Dignity Health Fort McDowell Yavapai Grant Application

City of Chandler — Regular Meeting (2022-04-28)

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Dignity Health Foundation — East Valley
Grant Application to Fort McDowell Yavapai Nation

Cover Sheet

Applicant Info:

City of Chandler

175 S. Arizona Ave., 5th Floor,
Chandler, AZ 85225

Dawn Lang, Deputy City Manager — CFO
Dawn.lang@chandleraz.gov
480-782-2255

Dignity Health Foundation East Valley

Chandler Regional Medical Center & Mercy Gilbert Medical Center
1727 West Frye Road, Suite 230

Chandler, AZ 85224

Primary Contact:

Laure! Vetsch, Grants Manager,

1727 West Frye Road, Suite 230

Chandler, AZ 85224

Laurel. Vetsch@DignityHealth.org, 480.728.3130

Sponsor Info:

City of Chandler

Dawn Lang, Deputy City Manager — CFO
Dawn.lang@chandleraz.gov
480-782-2255

Acknowledgment Signature:

Dawn Lang, Deputy City Manager - CFO
City of Chandler

Project Summary

Dignity Health is forming and launching the only Graduate Medical Education program in the East Valley.
Offering residency programs in key clinical areas will provide more clinical physicians in the community.

General Surgical and Robotic Simulators are key to educating the next generation of surgeons to perform
expertly-trained intricate surgeries with utmost precision.

1. Describe the proposed program or project, and whether it is a new or continuing project:

Graduate Medical Education (GME) is a formal, hospital-sponsored or hospital-based training program for
individuals who have completed medical school and earned an MD or DO degree. It includes residency,
internship, fellowship, specialty and subspecialty programs. This Graduate Medical Education is a new
program for Dignity Health in the East Valley.

Objectives of implementing our GME program are as follows:

e Increasing the physician workforce pipeline, particularly for our area

e Providing more clinical service coverage and efficiency in response to our growing population

e Ensuring all East Valley residents, including those from surrounding rural areas, have ongoing access to
state-of-the-art patient care

e Educating more physicians to be catalysts for complex care and achieving enhanced clinical outcomes

e Increasing our outreach of medical services to the community through community physician partnerships,
collaboration and instilling a vision for community service

We will be offering GME in the following service areas with number of residents at full capacity:

Family Medicine
(18 residents)

Expand availability of
expertly-trained Family
Medicine providers in
East Valley.

An innovative team
approach to evidence-
based patient-centered
care.

Focus on caring for
our patients and all
members of the
community.

Internal Medicine
(48 residents)

Compassionately care for
adults with complex
medical issues including
those recently discharged
from our medical centers.

Training in Internal
Medicine is required prior
to entering specialties
such as Cardiology,
Gastroenterology,
Hematology/ Oncology
and other specialties.

General Surgery
(18 residents)

Comprehensive training
with Robotic,
Laparoscopic and
Endoscopic Simulation.

Business of Medicine
curriculum promoting
cost effective/efficient
healthcare delivery.

Emergency Medicine
(24 residents)

Prepare physicians to
provide care in Level |
Trauma Center, General
Emergency Departments
and specialized
Pediatric/Obstetric
Emergency Departments.

OB/GYN
(16 residents)

Deliver additional
physician services in
Dignity Health's Women’s
and Children’s Pavilion
which provides greatly
expanded state-of-the-
art facilities and services.

Expert physician training
opportunities for
complex or rare labor
and fetal issues.

Implementation of our new GME program consists of renovating hospital space, purchasing equipment fora
simulation lab and teaching areas, providing robotic, laparoscopic and endoscopic trainers, renovating
hospital space to provide resident lounges, and building a new Family Medicine Clinic.

We are requesting $50,000 from the Fort McDowell Yavapai Nation to help us purchase simulators needed to
train our surgical residents:
Da Vinci Robot SimNow Simulator ($25,000 toward the full cost $550,000). This simulator provides realistic

simulations for practice of system skills, procedures training exercises, and virtual reality experiences
without any risk to human life.
Simbionix Ultrasound Mentor Male and Female Simulators ($25,000 toward the full cost $342,550). This

high-end medical simulator provides training of ultrasound-related examinations and interventions. The
Ultrasound Mentor offers a multidisciplinary, realistic hands-on training for the ever-growing utilization of
ultrasound in medicine especially at point of care setting.

