While the proprietary nature of the actual metalworking processes used for making “body parts” tends to be more mystique than technique, there are some things to think about for shops that are looking to do this kind of work.

It’s no secret that one of the very few bright spots in the metalworking business has been the machining of medical components. It only makes sense if one considers the demographic glut of the aging baby boomer generation.

More bodies are reaching a point where replacement parts are needed. Demand creates supply with so many of us among that aging human fleet.

Like much of the high tech label that surrounds medicine and its practice, some shops are hesitant to consider medical machining applications because they believe the special demands may be beyond their capability. There are exceptions, but in general the metalworking process knowledge to make medical components is generic. Cutting metal is cutting metal, and although some of the materials specified for medical components might be considered “exotic” they are certainly not exclusive to medical applications.

One area of medical machining where a shop looking to create a successful process might need to understand a few things is the application of metalworking fluids. In general, traditional machining guidelines for fluid use are in effect for most medical machining applications, but there are some considerations in applying them that can help make the job easier.

We spoke to Tom McClure, manager of the fluids business at TechSolve (Cincinnati, Ohio), and Greg Foltz, engineering and development manager for Cimcool at Milacron Inc. (Cincinnati, Ohio), to learn more about the role of metalworking fluids in machining of medical components.

Medical Parts

There are two main categories of machined parts for medical applications. They are components that are implanted in the body on a permanent or semi-permanent basis and those that are used in the body for short durations, such as during surgery. Most of the specialized cutting fluid considerations are targeted at the transplanted parts.

Implanted components such as hip joints, knee joints, bone screws, spinal fusion plates and other hardware must be designed to withstand a relatively tough environment within the human body. Many of these components are specified to be made from tough materials such as titanium and nickel alloys to withstand a hopefully long service life within the acidic environment that exists in our bodies, which have a general pH of around 5.4.

Greatly simplified, on skeletal replacement or reinforcement parts, the hope is that once the component is in place, the surrounding tissue will adhere to the surface of the metal–literally grow on it to form a strong connection–like a weld. This critical union between body and part is where what the shop did upstream through its application of metalworking fluid and the subsequent cleaning of the parts can be a determining factor in the transplant’s success.

Oil Is OK, But Be Careful

According to Mr. McClure, most of the medical machining shops that TechSolve has worked with use water-based coolants in their medical parts manufacturing. “That’s not to say oils cannot be used,” he says, “but the cleaning of those components must be especially thorough.”

It seems there was a lawsuit filed against a medical parts supplier after a batch of implanted parts failed to knit with the surrounding tissue. These had to be removed and replaced. No doubt the malpractice lawyers had a field day.

Analysis showed that microscopic amounts of the cutting oil were present in the microstructure of the implanted part. This residue was sufficient to prevent the tissue from bonding to the component. This is a patient’s horror story for sure, and a cautionary tale to parts suppliers.

Obviously if cutting oil is the right fluid for the job, the shop should use it. But it is important to make sure the subsequent cleaning process can get the oil off the parts.

Coolant Considerations

For medical component applications, coolant selection is a twofold exercise. First, of course, are the performance characteristics created by the interaction among the coolant, cutting tool material and the workpiece material. These are generic concerns applicable to any metalworking process.

Looking then at synthetic and semi-synthetic coolants, what should the shop think about? Matching the right coolant to the job is, of course, key. It is also important to reduce any incidences for bacterial growth in the coolant. According to Mr. McClure, most shops doing medical machining make coolant cleanliness a higher priority than is generally seen in traditional shops.

Coolant tanks are covered, and nothing foreign is allowed into the system. Way oil is monitored and removed regularly. Many shops use individual coolant tanks, one for each machine. In the case of an outbreak of bacteria or other contamination, dumping a single tank is less disruptive to production than dumping a central system, and it isolates any problems to a single machine instead of the entire shop.

When it comes to cases, trays and other enclosures for medical devices and emergency equipment, off-the-shelf products and those made from plastics may not be the best solutions. Before ordering or designing your next medical case or system, it could pay major dividends to consider the questions that many experts ask themselves.

Providing unfailing protection for medical devices and equipment–a function often performed by cases and other enclosures–is not to be taken for granted. While there is no shortage of medical case fabricators and other suppliers, selecting the right case–whether carrying case, instrument housing, sterilization container or other equipment enclosure–can be vital to the successful care of patients and accident victims.

