2026-02-09 MIL Instruments Serviced.pdf
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- Solicitation number
- 36C25226Q0075
About this file
This is a packing slip from STERIS Instrument Management Services, Inc. documenting the return of surgical instruments from Clement J Zablocki VA Medical Center in Milwaukee, Wisconsin. Order Number 4382079 (Service Request Number VOI763437) was shipped on February 9, 2026, with a subtotal of $0.00, indicating these are instruments being processed under an existing service agreement rather than a new purchase.
The packing slip lists ten separate instrument sets or repair bins containing surgical instruments at various service levels. The first item (SN:99990) is a repair bin with forceps, scissors, micro forceps, skin rakes, and other instruments undergoing Level 3-4 inspections, ultrasonic cleaning, sharpening, alignment, and similar maintenance procedures. Four items are marked as "Beyond Repair" due to damage or exceeded useful life. The remaining nine items (SN:C20005295 through SN:C10002791) are on-location instrument service sets for specialized surgical procedures including urology, vitrectomy, dental hygiene, arthroscopy, shoulder instruments, corneal transplant, laryngoscopy, and endovascular repair. Each set contains between 25 and 70 individual instruments requiring various levels of inspection, cleaning, lubrication, sharpening, alignment, and other maintenance services. The document notes that an invoice will follow separately and includes a disclaimer regarding any recalled items.
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Packing Slip Order Number: 4382079 Service Request Number: VOI763437
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/9/2026 Page 1 of 5
Customer
CLEMENT J ZABLOCKI - VA MEDICAL CENTER
5000 WEST NATIONAL AVENUE
MILWAUKEE, WI 53295
Deliver To
Purchase Order Department Operating Room
Last Ship Date
09-FEB-2026
Reference
Sales Person Fabitz, Eric E
Customer Contact Sandra Arntzen
Contact Phone Number 414-384-2000
Customer Number
Special Instructions
Notes :
Line Description Qty Unit Price Ext Price
1 SN:99990 (Repair Bin) 1 $0.00 $0.00
ONL2383 - Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL4303 - Micro Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL2873 - Skin Rakes: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr, Align, Repair Tips
1 $0.00 $0.00
ONL1404 - Supersharp Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Thin Blade, Replace Screw
2 $0.00 $0.00
ONL1304 - TC Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
OBR2355 - Elevators-D/E: Beyond Repair - Damaged Beyond Repair 1 $0.00 $0.00 OBR1107 - General Scissors: Beyond Repair - Exceeded Useful Life 1 $0.00 $0.00 OBR2069 - Cannulas/Sheaths: Forward to National Repair Center for Service 1 $0.00 $0.00 OBR2219 - Forcep-ENT: Forward to National Repair Center for Service 1 $0.00 $0.00
Item Total USD $0.00
2 SN:C20005295 ON-LOCATION INSTRUMENT SERVICE (MIL Urology Implant Pan 3) 1 $0.00 $0.00
ONL2061 - Cannulas/Sheaths: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 23 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
4 $0.00 $0.00
ONL2123 - Clamps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank
4 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
ONL1103 - General Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank
2 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL3102 - Needleholder: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws
2 $0.00 $0.00
ONL2731 - Retractors-Handheld: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL2782 - Retractors-Self Retaining: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Align, Reset
4 $0.00 $0.00
ONL2772 - Retractors-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
2 $0.00 $0.00
ONL2892 - Speculums: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust for Proper Function
1 $0.00 $0.00
ONL1303 - TC Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, 1 $0.00 $0.00
Service Request Number: VOI763437
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/9/2026 Page 2 of 5
Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank OBR2121 - Clamps: Beyond Repair - Cracked Box Lock 1 $0.00 $0.00 OBR2123 - Clamps: Beyond Repair - Pitting 1 $0.00 $0.00 ONL2541 - Pliers: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
Item Total USD $0.00
3 SN:C20003804 ON-LOCATION INSTRUMENT SERVICE (MIL Storz Vitrectomy Set 2) 1 $0.00 $0.00
ONL1204 - Delicate (Tenotomy/Iris) Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Deburr, Align, Proximate Tips, Thin Blade, Replace Screw
4 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL4751 - Micro Eye Caliper: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
4 $0.00 $0.00
ONL4301 - Micro Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
7 $0.00 $0.00
ONL4303 - Micro Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust, Straighten, Align Tips
2 $0.00 $0.00
ONL4103 - Micro Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
1 $0.00 $0.00
ONL2731 - Retractors-Handheld: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2141 - Clamp-Bulldog: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 7 $0.00 $0.00 ONL3151 - Needle Holder-Castro: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL2272 - Pick-Ophthalmic: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align
1 $0.00 $0.00
ONL2371 - Manipulator-Ophthalmic: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
4 $0.00 $0.00
ONL2441 - Retractor-Ophthalmic: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
4 SN:C10001352 ON-LOCATION INSTRUMENT SERVICE (Mil Dental Clinic Hygiene Kit 041)
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2731 - Retractors-Handheld: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2204 - Scaler-Dental: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs, Reshape Severly Damaged
9 $0.00 $0.00
ONL2533 - Pick: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Resurface Distal Tip
3 $0.00 $0.00
Item Total USD $0.00
5 SN:C10000270 ON-LOCATION INSTRUMENT SERVICE (MIL ARTHROSCOPY
INSTRUMENTS - 4)
1 $0.00 $0.00
ONL2031 - Arthro Biters: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust Handle Lock
12 $0.00 $0.00
ONL2062 - Cannulas/Sheaths: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Deburr