Program Timeline

Describe the purpose of the program or project and how it meets one or more of Fort McDowell’s funding
priorities:

The purchase of surgical and robotic simulators for our new GME program addresses Fort McDowell Yavapai
Nation’s priority funding areas of education and health. Funds will help to establish the training equipment
necessary to provide the education and skill crucial for today’s most complex surgeries. Education that is
provided with these simulators will be taught with cultural competencies in focus for a variety of different
populations, including the Native American population.

Describe the need that the program or project aims to fulfill, the population targeted, and the estimated
number of people who will be served by the grant:

As East Valley communities continue to grow rapidly, our area is experiencing a shortage of nearly 250
primary care providers. According to the American Academy of Family Physicians, statewide, more than 3 out
of 5 Arizonans live in a health professional shortage area. It is projected that there will need to be a 50%
increase in physicians (nearly 2,000) by 2030.

Research shows that 50% of residents stay in the area after they complete their residency and many
physicians hand select the residents they want to continue to employ. Recruiting physicians from outside is
expensive and adds to the cost of medical care. Our GME program will provide cost savings but many
physicians want to work at teaching hospitals, so this program will also help draw top talent.

Offering residency programs in key clinical areas will amplify the impact our ministry is able to make on the
health of residents of the east valley, while also offering a place for community health providers to turn to
recruit the next generation of respected, compassionate providers. We aim to champion diversity and
inclusion by training the next generation of health care providers that best represent our community, with
neighbors such as Fort McDowell Yavapai Nation.

Describe the partners in the program or project, and other entities providing funding and support (please
indicate whether the organization will be submitting applications to any other tribes):

We will be working in partnership with our Medical Directors and physician groups to provide the best faculty
members for our residents. Dignity Health has a long history of collaboration with the City of Chandler for
services and initiatives that improve the health of Chandler residents. The City of Chandler generously funds
several of our community outreach programs to uninsured and underserved Chandler residents. We are also
requesting support for our Graduate Medical Education program from Gila River and Ak-Chin Indian
Communities. We have embarked on an aggressive campaign to ensure funding is garnered for all the
necessary training equipment. Any contribution from the Fort McDowell Yavapai Nation will be paired with
other contributions to ensure that the equipment is purchased.

Describe the timetable for implementation of the program or project:

Spring
2023
Winter/
Spring 2022

Active Program
Resident match/scramble

Begin full resident complete

First residents

rotate

Program is Accredited

recruitment cycle Faculty and program development is
Development Is ongoing and Dignit ‘ongoing. Renovation nears
Soo ns Renovation continues. Program Oe
markets the program. Renovation of completion. Surgical simulators and
development continues.
hospital spaces for simulation labs, other necessary educational

library/computer research, and equipment are purchased and

resident lounges begins installed

Budget:

Proposed Budget Expense

Amount
requested from
Fort McDowell

Amount
requested or
secured from

In Kind
contributions

Total Budget

Male and Female Simulators

Yavapai other sources
1. Da Vinci Robot SimNow $25,000 $525,000 $550,000
Simulator
2. Simbionix Ultrasound Mentor $25,000 $317,550 $342,550

Soll cael Ped SA al

TOTAL

ye Department of the Treasury
a) IRS Internal Revenue Service

017548

In reply refer to: 0248344558

CINCINNATI OH 45999-0038 Sep. 22, 2017 LTR 4168C 0
74-2418514 go00000 00
00018398
BODC: TE

DIGNITY HEALTH FOUNDATION-~EAST
VALLEY

% RANDY BRADLEY

1955 W FRYE RD

CHANDLER AZ 85224

Employer ID Number: 74~-2418514
Form 990 required: Yes

Dear Taxpayer:

This is in response to your request dated Sep. 14, 2017, regarding
your tax-exempt status.

We issued you a determination letter in July 1986, recognizing
you as tax-exempt under Internal Revenue Code (IRC) Section 5O1Cc)
(3).

Our records also indicate you're not a private foundation as defined
under .IRC Section 509(a) because you're described in IRC Section
509(a)(3) as a Type I supporting organization. A Type I supporting
organization is operated, supervised, or controlled by one or more
publicly supported charities.

