycling across the country and much of the
world, but the business of recycling is also encouraged by
financial opportunity. The green movement in the medical equipment industry is much the same as any other industry that recycles. A technologically advanced piece of
equipment like a CT or PET scanner or MRI has a relatively long lifespan and can be bought and sold a number
of times before being considered officially obsolete and retired from the regular medical field, but the usefulness does
not end there. Some medical technologies can be used for
other applications, in veterinarian medicine, for instance, or
converted for use in industrial applications. If equipment
doesn’t find a new career in one of those fields, several
imaging technologies, including X-ray, CT, MRI and PET
can be processed by specialized recycling companies and
broken down into individual commodities – plastics, steel,
aluminum and copper, etc. – to be resold in those markets.
“All of these materials will go back in as feed stock
for new manufacturing,” says Entwistle. “They go to refineries in the United States and also overseas, but it’s all
broken down.”
Even nuclear medicine technologies, such as linear
accelerators, which use depleted uranium shielding, and
gamma knives, which house radioactive materials, can be
rendered perfectly safe and can be recycled after being
properly processed by a licensed and trained professional
for the removal of environmentally sensitive materials.
Entwistle may occasionally recycle X-ray equipment,
but other types of equipment like CT, MR and gamma
I april 2009
knives are outside his league, he says. Enter Martin Campbell, president of Campbell Technological Resources, Inc.,
and Tommy Geske, president of Sunrise Medical Technology, Inc. These gentlemen are versed in the “scrapping out”
of most of these and other types of medical equipment.
“When we bring the equipment in we obviously take
a look at it and make sure that there are no surprises,”
says Campbell. “CT and X-ray will have oil-fill transformers and those will have to be segregated and handled
with great care. MRI magnets are typically very heavy -6,000 to 30,000 lbs, so those require special equipment
for handling.”
Each piece of equipment has its own decommissioning and recycling protocol. With MRI, this protocol is split
even further depending upon the type of magnet used.
“There are two different kinds of MRI magnets,”
explains Campbell. “Cryogenic magnets can be ramped
down. You can use the resistance and the power supply to pull some energy out of the magnet and allow the
magnet to ramp down. If you have a permanent magnet,
you must ship the magnet in a container that protects the
environment from the magnetic field.”
“Most MR machines have a ‘quench’ circuit, which
automatically shuts down the magnetic field,” says
Geske. This is a good thing, because of the cost and labor
issues involved in ramping down a magnet. Once a magnet is quenched there is ordinarily no remaining magnetism, although some kinds of steel have been known to
retain some of the magnetic property. Proper inspection
of the equipment ensures that it is safe to recycle.
MRI magnets themselves are a virtual metal quarry
waiting to be mined, but the present economy has depressed commodity prices to such a degree that it is not
nearly as profitable to scrap equipment as it was just
twelve months ago.
“A year ago we did very well scrapping MRI and
CT, but there’s not a whole lot of activity going on with
salvage right now,” says Geske. “We have seven magnets in the warehouse that we’d love to scrap out.”
Instead of breaking down a piece of medical equipment into their respective commodities, folks like Geske
are obliged to “sit on it” until prices are more palatable.
“For example, six to seven months ago aluminum
sold for a little over a dollar a pound. Today, it’s down to
www.dotmed.com
above 15 cents a pound,” he says. “Copper hit an all-time
medicine. Hebert Marquez is president of Radiation Oncolohigh of $4.15 and now it’s down to $1.12.”
gy Services, Inc, a CA-based company providing worldwide
Campbell continues to recycle equipment and seems
installation, parts, service and removal of radiation therapy
to be handling plummeting commodity prices with due
equipment. Marquez says that some machines, like linear acpatience. If the equipment is delivered to their facility,
celerators, do not contain radioactive material, but do produce
the elimination of transport cost keeps scrapping profitradiation that may irradiate the machine’s depleted uranium
able. When one market suffers, others may thrive. The
shielding, thereby requiring special handling.
resale of medical equipment for veterinarian applica“Everything can be recycled except for the DU – the
tions appears to be a robust market. With no insurance
depleted uranium needs to be disposed of properly,” says
reimbursement issues, selling to veterinary practices can
Marquez.
be far more attractive than dealing with medical pracPhilotechnics, Ltd. operates out of Tennessee and is
tices that may be hindered by payer agendas.
one of the relatively few companies licensed to contain
“Veterinarian medicine represents an alternative for
and remove radioactive materials from decommissioned
a business person to get involved with because it’s a cash
nuclear medicine equipment. This process is regulated in
business,” explains Geske.
part by the Nuclear Regulatory Commission (NRC).
Other applications for resold medical equipment
“Depending upon what state you live in, the Nuclear
come care of the industrial sector, Geske
Regulatory Commission has authorized indisays. CT technology is often used in
vidual states to administer their own rules,”
non-destructive industrial applications,
says Andy Armbrust, president of
such as testing the structural integrity
Philotechnics. “This is called the
of vessels and pipelines, and more
agreement state process.”
specifically for testing industrial
The NRC and state regulatory agenwelds. Another option for used
cies license and inspect equipment
medical equipment is ininvolved in nuclear medicine,
Recycling
ternational exportation –
such as those that require or
medical
yet another cash market.
produce radioactive sources.
equipment is
“Perfectly functional
Examples of these include
equipment is oftentimes exblood irradiators that use
still typically a
ported to parts of the world
cesium-137 sources, and
better option
where new models just
cyclotrons, which are used
aren’t affordable, like parts
in proton therapy and can
of Russia and South America,”
produce a variety of protonsays Geske. Other regions, like
emitting radionuclide tracers for
Africa, are underserved and in
use with PET scanners. Another
more desperate need of important
example is gamma knife technoldiagnostic equipment. In this case
ogy, which pinpoints and destroys
“you might have two or three CT scancancerous tissues by administering a high
ners in a country of 15 million, and no MRI technology.”
dose of radiation using cobalt-60 sources. In orBut governmental and environmental-group regulader to be recycled these and other types of equipment need
tions regarding the export of used medical equipment are
to be demanufactured and the radioactive sources removed
growing steadily more stringent, especially on the receivfor the half-life, or period of decay, of the respective radioing end. For instance, several countries throughout the
nuclide, says David McIntyre, public affairs officer for the
world have implemented embargoes against importing
NRC. X-ray and CT technology is not regulated, because
used medical equipment. Brazil has such an embargo,
while they may conduct radiation, they do not contain any
and China does as well. This is partly due to the careless
radioactive materials themselves.
and predatory resale of nonfunctional equipment.
No matter what the equipment is, there is probably
“That’s why China closed its doors to the US for
a method for recycling some, if not most of it. The salused equipment,” says Geske. “It wasn’t rebuilt or refurvage and commodities market may not be as profitable
bished and ended up being junk and never worked.”
as it has been in the recent past, but recycling medical
Uninformed owners of large, complex medical techequipment is still typically a better option than outright
nologies are often in “a quandary” as to what to do with their
disposal for the environment and your bottom-line.
equipment, but that is not as much of an issue in nuclear
•
DOTmedbusiness news
I april 2009
43
shows & conferences
ANI: Healthcare Finance Conference
June 14-17, 2009
Washington State • Convention and Trade Center
S
ound Judgment and Fresh Thinking is what the
HFMA Educational Foundation will be promoting from June 14 through the 17th at the ANI: The
Healthcare Finance Conference with renowned
Keynote Speakers including The Honorable Al
Gore, Patrick Nencioni and Karen Davis, Ph.D.
The Healthcare Finance Conference offers more than 80 current, in-depth, expert-led sessions including “Breakthrough Financial Performance and Risk Management Practices,” “Refining
Cost Management,” “Revenue Cycle Best Practices in an Uncertain Economy,” and “Rethinking Capital Strategies and Source.”
“ANI is the meeting for healthcare finance professionals. It has the biggest attendance and the best programs of any
healthcare finance conference in the industry. The interaction
I’m able to have with other healthcare finance professionals
at this conference is priceless,” says Dennis Doody, CPA and
Managing Director Health Care Commonfund.
The Honorable Al Gore will present - Thinking Green:
Economic Strategy For the 21st Century. Arguing that physical changes in our plant will eventually influence our global
economy, Vice President Gore encourages businesses, including health care, to consider broader issues – environmental,
social and political – when planning economic strategy.
Patrick Lencioni will open session with The Five Temptations of a Leader, explaining how leaders often fail to see
that the answers to their problems are buried within the same
common sense that makes them good parents, spouses or little
league coaches. Lencioni captures the common pitfalls that all
leaders face and provides practical ways to overcome them.
Karen Davis, Ph.D., presents Moving Toward A High
Performance Health System – facilitating a conversation with
leaders of the country’s foremost health organizations who
will share their vision and direction in advancing promising
strategies for health system improvements.
ANI 2009 will focus on the current economic and healthcare
climate featuring numerous sessions targeted at cost savings, efficiency, revenue and capital strategies to help you lead your organization through turbulence and meet mission objectives.
There will be more provider case studies and takeaways
than ever before, offering a more diverse representation of hospitals and health systems, featuring case studies from the largest healthcare systems to smaller community hospitals. Interact
with peers in sessions designed explicitly to generate practical
take-aways and shred insights. Make contact with colleagues
and learn how they are responding to some of the same issues
I april 2009
you are facing. And choose from six CPE-eligible
sessions highlighting HFMA Peer Review(RO)
products and services, featuring leading-edge
provider case studies and solutions. Experience
the latest technology and innovative solutions.
Make plans to register and save! Go to
www.hfma.org.
•
www.dotmed.com
By Sean Ruck
Green Construction is a Bright Idea
O
ver the past few years
there has been more attention paid to the environment. With global
warming taking a center
stage, former Vice President Al Gore
waving the banner for nature, manufacturers offering “green” or at least more
environmentally friendly products and
even a whole television channel dedicated to going green (Discovery Channel’s “Planet Green”), it has been a hot
topic. President Obama even made it
a main focus during his election campaign. Then the economy tanked.
