Category Archives: Question

Will Hill-Rom Ruin Welch Allyn when they Buy them?

Note from Pat:
I love Welch Allyn and hate to see them on the brink of destruction.  Hill Rom is a dominant bed company.  They have proven to me that they cannot effectively manage companies in the greater healthcare arena.  They ruined MediqPRN.  Their acquisition of WatchChild was an unmitigated disaster.  I firmly believe that they will continue their pattern and make decisions that will cause much of Welch Allyn’s brain-trust to flee and their customer base to jump ship for more stable companies, is spite of the awesome technological releases of late.  My opinion only.   Pat

Hill-Rom to acquire Welch Allyn in $2 billion deal

(Story updated at 10:35 a.m. ET)

Hill-Rom, a Chicago-based medical equipment manufacturer, has announced it will acquire Welch Allyn, a Skaneateles Falls, N.Y.-based manufacturer of diagnostic and patient-monitoring equipment.

The $2.05 billion deal is expected to diversify publicly owned Hill-Rom’s portfolio, expand its international footprint and allow the capital equipment supplier to gain more revenue outside of the capital spending cycle. Welch Allyn, a family-owned company, has a leading presence in physicians’ offices, an area that will be important for Hill-Rom as more care shifts to outpatient settings.

The deal is expected to close before Sept. 30. Hill-Rom CEO John Greisch will serve as president and CEO of the combined company and certain members of Welch Allyn’s senior management will join the new, combined company.

The combined company is expected to be worth about $2.6 billion in revenue and be over 10% accretive to Hill-Rom’s fiscal 2016 adjusted earnings per share, and meaningfully higher thereafter, officials said. The company reaffirmed its guidance for the third quarter and fiscal 2015, expecting revenue growth of 13% to 15% in the quarter and 10% to 11% for the year.

Hill-Rom stock opened Wednesday at roughly $55.09 a share following the news, up $2.71, or 5%, from the closing price on Tuesday.

Annual cost synergies of at least $40 million are expected to come from the deal by fiscal 2018, with additional revenue synergy opportunities, Hill-Rom executives said. The company is expected to have roughly $110 million to $120 million in full-year ongoing capital expenditures.

Much of Hill-Rom’s revenues are tied to hospitals’ long-term capital-spending cycle for products such as beds, patient-handling equipment, furniture and stretchers. The life cycle for Welch Allyn’s products—such as thermometers, blood pressure cuffs and other point-of-care diagnostic equipment—is much shorter and is therefore expected to provide the combined company with a more steady revenue stream.

Welch Allyn will make up about 26% of the company’s pro forma revenue, which, combined with Hill-Rom’s existing surgical equipment and rental revenue streams, should provide the company with steady cash flow, Greisch said during a conference call. Acute-care capital equipment will still account for 31% of the combined company’s revenue.

Geographically, Welch Allyn has presence in Hill-Rom’s strongholds of France and Germany, as well as the U.K., but otherwise has limited international infrastructure, Greisch said. Hill-Rom believes it can accelerate international growth for Welch Allyn’s products; the combined company is expected to earn about 63% of its revenue from North America, 21% from Europe and 16% from emerging markets and other regions.

Adam Rubenfire

Adam Rubenfire covers breaking healthcare news and supply chain for Modern Healthcare. His beat responsibilities include capital equipment, group purchasing organizations, food service and general medical supplies. His work has appeared in the Wall Street Journal, Automotive News and Crain’s Detroit Business. He has a bachelor’s degree in organizational studies from the University of Michigan. He joined Modern Healthcare in 2014.

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Training DVD locks up after equipment warranty is over?

I just had a call from an imaging engineer I know.  It seems that someone from his shop attended a Philips training school.  He returned from the school with a CD (or DVD) which had all of the service information on it.   It required a password to access the CD.   Well, when the warranty on the piece of equipment expired, the password to access the CD also expired, and Philips won’t issue another password.  Has anyone else heard of this?

Pat

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Biomerieux Vitek 2 decontamination?

Hi all!

I don’t have much experience with the lab analyzers but just wanted to run it across you all to see if this sounds absurd or not.  We have a Vitek 2 that needs to be moved to a different location.  Biomerieux wants to charge us $6000 to decontaminate prior to the move…or if we cut a PO for a new piece of equipment they will waive the fee, sounds fishy to me!  Couldn’t our lab staff take care of the decontamination and then just have Biomerieux do the install at the new site?  Or anyone know of a company that could take care of the decontam for us…for a smaller fee?

