Instrument Inventory.pdf

FHCC SPS RME Master Inventory List

1 2 / 2 6 / 2 0 2 0 S C P a g e 1 | 20

Critical or Semi Critical

RME

RME Name Manufacturer Model #

Anesthesia Semi-Critical GlideRite Rigid Stylet Verathon Inc. 0803-0009 Semi-Critical Glidescope Video Batons and Spectrum Smart Cable and Reusable Titanium Blades

Verathon Inc. Ranger Video Baton 1-2, Ranger Video Baton 3-4, Cobalt Video Baton 1-2, Cobalt Video Baton 3- 4, Spectrum Smart Cable

Semi-Critical Re’sposable® F2® Reusable Manifold & Tubing

Kings System INFM-51

Semi-Critical Somatic Mouth Guard Somatics, LLC EMGD – Large (brown) EMGS- Small (blue)

Semi-Critical Flexible Intubation Video Endoscope

KARL STORZ Series 11301 BNX Series 11302

BDX

Semi-Critical CMAC® Video Laryngoscope KARL STORZ 8401 AXC and 8401 BXC

Cardiology Semi-Critical Transesophogeal

Echocardiography (TEE) ECG Z6M Transducer

Siemens ACUSON SC2000 / Z6Ms

Dental Semi-Critical Mouth Props Hu Friedy MP48, MP52, MP54, B-952, B-954, 100-0298, 100-6367 Semi-Critical Dental Kits and Torque

[Wrenches (Astra Tech, Nobel BioCare, Salvin)]

Astra Tech Dental, Nobel Biocare, Salvin

Multiple

Semi-Critical A-dec high volume extractor (HVE) Saliva ejector valve body assembly

A-Dec 11.1075.00 12.1100.00

Semi-Critical KAVO handpieces and motor

KAVO 80E, 4500 BR, 20E, E20L, E20 C

Semi-Critical A-dec handpieces, motor and coupler

A-Dec WA 99LT, WA 56LT, Ha 43a, WE57, EB79, HP 44M and EA-52, RA-24

Semi-Critical X-ray holders, positioners and bite sticks

Planmeca and Dentsply

Promax #10004280;

RVG5100/6100/6500

Semi-Critical Isodry Dental Isolation System

ZYRIS, Inc. EID0101

Semi-Critical Isovac Dental Isolation System

ZYRIS, Inc. EIV0102

1 2 / 2 6 / 2 0 2 0 S C P a g e 2 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Dental Semi-Critical Bien Air Dental Handpieces Bien Air 1600436-001 and 1501318-001 308 Every 3 years Semi-Critical NTI Dental Diamond Strips

Rotary Dental Instruments NTI-Kahla GmbH

FS2-F

FS2-M

FS2-SF

309 Every 3 years

Semi-Critical Brasseler Hygiene Pro Air Brasseler NL 455 (Handpirce) 310 Every 3 years Semi-Critical Midwest Handpieces Midwest Multiple 311 Every 3 years Critical Dentsply ASTRA TECH

Dental Implant System Dentsply Multiple 312 Annual

Critical 3i Dental Implant Kit Zimmer/Biomet Multiple 313 Annual Semi-Critical Star Dental Prophy Star 3 handpiece STAR DENTAL 264422 314 Every 3 years

Semi-Critical Parkell Digitest Pulp Vitality Tester Set

Parkell D626D 315 Every 3 years

Semi-Critical Piezosurgery 3 Ultrasonic Device

Mectron S.p.A

601-1-E113015 316 Annual

Semi-Critical Dental X-Smart Contra- Angle and Tulsa Handpieces

DENTSPLY and W&H

Dentsply X-Smart (X-Smart CA) W&H through Denstply

a. TUL – 8M

b. TUL – 1

c. TUL – 16M

317 Every 3 years

Critical Salvin Ebner Bone Grafer Blades (General Stainless Steel)

Salvin Dental Specialties, Inc.

EBNER-STRAIGHT 502 318 Annual

Semi-Critical Nobel Biocare OsseoSet

W&H

SI-923/SI-915 /REF:

NB00900117

319 Annual

Semi-Critical Dentium USA Dentium Advanced Sinus Kit (DASK)

Dentium USA Multiple 320 Annual

Semi-Critical Root ZX II Apex Locator J. MORITA

MFG. CORP.

