Endocare SOW.pdf

STATEMENT OF WORK

1. Contract Title

Endocare Cryoblation

2. Background

This Statement of Work, outlines the proposed cryoablation services to be provided by Endocare, Inc., a Delaware corporation, with its principle address at 9825 Spectrum Drive, Building 2, Austin, Texas 78717 (“Endocare”) to the VA Long Beach Healthcare System, with its principle address at 5901 East 7th Street, Long Beach, California 90822 (the “Facility”).

3. Services to be provided by Endocare to the Facility:

Endocare or a subcontractor will provide the following equipment and services to the Facility’s Interventional Radiology upon the requested and agreed date and time by the Nurse. In the event the Facility requires use of the Equipment at an unforeseen time other than those scheduled, Endocare or subcontractor shall make every effort to provide the Equipment to Facility upon forty-eight (48) hours advance notice from Facility personnel. In addition, Endocare or a subcontractor will also provide a cryosurgical technologist trained in the services and operation of the equipment to assist the attending physician in the operation of the equipment during scheduled cryoablation procedures at the Facility.

4. Term

Endocare proposes an initial term of one (1) base year followed by additional three

(3) option year renewal periods thereafter. Either party may terminate the agreement during the initial term or any renewal term upon sixty (60) days written notice.

5. Compliance with Law

Endocare shall be responsible for obtaining all necessary licenses, approvals and permits and shall comply with all federal, state, and local laws and regulations applicable to the Equipment and Technician Services provided under this Agreement including laws and regulations relating to the general use and disclosure of the protected health information of Facility’s patients.

6. Equipment and Services Supplied by Endocare and Fee Per Procedure

Equipment supplied by Endocare:

Endocare also supplies the following:

Cryocare® System - Cryocare CS®, Cryo 20/28, Cryo-SL or equivalent system

• Transrectal Ultrasound probe (as necessary)

• Argon & Helium regulator set

• Cryosurgery Technologist

• Tank carts (Min. 2)

• Trained Cryosurgical Technologist

QTY. ITEM NO. DESCRIPTION PRICE

EQUIPMENT USAGE FEE

1 CRYO-EQ CRYOABLATION EQUIPMENT

USAGE (PER PROCEDURE FEE) $ 600.00

TECHNICIAN SERVICES

1 CRYO-SVC TECHNOLOGIST SERVICES (PER

PROCEDURE FEE) $ 600.00

7. Equipment Furnished by the Facility

Facility provides the following:

Gas: Per Procedure –Facility should order all gases and have on-site 5 days prior to cases

(2) Argon tanks for each procedure: 99.998 pure or better (Grade 4.8 or better), 6000 PSI; Fitting: CGA677

(2) Helium tanks for each procedure: 99.995 pure or better, 6000 PSI (industrial grade or better), Fitting: CGA677

• Consumables/Disposables (cryoprobes)

• Sterile bowl

• (4) large hemostats

• (4) towel clips

• (2) extension tubings

• 60 cc syringe

• 10 cc syringe

• 20 cc syringe

• Bottles 2% lidocaine w/ epi

• Bottles 2% lidocaine w/o epi

• (2) 2-way valves

• Packs 4x4 gauze

• 18 gauge needles

• Bottle sterile water

• A basic biopsy tray

• Gloves (7.5 & 8)

• Sterile half sheet

• Sterile gowns

8. Facility’s Request on Number of Services:

QTY. ITEM NO. DESCRIPTION PRICE

EQUIPMENT USAGE FEE

15 CRYO-EQ CRYOABLATION EQUIPMENT

USAGE (PER PROCEDURE FEE) $ 9,000.00

TECHNICIAN SERVICES

15 CRYO-SVC TECHNOLOGIST SERVICES (PER

PROCEDURE FEE) $ 9,000.00

TOTAL $ 18,000.00

Estimated 15 procedures annually is established by the Facility. A procedure/case shall be considered a billable procedure once the technician is in the Interventional Radiology room and a cryoprobe is opened. A standby fee of 50% of the scheduled procedure fee shall be charged for any procedure/case not cancelled with 24 hours telephonic or written advance notice.

9. Scheduling of Patients, Equipment and Technician Services

Facility shall solely be responsible for the scheduling of patients for procedures/cases using the Equipment and Technician Services and coordinating the scheduling of Equipment and Technician Services for procedures/cases with Endocare. All requests for Equipment and/or Technician Services shall be sent either to Facility’s local Endocare representative or to Endocare by electronic mail at IOS.Support@Varian.com or by phone at (877) 467-2009, at least seven (7) calendar days prior to such procedure/case.

mailto:IOS.Support@Varian.com

10. Fee Schedule and Invoicing

Endocare will invoice Facility for the Equipment and any Technician Services according to the fee schedule set forth each time the Equipment and Technician Services are used for a cryoablation procedure.

11. Performance Monitoring

Endocare or a subcontractor of Endocare shall provide Facility with documentation of each technician’s training and current competence in operation of the Equipment in advance of scheduling any cases and shall update said documentation, upon request by Facility. Endocare or subcontractor’s promptness on the set scheduled procedure will also be monitored if there are any numerous rescheduling or delays caused by Endocare.

12. Governing Law

The governing law will be the commercial law of the State of California, and the United Nations Convention for the International Sale of Goods shall not apply. Any controversies, disputes or claims shall be resolved by binding arbitration.