Thanks in advance!

Sarah

Here’s a link to the manual –

http://www.frankshospitalworkshop.com/equipment/documents/automated_analyzer/user_manuals/Biomerieux%20Vitek%202%20-%20User%20manual.pdf

from TechNation March 18, 2013

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Sterrad 50 PM Procedure Needed

Hi,

We have a Sterrad 50 that was stored for 6 months and the user wants to put it back into service for another 6-10 months before they replace it. Sterrad wants $10k to do a PM and replace many PM parts, due to age.

We want to just perform a PM to see if it passes now, without the major PM parts replaced. Does anyone have the procedure that we could evaluate to see if we want to put it into service or not?

Thanks for your help or ideas on this issue.

Sincerely,

 

Bruce Andrews

President

Biomedical Technology, Inc.

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Service Issues with Hill Rom TotalCare Bed

Greetings. We’re starting to experience some interesting hydraulic conditions with our TotalCare beds, and I wanted to see if anyone here works on them like we do. If not, please ask whoever in your facility works on them.

We have had issues in the past with the seals on the “ice cube”
solenoids deteriorating. And it’s not the oldest beds, we have some P1900As in use and they don’t have this problem.

On one bed, it’s the head section, it slowly leaks down to where in a 20 to 30 minute span, it will go from 45 degrees to flat.

On two other beds, it’s the head side of the hi/low, where they slowly leaks down, One bed may take up to 24 hours to go all the way down, while the other may take 2 hours to go all the way down.

We’ve put in new seals in the hydraulic box, in one case at least twice, and the problem persists. The only other thing we can think of, and we’ve tried to jiggle it, is the CPR / Trend valve might be leaking.
We have not replaced any of them as of yet, and I’m wondering if anyone else out there has had this issue??

Thanks!

Ray Brown, CBET, KB0STN, BMET II
Freeman Health System, Joplin, MO
rabrown (at) freemanhealth (dot) com

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Most Common Failures of Medical Devices

I am looking for published statistic information of the most common causes of failure on health care technology, could somebody give me some references?

Dear Laura Patricia et al.:

The studies we published on JCE 2010 and 2011 show that the highest amount of equipment failures are typically in the USE category, i.e., caused by abusive use, accidents during use, utilities failures, etc., followed by accessories and batteries. Use error (human factors) are classified as “cannot duplicate” – CND or “no problem found” – NPF during corrective maintenance (please do not confuse them with NPF during scheduled maintenance).

Unpreventable failures (UPF) are the next category. Among the UPFs, the part that is most often replaced is the printed circuit board (PCB) according to a study conducted by J Collins. Very few failures that can be detected or prevented were found in our studies.

I would like to stress that we did not study “real” PMs, i.e., those that involved replacement of parts or chemicals. Our study was mostly focused on safety and performance inspections that are often miscalled “PM” but, in reality, cannot prevent failures but only detect failures that have already occurred or about to occur.

Here is the list of publications:
• Wang B, Fedele J, Pridgen B, Rui T, Barnett L, Granade C, Helfrich R, Stephenson B, Lesueur D, Huffman T, Wakefield JR, Hertzler LW & Poplin B. Evidence-Based Maintenance: Part III, Enhancing patient safety using failure code analysis, J Clin Eng, 2011, 36:72-84.
• Wang B, Fedele J, Pridgen B, Rui T, Barnett L, Granade C, Helfrich R, Stephenson B, Lesueur D, Huffman T, Wakefield JR, Hertzler LW & Poplin B. Evidence-Based Maintenance: Part II – Comparing maintenance strategies using failure codes, J Clin Eng, 2010, 35:223-230.
• Wang B, Fedele J, Pridgen B, Rui T, Barnett L, Granade C, Helfrich R, Stephenson B, Lesueur D, Huffman T, Wakefield JR, Hertzler LW & Poplin B. Evidence-Based Maintenance: Part I – Measuring maintenance effectiveness with failure codes, J Clin Eng, 2010, 35:132-144
• Collins JT. Work Histories in a Medical Equipment Management Program – An Analysis of Parts Replaced, American Society for Hospital Engineering (ASHE), Chicago IL, 2008

Hope this is helpful.