Because medical cases are often subjected to the stresses of harsh environments, such as chemical or autoclave sterilization, rugged use and atmospheric pressure, or carry devices that will benefit from special design features, it behooves medical equipment suppliers and practitioners to be highly selective when specifying case application requirements.
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“Many people in the medical community feel that cases, trays and other equipment enclosures are more or less standard items,” says Don Saak, Business Development Director for Zero Manufacturing, of North Salt Lake, UT. “The fact is that custom cases are not only practical, but are often critical for the protection, performance and efficient use of the equipment they contain.”

Saak notes that Zero Manufacturing has for many years built custom-designed products for aerospace, military and electronics, in addition to medical applications. “The standards of quality and functionality in these fields are benchmarks throughout the world,” he says. “The cases used to house or transport medical appliances, surgical tools and other devices can benefit directly from the materials and engineering advancements developed for the aerospace and electronics industries.”

What criteria should manufacturers and users of medical equipment consider in the specification of cases for their products? While that depends on specific applications and the sensitivity of case contents, Saak identifies five “rules of the road” for specifying medical cases:

1. Choose appropriate case materials

The materials from which cases are fabricated have a direct bearing on protection of the case contents and durability of the case itself.

Essentially, the choice of case materials is between metal and plastic. Metal cases are usually constructed of aluminum or aluminum alloys, and are typically either deep drawn or welded. Plastics, ranging from standard compositions to space age composites, are commonly vacuum formed, thermoformed, rotationally molded, blow molded or injection molded.

Metal cases are well known for their protective attributes. They offer high resistance to impact, can be sealed tightly, and can withstand extreme temperatures and can be made fireproof. “If an aluminum case is subjected to high impact, the shock will be absorbed by the entire case,” explains Saak. “We’ve received letters from customers that told how their metal cases withstood the impact of auto accidents and buildings collapsing. These cases may be dented, but they will take a beating or go through a fire and still protect tire contents.”

Plastic cases can also offer a good seal and, depending on composition, substantial resistance to impact. When plastic cases “give,” they tend to crush or crack. While metal cases are not crush- or crack-proof, they will usually sustain a wider range of extreme heat or cold. Aluminum becomes harder in extreme cold, whereas plastic becomes brittle. Aluminum dissipates heat, whereas plastics can deform or melt when subjected to extreme heat, exposing contents to shock and perhaps functional damage.

Sometimes overlooked, case materials can affect the hygiene of contents that undergo sterilization. “The materials that make up the plastic case could out-gas during some chemical sterilization processes,” Saak explains. “While this is not a common problem, it is one that could cause contamination of items such as surgical instruments or implants that are being sterilized.” Also, many plastics are weakened during autoclave sterilization, and may have a much shorter lifespan than their metal counterparts. One-piece deep drawn metal cases also offer the advantage of having no seams or welds, so there are fewer “hiding places” for bacteria and other foreign matter.

In some cases, applications require shielding from EMI/RF (electromagnetic interference/radio frequency interference), which will affect choice of materials. “We have a lot of experience in this with aerospace and military cases,” Saak says. “We know that aluminum provides a natural EMI/RFI shield, which will prevent stray emissions from affecting instruments inside or even outside one of our cases.” Plastic must be coated or impregnated with shielding materials.

BARIATRIC EQUIPMENT

ARJO, Inc.

Roselle, IL

Contact: Amy McCaw

Ph. (800) 323-1245 Fax (888) 594-2756

E-mail: info@arjousa.com

Web: www.arjo.com

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Camtec

Cambridge, MD

Contact: Sandy Conn

Ph. (800) 866-1156 Fax (410) 228-6403

E-mail: camtec@dmv.com

Web: www.camtecproducts.com

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Carstone Seating & Bariatrics

Somerset, KY

Contact: Sales Department

Ph. (888) 863-9543 Fax (606) 451-9234

E-mail: sales@carstone.com

Web: www.carstone.com

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Dale Medical Products, Inc.

Plainville, MA
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Contact: Allison Frazer

Ph. (800) 343-3980 Fax (800) 752-1230

E-mail: info@dalemed.net

Web: www.dalemed.com

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Graham-Field

Atlanta, GA

Contact: Mike Norby

Ph. (800) 347-5678 Fax (800) 726-0601

E-mail: mnorby@grahamfield.com

Web: www.grahamfield.com

See our ad on page 21

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Hill-Rom Company

Batesville, IN

Contact: Leah Schoettmer

Ph. (800) 638-2546 Fax (843) 740-8418

E-mail: leah.schoettmer@hill-rom.com

Web: www.hill-rom.com

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Liko, Inc.