Donors can deduct contributions they make to you as provided in IRC
Section 170. You're also qualified to receive tax deductible bequests,
legacies, devises, transfers, or gifts under IRC Sections 2055, 2106,
and 2522.

In the heading of this letter, we indicated whether you must file an

annual information return. If a return is required, you must file Form
990, 990~EZ, 990-N;, or 990-PF by the 15th day of the fifth manth after
the end of your annual accounting period. IRC Section 6033¢j) provides
that, if you don't file a required annual information return or notice
for three consecutive years, your exempt status will be automatically
revoked on the filing due date of the third required return or notice,

For tax forms, instructions, and publications, visit www.irs.gov or
call 1-800-TAX-FORM (1-800-829-3676).

If you have questions, call 1-877-829-5500 between 8 a.m. and 5 p.mey
local time, Monday through Friday (Alaska and Hawaii follow Pacific

Time).

0248344558
Sep. 22, 2017 LTR 4168C 9
74-2418514 000000 00
00018399

DIGNITY HEALTH FOUNDATION-EAST
VALLEY

% RANDY BRADLEY

1955 W FRYE RD

CHANDLER AZ 85224

Sincerely yours,

ES hla pl

Kim A. Billups, Operations Manager
Accounts Management Operations 1

Intuitive Surgicai, Inc.
1020 Kifer Road

800-876-1310

Company Information

Quote Details
Quote ID 157998.0 Hospital Name Dignity Chandler Regional
Quote Date 6/25/2021 Hospital
Valld Until 6/30/2021 SF 1D /IDN Affiliation 40486/CommonSpirit Health
Sales Rep Lauren Monte Address 475 S Dobson Rd
Phone Number 1(480) 550-1128 City, State, Zip Chandler, AZ, 85224-5695
Email Lauren.Morow@intusurg.com Contact Name.
Telephone

Please submit orders electronically via GHX or fax to 408-523-2377
ltems
Part Number laty litem [Price [Subtotal
Simulator Hardware
ISSNOW-01 4 Da Vinel SimNow Simulator $100,000.00 $100,000.00

includes items*

377773 Simulatar, SimNow

600092 First year of SimNow Service & Benefits (Free} Future Years 2-5 billed
annually at_$20,000,00

da Vinci System Upgrades
- da Vincl® Xi® Dual Console/Additional Surgeons Console

260110-01 1 Customer acknowledges that the da Vinck® XP™ Dual Surgeons Console comes $450,000.00 $450,000.00
‘with a one (1) year warranty period. Thereafter, the Annual Service Fee for tha da
Vinci®™ Surgical System(s) will increase by 25,000. The pricing may be prorated
in the second year fo be co-terminus with the System Service pricing. THE
AFOREMENTIONED CUSTOMER ACKNOWLEDGEMENT PROVISIONS MUST
BE CONTAINED IN YOUR PURCHASE ORDER

Total $550,000.00

Additional Information
Upgrade System Serial(s): na

Leasing Terms
Leasing options are available through Intuitive Surgical on systems and select upgrades, Please contact your Intuitive representative
for additional details.

Terms and Conditions

1) System Terms and Conditions:

1.1 Asigned Sales, License, and Service Agreement ("SLSA") or equivalent Is required prior to shipment of the System(s). Alll site
modifications and preparation are the Customer's responsibility and are to be completed to the specification given by Intuitive Surgical
prior to the installation date. Delivery is subject to credit approval. Payment terms are net 30 days from Intuitive Surgical's invoice
date. Each System includes the patient side cart, vision cart, and surgeon console(s). System enhancements required to support new
features may be purchased at Intultive Surgical’s then current list price. The price of the da Vinci® Surgical System includes the initial
installation of the System at Customer's facility and a one (1) year warranty for manufacture defect. All taxes and shipping charges are
the responsibility of the Customer and will be added to the invoice, as appropriate.

1.2 Intuitive makes no representation with regard to Certificate of Need requirements for this purchase. It is your (the Customer's)
responsibility to determine whether this purchase complies with your State's Certificate of Need laws and what Certificate of Need

filing, if any, needs to be made with regard to this purchase.

