An In-depth Look Into Surgical C-Arms: What To Buy Part 2

What to Buy Continued

(Read Part 1 click here)
Time frame is an important consideration, and you would be wise to ask your C-arm vendor upfront about theirs. When purchasing a refurbished unit, everything should be checked. Suppliers who quote less than two weeks time to recondition a unit following its sale are likely cutting corners somewhere in the process. As transit time can be a considerable portion of the total delay between purchase and installation, seven to ten day turnaround should only be expected for new units, or units which have already been through the complete (and documented) refurbishment process.
Most refurbished C-Arm purchased from reliable medical equipment companies come with an RTI Piranha Dosimeter report which documents recorded performance and calibration specs. Being proactive about requesting these documents and inspecting them yourself can both ingratiate you to your vendor, and help you maintain an active understanding of the overall radiology use across your facility. They are also often required when a licensed  physicist inspects your C-Arm for compliance with state regulations after your installation is complete.
If you are not available inspect the C-arm in your vendor’s facility prior to its release to your institution, be sure to send someone who can. Having “boots on the ground” prior to the completion of the sale will help ensure their best effort.
In addition, ask your supplier to send you photos which demonstrate the cosmetic condition and overall cleanliness of the unit post-refurbishment. The vendor should be instructed to include close-in and wide-angle shots of the serial number tag, to verify against the numbers listed on the sales agreement. Vendors should also be instructed to send a series of six photos that demonstrate the image quality of the C-arm; three images of the monitor displaying a blank field, at normal, mag 1 and mag 2 settings, and then three images of a metal object such as a coin or key shot at the same series of magnifications.
Once the unit arrives at your facility, it’s time for the in-house inspection. This final portion of your due diligence involves inspecting the delivered C-Arm unit in your own facility. The first step is a complete system inventory. Using your sales documentation, compare what was delivered to what was listed. Small items like foot-switches, printers and skin spacers can be easily misplaced. If parts are missing from the manifest, contact the vendor immediately and have them make note of the incomplete delivery.
If the delivery is complete, you can power on the C-arm system and attempt to replicate the six display images you received from the vendor prior to shipping. Vibrations during shipping can cause unremoved dust to occlude the imaging path. Checking the image will also confirm that the other components involved in the imaging process (the high voltage circuit and x-ray tube) are functioning correctly.
Ideally, you shouldn’t be afraid to ask your vendor anything you wish for, including to demonstrate what they intend to do and what they have done in the past. This is a smart way to avoid ending up in a long-term contract with a vendor who is under-performing.  Ask specifically about radiation, about how you can get the most useful imaging while using as little as possible.