Suddenly, the environment was put
on the back-burner. CEOs and presidents
who might have been considering some
changes to “green” their companies now
said, “We’d like to be more environmentally responsible, but . . .” and the “but”
was the economic slowdown. Many feel
that the change is too costly to justify in
this time of economic uncertainty. “That
is not the case,” says Tony Schifano,
president and founder of Antos Environmental. “You can be environmentally responsible and still save money.”
Schifano’s company has been helping hospitals and other businesses to
incorporate green sensibilities into their
practice for more than two decades. By
finding more and better ways to reuse and
recycle, costs are cut dramatically and
those savings go directly to the bottom
line. Additionally, goodwill generated by
being responsible members of the community helps to generate positive PR.
“It’s my opinion that health care
needs to take the lead in going green,”
Schifano says. There are challenges
to face when introducing the concept.
“Many times, we’re introduced to someone who has been running a hospital for
many years they may be reluctant to
change how they’ve been doing things,
especially if they’ve been successful.
When we illustrate how they can make
the change and actually save money,
they usually are on board at that point.”
Two Sides to the Story
-Sustainability
If your hospital is thinking about going
green, it’s important to note that there
are two key factors. The first is the one
that most people are familiar with – sustainability. To put it simply, sustainability will mean that you’re giving careful
consideration to what resources you use
and how you use them. On the day-today level, sustainability takes into account how much waste is generated
by your hospital and how much of that
waste is non-recycled.
On a deeper level, one that can literally go all the way to the foundation of
your hospital, sustainability takes into
account how renewable the resources are
that you’re using. For instance, in con-
struction, hardwoods may be favored but
the trees used for lumber are slow to grow
to maturity. Meanwhile, bamboo grows
quickly. Either can be used for flooring,
but bamboo is more sustainable.
Another material used for hospital
could be considered relatively friendly for
the environment – stainless steel. You’ll
see it everywhere. From legs on tables
and equipment to exam and lab table tops.
Stainless steel is easy to clean, requires little maintenance (translating to less chemicals and waste) and is 100% recyclable.
-Health
The second aspect of green design isn’t
as well-known, but that is beginning to
change. More information is being gathered to show the correlation between
materials we use to construct homes and
businesses. Some of that information is
troubling. Adhesive resins in plywood
and particle board have been shown to
“off-gas” urea formaldehyde. The gas
can cause respiratory irritation and may
cause cancer.
Other materials can be hazardous
as well, so it pays to be informed. Better
yet, if you’re constructing a new hospital wing for tens of millions of dollars, it
wouldn’t hurt to pay an expert to make
sure that your new wing will be the
healthiest selection for the environment,
your employees and your patients.
•
DOTmedbusiness news
I april 2009
45
They’re
Back!
What the GE/OEC
return means to
the C-Arms market
By Keith Loria
M
ay 5 of 2008 was a
monumental day in
the C-arms world, as
for the second time
in as many years, GE
Healthcare and its OEC surgery business rocked the very foundation of the
entire C-arms landscape.
Let’s rewind back to January of
2007 when the FDA revealed that the
current good manufacturing practices
with the OEC C-arm were deficient at
two OEC facilities, which resulted in
a consent decree that effectively shut
down shipments of the industry-leading
OEC products, including the 9900 Elite
C-Arm System, 9900 Elite NAV C-Arm
System, 9800 C-ARM System, 2800
UroView System, 6800 MiniView System, Insta-Trak 3500 NAV System and
ENTrak 2500 NAV System.
While this may have seemed like
good news to the other OEMs, the sudden influx of orders created some chaos
and supply problems. Philips came away
with the lion’s share of the business
thanks to their introduction of their new
generation of C-arms, which included
the Pulsera, offering 3D imaging.
“Just when we finished developing
Pulsera to the new platform, GE had the
consent decree and shut down operations
for 18 months,” says Scott Burkhart, Vice
President of general X-ray for Philips.
“Three years ago we were a relatively minor player and we really set about to fix
image quality and be world class in image
quality, which was accomplished.”
I april 2009
But everything changed again last
May when GE/OEC was cleared to release some of its product and began
manufacturing the popular OEC 9900 CArms once again. Even though they have
still yet to get clearance for their vascular
or mini C-arms, their return has changed
the entire marketplace for both new and
refurbished equipment once more.
“We came back in May with the OEC
9900 Elite, the most reliable product in
our history, and sales have been great,”
says Elizabeth Usher, Chief Marketing
Officer for GE Healthcare Surgery. “We
see growth in the market in 2008 primarily driven by our re-entry.”
In the full size C-arm market, GE reports high single-digit market growth and
the capture of more than 40% share of this
specific segment in 2008, climbing even
higher in the year’s final quarter.
“That trend is very encouraging and
speaks to the quality and reliability our
customers see in the product,” Usher says.
“In today’s economy, it is reasonable to
anticipate some pressure in the market,
but given C-arms are used in critical surgical procedures and that these surgical
procedures are growing with increasing
focus on minimally invasive approaches,
we continue to anticipate growth.”
Not to say that the other OEMs are
www.dotmed.com
hurting. Although they may have been
caught off guard when the original stopgap was announced, over the past two
years many of them have better positioned themselves into the market and
even with the reemergence of GE, have
continued to be successful.
Siemens Medical Solutions had a
very profitable year by gaining popularity with their Artis zee system, which
uses contrast media for spatial visualization of blood vessels. Without competition from GE, Hologic picked up
about 90% of the mini C-arm business
– more on that later. Meanwhile, Philips
took control of the vascular part of the
C-arms business and will soon release
their new flat plate technology.
“Our market share skyrocketed and
our reach into the market skyrocketed
and we had a free run at the market for
18 months. We took advantage of it and
that made us a much better company in
terms of operations, quality and procedures,” Burkhart says. “Philips has inherited the vascular end and when we
come forth with this flat plate technology, we will have not only inherited it,
we will have refined it. The customers
who have seen the platform and seen the
images are excited about that.”
At the time of the GE shutdown,
industry experts pegged them as having
held 70% to 80% of the market. That
percentage now stands at closer to 50%
to 60%; not bad for a product that has
been gone for so long.
“We had many customers who have
been waiting for us to come back into the
market and I think we have been welcomed
with open arms,” Usher says. “The OEC
9900 Elite has a strong following in the
U.S market and meets the surgeons’ needs
in a number of surgical specialties.”
and has a lot of loyal OEC buyers who
were willing to wait. When they are not
selling new, people aren’t buying; there
are no trade-ins and nothing coming in
on the used equipment market.”
Bill Adkins, President of National
X-Ray Corporation, based in Palmetto,
Fla. has a 5,000 square foot warehouse
for parts, but has seen a drop in sales
over the past two years on equipment.
“Two years ago it was just incredible,” Adkins says. “Before OEC had their
problem, we would get a truck load of Carms a month. At any given time I could
have 20 to 25 C-arms in the shop. Now,
we’re talking a handful. The used market
is still not back to where it used to be. Our
volume has dropped drastically since the
OEC shutdown. The amount of used Carms in the marketplace has been reduced
quite a bit in the past two years.”
GE resuming shipment of C-arms
has increased the supply of used systems available, decreasing the wholesale price to pre-shutdown levels.
“Since the gates have been opened
up with OEC there’s been a good influx of good equipment and prices have
come down substantially. That’s good
for everyone,” Serros says.
Russ Surratt, President of Bighorn
Biomedical Services, Inc. in Wyoming
isn’t so sure. While the company has done
anywhere from 60 to 120 C-arm refurbishments in the last five years, he sees
GE’s return as a bad thing for business.
“When OEC was down, we sold a
whole bunch and now that they are delivering again, we aren’t selling as many,”
he says. “OEC is doing everything they
can to get business so that includes price
and offering a much better warranty.”
Surratt’s business is concentrating
on the vascular and mini C-arms for
now, but once GE is cleared to distribute those, he expects another drop.
The economic crisis has also played
a role in the refurbished market. You
might think that people looking to save
money would be good for the refurbished
Domino Effect
It’s not just the OEMs who were affected by GE/OEC, as the refurbished
market for C-arms had to deal with less
inventory, which was bad for business.
“In the last six months to a year, the
supply has been slow and the demand
has been high so prices have been high
for everyone—the end users, dealers, everyone involved,” says Robert Serros, Jr.
President and CEO of Amber Diagnostics. “GE had such a large market share
DOTmedbusiness news
I april 2009
47
market, which offers prices at as much as
70% cheaper than new, but the financial
uncertainty has been felt by all.
“It seems like the smaller clinics do
not have the money to spend or are just
unwilling to part with it,” says Adkins.
“Many doctors that I know have personally lost quite a bit in the stock market;
therefore they appear to not be willing
to risk their remaining funds even on
their own business.”
Philips BV Pulsera
The refurb process
Amber Diagnostics sold about 80 to 100
refurbished C-arms last year, and have a
very stringent refurbishing process.
“When it first comes in, we do
proper inventory and assessment of the
machine. From that point, it gets disinfected and is totally stripped down
with all major components taken off
the machine and disinfected again because of blood and other things,” Serros
says. “From that point, they are sanded,
prepped, primed, painted, re-decaled,
and replacement parts are added and reassemble. We add upgrade features and
replace worn parts and then put it back
together and we do a burn in where we
try to make it not work and put it under
the most stressful circumstances. When
it passes that portion, we take it through
quality control measures.”
When it comes to refurbishing
C-arms, Wayne Horsman, VP Columbia
Imaging Inc. a C-Arms dealer based in
Columbia, has a different view than
many others.
“One of the things we decided,
through our experience, is that the usual
process of refurbishment, we completely
disagree with,” Horsman says. “Normally, they get equipment at the end of life
and rewire, repaint and redo them. Our
philosophy is to find the nicest, newest,
best piece of equipment we can find so
we don’t have to do all that to it.”