4.3 Customer acknowledges that the cleaning and sterilization equipment, not provided by Intuitive, is required to appropriately
reprocess da Vinci instruments and endoscopes. Please refer to the Intuitive Surgical Reprocessing website:
https://reprocessing.intuitivesurgical.com. Customer is responsible for ensuring that its’ cleaning and sterilization program comply with

all health and safety requirements.
2) System Upgrade Terms and Conditions:
2.1 Asigned Purchase Order and/or an addendum to the existing Sales, License, and Service Agreement ("SLSA’) is required prior to

shipment of the System upgrade. All site modifications and preparation are the Customer's responsibility and are to be completed with
the specification given by Intuitive Surgical prior to the installation date.

2.2 Payment terms are net 30 days from Intuitive Surgical's invoice date. The price includes: the System upgrade, the initial installation
at Customer's facility and a one (1) year warranty for manufacture defect. All taxes and shipping charges are ihe responsibility of the
Customer and will be added to the invoice, as appropriate, Delivery is subject to credit approval and inventory availability. Standard
shipping terms are FCA from Intultive Surgical™ warehouse. A $9.95 handling charge will be applied for any shipments using a

customer designated carrier.

3) 1&A Terms and Conditions:

3,1 To place an order, please fax Purchase Order to Intultive Surgical Customer Service at 408-523-2377 or submit through the Global
Health Exchange (GHX). Payment Terms Net 30 Days from invoice date. Delivery is subject to credit approval by Intuitive Surgical.
Estimated 2-Day standard delivery. Standard shipping terms are FCA from Intuitive Surgical™ warehouse and are subject to Inventory
availability. Pricing is subject to applicable shipping costs and taxes. Pricing is subject to change without notice. A $9.95 handling
charge will be applied for any shipments using a customer designated carrier.

4) Return Goods Policy :

4.1 All returns must be authorized through Intuitive Surgical Customer Service, please call 800-876-1310 to obtain a Return Material
Authorization Number (RMA#). All items must be accompanied with valid RMA# for processing and are requested to be received
within 14 days of issuance or the RMA could be subject to cancellation. Intuitive Surgical will prepay for the return of the defective
instruments. Upon identification of a defective instrument, please call Intuitive Surgical Customer Service within 5 business days.
Prior to returning to Intuitive Surgical, items must be cleaned and decontaminated in accordance with the then current local
environmental and safety laws and standards. For all excess inventory returns, items are required to be in the original packaging with
no markings, seals intact, and to have been purchased within the last 12 months. Package excess returned inventory in a separate
shipping container to prevent damage to original product packaging.

5) Exchange Goods Policy :

5.1 Repairs to Endoscope, Camera Head and Skills Simulators may qualify for Intuitive Surgical advanced exchange program. Please
contact Customer Service or send emall to CustomerSupport-ServiceSupport@intusurg.com to obtain information on our current
exchange program.

8) Credit Policy :

6.1 Intuitive Surgical will issue credit against original purchase order after full inspection is complete, Credit for defective returns:
Intuitive Surgical will issue credit on products based on failure analysis performed and individual warranty terms. For instruments,
credit will be issued for the remaining lives, plus one additional life to compensate for usage at the time the issue was identified.
Evidence of negligence, misuse and mishandling will not qualify for credit. Credit for excess inventory returs: Excess Inventory
returns will be valued at the invoice price. Original packaging must be unmarked, undamaged and seals intact to qualify for credit,
Credit will be issued if the products were shipped less than 12 months prior to return request, the original package is intact and the
product is within expiration date. intuitive Surgical will retain all returned product.

7) Miscellaneous :

7.4 Warranty: Warranties are applied for manufacturing defects. Endoscope, Camera, Simulator, and System upgrades — 1 year
warranty. Accessories - 90 day warranty. Instruments: see above for credit.

7.2 Any term or condition contained in your purchase order or simitar forms which ts different from, inconsistent with, or in addition to
these terms shall be vold and of no effect unless agreed to in writing and signed by your authorized representative and authorized
representative of Intuitive Surgical.

The terms and conditions of this quote, including pricing, are confidential and proprietary information of Intuitive Surgical and shalt not
be disclosed to any third party without the consent of Intuitive Surgical.