Multiple 321 Every 3 years

Semi-Critical Dentsply Pro Ultra Piezo Ultrasonic Handpiece

DENTSPLY,

SIRONA

Multiple 322 Every 3 years

Critical BRASSELER ALUMINUM

BUR BLOCKS, DIAMONDS

BURS & DISCS AND

CARBIDE BURS

BRASSELER Multiple 323 Annual

Semi-Critical CS Panoramic Bite Sticks CareStream

(CS)

8000, CS 9000, CS 9300, and

CS 9500

324 Every 3 years

1 2 / 2 6 / 2 0 2 0 S C P a g e 3 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Dental Critical NTI Tissue Trimmer and Bur KERR ENDO

NTI

STT 016

STL 016

325 Annual

Critical DENTSPLY / ULTRADENT PRODUCTS TrioDentTM V3 Sectional Matrix System

DENTSPLY

SIRONA

Multiple 326 Annual

Semi-Critical CALAMUS Dual Flow Obturation Delivery Device

DENTSPLY Multiple 327 Annual

Semi-Critical Kerr Sonic Fill Handpiece and Coupler

Kerr Sonic KaVo Care Spray 0.411.9660

SonicFill MULTIflex coupling 35134

329 Annual

Semi-Critical StarDental Titan® SW Plus & K Plus Sonic Scaler

STAR DENTAL Multiple 330 Annual

Critical Contene Whaledent Parapost Plus System

COLTENE-

WHALEDENT,

Inc.

Multiple 332 Annual

Semi-Critical Varios2 and Varios 750 Clinical Ultrasonic Scaler Tip

Brasseler/NSK Varios2 (VA970LUX) and Varios 750

333 Annual

Critical BTI Implant Removal Kit BTI® Human Technology

Multiple 334 Annual

Critical Meisinger Benex-Control Root Extraction Kit

Hager & Meisinger GmbH

Multiple 335 Annual

Semi-Critical NSK Titanium & High-Speed Air Turbine Handpieces

NSK

Brasseler (Distributor)

NL Series 45 series 336 Annual

Semi-Critical SybronEndo Elements Free KERR /

SYBRONENDO

Pluggers

a. .04 952-0031

b. .06 952-0004

c. .08 952-0005

d. .10 952-0006

e. .12 952-0007

Cartridge Needle Bender 973-0100

337 Annual

Critical SybronEndo Ruddle Post SYBRON Multiple 338 Annual Semi-Critical PerioLase MVP-7 Dental

Laser Millennium Dental Technologies / PerioLase®

MVP-7™ 339 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 4 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Dental Semi-Critical Odyssey 2.4G & Navigator

Diode Laser HP (Note that page 3 should read 15 minutes)

A-dec Multiple 340 Annual

Semi-Critical Waterpik Tofflemire Matrix Bands

Waterpik® Tofflemire®

Matrix Retainer 061102 – contra angle 20016453 061100 20016455 – contra angle

Matrix Bands (062002)

341 Every 3 years

Semi-Critical KAVO Sonicflex 2000 Kavo SONICflex 2000L 0.571.5020 Torque wrench 1.000.4887 Nozzle needle 0.410.0911 Scaler Tips 1.000.4983 (long thread) MULTIflex coupler 0.533.1600, 0.533.1550

342 Every 3 years

Semi-Critical OmniCam Sirona Dental Systems GmbH

Cerec OmniCam 343 Annual

Semi-Critical Zest Anchor Core Tool Wrench Kit

Zest Dental Solutions

08393-SB 344 Annual

Semi-Critical ISOLITE System ZYRIS™ Inc. Control Head Hose: PIL0301 Power Vacuum Base: PIL0302 Vacuum Light Pipe: PIL0303 (only one that gets sterilized) Double Ended Tube Brush:

AIL0204

345 Every 3 years

Critical Hall Micropower and Oral Max Elite

ConMed Instrument Systems

*see below 346 Annual

Critical Sirona Dental CAD CAM Scan Post

Sirona Dental System GmbH

Scan Post, Fixing Screw, Scanbody

347 Annual

Semi-Critical Nupro Prophy Grips DENTSPLY Professional

SKU: 801207 348 Every 3 years

Semi-Critical CS 9300c Accessories CareStream Multiple 349 Every 3 years Critical Medicon AARhus Mini

Implant MEDICON Aarhus mini-implant system 350 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 5 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Dental Semi-Critical The Powertome WestPort

Medical USA 110-0021-00

351 Annual

Critical Dine Autoclavable Plastic Retractors

Dine Corp. Autoclavable plastic retractors 352 Every 3 years

Critical Allen Soft Tissue Kit Hu-Friedy Multiple 353 Annual Semi-Critical Sybronendo Contra Angles SybronEndo/Kerr 815-9010 354 Every 3 years Semi-Critical Oraqix™ Dispenser:

Dentsply Sirona Dentsply Sirona

66400 355 Every 3 years

Critical Micro Apical Placement System

Produits Dentaires S.A.