At Bighorn Biomedical, the company completely dismantles the C-arms and
goes through them at the component level. “We put about 120 manpower hours
into the unit,” Surratt says. “We replace
the batteries that power up the unit and
the little batteries that run the computer
system, which most people don’t.”
Anything less than perfect
is not good enough.
800-722-3646
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I april 2009
Mini C-Arms strong
As noted previously, Hologic had just
introduced a new digital version of their
mini C-arm when the GE decree came
down, so they inherited about 90% of
the mini market.
“The timing was good because we had
a good, solid product but the manufacturing couldn’t gear up any faster so we did
have a supply issue with lead times going
from 30 days to as much as 90 days,” says
Richard Keil, National Sales Manager for
Hologic Fluoroscan. “We’ve been quick
learners and have gotten the lion’s share
of the business over the last two years and
really saw business boom.”
Since GE still hasn’t been cleared to
ship their mini C-arms, Hologic should
continue to be the OEM leader.
“The business of the mini C-arm is
healthy because there’s a big demand
and need for it,” Keil says. “It’s hard to
get a hold of a large C-arm sometimes
so when an extremity surgeon wants
to do a foot or hand or ankle surgery,
the perfect solution has been this lower
cost, lower dose, mini C-arm.”
Over the last few years, the biggest
changes in the mini C-arms have been
the switch from an analog system to
digital system and from regular to flat
panel monitors.
One troubling trend that Keil has noticed in the last few months is that some
customers are starting to be scared off by
the economic uncertainty in the U.S.
“Although the last two years have
been a big boom for us, since January, the
opportunity for sales has dropped down
and we are hearing a lot of customers saywww.dotmed.com
ing they are going to hold off,” he says.
“They aren’t saying they are not going
to buy, just going to hold off six to nine
months to see how the financial landscape evens-out before they purchase.”
Customers are also turning more towards the refurbished market for minis.
“Mini C-arms sell as fast as you
can get your hands on them. This is
a very fine example of supply and
demand,” says Adkins. “We haven’t
been able to part a mini C-arm out
for two years. Their value is so high
on the market. They are hard to get
and you can sell them as soon as you
get them in. I could sell three or four
today if I had them. OEC still isn’t
putting any out so it’s a big problem.
People want OEC.”
Future Looks Bright
Philips will soon introduce their flat
plate technology, which will provide
much better special resolution and contrast resolution.
“You can instantly adjust controls
and bring out tissue or bones and you
can find small fractures or hairline issues that may be going on in the bone,”
Burkhart says. “Integration of high end
technology into C-arms has been spectacular. There are some very innovative
things we are working on.”
Future developments also include
using 3D in urology, seed placement
in the lungs and using C-arms to help
pain management by finding the nerve
bundles with better contrast resolution.
The latest generation of Siemens
ARCADIS C-arm family optimizes
surgical workflows through numerous improvements. Innovations, such
as the new ergonomic monitor trolley
and the easy user interface provide
optimal user experience, while an intelligent algorithm automatically adjusts and optimizes the image quality
in all imaging situations. Their systems are suitable for broad clinical
applications in orthopedics, trauma,
and neurosurgery, as well as gastroenterology, vascular and cardiac surgery or in urology.
“The next ARCADIS generation
continues the pace-setting tradition of
achieving a new level of clinical excellence,” says Anders Steiner, vice president, Special Systems, Siemens Medical Solutions USA, Inc. “Focused on
improving everyday practice and solely
led by the customers’ needs, ARCADIS
incorporates numerous unique to-thepoint solutions. From image quality
to operability, from versatility to efficiency, the groundbreaking features of
our ARCADIS family set benchmarks
– with outstanding functionalities that
make perfect imaging a snap and an
overall ergonomic concept that redefines clinical workflow in many fields
of practice.”
As for GE, they are continuing to
work with the FDA on their mini and
vascular models, and expect a resolution to be reached shortly.
“We are working with the FDA
very closely and it’s very promising,”
Usher says. “Behind the scenes we are
ramping up and getting ready to move
forward as soon as we can.”
Once that happens, expect big
changes again.
•
I april 2009
www.dotmed.com
DOTmed Registered C-Arm Equipment Sales & Service Companies
Name
John Stringer
Terry Michel
Ted Huss
Rick Stockton
Ronald Lorg
David Denholtz
John Pereira
German Filgueira
Robert Serros, Jr.
Bill Adkins
Ed Ruth
Deon Armes
Maddi Moore
Travis Nipper
Mark Ardoin
Davyn McGuire
Richard Keil
Wayne Horsman
Jason Crawford
Asif Bhinder
William Brooks
Robert Manetta
Kristopher Derentz
Gary Benitez
Leon Gugel
John Kollegger
John Patti
Edward Rawley
Kenneth Saltrick
Chris Popper
David Wingo
Mike Jackson
Andrew Herris
Elizabeth Usher
Scott Burkhart
Russ Surratt
Name
Christian von Leipzig
David Lapenat
Abdelrahim Khalil
Rami Wahba
Juan Garcia
Andres Lomelli
Company - Domestic
The Stringer CO
Radiology Systems Engineering, Inc.
Medical Imaging Resources
Allied Resource Technology, Inc.
United Medical Technologies Corp.
PODER, Inc.
Amber Diagnostics
National X-Ray Corporation
Managed Medical Imaging
A.X.S. Medical Systems, Inc.
MED iMAGE
Clinical Engineering Consultants, Inc.
Omni Imaging Service
Med Exchange International, Inc.
Hologic, Inc.
Columbia Imaging Inc
Tekyard
Salem Medical Electronics, Inc.
KenQuest Medical
Crown Medical International
Metropolis International
Bay Shore Medical, LLC
NCD Medical Corporation
Classic Diagnostic Imaging LLC
Engineering Services
Encore Medical International, Inc.
Radiology Equipment Partners
Combined Imaging Associates
Herris Medical
GE Healthcare
Philips Healthcare
Bighorn Biomedical Services, Inc.
Medical Ray
ANDA Medical, Inc.
Besisc
Scope Care
Issste
Movil Salud C.A.
I april 2009
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Cullman
Cherry Valley
Colfax
Ontario
Dunedin
Fort Myers
Fort Myers
Miami Beach
Orlando
Palmetto
Pembroke Pines
Tampa
New Lenox
Erlanger
Abita Springs
Agawam
Bedford
Columbia
Lansing
Burnsville
Clemmons
Brick
Henderson
Beechhurst
Long Island City
Ronkonkoma
Eastlake
Macedonia
Twinsburg
West Chester
Brentwood
Cottontown
Knoxville
Salt Lake City
Bothell
Moorcroft
City
Salta
Ottawa
Cairo
Cairo
Pinotepa Nacional
Valencia
State
Certified
DM100
AL
CA
CA
CA
FL
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IL
KY
LA
MA
MA
MD
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TN
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Argentina
Canada
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www.dotmed.com
This Month
in Medical History
Polio Vaccine is Made Public
W
ith the possible exception of AIDS,
there hasn’t been a
disease in American history causing
more public concern than the polio epidemics that would spring-up periodically across the country barely more than
five decades ago.
Polio has plagued humans for thousands of years. In fact, there are stone
engravings in Egypt referencing the
paralyzing affects of the disease dating
back three millennia. Ironically, the disease became a larger problem over the
centuries as sanitation improved. With
the improvement, there was less exposure to the Polio virus, which translated
to less people building immunity. That
meant when someone did contract it, it
had a greater chance of being more virulent and stood a better chance of becoming an epidemic. That was the case in
America in the early 1900s, with repeated large outbreaks. One outbreak had
reports of more than 9,000 cases in New
York City alone. During that stretch,
Franklin Delano Roosevelt would contract the disease, a decade before being
elected President.
Shortly after World War II, the United States averaged more than 20,000 cases a year from 1945 to 1949 with about
1% of the cases leading to paralysis. The
public by this time was in a panic. The
National Foundation for Infantile Paralysis, now known as the March of Dimes,
undertook a strong fundraising effort to
provide money for researching a vaccine.
The money helped fund the research of
Dr. Jonas Salk.
Salk, building his work upon that of
John Enders at Harvard University, cre-
ated a vaccine using dead viruses, which
was able to immunize against the living
virus while only creating a mild infection.
He reported his findings to the American
Medical Association and nationwide testing commenced, sponsored by the March
of Dimes. The results were welcome
news to a frantic country. The initial tests
showed 60% to 70% prevention. But
the elation didn’t last long – soon, about
200 cases of polio were reported as being caused by the vaccine resulting in 11
deaths. Testing ceased until investigation
traced the outbreaks to a bad batch of
the vaccine. Production standards were
strictly enforced and news of the successful trials was announced at a press
conference on April 12, 1955. A national
vaccination program was mobilized almost immediately.
Just prior to the vaccination program, there were 28,985 reported cases
of polio in the U.S. By 1957, the number dropped to 5,894. Although Salk’s
vaccine was proving successful, there
were detractors among his peers.
Researcher Albert Sabin felt that
Salk’s vaccine using a dead virus wasn’t
as effective as a vaccine using a weakened, live virus would be. Sabin conducted experiments using a weakened
form of the virus on more than 9,000
monkeys and 100 chimpanzees before
isolating a form of the virus that would
be safe to present live in a vaccine. That
form of the virus would reproduce in the
intestinal tract but would not do so in the
central nervous system. His vaccine also
had the added benefits of not only being
less expensive to produce but also easier
to take – unlike Salk’s vaccine which required injection; Sabin’s vaccine could
be delivered by ingestion. In 1957, Sabin
began human trials, testing in the Soviet
Union and Eastern Europe. Although
some U.S. researchers expressed opposition to Sabin’s vaccine due to its ties to
the Soviet Union, it was licensed in 1962
and quickly supplanted Salk’s vaccine.