For questions please contact Customer Service at 800-876-1310

Proposal Dat “December 10, 2021 wb

Proposal Number: 20211210TB su rgicalscience

Dr. Jesse Shriki
Chandier Regional
602-703-7813
shrikido@gmail.com

Quotation for Simbionix
U/S Mentor™ Simulator

surgicalscience

PRICING OPTIONS

Description Price
All platforms come pre-loaded with:
° MentorLearn Offline
Simbionix U/S Mentor * Stand-alone Cart .
Male Simulator * Sonography Basic Skills Module
Platform e ONE Module for selection of the relevant training modules listed $54,000
—_ below (excluding Advanced Echo and TEE)
® Suggested curriculum for basic echocardiography and OB/GYN
{in compliance with AIUM consensus report)
The price includes on-site setup, installation, and training.
Male to Female Package:
e Add-On Female: Female Mannequin plus ONE of the female U/S $23,000
training modules
Female Mannequin Belly Add On Included
Optional Add-Ons i
Interventional U/S platform: Includes mannequin.and ONE of the $25,000
Interventional U/S training modules listed below ,
MentorLearn Cloud** Software License (annual fee) From 53,600
U/S Mentor MyCase*** $15,000
Abdominal Module $10,000
eFAST and RUSH Module $12,000
Bedside Echocardiography Module $12,000
Advanced Echo Module Included
Male Module Trans-Esophageal Echocardiography (TEE) Module $15,000
ale Modules
TEE Emergency Module $15,000
TEE Package (both TEE Modules) $24,000
Lung Ultrasound Module $15,000
COVID-19 Module $8,000
Lung Package includes Lung and COVID-19 Modules $20,000

Surgical Science / Simbionix Products
811 1st Ave, Suite 408, Seattle, WA 98104

Phone: 1-803-326-9050 WWW.SIMBIONIX.COM Fax: 1-216-229-2070

surgicalscience

Description Price

Neck Ultrasound Module $12,000
Basic GYN TVS/TAS Module $12,000
1st Trimester Obstetrics Module TVS/TAS Included
2nd Trimester Obstetrics Module TVS/TAS (pre-requisite Belly Add

Female Modules On) $15,000
Fetal Echo Obstetrics Module TVS/TAS (pre-requisite Belly Add On) $15,000
Fetal Neurosonography Focused Clinical Scenarios Module {real $7,000

ultrasound images, pre-requisite Belly Add On)

U/S Guided Central Line Placement Included

Interventional U/S U/S Guided Thoracentesis Upright Position (plus extra puncture pad) $15,000

Modutes U/S Guided Thoracentesis Supine Position (plus extra puncture pad) $15,000
U/S Guided Pericardiocentesis $15,000
Additional Puncture Pad One Each, Central Line Placement $1,100
Additional Puncture
Pads for Additional Puncture Pad One Each, Thoracentesis Upright position $300
Interventional Additional Puncture Pad One Each, Thoracentesis Supine position $100
Mannequin _ 7 ~
Additional Puncture Pad One Each, Pericardiocentesis $800
Shipping & Handling Charges per system $2,500

Dignity Health 15% Discount $60,450

Total $342,550

This offer is confidential and is meant for the customer and its staff only. The offer and any part thereof may not be shared or disclosed by any means to any
third party, including, but not limited to, a competitor of Simbionix. This offer shall be in force for 30 days following the proposal date written above.

Price does nat include customs duties, sates tax, brokerage fees, and any other taxes and fees. ** Please refer to quotation, under separated cover, for the
MentorLearn™. This will include descriptions, Software License Agreement, General Terms and Conditions, Cloud prices and special packages. ***MyCase
requires win10 for operation. If an upgrade is needed the price will include an additional cost.

Surgical Science / Simbionix Products
811 Ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM — Fax: 1-216-229-2070

surgicalscience

EXTENDED SERVICE CONTRACT

Service Features

Gold Service

Platinum Service

malfunction

24/7 technical support line v v
Software versions updates Vv Vv
Parts replacements for installations 50% v
that do not require on-site Surgical

Science - Simbionix technical support

Replacement of system/parts in case of Vv v

Shipment type: US

"Second Day Delivery”

“Next Day Shipment"

Shipment type: International

"International Economy”

“International Priority’

System:

Shipments costs Return shipment of v

replaced parts/system is at

the customer’s expense

24/7 phone repair support v v
Discount for any new or add-on 20% 30%
module/s purchased during the Service
Contract period
Annual Extended Service Price Per $5,500 $8,250

Completed Service Contract Agreement document required far contract execution. Ask your sales representative for a detailed contract.