(PD)

US: Roydent ™ Dental Products

Multiple 356 Annual

Semi-Critical SybronEndo Endodontic System B HeatSource Model 1005

SybronEndo Multiple 357 Every 3 years

Semi-Critical Vitality Scanner Model

Kerr/SybronEndo 973-0234 358 Every 3 years

Semi-Critical AdDent MicroLux Transilluminator

AdDent, Inc. P/N 630003 Standard 3mm Light Guide P/N 600045 Micro Tip 2mm Light Guide P/N 110066 Pedo Light Guide, 2mm

360 Every 3 years

Semi-Critical Aseptico Endo DTC Torque Motor Control, AEU-25

Aseptico, Inc. AEU-25 361 Every 3 years

Semi-Critical Macan Radio Surge Electrosurgery Unit, M13-

Macan Manufacturing

M13-0200 362 Every 3 years

Semi-Critical Dentsply Cavitron Plus with Tap-On Technology

Dentsply Sirona

*See below 363 Every 3 years

1 2 / 2 6 / 2 0 2 0 S C P a g e 6 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Dermatology Semi-Critical Hyfrecator 2000 Handpiece ConMed 7-900-5 & 7-900-6 129 Every 3 years

ENT

Semi-Critical ENT Flexible Rhino-Laryngo

Fiberscope

KARL STORZ 11003 BC1

11101 RP2

11101 SK2

11101 VN/VNS

148 Annual

Semi-Critical Rhino-Laryngofiberscope OLYMPUS® ENF-P3

ENF-P4

125 Annual

Semi-Critical ENT Bipolar Stammberger Sinus Forceps & Cord

Pilling/ Karl Storz

*see below 128 Annual

Semi-Critical ENT Oro-Tracheal Injection Instrument Integra® ENT 1650025 143 Annual

Critical ENT Medtronic Fusion Medtronic *see below 144 Annual

Eye Critical Care and Handling of Eye

Instruments Multiple Multiple 100 Annual

Critical Alcon Infiniti Phaco Ultrasound Handpiece

Alcon 8065750469 123 Annual

Critical Glaukos® iPrism® Glaukos® iPrism®

OTB/LH-2 OTB/RH-2, OA/LH2,

OA/RH-2

139 Annual

Critical ASICO Nishi Tension Ring Inserter AE-4967 ASICO AE-4967 147 Annual

Semi-Critical ASICO ALGERBRUSH II and Carbide Burrs

Alger Company, Inc.

Multiple 151 Every 3 years

Critical Alcon UltraFlow Handpiece Alcon 159 Annual Critical Alcon Intrepid Autosert IOL

Injector Handpiece Alcon 161 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 7 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

GI

Semi-Critical ConMed American

Dilatation System ConMed *see below 107 Annual

Semi-Critical M-Flex Blue Silicone Maloney & Hurst Esophageal Bougies

Diversatek Healthcare

Multiple 160 Annual

Semi-Critical Gastrointenstinal Videoscope and accessories

OLYMPUS® GIF 2TH180 118 Annual

Semi-Critical Duodenovideoscope and accessories

OLYMPUS® TJF-Q180V 120 Annual

Semi-Critical GIF CF PCF type 190 endoscopes

OLYMPUS® GIF-H190,

GIF-HQ190, GIF-1TH190

CF-HQ190L

PCF-H190L, PCF-PH190L

121 Annual

Semi-Critical Small Intestinal Videoscope OLYMPUS® SIF Q180 122 Annual Semi-Critical OLYMPUS® Semi-Critical OLYMPUS® Semi-Critical Ultrasound

Gastrovideoscope

OLYMPUS® GF-UCT140-AL5, GF-UC140P-

AL5, GF-UCT180 (with elevator)

GF- UE160-

TGF-UC180J

145 Annual

Semi-Critical Loop Cutter OLYMPUS® FS-5L/Q/U-1 158 Annual Semi-Critical Zutron Colonscope

