Third-party companies who deal with injectors have also faced some problems recently because of some mergers and acquisitions that occurred over the past few years. In 2008, when Bracco finalized a deal to purchase E-Z-EM, Inc., a once major manufacturer of contrast media and medical devices for gastrointestinal radiology, it created headaches for those providing service and refurbishments of the former E-Z-EM products.


"Bracco has a strict policy of not working with third-party groups and they won't sell parts, where E-Z-EM was very customer-friendly prior to that," says Mangione. "It's made it very difficult for us to service E-Z-EM injectors now. I wish they would realize it's not going to stop us....We own E-Z-EM injectors and if they are refusing to sell us parts on active injector systems, our attorneys are looking at the legal aspects of that."

Hospitals have found a way around this so far by ordering the parts themselves and then hiring ISOs to come out and service the systems.

Third-party markets
The injector business has been on the rise for those dealing in refurbishing systems. While a new system can run upwards of $50,000-$60,000 a refurbished model can be sold for about 60 percent to 70 percent of retail price.

Precise's Mangione says the company has tripled its injector business over the last year. He describes the refurbishment process as follows: "We dismantle the injectors, clean them inside and out looking for anything questionable. Noisy motors are replaced and all rubber goods and gaskets that seal the injector to keep it contrast-free are replaced. All movable parts receive lubrication. Circuit boards are [looked at], but we use the original ones if they give us no reason to replace them."

Scott Scofield CEO for Vivid Imaging, which specializes in the service, distribution, and sale of power injectors, contrast media pharmaceuticals and injector syringes and related disposables, saw sales and service exceed 8,000 injectors in 2009.

"Our independent injector service grew by 15 percent last year," he says. "This was in line with expectations. However, our private labeled service to manufacturers exceeded 60 percent growth. We attribute this growth to the current economic conditions in the United States and Europe. Manufacturers are increasingly more open to outsourcing field service with proven companies like ours."

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