FLEXIBLE FINANCING OPTIONS

In addition to a traditional purchase agreement, Surgical Science - Simbionix offers a range
of lease solutions through DLL Financial Solutions Partner. These leases allow you to
acquire equipment now and delay your payments until capital dollars are available.

Ask about leases with terms that support your requirements. Whether your preference
be a capital lease, operating lease, deferred or step payments, bridge-to-budget or other
options, there is a lease option for you. To take advantage of any of our lease options, contact your sales

manager for an application.

ABOUT SURGICAL SCIENCE - SIMBIONIX

Surgical Science / Simbionix Products
811 1st Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM — Fax: 1-216-229-2070

surgicalscience

Simbionix virtual reality medical simulators by Surgical Science - Simbionix are designed to provide realistic
hands-on training of critical skills and full procedures without patient risk for a variety of procedures including
laparoscopy, endovascular, robotics, GI endoscopy, urology, ultrasound interventions, orthopedics and more. All
our products are developed in collaboration with global medical experts who play an active role in simulation
design, content definition, and product testing and validation.

Cooperation with leading professional societies, credentialing boards and academic institutions around the
world are all part of establishing simulation-based curricula and meeting certification requirements. In addition,
our products have been validated in numerous scientific studies, the details for which can be found on our
website at www, simbionix.com.

Below are just a few of the reasons why Surgical Science - Simbionix has become the partner of choice for the
medical device industry and an approved vendor for governments and academic institutions around the world:

24/7 global customer support call center, remote access, and a dedicated industry support team
Global footprint with production in the US and Israel, and hubs in the Netherland, Spain, and UK

Full spectrum of MIS Simulators

Pioneers in the development of innovative simulation applications such as patient-specific simulation
through our Procedure Rehearsal Studio™;

Endorsed by, collaborates with, and maintains ongoing relationships with multiple medical professional
societies

The Surgical Science - Simbionix simulator product line is a registered US Government Services
Administration vendor (Schedule 874, Contract #GS-02F-0049) with a consistent track record of excellent
compliance with GSA contractor evaluation scorecards. Our imaging software D2P and PRS are ISO
13485:2016 compliant, and Simbionix is in the final stages of obtaining ISO 9001:2015.

ht ra

Fastest

Surgical Science / Simbionix Products
811 1st Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM Fax: 1-216-229-2070

surgicalscience

| WHY U/S MENTOR?

Unique Features & Benefits:

The U/S Mentor simulator’s unique features provide a realistic training experience for enhanced clinical results:

Realism
- True-to-life ultrasound image with realistic anatomies, ultrasound artifacts, physiology,

and pathologies
- Advanced echo features for cardiac - CW/PW Doppler, M-mode, auto measurements and

more,

Self-learning and educational value

~ Promoting self-learning with skill & procedural tasks

- More than 15 different Scanning protocols with step-by-step cases

- Based on real clinical paradigm from patient complaint to image interpretation

~ Developed based on leading societies guidelines

- Complete didactic environment enhances the learning curve: skill tasks, 3D
visualizations, anatomical aids, procedural aids, video tutorials and more

Monitor progress towards proficiency

- Competence evaluation based on meaningful performance metrics

- Integrated curricula through MentorLearn — raising the level of difficulty, didactics,
benchmarks for trainee assessment and standard courses

A modular cross-specialty platform
- Elegant all-inclusive platform: quick & easy setup, table-top/cart configurations
- True-to-life training workflow: seamlessly altering probes during case performance;

seamlessly altering mannequins during training sessions
- Amulti-disciplinary, modular, training platform offering relevance to numerous Medical

Specialties.
- Diverse scanning approaches: trans-thoracic, trans-abdominal, trans-vaginal, trans-

esophageal and linear.