Franklin, MA

Contact: Melissa Nowitz

Ph. (888) 545-6671 Fax (508) 528-6642

E-mail: info@likoinc.com

Web: www.liko.com

Liko specializes exclusively in healthcare lifts. We design and build our products with equal consideration for the safety and comfort of patients and the protection of caregiver staff. Liko’s offerings range from compact, lightweight mobile lifts to high-capacity, ceiling-mounted “total lifting solutions.” In addition to patient lifts, Liko offers the most extensive line of slings and lifting accessories, clinical application assistance, installation assistance, training services, and strategically located stocks of spare parts.

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Medline Industries, Inc.

Mundelein, IL

Contact: Travis Winegarner

Ph. (800) 633-5463

E-mail: info@medline.com

Web: www.medline.com

Medline provides a comprehensive line of bariatric products including 500-1b-capacity canes, 500-lb-capacity walkers with easy-to-use pushbutton mechanisms, 650-lb-capacity crutches up to 54″, 550-lb-capacity transfer and bath benches, and up to 850-lb-capacity commodes. Medline also offers a wide selection of bariatric furniture, including chairs, sofas, and beds.

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ROHO Group, The

Belleville, IL

Contact: Customer Service

Ph. (800) 851-3449 Fax (618) 277-9561

E-mail: mail@therohogroup.com

Web: www.therohogroup.com

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BATHING EQUIPMENT/SUPPLIES

BodyVac Products, Inc.

Glendale Hts., IL

Contact: Greg Pearson

Ph. (877) 263-9500 Fax (630) 924-0229

E-mail: sales@bodyvacproducts.com

Web: www.bodyvacproducts.com

Your in-bed bathing solution is finally here! Stop lifting, transferring, and struggling with all of your bedfast residents. Bathe them while they stay in bed, fully covered and comfortable, and do it in minutes with the In-Bed Bathing Spa; do hair and peri care in seconds and a complete body bath in 15 minutes! You owe it to yourselves and your residents to make the change. Seeing is believing!

See our ad on page 39

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Clarion Bathware

Shippenville, PA

Contact: Lee Wentling

Ph. (800) 576-9228 Fax (814) 226-0730

E-mail: lwentling@clarionbathware.com

Web: www.clarionbathware.com

See our ad on page 58

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Invacare Continuing Care Group

St. Louis, MO

Contact: Sales Department

Ph. (800) 347-5440 Fax (800) 797-8402

E-mail: info_iccg@invacare.com

Web: www.invacare-ccg.com

See our ad on Cover 2

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MasterCare Patient Equipment, Inc.

Columbus, NE

Contact: Diane Walkowiak

Ph. (800) 798-5867 Fax (402) 563-9102

E-mail: mastercarepeinc@frontiernet.net

Web: www.mastercarebath.net

MasterCare Patient Equipment, Inc., is celebrating more than ten years of manufacturing a complete line of bathing systems. MasterCare designs ergonomic and economic patient care solutions, incorporating such features as BathAire, barrier-free access, and a no-lift/low-lift bathing philosophy. With our national distribution chain, we can provide local demonstrations, in-service training, and support after the sale. The needs of your facility, residents, and staff are our number one priority. MasterCare equipment is made in the USA.

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Rane Bathing Systems

Ephrata, PA

Contact: Joe Chesnutt

Ph. (888) 880-7373 Fax (717) 733-3947

E-mail: info@ranetubs.com

Web: www.ranetubs.com

Rane Bathing Systems is putting a fresh new look to bathing in the institutional setting. The trend is to more homelike environments in which bathing can be a more enjoyable experience. Rane delivers, with beautiful systems that offer function with style. Choices include side door access, state-of-the-art lifting and transfer systems, and air spa with the latest features. Rane also has a walk-in tubs and tub/shower combinations suitable for independent living.

Research and Markets  has announced the addition of The Guide To Distributors of Medical Equipment & Supplies Worldwide 2006 to their offering.Over 1,450 detailed and fully verified profiles of specialist distributors in more than 115 countries around the globe.

Whatever your sales representation needs this essential guide will help. Unlike simple address listings, each profile has been researched and verified directly with the company by our researchers, and details provided include, where available:

Sales success in export markets requires local business and cultural knowledge - knowledge that can effectively be found via sales agents and distributors.

Full contact details

Years established

Number of employees, including sales/servicing split

Turnover

Product areas represented

Potential new product areas

Companies represented

Summary

The information you need in the format you want

The Guide is provided in two formats to meet the needs of customers.

Print edition: Published November 2005, the print edition is available in 4 regional volumes (Europe, Middle East/Africa, Americas and Asia/Pacific).

Web edition: Updated and maintained on a daily basis, the web edition provides fast and easy access to all the data in the Guide. A simple search facility allows you to identify representatives by different criteria (eg. country, product type etc.)

Easily find and evaluate medical sales agents and representatives in….