Stiffening Device Zutron Medical

A005 187 Annual

Respiratory Semi-Critical Bronchovideoscopes and

Accessories OLYMPUS® BF - Q180-AC 119 Annual

Non-critical Fisher & Paykel Humidifier Temperature Probe

Fisher & Paykel

#900MR869

Every 3 years

Semi-Critical TELESPIROMETRY Flow Sensor Vmax Series Respiratory System

VYAIRE

MEDICAL /

CAREFUSION

775274

Every 3 years

Semi-Critical OLYMPUS® Endobronchial Ultrasound (EBUS) Endoscope BF-UC180F

OLYMPUS® BF-UC180F 186 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 8 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Surgery/OR Critical General Stainless-Steel

Instruments Multiple Multiple 101 Annual

Semi-Critical Flexible Choledochoscopes KARL STORZ 11292 ADU1/AD1 and 11292 DE1 126 Annual Semi-Critical Rigid Reusable

Proctoscopes, Anoscopes, Sigmoidscopes, and accessories

Welch Allyn, Inc.

Light Carrier:36019, 38700 Light Handle Assembly: 73211 Power Supply: 73305

106 Annual

Critical Mediastinoscope DCI-D1 and Instruments

KARL STORZ Lerut Video – 10971MV DCI® 30°/4mm – 10970BA DCI-DI Camera – UZ766402-H

181 Annual

Critical Air Dermatome

Zimmer Biomet®

8801-01, 8802-01, 8802-02 8802-03, 8802-04, 8802-05 5052-10

108 Annual

Critical Electric Dermatome

Zimmer Biomet®

8821-01, 21920, 8802-01, 8802-02, 8802-03, 8802-04

206 Annual

Critical Skin Graph Mesher Zimmer Biomet®

1. Skin Graft Mesher:

00770100000

2. Ratchet Handle: 0077010200

3. Cutters:

a. 00-7703-015-00

b. 00-7703-020-00

c. 00-7703-030-00

d. 00-7703-040-00

4. Autoclave Case:

00-7701-003-00

104 Annual

Critical Orthopedic Surgical Instruments

Multiple Multiple 109 Annual

Critical Trimano Support Arm

Arthrex AR-1640 (Support Arm) AR-1641 (Coupling)

110 Annual

Critical Rigid Telescopes, Sheaths, Obturators, Bridges, Working elements and instruments

OLYMPUS® *see below 111 Annual

Critical Fiber Optic light guide cables

*see below *see below 112 Annual

Semi-Critical Hyfrecator 2000 Handpiece

ConMed 7-900-5 & 7-900-6 129 Every 3 years

1 2 / 2 6 / 2 0 2 0 S C P a g e 9 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Surgery (OR) Critical De Mayo D2 Knee

Positioner

INNOVATIVE

MEDICAL

PRODUCTS, INC.

(IMP)

803-114 130 Annual

Critical Depuy Synthes Trauma Recon

Depuy Synthes Handpiece (05.001.201/05.001.240) Lid (05.001.231/05.001.241) Power module (05.001.202) Attachments – Multiple

132 Annual

Critical Depuy Synthes Battery Power Line II

Depuy Synthes *see below 133 Annual

Critical Atraumatic Vascular Clamp

AESCULAP/Braun PL530R, PL531R, PL544S, PL545S, PL548S, PL549S

134 Annual

Critical APS II Shaver Handpieces Arthrex® Adapteur Power System™ II (APS II) Shaver Handpiece (AR- 8330H)

135 Annual

Critical Gore Tunneler W. L. Gore & Associates, Inc.

*see below 137 Annual

Semi-Critical RUMI® II Reusable Uterine Manipulator Handle

Cooper Surgical, Inc.

UMH650 138 Annual

Semi-Critical Euro-Med Mini Cervical Dilator Set

Cooper Surgical, Inc.

64-374 140 Annual

Critical Nathanson Liver Retractor System COOK Medical 141 Annual

Critical EndoCAMeleon® HOPKINS® ll Telescopes, HOPKINS® Telescopes, Irrigation and Suction Sheath

KARL STORZ

ENT (7230 AE)

Lap (26003AEE) Irrigation and Suction Sheath

(7230AES)

142 Annual

Critical Ethicon LAPRA-TY Suture Clip Applier

ETHICON™ KA200

Annual

Critical OLYMPUS® Thunderbeat® Transducer and Sonicbeat Transducer

OLYMPUS® TD-TB400 and

TB-SB400

Annual

Critical Ethicon Harmonic Handpiece

ETHICON™ HP054 and HPBLUE

Annual

Critical Ethicon Endopath 5mm Endoscopic Needle Holder

ETHICON™ E705R

Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 10 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Surgery (OR) Critical IMMEDIATE USE STEAM

STERILIZATION (IUSS) and Care for FlashPak® Sterilization Container System

Symmetry Medical, Inc.