Surgical Science / Simbionix Products
811 ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM — Fax: 1-216-229-2070

surgicalscience

SIMULATOR PLATFORMS

The U/S Mentor simulator combines realistic mannequin with true-to-life external landmarks and virtual
patients for the practice of scanning and diagnosing various anatomies and pathologies.
This multidisciplinary platform offers hands-on training for diverse ultrasound examinations and interventions,
as performed by a rapidly growing number of medical specialties
It features a highly realistic simulation within a comprehensive educational environment, supporting
independent or instructed hands on training
System components includes:
- 27” multi-touch screen
- intel NUC 8 VR computer
- Specially designed connection box for needles, sensors, and probe tracking
- Emulated probes designed for simulation usage provided with relevant modules:
o Cardiac phased array U/S probe
o Curved array U/S probe
o TEE probe
o Linear probe
- Accessories - Single foot switch, TEE probe hanger (for TEE module only) and Trackable needles (for
interventional modules only}
- Stand-alone cart (optional) - features a rotatable, height-adjustable table to support various scanning
positions (standing or sitting on a high stool)
- Replaceable mannequin for different training purposes:

Male U/S Female U/S Interventional

—S
™>

Head to pelvis Head to pelvis Replaceable cartridge/s of
anthropomorphic, palpable, anthropomorphic, palpable, palpable, puncturable anatomies
torso pregnant torso; 2nd / 3rd

Trimester Belly add-on

Surgical Science / Simbionix Products
811 Ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM | Fax: 1-216-229-2070

surgicalscience

U/S VR add-on

A Virtual Reality Ultrasound Training Solution - providing Immersive, Fun

and Affordable training.
Offering a Personal Training Experience anywhere, with the high-fidelity
U/S Mentor training, customized to standalone VR setting.
System components includes:
- HTC Vive VR kit (2 base stations, googles, handles, link box and
cables)
- VR Simulation station (mannequin plate, Bluetooth enhancer, tripods, and sensor mounts)
- Anemulated curved array ultrasound probe plus tracker

U/S Mentor MyCase

U/S Mentor MyCase is a unique ultrasound simulation case editor are that imports real patient scans (volumes)
from an ultrasound machine* into the U/S Mentor. The scans are converted into simulation cases, creating a
library of unlimited scenarios that can be practiced in a valuable hands-on learning experience.

Features and Benefits:

Available for OB/GYB cases and Echocardiography cases.

- Intuitive and quick workflow allows users to create new cases in no time.
- Create and edit your own clinical findings for in-depth diagnostics reporting.

- Customize your own measurements menu, including the expected results. Trainees will receive
evaluation at the end of the training.

- Full integration with MentorLearn:
o Export new cases to MentorLearn and add them to existing modules.
o Full performance report at the end of the case for objective trainee evaluation.

Surgical Science / Simbionix Products
811 Ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM Fax: 1-216-229-2070

surgicalscience

MENTORLEARN

MentorLearn, our offline and optional cloud-based simulator curricula management system provides the
optimal solution for managing curricula, hands-on simulation training and educational needs. It allows users to
upload didactic content such as documents and videos to ots

enhance your institutions training and education. This easy-to- ; &
use system facilitates performing administrative tasks, creating, sweatin

SS
and assigning your own or ready-to-use courses and exporting

data in simulation centers, medical associations, workshops, ray
courses, and industry medical educations centers easy. The MontesLeaen
option of MentorLearn cloud allows users to perform all gation Cloud
£
Ss

activities with more ease and in a time efficient manner by g “a

being a centralized system linking all your simulators data to g 2 ae

one place. It also allows you to monitor simulator activity and amy Sor 4 H &
learner’s progress from anywhere, anytime. “nine?

MentorLearn Cloud provides a single access point to all your Simbionix simulators with the following benefits:

Perform registration and administration tasks with ease-of-use.
Manage ready-to-use or custom courses from your home or office.
Provide documentation of training for accreditation and certification - the ideal solution for the ACGME

requirement for simulation-based training.
Ensures the smooth operation of the center with the best way to keep systems updated and serviced.
Access aggregated performance data from all simulation training.

CURRICULA

Surgical Science - Simbionix is very proud to work in collaboration with key leaders in medical education and
ultrasound training programs to provide our worldwide customers with well thought out curricula. The simulator
serves as a tool for delivering a hands-on learning experience. The curricula are intended to enhance the learner
experience for an enjoyable, effective, and efficient way of acquiring new skills using simulators.