Volume I: Europe - Over 525 specialist medical sales companies in 41 countries

Volume II: Middle East/Africa - Over 250 specialist medical sales companies in 28 countries

Volume III: Americas - Over 325 specialist medical sales companies in 27 countries

Research and Markets  has announced the addition of The Guide To Distributors of Medical Equipment & Supplies Worldwide 2006: Americas to their offering.** Please note this report is a subset of The Guide to Distributors of Medical Equipment & Supplies Worldwide 2006. For more information please search our site.

The Guide to Distributors of Medical Equipment & Supplies Worldwide 2006 contains 1,450 detailed and fully verified profiles of specialist distributors in more than 115 countries around the globe.

Whatever your sales representation needs this essential guide will help. Unlike simple address listings, each profile has been researched and verified directly with the company by our researchers, and details provided include, where available:

Sales success in export markets requires local business and cultural knowledge - knowledge that can effectively be found via sales agents and distributors.

Full contact details

Years established

Number of employees, including sales/servicing split

Turnover

Product areas represented

Potential new product areas

Companies represented

Summary

Volume III: Americas

Over 325 specialist medical sales companies in 27 countries

Argentina

Bahamas - Barbados - Bermuda - Bolivia - Brazil - Canada - Chile - Colombia - Costa Rica - Cuba - Dominican Republic - Ecuador - El Salvador - Grenada - Guatemala - Honduras - Jamaica - Mexico - Panama - Paraguay - Peru - Puerto Rico - Trinidad & Tobago - United States - Uruguay - Venezuela

** Please note this report is a subset of The Guide to Distributors of Medical Equipment & Supplies Worldwide 2006. For more information please search our site.

The Guide to Distributors of Medical Equipment & Supplies Worldwide 2006 contains 1,450 detailed and fully verified profiles of specialist distributors in more than 115 countries around the globe.

Whatever your sales representation needs this essential guide will help. Unlike simple address listings, each profile has been researched and verified directly with the company by our researchers, and details provided include, where available:

Sales success in export markets requires local business and cultural knowledge - knowledge that can effectively be found via sales agents and distributors.

Full contact details

Years established

Number of employees, including sales/servicing split

Turnover

Product areas represented

Potential new product areas

Companies represented

Summary

Volume IV: Asia/Pacific

Over 340 specialist medical sales companies in 22 countries

Australia - Bangladesh - Brunei - China - French Polynesia - Hong Kong - India - Indonesia - Japan - Korea (South) - Kyrgyzstan - Malaysia - Myanmar - Nepal - New Zealand - Pakistan - Philippines - Singapore - Sri Lanka - Taiwan - Thailand - Vietnam

After Clark Griffith purchased Medical Center Pharmacy in Scottsbluff, Neb., in 1985, he saw that his community needed an efficient supplier of home medical equipment such as wheelchairs and hospital beds.

At that time, wheelchairs came from an equipment-rental business; oxygen–another need of some in frail health–was available only from welding companies; and none of the firms delivered or set up equipment.

To provide those services, Griffith formed Medical Equipment Specialties in 1988. But soon he saw a further need–for on-site equipment repair and custom building of wheelchairs and scooters, so that patients wouldn’t have to travel as far as Denver, Rapid City, S.D., or Omaha, Neb., for such services.

Griffith’s expanded operation a]lowed patients to receive customized services within their community, typically with the help of a physician, a physical therapist, and a technician from Griffith’s organization.

In 1991 he opened a second full-service facility in Torrington, Wyo., and two years later he expanded his Scottsbluff facility.

Griffith then turned to patients in rural areas and those who could not get to his stores easily. In the spring of 1996, he designed a 40-foot mobile showroom and shop. He stocked it with manual and powered wheelchairs, seating systems, a drill press, welding equipment, and a full range of tools–everything needed to build custom seating and chairs off-site.

“This was a dream I’ve had for a long time, ever since back in the early ’90s, when I got the idea,” he says. “With this rig, we can basically build a custom wheelchair on the spot.”

During an early excursion, Griffith says, the mobile crew had parked the truck and was about to begin an appointment “when a lady in a handicapped-accessible van pulled in front of them, jumped out, and–all excited–asked, ‘Do you guys work on private individuals’ wheelchairs?’”

The crew said yes, he continues, and before long the crew’s cellular phones “were ringing with people wanting to know when they could see the truck. We knew right then it was a success.”

Now the truck, based in Casper, Wyo., is on the road four weeks out of every five.

China is poised to be a large exporter of medical imaging equipment in the world. Their market share is expected to increase further as suppliers boost production, gain CE marking and FDA approvals and new players enter the market. While manufacturers are presently focused on low technology products we did find evidence of increasing R&D expenditures and a commitment from manufacturers to develop more sophisticated products to compete globally.