(FlashPak®)

FlashPak® 9020 /w 9020-08 Basket 9030 /w 9030-08 Basket 9040 /w 9040-08 Basket 9050 w/ 9050-08 Basket

157 Annual

Critical Lima Orthopaedic Instruments

LIMA

CORPORATE

Multiple

Annual

Critical

Microaire Power System

MicroAire Surgical Instruments, LLC.

*See Below

Annual

Critical Synthes Instruments, Instrument Trays and Cases DePuy Synthes

Multiple

Annual

Critical Weck® Hem-o-lok® Appliers 5mm and 10mm Weck®

544965T 544995T 167

Annual

Critical Lead Hand Malleable

BD MEDICAL /

V. MUELLER™

OS5004

OS5002 168

Annual

Critical The Hall® Micro 100™

CONMED

Critical Smith & Nephew SPIDER Limb Positioner

Smith & Nephew

Multiple

Annual

Critical Karl Storz H3 Camera Head KARL STORZ 22220130-3 176 Annual Critical

Integra MicroFrance Wormald Bipolar Forceps with Suction

Integra® Life Sciences

MCEN64

MCEN54

CP393

MCEN640 177

Annual

Critical

General and Bariatric Laparoscopic Cholecystectomy (multiple manufacturers)

KARL STORZ

BD MEDICAL /

SNOWDEN–

PENCER™

BD MEDICAL /

V. MUELLER™

Multiple 188 Annual

Critical Karl Storz Clickline Laparoscopic Instruments KARL STORZ

Multiple

Annual

Critical Key Surgical K-Wire & Steinmann Pin Covers Key Surgical® Multiple 192 Every 3 years

Critical Carefusion Genesis Container CAREFUSION Multiple for different Sizes 201 Every 3 years

1 2 / 2 6 / 2 0 2 0 S C P a g e 11 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

Surgery (OR) Critical Artisan Medical Devices St.

Mark’s Lighted Retractor and Light Cord

Artisan Medical

AMH-583L, AMH-32732

Annual

Critical Arthrex Autoclavable DualWave Remote Control

Arthrex®

AR-6482

Autoclavable DualWave Remote Control

Every 3 years

Critical

CONMED Hall® Sternum Saw

ConMed

Sternum Saw (5059-05), Hose 10

ft. (5052-010), Sternum Guard (5059-006), Collet Nut (5059-09) Locking Wrench (5059-007)

Annual

Urology Semi-Critical URF Type V Uretero-Reno

Videoscope Olympus URF Type V 124 Annual

Semi-Critical

Flexible Ureteroscope Karl Storz

11273 BDU1/BD1, 11274

AAU1/AA2, 11278 AU1/A2,

11278 ACU1/AC2

Annual

Semi-Critical BK Ultrasound Biplane Transducers BK Ultrasound Type 8808e 131 Annual

Semi-Critical GU Flexible Cystoscopes Karl Storz 11272 CU1 149 Annual Semi-Critical Olympus OES

Cystonephrofiberscope Olympus® 169 Annual

Semi- Criticial

VISERA Cysto-Nephro Videoscope Olympus® CYF Type V2 179 Annual

Semi-Critical Olympus® CYF VA VISERA CystoVideoscope Olympus® CYF Type VA 180 Annual

Semi-Critical Olympus® URF-V Uretero- Reno Videoscope Olympus® URF Type V 182 Annual

Semi-Critical Karl Storz Flexible Video- Uretero-renoscope

Karl Storz FLEX-XC series 11278, VA/VUA/VSA/VSUA

Women’s Health

Semi-Critical Toshiba Canon Endocavity Transducers

Toshiba/Canon PVT-681MV, PVT-661VT, PVT-

781VTE

116 Every 3 years

Semi-Critical Leisegang LM-900 Cryosurgery System

Cooper Surgical, Inc.

50501, 50502 136 Annual

Semi-Critical Sonosite Transvaginal Transducer

FUJIFILM

SonoSite, Inc.