In 1988, there were only 350,000
cases of Polio reported worldwide. Just
five years later, that number dropped to
about 100,000. China rolled out an extensive vaccination program in 1994, immunizing 80 million children and the entire
Western Hemisphere was declared “polio
free.” The following year, India immunized more than 87 million children.
Although there has been a substantial effort to totally wipe polio from the
face of the planet, there is still work to
be done. In 2008, more than 1,600 cases were reported worldwide with some
previously “cured” areas experiencing
a reintroduction of the virus. It’s frightening to imagine where we’d be today
without the work of Salk and Sabin.
•
DOTmedbusiness news
I april 2009
53
people & companies
Medtronic Buys Two Heart Valve Companies for $1.03 billion
MagnaServ Enterprises Inc. Announces
Formation of a New LLC Venture
Medtronic, Inc. recently announced it is buying two privately
owned heart-valve companies for $1.03 billion. The companies both have transcatheter technology that enables the replacement of diseased aortic heart valves without the need for
open heart surgery.
The purchases will catapult Medtronic into this fast-growing, sought-after market, while pitting it against Edwards Lifesciences, now locked in patent litigation with CoreValve.
MagnaServ Enterprises, Inc. (MagnaServ) is pleased to announce a new venture “General Radiology Group, LLC,”
based in Stuart, Florida. The LLC team is composed of three
forward thinking, customer oriented companies, namely: Consolidated Imaging Consultants, Softwind Capital and MagnaServ Enterprises, Inc.
•
Ohio Businessman Indicted on Fraud and
Tax Charges
A Federal Grand Jury in Cleveland, Ohio, returned an indictment charging Robert E. Alick with 11 counts of mail fraud,
2 counts of wire fraud, 1 count of corruptly endeavoring to
obstruct and impede the Internal Revenue Service, 1 count of
conspiracy to defraud the Internal Revenue Service, 6 counts
of willful failure to pay over employment taxes, and 13 counts
of willful failure to collect, account for and pay over employment taxes. The proceedings took place Feb. 25, 2009 the IRS
informed DOTmed News.
The indictment alleges that from about July of 2002
through April of 2006, in the Northern District of Ohio, Alick did knowingly devise and intend to devise a scheme and
artifice to defraud and obtain money by means of false and
fraudulent pretenses, representations, and promises. As part of
the scheme Alick agreed to purchase medical equipment and
took possession of the medical equipment, falsely representing that he would pay for the equipment.
As part of the scheme, Alick took money from his customers that was intended to be used to purchase used medical
equipment and did not deliver any equipment, delivered the
wrong equipment, or delivered broken equipment.
•
Hansen Medical, Inc. Announces Equity
Investment in Advanced Cardiac Therapeutics, Inc.
Hansen Medical, Inc. announced an equity investment in Advanced Cardiac Therapeutics, Inc. (ACT), and the securing of
exclusive rights to certain ACT intellectual property for certain
robotic applications. ACT, a privately held company located in
Laguna Beach, Calif., is developing a novel technology that
is designed to accurately measure the temperature in a lesion
during cardiac ablation procedures.
•
I april 2009
The packages will include pre-site management with
customers’ contractors, full installation, start-up and training services as well as full financing assistance, whether
it be short term, long term, fee per service, and/or customized lease-to-own arrangements. For qualified customers a full service installation and service package
can be put together with minimal upfront cash outlay.
•
GE Healthcare and STERIS Corporation
Announce Collaboration
GE Healthcare, a global leader in healthcare technology and
devices, has entered into collaboration with STERIS Corporation, a recognized leader in surgical technologies, to offer
STERIS products in GE interventional suites. The desire to integrate and equip Interventional suites with leading-edge technologies from both companies inspired the agreement, which
was announced at the Society of Interventional Radiology’s
annual meeting in San Diego.
Through this collaboration, GE Healthcare will provide
specialized X-ray equipment and interventional technologies,
while STERIS will supply custom-designed HD 360° Suites
featuring LED surgical grade lighting, video-switching and
visualization systems, and equipment management solutions.
•
www.dotmed.com
Merck to Buy Schering-Plough for $41.1
Billion
Cardinal Health Extends Radiopharmaceutical Network
Merck said it would buy Schering-Plough for $41.1 billion in
a cash and stock deal that would help it become less vulnerable now that its blockbuster drug Fosamax for osteoporosis
has gone generic and will be followed by its popular allergy
medicine, Singulair, in a few years.
Schering’s allergy medicine, Nasonex, has a longer patent
life and Merck and Schering are already partners in the marketing of two cholesterol drugs, Vytorin and Zetia.
What’s more, Merck is a top maker of vaccines, and acquiring Schering-Plough will give it a pipeline of biological
drugs, due to Schering’s 2007 acquisition of Dutch biopharmaceutical company Organon Biosciences. Biologics are highlypriced and are still unable to be copied by generic drug makers,
so they are seen as a white-hot area of growth for big pharma.
Cardinal Health, a global provider of products and services
that improve the safety and productivity of health care, has
opened a new facility in Omaha, Nebraska that manufactures
radiopharmaceuticals, giving local physicians new tools that
aid in the early diagnosis and treatment of disease.
The new manufacturing facility, a cyclotron, will produce fluorine-18 (F-18), a raw material needed to create
imaging agents that, when injected into patients, are visible
during a Positron Emission Tomography (PET) scan. This
technique uses low levels of radiation to enable physicians
to diagnose and treat certain forms of cancer, cardiovascular
and neurological diseases, as well as other serious medical
conditions, at an earlier stage of onset. The new facility has
created 30 highly skilled jobs across the areas of nuclear pharmacy, health physics and radiopharmaceutical manufacturing.
•
Barrington CT X-ray Tube Winner Named
Mark Elam, M.D. of Open MRI of Dalton (GA) is the recipient of the free CT X-Ray Tube in Barrington Medical Imaging’s recent promotional program.
The prize includes a new CT Tube, shipping, installation
services to OEM specifications, and manufacturer’s warranty.
The giveaway program was held for a new CT replacement
tube from www.dunlee.com/content.cfm/ct_tubes.
Entrants in the program also received a subscription to
DOTmed Business News.
•
•
ContextVision Continues to Bolster its Xray Division
ContextVision, the software imaging partner for the
most recognized medical imaging manufacturers worldwide, recently announced its continued investment in its
X-ray division. ContextVision added to its team of image enhancement experts and announced a new version of its X-ray tuning software, GOPView® XR2-T.
•
MEDRAD Multi Vendor Service Launches
TotalRepair on Select Ultrasound Probes
MEDRAD Multi Vendor Service has announced the launch of
TotalRepair, the first and only guaranteed repair solution on select
ultrasound probes. Enabled by 100% repair capabilities, TotalRepair allows healthcare facilities to spend less on costly exchanges
and replacements by maximizing the use of probe repair.
“MVS is committed to developing new repair techniques that will make equipment service budgets go farther.
This has immense value to healthcare systems during grueling economic times like these,” said Diane Watson, executive director of MEDRAD Multi Vendor Service. “With
our ever-increasing repair capabilities and new offerings
like TotalRepair, MVS can help hospitals and imaging centers save money by extending the life of their equipment.”
•
DOTmedbusiness news
I april 2009
55
Getting to Know the AMSP
and Getting a Better Deal
By Sean Ruck
I
n February, I travelled to Puerto
Rico with DOTmed president
Phillip Jacobus to attend the
winter meeting of the Association of Medical Service Providers (AMSP). The AMSP had invited us
to give a presentation at their meeting
and learn more about their association.
We discovered that they were a very
welcoming group of people, we also
found the members to be passionate
about the industry, practical in their
approach and perhaps most important,
a group that could potentially offer significant savings for DOTmed Business
News readers.
The presentation we offered wasn’t
an attempt to sell anything to the AMSP.
Instead, we used the time they had offered us to get to know the group better. Our presentation was technically
brief – I spoke for maybe 20 minutes.
Those 20 minutes were divided into the
better part of two hours though. There
were questions I had and the members
in attendance were more than happy to
respond to them. This is how I found
out how this association could benefit
our readership.
To understand how you might
benefit, it’s important to understand a
little more about the AMSP, who they
are, what they do and why they do it.
To begin with, the association is comprised of Independent Service Organizations (ISOs). These ISOs provide a
vital link in the services provided to
the health care industry. ISOs, Original
Equipment Manufacturers (OEMs) and
smaller, third-party vendors all help to
keep health care humming. Each has
its own strengths and weaknesses and
those attributes can vary even from
company to company under one of
those three umbrellas.
One of the first questions we asked
those in attendance was, “Who is the
ideal customer for an OEM?” After
I april 2009
From left to right: Steve Elmendorf, Carl Hoffman, Sean Ruck,
James Massengill, Hardy Rankin, Robin West, Brian Ashby,
Trey Gamble, Tim Wright, Robert Probst, Tim Martin, Anthony Bodenheimer,
Charles Lambert, John Snyder, Mark Schaeffer
some discussion, the consensus was
that an ideal customer would be an individual or entity looking for name recognition. Even if the service provided
by an ISO is the same as an OEM for a
better price, some customers are reluctant to go the non-OEM route. As one
AMSP member pointed out, “If something were to go wrong with an order,
equipment or service, it’s less likely that
the fault will be placed on the person in
charge at the hospital if they were working with a big OEM. If they were working with a smaller company they might
be put on the defensive about why they
went that route.”
That is unfortunate though. “A customer who understands the market and
is in the position to make purchasing
decisions can potentially save their hospital a substantial amount,” said member Brian Ashby, Service Manager for
Medical Imaging Systems.
Even if a hospital decides not to
go with an ISO, there can still be benefits to looking into that relationship.
“A smart customer in any business does
some comparison shopping,” said John
Snyder of Cal-Ray, Inc. “By doing that,
you approach potential vendors with information you can use to help you get
the most favorable prices or conditions.
Often though, this does lead to people
realizing we’re a good choice for them
to work with so we welcome the comparison shopping.”