With “Medical Imaging: Supplier capability in China” you will:

– Pre-qualify manufacturers that are leading exporters with CE marking and FDA approval.

– Benefit from detailed profiles of 25 leading suppliers that highlight their company facts, main products, production capacity, R&D plans, export strategies, QC procedures and expansion plans — based on personal factory visits and telephone interviews with senior managers.

– Benchmark 75 additional suppliers using concise profile tables that highlight key sourcing data such as product lines, export capabilities, and product certifications.

– Learn about R&D initiatives and emerging new technologies.

– Discover manufacturing capabilities and export experience from key medical imaging equipment manufacturers throughout China.

Companies are rated based upon their size, exports, and our own perception of their capabilities, their ability to communicate in English, FDA Registration, ISO Certification and CE Marking. This report allows you to identify all Chinese medical imaging equipment manufacturers in alphabetical order, geographical location and recommendation level.

Topics Covered

Chapter One: Executive summary

1.1 Introduction

1.2 Key Trends

1.3 Index Method

Chapter Two: Industry overview

2.1 Market Details

2.2 Main Export Countries

2.3 Supplier Demographics

Chapter Three: Manufacturing

Chapter Four: Research & Development

Chapter Five: Supplier Profiles

Chapter Six: Product index

Chapter Seven: Recommendation level index

Chapter Eight: Geographical index

Imagine shrinking an entire blood-testing lab into a device no larger than the head of a thumb tack. This may seem fantastic, but it’s very much a reality. The “lab-on-a-chip,” offered by such companies as New Jersey–based i-Stat Corporation, is revolutionizing the way hospitals treat their patients. Traditionally, when blood had to be tested, emergency room doctors had no choice but to send it to a remote lab, sometimes waiting hours for the results. With this lab-on-a-chip, typically housed in a handheld device, they can test the blood themselves in a matter of minutes.

“These tiny chips, containing complex arrays of channels and pumps and valves, can instantaneously tell doctors what they need to know,” says Marlene Bourne, a senior analyst with research firm Cahners In-Stat Group who’s spent the past six years following the progress of such miniatures devices. “That could be the difference between saving a patient’s life or not.”

Miniature devices like this lab-on-a-chip are known as microelectromechanical systems or MEMS. They’re manufactured using many of the same photolithographic techniques used to manufacture silicon microprocessors, but unlike microprocessors, which are purely electrical devices, MEMS are also mechanical in nature. “Whereas microelectronic technologies have allowed us to miniaturize transistors, MEMS technologies allow us to miniaturize everything that’s not a transistor,” says Dr. Khalil Najafi, a professor at the University of Michigan College of Engineering and deputy director of the National Science Foundation’s Engineering Research Center for Wireless Integrated Microsystems. His research is solely dedicated to MEMS. “There are lot of things that you can do with very small devices that are not electronic.”

MEMS have moving parts or at the very least, the ability to shuttle things other than electricity. “Most of these can be described as tiny three-dimensional objects with moving parts that perform some kind of mechanical function,” says Bourne, “but there are some on the market, such as tiny ink-jet nozzles, that have no moving parts but are able to move fluid.”

Ever since the first healthcare facility opened its doors, wheelchair cleaning has been an unwelcome job. Avoidance behavior is the norm when it comes to cleaning the devices. Consider what’s involved in your typical wheelchair: 3,000 inches of tubes, grit, food, body wastes, plastic, metal, fabric and germs in a complex blend of hundreds of parts.

Considering what’s in a typical wheelchair, quality cleaning is therefore a labor intensive, time consuming, inefficient, manual process that can take 20 to 45 minutes for one wheelchair. To clean and sanitize wheelchairs in a fast, focused and standardized quality procedure with manual methods is almost impossible, and is a constant challenge for healthcare facility managers.

The absence of an infection control process between patients using equipment can lead to cross contamination where contagious diseases are spread from surfaces to hands and mouth particularly evident in group settings. Thorough cleaning followed by an infection control application using the correct dilution and the required contact time for the chemical to be effective is far from standard operating procedure.

Current methods are typically subjecting equipment to excessive hot water and/or blasting away with a pressure washer. That only leads to saturated upholstery, displaced lubricants, increased corrosion and fabric fatigue. Furthermore, these methods are often inconvenient leading to infrequent cleaning schedules. So, it’s not surprising that automated cleaning and infection control systems for wheelchairs and other durable medical equipment have entered the market. Healthcare facilities and equipment providers are purchasing sys terns or contracting cleaning and infection control services through service businesses using this automated technology.

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