ICTxp 155 Every 3 years

Semi-Critical Cooper Surgical Milex® Pessary Fitting Kit

Cooper Surgical

Milex® Pessary Fitting Kit 165 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 12 | 20

Semi-Critical Stereotaxy Breast Biopsy Kit

Metal Components GE Medical

Multiple 185 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 13 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

SPS

Critical Steris reliance vision single chamber washer disinfector Steris AMSCO 7000 Series 001

Critical STERRAD NX Sterilizer Advanced Sterilization Products

STERRAD NX

Annual

Critical Amsco V-PRO max Steris AMSO V-PRO maX 003 Annual Critical Celerity HP Incubator

Steris Celerity HP Incubator: (LCB046), Celerity™ 20 HP Biological Indicator: (LCB044)

Annual

Critical OER-PRO Olympus OER-PRO 005 Annual Critical

VERIFY® All clean test washer indicators

Steris LCC012 Verify All Clean Test Washer Indicator Strips, LCC010 Verify All Clean Test Washer Indicator Holder

Annual

Semi-Critical Cidex® HLD [OPA quality control and high-level disinfection procedures]

Cidex® OPA 008 Annual

Critical Steris Acu-sinQ Enzymatic dosing system Steris Steris Acu-sInQ

MPG PN: 7164085 009 Annual

Semi-Critical QUATTROCARE PLUS Quattrocare Plus

2104A Dental Handpiece Unit 010 Annual

Semi-Critical Trophon EPR GE Healthcare Trophon EPR 011 Annual Critical Channel check testing for residual soil Healthmark Industries

UCC-222 013 Annual

Semi-Critical Olympus ALT-PRO automated endoscope leak tester

Olympus *See below 014 Annual

Semi-Critical MU-1 and MB-155 Leak Tester

Olympus MU-1 and MB 155

015 Annual

Semi-Critical Olympus Reprocessing Accessories

Olympus *See below 016 Annual

Semi-Critical Delayed Olympus endoscope reprocessing Olympus All Flexible Scopes 017 Annual

Semi-Critical Scope Buddy Plus Medivators, Inc.

SBP-1000 018 Annual

Critical Steris AMSCO 400 Series Steam Sterilizers

Steris

48H

60SL

019 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 14 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

SPS

Critical McGan MicroMed PD-8K McGan

Technology, LLC

PD-8K

Annual

Critical Prepzyme® Forever Wet Ruhof 34577 021 Annual Critical Personal Protective

Equipment 022 Annual

Critical Steris Pre-Klenz Steris 150377 023 Annual Critical 3M™ Attest™ Auto-reader

Model 490 3M 490 (Steam and VH202) 024 Annual

Critical ASSI Demagnetizer ASSI ASE-14 025 Annual Critical Steris Caviwave Ultrasonic

Cleaning System Steris CR-12 (20 gal) CR-15W (15 gal) 026 Annual

Critical Insulation Integrity Tester Electrosurgical Instruments Model MM513

McGan Technology

MM513 027 Annual

Critical Inspektor Boroscope INSPEKTOR® NCI, Inc.

INS 7004

INS 8007

028 Annual

Critical Famos F108TX Rotary Heat Sealer

Famos B.V. F108TX 029 Every 3 years

Critical NATUS Olympic Sterile Drier Model

NATUS 43 & 44 030 Annual

Critical SonocheckTM Ultrasonic Function Test

Healthmark Industries Co.

TI-108 032 Annual

Critical Branson Ultrasonic Cleaner

VWR -B5500A-MTH

VWR® B5500A-MTH/98000-342 033 Annual

Critical Bien Air Lubricare Unit Bien-Air Dental SA

HIM-1 034 Annual

Semi-Critical Steris Reliance Cart Washer Steris Reliance 120L 035 Annual Semi-Critical Suburban Surgical Case

Carts Suburban Surgical

Multiple 036 Annual

Semi-Critical Assistina 301 Plus Maintenance System

W&H Dentalwerk Burmoos GmbH

00030140

Annual

Semi-Critical Healthmark Ultrasonic Cleaning Pouch

Healthmark Industries Co

8001, 8002, 8003 038 Every 3 years

Critical Healthmark CartWash Check

Healthmark Industries Co

CW-101 039 Annual

Semi-critical Quantum Storage Systems Red/Blue

Quantum® Storage

Different Sizes 040 Annual

1 2 / 2 6 / 2 0 2 0 S C P a g e 15 | 20

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

SPS Admin Critical Transport of Soiled, Clean and Sterile Items n/a n/a 041 Annual

Semi-Critical Cleaning Interruption n/a n/a 047 Annual Critical Event Related Sterility n/a n/a 117 Annual

RME

RME Name Manufacturer Model # SOP Identifier

Competency Frequency (based on Risk

Analysis)