ISOs are also a good choice for
hospitals with limited budgets. “Any
customer who can define their technical
and clinical requirements clearly has the
potential to benefit from working with
an ISO,” said Tim Wright, of Virtual
Medical Sales and the 2008-2009 president of the AMSP.
In order to find an ISO to work with
do a little homework. Don’t be afraid to
ask some questions like, how long they
have been in business, how much and
what kind of training their technicians
undergo, what professional organizations they belong to and most importantly, ask for references. It may take a
little more effort but it will be time wellspent and likely, money saved.
•
www.dotmed.com
Law
& Order
By Astrid Fiano
Federal: EEOC Has Proposed Rules for
GINA Legislation
Federal: FTC Approves Interim Monitor and
Agreement for Getinge AB/Datascope
In 2008, President Bush signed the Genetic Information Nondiscrimination Act (GINA) of 2008 (see DM 6108). The Equal
Employment Opportunity Commission (EEOC) is the federal agency required to issue regulations for Title II of GINA,
prohibiting the use of genetic information in employment,
prohibiting the intentional acquisition of genetic information
about applicants and employees, and imposing strict confidentiality requirements. The EEOC is now proposing a rule for
the implementation of GINA, and inviting public comment.
The public may submit comments by letter, fax or electronic
method. The complete proposed rules and details of how to
comment are available at: http://edocket.access.gpo.gov/2009/
E9-4221.htm
“Concerns about discrimination on the basis of genetic
information makes many people wary about having genetic
tests, even when those tests can help them protect their health,”
said Andrew Imparato, President and CEO of the American
Association of People with Disabilities, speaking to DOTmed.
“Strong enforcement of the new Genetic Information NonDiscrimination Act by the Equal Employment Opportunity
Commission will help protect workers and create a climate
where workers are more willing to use the new technology to
assess health risks and make decisions that can improve their
health and wellbeing.”
The proposed regulation includes definition of the statutory language barring actions by covered entities--including
limiting, segregating, or classifying employees on the basis of
genetic information. The EEOC proposed rule has as example:
an employer would not be allowed to reassign an employee of
whom the employer learned had a family medical history of
heart disease from a job the employer believed would be too
stressful and might eventually lead to heart-related problems
for the employee. The proposed regulation also reiterates the
statutory prohibition against an employer retaliating against an
individual who has opposed any act made unlawful by GINA,
and filed a charge of discrimination or assisted another in doing so, or gave testimony in connection with a charge.
The Federal Trade Commission FTC has announced it has approved the appointment of Quantic Regulatory Services, LLC
as the interim monitor in the matter concerning Getinge AB’s
acquisition of Datascope Corporation, and also has approved
the related interim monitor agreement. In January, the Commission voted to accept a consent order resolving the anticompetitive concerns related to the proposed acquisition. Getinge,
a company headquarted in Sweden and with a U.S. subsidiary,
is engaged in the research, development, marketing and sale of
cardiac surgery devices, including endoscopic vessel harvesting (EVH) devices. Datascope, a Delaware corporation, also
engages in research, development, manufacturing, marketing,
and sale of cardiac surgery devices, including EVH Devices.
The FTC had previously intervened in Getinge’s acquisition of Datascope, under concern that the acquisition would
give the company a near-monopoly share of the market for
EVH devices used in coronary bypass surgeries. According to
a press release on the matter, under the terms of the decision
and order, the Commission may appoint an interim monitor to
ensure the respondents’ compliance with its terms. Through
the action just announced, the Commission has exercised that
option. The press release says Quantic’s president, R. Owen
Richards, is a highly qualified expert on FDA regulatory matters who has successfully served as interim monitor in previous FTC matters.
National: Legislation introduced for TaxDeferred Savings Accounts for the Disabled
Representative Ander Crenshaw, (R-FL) has introduced
H.R.1205, the Achieving a Better Life Experience (ABLE)
Act of 2009, legislation to amend the Internal Revenue Code
of 1986 to provide for the establishment of ABLE accounts
for the care of family members with disabilities, and for other
purposes. The bill has been referred to House Committee on
Ways and Means, and in addition to the Committee on Energy
and Commerce.
DOTmedbusiness news
I april 2009
57
According to Rep. Crenshaw’s web site, the ABLE Act
“creates a tax exempt ‘ABLE Account’ that could be used for
expenses related to a disabled beneficiary including: education, medical and dental care, community based support services, employment training and support, moving, and assistive
technology.”
“Too often persons with disabilities are caught in between
the cracks in our society. The ABLE Act will provide families
with a savings tool that is flexible and portable. The accounts
are designed to help ease difficult financial situations and provide peace of mind to the families of individuals with disabilities,” Rep. Crenshaw says in a press release on his web site.
arthritis prevention and management efforts. The bill creates
a juvenile arthritis population-based database and establishes
education loan repayment and career development award programs to encourage more health professionals to enter the field
of pediatric rheumatology. The bill has been referred to the
House Committee on Energy and Commerce.
State: New York Legislation on
Anesthesia Administration
New York has new legislation under consideration, A 4509/S
1515, which allows for administration of anesthesia to a patient by certified registered nurse anesthetists (CRNAs) under
the supervision of an anesthesiologist immediately available,
or under the supervision of the operating physician who is
physically present, or under the supervision of a dentist, oral
surgeon, or podiatrist, who is physically present and authorized by law to administer anesthesia. The act also provides for
a certification process for nurse anesthetists.
Another New York Bill, A 3981, would have insurance
policies providing coverage for anesthesia services also including coverage for anesthesia services provided by an independently employed certified registered nurse anesthetist;
the law also defines “certified nurse anesthetists” as a person
who has satisfactorily completed educational preparation for
the practice of nurse anesthesia in a program accredited by
a national accrediting body recognized by the department of
health. The justification of this bill, according the legislative
web site, is the problem of New York not having recognized
CRNAs, and that CRNAs are often the only providers of anesthesia services in rural New York. The commentary on the
legislation states that Insurance providers failing to reimburse
such CRNAs have placed a tremendous financial burden on
the profession in the rural regions of the state.
National: Arthritis Prevention Bill Introduced
Reps. Anna G. Eshoo (D-CA ) and Fred Upton (R-MI) have
introduced a bill, H.R. 1210 - The Arthritis Prevention, Control, and Cure Act of 2009 - in order to “address the nearly
one in five adults and 300,000 children in America who suffer
from arthritis,” according to Rep. Eshoo’s website.
“Arthritis is already the leading cause of disability in the
United States,” Rep. Eshoo said in a press release. “Many of
those suffering are not receiving the care or the basic information they need to manage the disease. My legislation will help
the millions of Americans with arthritis and other rheumatic
diseases by helping to treat, cure, and ultimately prevent the
disease that diminishes their quality of life and affects the lives
of their caregivers and families.”
According to Rep. Eshoo, the bill enhances the National
Arthritis Action Plan by supporting federal, state, and private
I april 2009
National: Representatives Introduce
Amendment to FMLA
Congressperson Carolyn Maloney (D-NY) along with ten
other congressperson co-sponsors, has introduced an amendment to the Family Medical and Leave Act, enabling covered
employees to participate in or attend an activity that is sponsored by a school or community organization and relates to a
program of the school or organization that is attended by a son
or daughter or a grandchild of the employee. The Amendment
also allows an employee leave to meet routine family medical care needs, including medical and dental appointments of
the employee or a son, daughter, spouse, or grandchild of the
employee, or to attend to the care needs of elderly individuals
who are related to the eligible employee, including visits to
nursing homes and group homes.
The Amendment also broadens the category of covered
entity employers from those with 50 or more employees to
those with 25 or more. An eligible employee may choose or an
employer may require the employee to substitute accrued paid
vacation leave, personal leave, medical or sick leave, or family
leave of the employee for any leave under this Amendment.
The bill has been referred to the Committee on Education and
Labor, and in addition to the Committees on Oversight and
Government Reform, and House Administration.
State/National: California Man Found Guilty
of Selling Unapproved Medical Devices
United States Attorney Karen P. Hewitt of the Southern District of California has announced in a press release that James
Folsom was found guilty after a two-week trial by a federal
jury United States District Court in San Diego of twenty-six
felony counts relating to sale of an unapproved medical device. The trial was before the Honorable John A. Houston,
United States District Judge.
www.dotmed.com
Sentencing is scheduled for May 11, 2009.
According to the U.S. Attorney Hewitt’s press release,
the evidence presented at trial showed that from 1997 through
August 11, 2008, Mr. Folsom “conspired with others to ship
adulterated and misbranded Rife-type biofrequency devices in
interstate commerce.” The press release says the device was
sold under the names “NatureTronics,” “AstroPulse,” “BioSolutions,” “Energy Wellness,” and “Global Wellness.” The
press release says that testimony at trial indicated devices were
manufactured by the defendant and others in the San Diego
area, which was not registered with the Food and Drug Administration (FDA) as a device manufacturing establishment.
The testimony also indicated the defendant marketed his device “for investigational purposes,” which deceived consumers into the false belief that he possessed a valid investigational device exemption from the FDA. The press release says
evidence showed the device had settings for specific conditions including AIDS, diabetes, stroke and more.
The press release states that Assistant U.S. Attorney
Melanie K. Pierson, who prosecuted the case, said the devices
were adulterated - marketed without a valid investigational device exemption, without pre-market approval, and marketed
without valid clearance from the FDA, did not bear the name
and address of the manufacturer on the labeling, and were produced in an unregistered manufacturing establishment.
National: House Committee Holds
Hearing on Strengthening Employer-Based
Health Care
The Health, Employment, Labor and Pensions Subcommittee
of the House Education and Labor Committee recently held a
hearing on ways to increase health care insurance coverage for
Americans through their employer. According to Rep. Robert
Andrew’s (D-NJ) opening remarks, this hearing will be part of
a series on health care reform. The House Committee’s web
site says that while nearly 47 million Americans currently
have no health insurance at all, more than 27 million of those
uninsured have jobs.