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 10 $0.00 $0.00 ONL2221 - Curettes: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2353 - Elevators-D/E: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen, Reshape Edge
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
Service Request Number: VOI763437
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/9/2026 Page 3 of 5
ONL1103 - General Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank
2 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2562 - Mallet: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Deburr 1 $0.00 $0.00
ONL3102 - Needleholder: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws
1 $0.00 $0.00
ONL2801 - Rongeurs-D/A: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2873 - Skin Rakes: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr, Align, Repair Tips
2 $0.00 $0.00
ONL1303 - TC Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank
1 $0.00 $0.00
OBR2123 - Clamps: Beyond Repair - Pitting 2 $0.00 $0.00 OBR2383 - Forceps: Beyond Repair - Pitting 1 $0.00 $0.00 OBR1103 - General Scissors: Beyond Repair - Pitting 1 $0.00 $0.00 OBR3103 - Needleholder: Beyond Repair - Pitting 1 $0.00 $0.00
ONL8561 - Arthro Graspers: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust Handle Lock
3 $0.00 $0.00
ONL1351 - Arthro Scissors: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust Handle Lock
1 $0.00 $0.00
ONL2602 - Nerve Hook: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00 ONL2691 - Suture Grasper: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
6 SN:C10000233 ON-LOCATION INSTRUMENT SERVICE (MIL ARTHREX SHOULDER
INSTRUMENTS - 1)
1 $0.00 $0.00
ONL2321 - Drill Bits: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2322 - Drill Bits: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen 1 $0.00 $0.00
ONL2343 - Elevators: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen, Reshape Edge
3 $0.00 $0.00
ONL4102 - Micro Scissors: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen
1 $0.00 $0.00
ONL2701 - Rasps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00 ONL2731 - Retractors-Handheld: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
3 $0.00 $0.00
ONL2912 - Suction Tubes/Tips: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Straighten
2 $0.00 $0.00
ONL2601 - Nerve Hook: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL2533 - Pick: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Resurface Distal Tip
3 $0.00 $0.00
ONL2681 - Suture P/C: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00 ONL2691 - Suture Grasper: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 5 $0.00 $0.00 ONL2962 - Probe: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
Item Total USD $0.00
7 SN:C10005286 ON-LOCATION INSTRUMENT SERVICE (MIL CORNEAL
TRANSPLANT SET 1 - 002)
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 2 $0.00 $0.00 ONL2342 - Elevators: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen 1 $0.00 $0.00 ONL2351 - Elevators-D/E: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2551 - Knives: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL4301 - Micro Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
8 $0.00 $0.00
ONL4302 - Micro Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust
5 $0.00 $0.00
Service Request Number: VOI763437
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/9/2026 Page 4 of 5
ONL4103 - Micro Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
4 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
OBR2783 - Retractors-Self Retaining: Beyond Repair - Pitting 4 $0.00 $0.00 ONL3151 - Needle Holder-Castro: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00 ONL2601 - Nerve Hook: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
8 SN:C10000627 ON-LOCATION INSTRUMENT SERVICE (Mil Direct Laryngoscopy 3) 1 $0.00 $0.00 ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 3 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2912 - Suction Tubes/Tips: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Straighten
2 $0.00 $0.00
ONL1303 - TC Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank
1 $0.00 $0.00
ONL2071 - Punch-Biopsy: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
7 $0.00 $0.00
ONL2211 - Forcep-ENT: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 1 $0.00 $0.00
Item Total USD $0.00
9 SN:C10001761 ON-LOCATION INSTRUMENT SERVICE (MIL Dental Clinic Hygiene Kit 075)
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2731 - Retractors-Handheld: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
OBR2066 - Cannulas/Sheaths: Beyond Repair - Unsafe for Continued Use 1 $0.00 $0.00
ONL2204 - Scaler-Dental: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Remove Burrs, Reshape Severly Damaged
9 $0.00 $0.00
ONL2533 - Pick: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Resurface Distal Tip
2 $0.00 $0.00
OBR2535 - Pick: Beyond Repair - Damaged Beyond Repair 1 $0.00 $0.00
Item Total USD $0.00
10 SN:C10002791 ON-LOCATION INSTRUMENT SERVICE (Mil Evar Set - 003) 1 $0.00 $0.00 ONS755 - Diamond Dusting (Needle Holder) 2 $0.00 $0.00 ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 15 $0.00 $0.00 ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL3102 - Needleholder: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws
2 $0.00 $0.00
ONL3152 - Needle Holder-Castro: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align
2 $0.00 $0.00
ONL2481 - Forcep-TC: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 2 $0.00 $0.00 ONL2681 - Suture P/C: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
Customers: Do not pay from this document, invoice will follow.
Where applicable, tax and shipping/handling will be added.
******************************************************************** Subtotal USD $0.00
Service Request Number: VOI763437
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/9/2026 Page 5 of 5
Customer Signature
We appreciate your business!
In the event any item(s) identified on this Packing Slip is currently subject to a recall, please be aware that in the process of completing the repairs indicated, IMS did not take actions related to any such recall. We encourage you to strictly follow any guidance provided by the Recalling Firm with respect to any recall in effect.
File details come from the government source that posted it. Updated .