1 2 / 2 6 / 2 0 2 0 S C P a g e 16 | 20

SPS Admin Instrument Management 012 SPS On-Call Staffing

Requirements Weekends and Holidays

Break in sterility r/t RME 173 RME transport to the soiled room

Loaned, Borrowed and Early Release of Instruments

Creutzfeldt-Jackob Disease 194

Model #s:

1. *ConMed American Dilation System 000270, 000288, 000271, 000289, 000272, 000273, 000274, 000275, 000290, 000277, 000278, 000279, 000280, 000281, 000291

2. *GU Bipolar Resectoscopes

a. 30⁰ Cystoscope 27005BA

b. 12⁰ Cystoscope 27005FA

c. Bipolar Resectoscope Working Element 27040EB

d. Ellik Evacuator Adapter 27224 ALO

e. 26 Fr Inner Sheath 27050CA

f. 26 Fr Outer Sheath 27050SC

g. 26 Fr Deflecting Obturator 27048CK

h. 28 Fr Inner Sheath 27050CB

i. 28 Fr Outer Sheath 27050SD

j. 28 Fr Obturator 27048CO

3. *OLYMPUS® Rigid Telescopes, Sheaths, Obturators, Bridges, Working Elements, and

Instruments

1 2 / 2 6 / 2 0 2 0 S C P a g e 17 | 20

a. Telescopes: A22000A, A22001A, A22002A, A22003A, A22004A, A22005A, A4673A, A4674A, A4675A, A70940A, A70941A, A70942A, A70960A, A70961A, A70962A, A70963A, WA50372B, WA50373B, WA50374B, WA52005A, WA52006A, WA53000A, WA53005A, WA53010A; A5281A, A5282A, A5290A, A5291A, A5292A, A5294A, A5295A, A5296A, A5297A, A5298A, A5299A, A5372A, A5373A, A5374A, A50372A, A50373A, A50374A, WA50295L, WA50296L, WA50372B, WA50373B, WA50374B, WA52005A, WA52006A, WA53000A, WA53000B, WA53005A, WA53005B, WA53010A, WA53010B

b. Laryngoscope: WA96100A,

c. Sinuscopes: WA96200A, WA96201A, WA96202A, WA96203A, WA96204A, WA96205A, WA96206A, WA96208A; Hysteroscope Sheaths: A4770, A4771, A4772, A4773, A4775, A4776;

d. Cystoscope Sheath: A20911A, A20912A, A20913A, A20914A, A20915A, A20916A, A20930A, A20931A, A20933A, A20934A, A2911, A2912, A2913, A2914, A2915, A2930, A2931, A2933, A2934;

e. Working Inserts/Bridges: A20971A, A20972A, A20975A, A20976A, A20977A, A20978A, A2971, A2972, A2975, A2976, A2977, A2978;

f. Optical Urethrotome Sheath: A3551

g. Optical Urethrotome Working Element: A3550; Knife: WA35057A

4. *Fiber Optic Light Guide Cables (Stryker, Olympus, Gyrus ACMI, Inc., Karl Storz, Invuity, Inc., Electro-Surgical Instrument (ESI), Pilling, Snowden-Pencer™, Acclarent

MANUFACTURERS:

a. Stryker

b. Olympus

c. Gyrus ACMI, Inc.

d. Snowden-Pencer™

e. Karl Storz

f. Invuity, Inc.

g. Electro-Surgical Instrument (ESI)

h. Pilling

i. Acclarent

MODEL NUMBERS:

a. Stryker: 233-065-010, 233-050-090, 233-050-064, 233-050-065, 233-050-069,

b. 233-050-067, 233-050-084

c. Olympus: A3200, WA00331A, WA03200A, WA03202A, WA03210A, WA03212A, WA03021A, WA03022A, WA03023A, WA03300A, WA03310A, WA03320A

d. Gyrus ACMI, Inc.: G91, G92, G92-45, G93, G93-45, G96, G96-45, G96-90

e. Karl Storz: 495 NT, 495 NTA, 495 NL, 495NA, 495ND, 495NB, 495NCS, 495NE, 495NTW, 495NTX, 495 NW, 495 NWM, 495 NWL, 495 NV, 495 NVL, 495UD, 495 AD, 495BD, 495 H, 495 DV, 495 DC

f. Invuity, Inc.: FC1S, FC1B

g. Electro-Surgical Instrument (ESI): 01-0350, 01-05000

h. Pilling: 01-003-73

i. Snowden-Pencer™: 88-9760

1 2 / 2 6 / 2 0 2 0 S C P a g e 18 | 20

j. Acclarent: LGC2, LGC2A

5. * ENT Bipolar Stammberger Sinus Forceps & Cord

Karl Storz 461010 FORCEPS BIPOLAR 15DEGREES Storz 461015 FORCEPS BIPOLAR UPTURNED 45DEGREES Pilling 461010 BIPOLAR FORCEPS 15° UPTURNED Karl Storz 8614AS Bipolar Suction Forceps Pilling 461015 BIPOLAR FORCEPS, 45° UPTURNED WITH SUCTION Channel, 12.5cm Karl Storz 847002V Bipolar High Frequency Cable