National: Senators Introduce Physician
Payment Sunshine Act
A bill has been introduced by Senators Chuck Grassley (R-IA)
and Herb Kohl (D-WI), which amends title XI of the Social Security Act to provide for transparency in the relationship between
physicians and manufacturers of drugs, devices, biologicals, or
medical supplies for which payment is made under Medicare,
Medicaid, or SCHIP. The Physician Payments Sunshine Act of
2009 would require the makers to report payments to doctors
to the Department of Health and Human Services, and in addition, those payments would be posted online for public review.
Penalties for knowingly failing to report the information could
be as high as $1 million. According to Sen. Grassley’s web site,
the bill incorporates many recommendations of the Medicare
Payment Advisory Commission, an independent congressional
agency advising Congress on issues affecting the Medicare program. The bill is now in the Committee on Finance.
“Shedding light on industry payments to physicians would
be good for the system,” Grassley said in a press release on his
website. “Transparency fosters accountability, and the public
has a right to know about financial relationships. Patients rely
on their doctors’ advice. Taxpayers spend billions every year
on prescription drugs and medical devices through Medicare
and Medicaid. They also fund tens of billions of dollars of
medical research each year, and the doctors conducting that
research have a big influence on the practice of medicine.”
Sen. Kohl was also quoted in the release: “Since we first
introduced the bill, there has been a groundswell of support
from every corner. Patients want to know that they can fully
trust the relationship they have with their doctor. I am confident this legislation will pass during the 111th Congress.”
The witnesses included Mark Derbyshire, a Small Business Owner of Aberdeen, MD, who testified that small businesses such as his that did provide health insurance bears the
brunt of the costs for the uninsured workers of other companies. John Sheridan, CEO Cooper University Hospital, testified
about the decline in health care coverage and increase in the
uninsured and underinsured in New Jersey. Mr. Sheridan also
spoke of the costs of uninsured patients shifting to the paying patients (employer-based health coverage) and said that
increasing health care insurance coverage will help to stabilize
the inflation of health care expenses yet still would be insufficient to reduce health care costs, unless greater resources are
allocated to primary care and the proper clinical management
of chronic diseases. Jim Winkler, Health Management Practice Leader Hewitt Associates, stated that many of the large
employers Hewitt surveyed were concerned that rising health
care costs would result in small- and medium-sized businesses
dropping health coverage to keep their business competitive,
and leading to the large employers assuming an even larger
economic burden including increased costs picked up indirectly through cost shifting.
DOTmedbusiness news
I april 2009
59
old into gold
DOTmed Premium Auction Success Stories
Bringing Customers
Together
DOTmed Auction Specialist Mike
Galella contacted White Plains Hospital Center in Westchester County New
York to inventory some equipment for
auction.
The center had some endoscopy
equipment as well as a three year old
“never used” Air Shields TI 500 Transport Incubator.
The endoscopy equipment sold
quickly but the plans to start a transport
kitch with another hospital failed to materialize.
Fortunately, Vassar Brothers Hospital in Poughkeepsie New York - another
DOTmed user - found the Transport
Incubator on our site about four weeks
into the auction.
They took part in the auction and
were the high bidder at $12,500, both
parties were very pleased with the outcome of this auction.
The seller was happy about the sale
price and the buyer was happy about
finding a great piece of equipment at a
decent price that fulfilled their need to
replace an older unit.
A New Radiologist in
Pennsylvania Means
New Equipment for the
Hospital … and Zambia
A hospital in Pennsylvania hired a
new radiologist with the condition that
the radiologist would work with only
Hologic digital mammographers. The
problem was – the hospital had purchased a GE Senographe 2000 D just
the year before. This machine now
needed to find a new home.
The machine was purchased by a
dealer in Florida who then relisted for
sale on DOTmed with a starting price
of $100k and a Purchase Now price of
$175k. The system sold for the Purchase Now price to a company in Lusaka, Zambia that is currently building
a state-of-the-art medical center.
Due to the delicate nature of the
equipment and the high price involved,
DOTmed arranged for an independent
engineer to inspect the staged system and
to remove the digital plate for shipping
purposes. DOTmed Auction Managers
worked with the buyer and seller to arrange crating and shipping. The medical
center was able to save up to $200k by
purchasing a system just a year old.
Repeat Business
In January a DOTmed user successfully
auctioned a Toshiba Aquilion. The experience went so well that they recently
returned to list a Dornier Epos Ultra.
The auction started a little slow with rejected bids of $10k and $15.5k before
hitting the magic amount of $20k from
a dealer in California.
Auction Manager Cole Johnson assisted with arranging the shipping from
Wisconsin to California and another
successful Auction concluded.
Third Time’s the Charm –
So Were the Second and
the First
Twice last year EECP units were auctioned by a cardio clinic in Missouri.
Both auctions went so well that they decided to give it one more try with a final
unit they had left. Just like the others, this
unit successfully sold. The final price
saw the unit out the door for $7500.
You Can Auction Online!
Learn how easy it is to turn your idle
assets and used equipment into cash.
Call 212-742-1200 Ext. 296
Ask about DOTmed’s Full-Service Auctions –
“We Do The Work, You Get The Money.”
DOTmed.com
I april 2009
www.dotmed.com
…To Your Phone And Call Us Today!
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Owen Kane Holdings, Inc.
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owenkane.com
[email protected]
P: 212-558-6600
F: 212-558-6615
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Medical Sales & Services, page 58
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I april 2009
Parts for Sale, page 62
Employment Opportunities, page 63
www.dotmed.com
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DOTmedbusiness news
I april 2009
63
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APRONCHECK.COM
P.O. Box 751355
Houston, TX 77275
www.aproncheck.com
Call Steve Foos directly at 530-247-3821
or e-mail: [email protected]
Cell Counter:
Bone Densitometer:
632650 - HOLOGIC QDR 1000 Plus
Bone Densitometer
The unit needs a belt and recalibration to
bring it to working order. Stephen Shebes,
Scan Consultants,LLC, 561-445-0358
635525 - HOLOGIC QDR 1000 PLUS Bone
Densitometer $6,000
2003 Hologic QDR 1000 PLUS Full Body
Bone densitometer just deinstalled has all
manuals, Phantoms, complete working unit
location Miami Florida. Dave Germaine,
GMB Medical Brokers
CR:
635495 - KODAK POC260 CR $23,000
NEW in the box Carestream POC (Point
of Care)260 CR (60 1417 plates per hour
throughput). Neil Cox, CIMS
625257 - COULTER act t diff Cell Counter
$2,899
nice low count coulter with reagent card
guaranteed to work. mark cochran, sterling
animal clinic, 9705210333
Coagulation Analyzer:
Centrifuge:
Colonoscope:
635029 - JOUAN KR-4,22 Centrifuge
$1,895
. John Mendez, MED-LAB EXESS
635366 - PENTAX EC-3470LK Colonoscope $5,500
Pentax 70 series video colonoscope in excellent condition. Michael Lay, Life Systems
Inc.
Chemistry Analyzer:
628779 - BECTON DICKINSON FACSCalibur 4 Color Chemistry Analyzer
Becton Dickinson FACSCalibur 4-color
Flow Cytometer available for sale. Joseph
LaFrange, Harlow Scientific
597229 - HEMOCHRON SP0335
Coagulation Analyzer $495
1qty- Hemochron Jr. mark cochran,
sterling animal clinic, 9705210333
DNA Related:
628867 - AMERSHAM Typhoon Trio 2005
DNA Related
Amersham Typhoon Trio(2005) Dual Fluorescence Imager available for sale. Joseph
LaFrange, Harlow Scientific
Classifieds Rate Card
4 lines: $100 • 8 lines: $175 • 16 lines: $325
I april 2009
www.dotmed.com
EQUIPMENT FOR SALE
Want to buy?
Laser - Excimer:
635534 - VISX Star S4 Laser - Excimer
$95,000
Visx Star S4 Excimer Laser System in excellent condition. James Hogan, Ohio Valley
Enterprises
Microscope:
633246 - LEICA C ME Microscope $989
Leica C ME Binocular Microscope. Terence Michael, S E O Enterprises, Inc. ,
863-644-3555
Search Equipment
[ ? ] 456102
Lithotripter Mobile:
633271 - OLYMPUS CX 21 w/ PLAN obj.
Microscope $1,075
Olympus CX 21 Binocular Microscope with
PLAN objectives. Terence Michael, S E O
Enterprises, Inc. , 863-644-3555
ad on DOTmed.com.
635094 - SIEMENS LITHOSTAR Lithotripter Mobile $15,000
Siemens LithoStar Lithotripsy System: PART
ONLY - Ceiling Mounted X-Ray Tubes (...
Mark Swaffer, American Diagnostics Inc
MRI Coldhead:
113105 - APD F2000 MRI Coldhead
APD F2000 cold head rebuild kit available.
Marc Fessler, Independence Cryogenic
Engineering, 609-294-0012
MRI Compressor:
113099 - SUMITOMO CSW71D MRI
Compressor
Remanufactured Sumitomo compressor
available. Marc Fessler, Independence
Cryogenic Engineering, 609-294-0012
MRI Mobile:
635197 - SIEMENS Seimens Impact 1.0
MRI Mobile $75,000
Siemens Magnetom Expert Plus 1. manny
go, pacific coast mri
Mammo Unit:
633719 - GE DMR Plus Mammo Unit $10,000
2000 Dmr Plus was desinstalled working in
very good condition. Ramon Diaz, Electromedicine Services,Inc.
Microbiology:
635855 - BACTEC BAC-T-ALERT Microbiology $12,500
This is as Model BTA 100-120 microprocesser controlled 240 vial cabable unit r. Thomas
Marr, Arrowhead Biomedical
You can post a free classified ad on
DOTmed.com.
