Companies are careful to use the term "reconditioned" or "refurbished" as opposed to "remanufactured" because the latter has more FDA guidelines attached to it. Since a remanufactured device is basically a remade device devoid of its OEM warranties, the facility doing the remanufacturing must be registered with the FDA and have a 510 clearance on file. To be a refurbisher, a company does not have to abide by such regulations.

ISOs who sell and service Some C-arms dealers only focus on refurbishing and reselling equipment, but most provide service as well. Those who do recommend regular PM (preventive maintenance) schedule is the best way to avoid big repair bills. The number of times a years PMs are required depends on the frequency of use. Some C-arms just need an annual check-up, some should be seen more often.



Philips BV Pulsera is one of the newest
generation of C-arms designed for hospital use.

Don't buy more C-arm than you need

ISOs report that many doctors are simply uneducated about medical equipment, or buy more bang with more bucks than they need to. Doctors often ask for a specific make and model without taking into account their anticipated usage. Knowing your surgical needs is paramount in selecting the right C-arm. "Ask questions. Inquire about how many lines-per-inch the manufacturer guarantees," advises Dave Denholz. Orthopaedic and podiatric centers, for example, may be well served by a mini-C. Those who use the relatively inexpensive, small devices say technology has advanced to the point where the mini-Cs can provide excellent image quality and ease of use -- all without the need for a costly radiology technologist.

It is also important for doctors to weigh the pros and cons of mobile and fixed c-arms: mobile are more likely to break-down, but there are more FDA guidelines for fixed equipment than mobile ones.

Turning around the tables

Most people are aware that C-arms work in conjunction with specially designed C-arm tables. But many of the ISOs we spoke to said too many end users don't pay enough attention to the table, and sometimes buy the wrong type.

One key feature is design: the table should allow maximum freedom of movement and positioning of the C-arm around the patient. Some tables have a cantilever design -- they look something like a diving board -- which facilitates the C-arm's movement.

Another key feature: the table should be as translucent to X-rays as possible. Carbon fiber tables have this characteristic, and are also lightweight and strong. Carbon fiber is used in many applications where high strength-to-weight ratios are advantageous, such as in jet fighter components. And think about weight capacity -- 500 lbs. should be the minimum, unless it's a purely pediatric application.

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