Best regards to all,

Binseng

 

Guess you missed my presentation of Evidence-Based Maintenance in Viña del Mar. We have codified these failures as SIG: service-induced failure, ie, failure induced by corrective or scheduled maintenance that was not properly completed or a part that was replaced and had premature failure (‘‘infant mortality’’). Our statistics from over 150,000 workorders suggest that these failure causes are very rare, typically <<1% in terms of annual probability. Failures caused by scheduled maintenance only would be probably less than one-half of that with very few known exceptions. The vast majority is simply unnecessary work performed to confirm that the equipment is working properly and safely.

The best known exception is one from a sterilizer manufacturer that discovered that one of its valves replaced during scheduled maintenance was failing so often that it was reducing the reliability of the sterilizer they were servicing under agreement. Afterwards, they reduced the replacement frequency from quarterly to semi-annual and improved the design/production of that valve.

Best regards to all,

Binseng

 

 

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Making Equipment Hard to Service

This article refers to general technology, including computers.  But I am sure that there are a lot of additional ways that Medical Device manufacturers deliberately make it hard for others to field repair their devices.  Anybody want to comment on their observations?    Pat

Five ways manufacturers make devices hard to repair

August 16, 2012, 10:27 AM PDT

Takeaway: Bill Detwiler shows you five ways manufactures are making our gadgets harder to fix and gives you tips on working around these self-repair roadblocks.

Computers, smartphones, and tablets are smaller, thinner, and lighter than ever before. But to build today’s ultra-slim, ultra-portable devices, designers and engineers often make their creations more difficult, if not impossible, to repair.

On this special episode of Cracking Open, I show you five ways manufactures are making our gadgets harder to fix and give you a few tips on working around these self-repair roadblocks.

 

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1. Tamper-resistant screws

Tamper-resistant pentalobe screw on the MacBook AirTamper-resistant pentalobe screw on the MacBook Air

Our first self-repair roadblock, tamper-resistant screws, aren’t new or unique to computers, but manufacturers are using them on a lot of devices. Nintendo used tri-wing screws on the Wii and Gamecube. Sony used special security torx screws on the slimline PS3. And, Apple uses pentalobe screws on the iPhone, MacBook Air, and Retina MacBook Pro.

Luckily, this roadblock is also the easiest to overcome. With a little online research, you can buy a driver or bit to handle any of these screws.

2. Glued-on components

Unfortunately, some manufacturers are abandoning screws altogether–choosing to glue components in place. And, that’s our second roadblock.

Whether is the iPad’s front panel, Galaxy S III’s ribbon cables, or Retina MacBook Pro’s battery, removing glued-on components can be difficult and risky. And, it’s best not to remove a working component that’s glued in place. If you absolutely must do so, heat can sometimes help weaken the adhesive, but should be used very carefully.

3. Tiny, fragile connectors

If glued-on components weren’t enough, today’s gadgets are also filled with tiny, fragile connectors.

Whether it’s a board-to-board connector or flexible-flat-cable connector, tablets and smartphones are filled with them. The keys to working around this roadblock are a little patience, a light touch, and a few really thin tools.

4. Battery soldered to the motherboard

Up to now, I’ve been able to help you overcome the repair roadblocks on our list. But, the last two aren’t as easy to work around.

At number four is a roadblock that manufactures are using less frequently, but that still appears from time to time–batteries that are soldered to the motherboard.

Favored by some tablet and smartphone manufacturers, there’s no way to replace a battery like this without using a soldering iron or wire cutters. Replacing a soldered battery is definitely an advanced do-it-yourself fix.

5. Fused front/panel display assembly

iPhone 4 fused front panel/display assemblyiPhone 4 fused front panel/display assembly

Lastly, there’s one repair roadblock that’s almost impossible to overcome. And unlike soldered batteries, device manufacturers are actually using it more frequently. It’s a fused front panel and display assembly.

Whether it’s on the Apple iPhone or Google Nexus 7, a fused front panel and display assembly makes repairs more expensive. Because, if one component breaks, you have to replace both. And while it’s sometimes possible to separate the two components, you often risk damaging the working half in the process. It’s just not worth the risk.

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