[ ? ] 456102
Search Equipment
To run a classified in
call 212-742-1200
Ext “Ads” (237)
635565 - BRISTOLINE BristoScope Microscope $300
This microscope is great for any doctor
or student. JOE HALLORAN, DR’S TOY
STORE
Want to sell?
635396 - ACUSON 128XP - 10 OB / GYN Vascular Ultrasound $3,500
Acuson 128XP - 10 Imaging Modes 2-D
M-Mode Color Flow CW Doppler PW Doppler Har... Anthony Garcia, Imagine Imaging
International Inc.
O/R Camera:
635584 - LINVATEC LIS8170 w/light&more
O/R Camera $1,400
Listing includes: 1x camera box LIS8170, 1x
camera head 8171 non-autoclavable, ... Andy
Senske, Excess Materials Management
635547 - STRYKER 1088 HD, X700, 40L
O/R Camera $9,900
Stryker Laparoscopy/Arthroscopy Tower.
Scott Haas, H+H Surgical Technologies, LLC
633807 - LINVATEC C3134E O/R Camera
$1,200
Linvatec C3134E 3CCD Digital Camera Box
With C3136 Camera Head. Sam Kanaan,
Laproman
O/R Instruments:
635281 - AUTOMATED MEDICAL PRODUCTS ARH 22 O/R Instruments $1,500
22” in length single arm, with 3/D Swinger
(U. Shirley B. Pia, Champia Medical Consultants, Inc.
O/R Instruments Power:
633737 - XOMED Micro-Craft Power Drill
System 2000 O/R Instruments Power
$1,700
Xomed Micro-Craft Power Drill System 2000
Comes with Foot Pedal & 2 Xomed MPS
2000 Instruments Please feel free to contact
us ig you have any questions. Danny Tipei,
Inex Surgical, Inc.
635195 - SIEMENS ELEGRA OB / GYN Vascular Ultrasound $10,000
siemes elegra(mfg 2000), excellent
condition,like new, wiht 3 probe to choose(.
Raul cruz, Integrated Diagnostic Services
OB / GYN Ultrasound:
629473 - GE Voluson 730 Pro OB / GYN
Ultrasound
AB2-7, RAB4-8, RIC5-9, SP6-12 Transducers available, Color & B&W Printer. Maureen
Dutton, Pinnacle Diagnostic Solutions,
901-312-1010
632968 - GE Voluson 730 Expert OB / GYN
Ultrasound
Voluson 730 Expert BT05, RealTime 4D,
DICOM, SRI, TUI, STIC, VOCAL II, VCI,
B-FLOW, Extended view, B&W Printer, Color
Printer, Intergrated DVD. Maureen Dutton,
Pinnacle Diagnostic Solutions
Orthopedic - General:
635533 - STRYKER Cast Saw Orthopedic
- General $1,200
Stryker Cast Saw with vaccuum. Ray Carter,
Hospital Equipment 4U
Orthopedic Table:
633447 - CHICK CLT Orthopedic Table
$600
This Orthopedic table is complete with all
attacments. Art Stanfield, A. L. Stanfield &
Associates, Inc.
OB / GYN - Vascular Ultrasound:
625675 - ACUSON Aspen OB / GYN Vascular Ultrasound $13,500
Save 75% off OEM Pricing! The Acuson
Aspen ultrasound system resulted from a u.
Kristi Edwards, Echoserve, 303-384-3246
Phototherapy Lamp:
627742 - REVITALIGHT ST-747 Phototherapy Lamp $4,000
This is an excellent unit in perfect working
condition. Bruce Hoffman, Rejuvange
DOTmedbusiness news
I april 2009
65
EQUIPMENT FOR SALE
You can post a free classified ad on
DOTmed.com.
[ ? ] 456102
Search Equipment
To run a classified in
call 212-742-1200
Ext “Ads” (237)
Portable X-Ray:
635151 - GE AMX4 w/Canon DR Portable
X-Ray $100,000
Refurbished GE AMX4 Portable with New
Canon 50G DR Panel. Jason Olenio, Associated X-Ray Imaging Corp.
Pump IV Infusion:
635605 - BAXTER AS50 Pump IV Infusion
$1,400
Units come patient ready with 90 day warranty, pole calmps, chargers. Jason ragazzo,
Biomedix Medical
SPECT Camera:
633631 - ELSCINT SPX-6 SPECT Camera
$10,000
Or Best Offer 1995 Elscint SPX – 6 The
system is available for immediate delivery.
Reno Itzhaki, Eltec Eng
Sterilizer:
634990 - RITTER sybron Sterilizer $1,095
Ritter SYBRON STEAM Sterilizer Model:
1100v 11” tray Condition: Used In fully . Todd
Fentress, Bio Equipment Sales and Services
Sutures:
635747 - US SURGICAL Auto Suture
TA30V3S Sutures $79
US Surgical Tyco Healthcare Auto Suture
TA30-V3 (TA30V3S) DST Series 2. Abbott
Jackson, Alpha Equipment LLC
Ultrasound Table Ultrasound:
635000 - BIODEX 056-605 Ultrasound
Table Ultrasound $1,200
U/S Chair No arm rails. Jim Connolly, ICON
MEDICAL INC
Ultrasound Transducer Ultrasound:
635222 - PHILIPS 21369A Ultrasound
Transducer Ultrasound $7,500
Phillips 5. Rita Napal, Arc Diagnostics
I april 2009
EMPLOYMENT OPPORTUNITIES
635580 - TOSHIBA PVF 375MT Ultrasound
Transducer Ultrasound $2,000
3. LAKSHMI NARAYANA, MAN MACHINE
ELECTRONICS
Ureteroscope:
635237 - STORZ 27410SL Ureteroscope
$4,500
Karl Strorz Endoscope semi rigid Ureteroscope 7. Miguel Rosello, Biomedical
Technician
Urological Procedure Table:
633597 - BIODEX Model 058-800 Urological Procedure Table $34,900
Fully Accessorized for Urologic Procedures The Urology C-Arm Table features m... Rich
Schubert, Biodex Medical Systems, Inc.
Ventilator:
375170 - SIEMENS Servo 300A with 390
Graphic Monitor Ventilator
Siemens Servo 300A Ventilator with
Automode and 390 Graphic Monitor Basic
Description Manufacturer: MAQUET GmbH
& Co. Bill Murdock, VIP Medical, Inc., 888
931 9996
Video Endoscopy:
634863 - OLYMPUS vecas 140 Video Endoscopy $7,500
complete 140 system with gastro scope 140
cv 140 clv u20d monitor. Fusako Hashimoto,
Fair Medical
Join the industry’s fastest
growing Independent MRI
and CT Service and Sales
organization.
Due to increased growth,
Genesis Medical Imaging is seeking
experienced MRI and CT Field
Service Engineers — we have
openings nationwide.
Full benefits Package includes:
t$PNQSFIFOTJWF4BMBSZ#POVT
& Commission Package
t)FBMUI%FOUBM-JGF*OTVSBODF
t,
t"VUPNPCJMF1BDLBHF
Forward resume with
salary history to:
KPCPQFO!BPMDPN
Viewbox Motorized:
635418 - DDP MAMMOVIEWER 810 Viewbox Motorized $3,500
Medical Office Upgraded. Debbie Medina,
BUYTHETRUCKLOAD
635300 - DDP Vidiviewer 4000 Viewbox
Motorized $3,499
Features Portable membrane switch control
panel Moveable rheostat-controlled br...
Rosina Kanerva, EFW Radiology
Wheelchair:
634828 - UNKNOWN Permobil Chair-man
Wheelchair $2,000
This wheelchair was known as the “Cadilac”
of wheelchairs. Judy Joiner, Candlelight
Christian
0óDF
'BY
www.genesismedicalimaging.com
Want to buy?
Search Equipment
[ ? ] 456102
Want to sell?
ad on DOTmed.com.
Post Jobs for Free on DOTmed.com
Just register for Free on DOTmed, then post
up to 30 jobs at a time – for Free.
Try it today!
www.dotmed.com
EMPLOYMENT OPPORTUNITIES
EXECUTIVE MANAGEMENT
NURSING
631596 - Management Position,
Phoenix, AZ, USA
Client looking to hire a full time Cath Lab
Manager., Jim Angel, SpringBoard Healthcare Staffing, 866-465-6286
632708 – Nursing Position,
West Coast hospitals
National Hospital System searching for
an Area Director of Case Management - 5
facilities.
Tamarahan Gaudet, Hyman Medical Group,
281-213-4684
603983 - Management Position,
Kalamazoo, MI
Opportunity in Health Information Department for a RHIA or RHIT to manage and
coordinate.
PHYSICIAN
623953 - Family Practice, Alabama, USA
Physician needed to join a well-established private practice, wanting to add
due to increase in volume & retirement.
Kelly Bownes, MedPlan Recruiting, Inc.,
205-870-7068
604012 - Neurology Position,
South Carolina, USA
BE/BC Neurosurgeon with excellent clinical
skills and experience in practice to join a
Private Practice Neuroscience group. Steve
Cannon, Franklin Joseph & Associates,
888-575-4511 x3607
599505 - Physician Position(s),
throughout Texas, USA
Physicians (MD/DO) for Physician House
Call Practice needed throughout Texas. No
nights/No weekends/No call
572716 - Nursing Position,
Baton Rouge, LA
Director of Post Surgical Services to develop
and recommend policies and procedures.
Tom Gradowski, Paramount Healthcare
Placement Service, 610-636-2252
621098 - Nursing Technician,
Las Cruces, NM
Telemetry Nurse in 168-bed facility with fully
staffed 24-hour emergency care and more.
TECHNOLOGIST/TECHNICIAN
630429 - Laboratory Technologist,
Montana, USA
part-time 16 hours/week who can function
as a generalist, incl. working in blood bank
(does not include micro). Karyn Trainor, St.
Patrick Hospital and HSC, 406-329-5716
627057 - CT Service Engineer, Chicago, IL
Field Service Technician 2 - responsible for
CT/MR general service, planned maintenance, updates and installation.