6. *Depuy Synthes Battery Power Line II

05.01.204 Universal Battery Charger II

i. 530.705 Battery Reamer/Drill II

ii. 530.710 Battery Oscillator II

iii. 530.715 Battery Reciprocator II

iv. 530.630 Battery for Power Line II

v. 530.660 Insertion Shield for Battery Power Line II

vi. 530.690 Battery Casing for Battery Power Line II

vii. 530.796 Quick Coupling Pins 3.2mm diameter

viii. 530.730 Drill Chuck with Key

ix. 530.782 Hudson Quick Coupling

x. 530.783 Trinkle Quick Coupling

7. *Gore Tunneler

a. Standard Curve

1. 6 and 8mm x 50cm TUN60850 (Kit)

2. 6 and 8mm x 65cm TUN60865 (Kit)

b. Standard Curve Access

1. 6mm x 25cm TUN06025

2. 8mm x 25cm TUN08025

3. 6 and 8mm x 25cm TUN68025 (Kit)

c. Full Curve Access 6mm x 25cm TUN6C025

d. Tunneller Handles TCAP

e. Dissecting Tip 6mm TIPA6

f. 6mm Tip TIP06

g. 8mm Tip TIP08

8. Hall® MicroPower® Oral Max Elite Handpieces

Handpieces Bur Guards Consumables (Drill/Saw) 600-021, 6021-021, 6020-025, 6021-025, 6020-026, 6021-026

Medium – 137-012 High Speed Drill – 6020-025, 6020-026, 6021-025, 6021-026

6020-022, 6021-022 Long – 1375-011 Sagittal Saw - 6020-022, 6021-022

1 2 / 2 6 / 2 0 2 0 S C P a g e 19 | 20

6020-023, 6021-023 Extra Long – 1375-023 Reciprocating Saw – 6020-023, 6021-023 6020-024, 6021-024 Tissue Retractor

1387-022 Oscillating Saw – 6020-024, 6021-024

Bur changer 375-003 Medium speed drill – 6020-021, 6021-021

9. Dentsply Cavitron Plus with Tap-On Technology

1. Handpiece

a. Gray – 78688

b. Black – 8183001

2. Steri-Mate® Grip

a. Blue Grip – 8201

b. Fuchsia Grip – 8169202

c. Violet Grip - 8169203

10. Olympus ALT-PRO automated endoscope leak tester

a. Olympus ALT-Pro, ALT-Pro leak test air tubes (MAJ-2009), Endoscope with a built-in scope ID memory chip or a scope ID tag (MAJ-1545), ID chip (MAJ-1546), ALT-Pro interface cable (MAJ-2052), Printer (MAJ-1937), Water-resistant cap (only for EVIS series endoscope)

11. Olympus Reprocessing Accessories

a. MAJ-222, MAJ-350, MAJ-420, MAJ-621, MAJ-629, MAJ-855, MH-974, MH-856, MH-

944, MH-946, MH-948, MH-553, MAJ-896, MAJ-1214

12. Microaire Power System

1. Black Hall Cord 9103-00

2. Hall Style Aire Motor 1000-200

3. Reciprocating Saw 1945

4. Wire Driver 1995

5. Hall Style Keyless Sagittal Saw 1950

6. High Speed Drill 2130

7. Oscillating Saw 1970

13. ENT Medtronic Fusion Navigation Instrument Set

1. FESS Frame Strap 960363

2. Head Frame 9733445

1 2 / 2 6 / 2 0 2 0 S C P a g e 20 | 20

3. Registration Probe 9733446

4. Straight Probe 9733447

5. Curved Probe (Ostium Seeker) 9733448

6. Straight Suction 9733449

7. 70⁰ Curved Suction 9733450

8. 90⁰ Curved Suction 9733451

9. Silicone Pad 9732501

10. Instrument Tray 9733455