MagnaServ is a nationwide ISO
specializing in MRI and CT modalities.
MagnaServ is currently seeking Field Service
Professionals with 5 or more years of experience
for employment opportunities in various markets.
MagnaServ offers a competitive salary and
benefits package that includes: car allowance,
medical, dental, vision, life, and 401K.
Please email or fax your resume in confidence,
or fill out our application online.
2862 S.E. Monroe Street, Stuart, FL 34997
Parts: 772-219-2229 ● Fax: 772-283-2450
Office: 772-283-4288
[email protected]
www.magnaserv.com
THE TECHNICAL RESUMEBANK
NATIONWIDE OPPORTUNITIES
BIOMEDICAL & RADIOLOGY
629355 - MRI Position, Locations in USA
International OEM seeks experienced field
service profs. to install in top hospital/medical center environment.
Index of Advertisers
Advertiser
Amber Diagnostics
ANDA Medical
Atlantis Worldwide, Ltd.
Bay Shore Medical, LLC.
Beacon Surgical
C & G Technologies
Colossus Medical
DUNLEE
Endoscopy Development Company
Imaging Services
MagnaServ, Inc.
Marston Technical Service, Inc.
Page
20
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8
52
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32
Inside Ft. Cvr.
39
40
23
48
7
33
Advertiser
MED iMAGE
Med1Online
Medical Imaging Resources, Inc.
MEDRAD MVS
Metropolis International
Oxford Instruments
RedMedPar
Sage Point Transport, LLC
TYRX, Inc.
Unfors Instrument, Inc.
Varian Medical Systems
Viable Med Services
Page
50
Inside Bk. Cvr.
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9
47
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13
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36
51
4
Back Cvr.
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DOTmedbusiness news
I april 2009
67
blue book price guide
Recent equipment and parts auctions on DOTmed with actual for-sale prices.
SURGICAL
MEDTRONIC Defibrillators Lifepak 500 This
is a LOT of Four (4) Medtronics Lifepak 500
Automated External Defibrillators. Each
Medtronics AED 500 Bi-Phasic Defibrillator
includes a pad and impact-resistant suitcase
with removable foam inserts. LIFEPAK 500
Automated External Defibrillator : Sleek,
lightweight design for grab-and-go portability. Each unit weighs approximately seven
pounds. Clear screen messages, voice
prompts, readiness display and lighted buttons guide responders. Intuitive design ideal
for infrequent or inexperienced users. Preconnected QUIK-COMBO electrodes with
REDI-PAK preconnect system save valuable
time on-scene. Electrode pad diagrams illustrate optimum placement. The field-tough
design is proven in real-world emergency
conditions. Automatic self-testing helps
assure you that your device is ready to go.
Auction 6038 – sold for broker in Pennsylvania, $3,500.
HOMECARE/REHAB
INOGEN Oxygen Concentrator One 10-100
This is a InogenOne 10-100 oxygen concentrator. Less than a year old, used briefly.
Perfect running condition. Includes: Mobile
power charger BA-106 AC Power supply
BA-101 Satellite Conserver SC-100 5 batteries BA=100 external battery charger BA-103
Inogenone Carte and carry bag CA-100 Excellent cosmetic condition. All accessories in
original boxes and have patient manual and
instructions for use. Unit is unblemished and
in perfect working order. Auction 6095 – sold
for an individual in Canada, $2,500.
IMAGING
DORNIER ESWT Epos Ultra This is a
Dornier Epos Ultra Extracorporeal Shock
Wave Therapy System. B-K Medical 1101
Merlin Ultrasound Scanner B-K Medical
8560 8 MHz MFI Transducer. Auction 6228
– sold for a leasing company in Wisconsin,
$20,000.
GE Shared Service LOGIQ 500 MD GE
LOGIQ PRO 500 MD MR3 ULTRASOUND
SYSTEM VERSION: 4.10 M/N: 2212962
S/N: 514558YM6 DOM: DECEMBER
1998 VOLTS: 120 Vac 1 PHASE POWER:
1350VA FREQUENCY: 60Hz INCLUDES:
-SONY VIDEO CASSETTE RECORDER
M/N: SVO-9500MD2 S/N: 31062 AC120V ~
0.6A ~ 50/60Hz -SONY UP-897MD VIDEO
GRAPHIC PRINTER -PRESETS -PROBES:
I april 2009
739L: M/N: 2103319-2 S/N: 656179YM9
FREQ: 6.7/D5.0MHz. Auction 6246 – sold
for a broker in New York, $6,000.
MEDRAD Injector MRI Spectris This is a
Medrad Spectris Injector: This unit was used
with a Picker Polaris that was just removed
from service. Removed in working condition.
Auction 6399 – sold for a broker in Texas,
$4,000.
FUJI CR FUJIFILM FCR CAPSULA XL CRIR 356 Specifications Standard Components: • FCR CAPSULA XL Image Reader
(Model: CR-IR 356) • AC power cord Other
System Components: • IP cassette type
CC, LC • CR Console • Image Recorder :
DRYPIX 1000/3000/4000/7000 Supplies:
CR Plates Included: 3 X = 14 x 17 inches
3 X = 24 x 30 cm 2 X = 18 x 24 cm Reading Gray Scale: 12 bits Network: 10 Base
T/100 Base TX Dimensions (W x D x H): 590
x 380 x 810 mm (23” x 15” x 32”) Weight:
99 kg (218 lbs.) Power Supply Conditions:
Single phase 50-60Hz 120-240V ±10% 5A
(max) Environmental Conditions: • Operating
Conditions: Temperature: 15-30°C Humidity:
15-80%RH (No dew condensation) • Nonoperating Conditions: Temperature: 0-45°C
Humidity: 10-90%RH (No dew condensation) Easy-Operations Viewed On Small
Monitor Capable of automatically launching
the image reading process when the IP cassette is inserted, the system is designed with
simple operations to read, erase or set other
settings with buttons while viewing the monitor. The screen also displays the status and
the time remaining to complete the reading process to enhance user-convenience.
Compact Frame to Effectively Utilize Work
Space FCR CAPSULA XL is designed with
an IP cassette inserted in an angle to ensure
effective utilization and layout of the equipment in the working area that tends to be
packed with many high-tech medical equipment. As a result, the new model requires
less installation space to setup the main unit
compared to previous horizontal insertion
models, and therefore, can flexibly be setup
in smaller work areas. Supporting Various
Diagnostic Imaging Sizes The equipment
can be set with 2 IP cassette types (Type
CC, LC) for various image sizes according to
the image of the body part, since it provides
IP cassettes for chest, lumber, extremities,
as well as pantomography (15 x 30 cm).
Compact with High Efficiency FCR CAPSULA XL enables extremely high throughput
of up to *94 IPs/hr. and time to display on
the CR Console is just 26 seconds or less
regardless of its small size. Featuring Image
Intelligence™ Processing Image Intelligence Image Display and Processing – CR
Console A multi-function console that allows
quality assurance activities, image processing, as well as all the complex procedures
of digital X-ray imaging – patient ID, image
preview, processing and printing, DICOM
interface, etc. – from a single workstation.
A multi-function console that allows quality
assurance activities, image processing,
as well as all the complex procedures of
digital X-ray imaging – patient ID, image
preview, processing and printing, DICOM
interface, etc. – from a single workstation.
Auction 6415 – sold for an imaging center in
Canada, $25,000.
PHILIPS Rad Room Bucky Diagnost TH
This is a Philips Bucky Diagnost TH General
Radiographic System with a Optimus 3
PH 50 KW generator. Manufactured 2002
“LIKE NEW CONDITION” Includes: Optimus
3PH 50 KW Generator APR, SRO25/50
SRO25/50 X-ray Tube/Manufactured 2001
Ceiling Mounted Tube Crane Motorized 4
Way Float Top Elevating X-Ray Table 90
Degree Tilt Wall Bucky with attached Collimator Control and Light System has Servo
and Auto Collimation UPGRADEABLE TO
DR The Bucky Diagnost is the workhorse
RAD system, desinged to perform the entire
range of general RAD applications. From
its superb reliability, to its well thought out
design and efficiency, the Bucky Diagnost
is the perfect system for the busiest room in
the X-ray department. Auction 6411 – sold
for a manufacturer in Canada. $12,500.
BEDS
MIDMARK Beds Electric Midmark 204 You
are bidding on: 8 Midmark 204 tables ($540/
ea) 1 Midmark 204 with a bad cover ($400)
1 Brewer Access manual Table ($540). Auction 6832 – sold for a broker in New York,
$5,260.
DOTmed Auctions
Want to auction equipment
on dotmed.com?
Contact an auction specialist.
212.742.1200, ext. 296
or [email protected].
www.dotmed.com
Replacing your
GE Mammography Tube?
Replace your Senographe 500T, 600T, 700T, 800T,
DMR, or DMR+ with a Varian!
You have used the Varian M-151 for years for your 500T
and 600T; Varian now offers a replacement tube for your
GE Senographe 700T, 800T, DMR, and DMR+.
Varian replacements meet MQSA requirements!
M-151: a direct replacement for the GE D4122M
M-152: replaces the GE D4142M & D4172M.
sRhodium/Moly track.
sDesigned to calibrate on DMR and DMR+ systems.
M-153: is a direct replacement for the D4162M.
sUpgraded bearing.
sDesigned specifically to calibrate on the 700T and
800T systems.
Contact Varian Interay or your favorite dealer
for all your GE mammography replacement
tube needs today!
USA Contact Information
Europe Contact Information
Varian Interay
Varian X-ray Products Germany
1-800-INTERAY
TEL 843.767.3005
FAX 843.760.0079
E-mail [email protected]
TEL 49-2154-924-980
FAX 49-2154-924-994
[email protected]
www.varian.com
“All trademarked terms are property of the respective manufacturer.”

The Green Issue

Transcription

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