Surgical Science / Simbionix Products
811 ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM — Fax: 1-216-229-2070

surgicalscience

| LIBRARY OF MODULES

The U/S Mentor’s library of modules supports acquiring and perfecting the skills that are essential to building

confidence and proficiency in a variety of ultrasound techniques and procedures:

c. f : A < accra
aed SONOGRAPHY EFAST & RUSH
MALE BASIC SKILLS

ADVANCED ECHO

" SONOGRAPHY BASICGYN OBSTETRICS OBSTETRICS 2"!
FEMALE BASIC SKILLS 1° TRIMESTER ‘TRIMESTER
FETALECHO —~ FETAL NEURO-
SONOGRAPHY
—

PERICARDIO-

INTERVENTION CENTESIS

OBSTETRICS 2" — EFAST & RUSH

VR AD D-ON TRIMESTER

Surgical Science / Simbionix Products
811 ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM Fax: 1-216-229-2070

surgicalscience

TERMS & CONDITIONS

| General Provisions The Agreement governs the sale by Simbionix of Equipment and the license by Simbionix of the associated

| proprietary computer programs and related information (collectively, “Software") included with the Equipment at the time of sale or
provided separately, and listed on the face of the Agreement to Customer. Customer has selected the Equipment and Software
based only on their specifications. CUSTOMER ACKNOWLEDGES THAT THE EQUIPMENT AND SOFTWARE MAY CONTAIN RECYCLED
CONTENT INCLUDING COMPONENTS OR MATERIALS THAT ARE USED OR RECONDITIONED TO LIKE NEW PERFORMANCE AND
FUNCTIONALITY. THE EXISTENCE OF RECYCLED CONTENT MAY 8E DISCLOSED AS SUCH ON THE FACE HEREOF AS WELL AS ON AN

. EQUPMENT-SPECIFIC LABEL. If either party believes that other matters beyond those covered in this document are part of the

: Agreement, the parties will (a) describe and acknowledge them on the front of the Agreement or (b) staple a copy or description of
them to the Agreement and initial them before signing; otherwise, they are not included as part of the Agreement for the purchase
of this Equipment and license of Software. After Customer signs the Agreement {or any Amendment to it), the Agreement will
become a binding contract when and if it is executed by an officer or other authorized designee of Simbionix.

_ Software License Customer acknowledges and agrees that the Software shall be licensed to Customer pursuant to terms and
conditions contained in a license appearing on a computer screen during installation of the Software (commonly referred to as a

“click-through” license). Customer and Simbionix agree that the terms and conditions of any click-through license contained in the

| Software are hereby incorporated by reference into the Agreement as if fully set forth herein. Customer agrees to be bound by the
terms and conditions in any click-through license contained in the Software, regardless of whether the Software generating such

: click-through license ts installed by Customer’s employee or by Simbionix or an independent contractor installing the Software for

Warranty Equipment - Simbionix or its Authorized Service Provider will promptly repair or replace the Equipment, if required, to

make it free of defects at the time of delivery and during the warranty period. The Equipment is free from defects if it meets, upon

the passing of risk, the specifications provided in the Agreement or in manuals, marketing or other informational materials of

Simbionix or on Simbionix' website at www.3dsystems.com. Repairs required during the warranty period because of abnormal use

or conditions (such as riots, floods, misuse, neglect, uploading of any software not provided to the customer by Simbionix, use not in

accordance to Simbionix user manual or improper service by anyone except Simbionix or its Authorized Service Provider), are :

° excluded from this warranty. If requested by Simbionix, customer shall return to Simbionix, at Simbionix’ expense, defective parts

that have been replaced by Simbionix under warranty, and Simbionix shall have title to such parts. The warranty period for the

Equipment is one (1) year, unless otherwise stated on the face hereof, and shall start thirty (30) days after delivery to the carrier

(F.0.B. Simbionix Plant) or upon installation, whichever is sooner. Warranty terms regarding the Software are contained in the click-

through license contained in the Software.

a. THE FOREGOING WARRANTIES ARE IN LIEU OF ANY OTHER WARRANTIES, WHETHER EXPRESS OR IMPLIED, INCLUDING
WITHOUT LIMITATION ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR INTENDED OR PARTICULAR PURPOSES, EACH;
OF WHICH IS HEREBY DISCLAIMED. i

Limitation of Liability Simbionix will not be responsible to Customer for consequential, exemplary, or incidental damages (such as
loss of profit or employee's time} regardless of the reason. In no event shall the liability and/or obligations of Simbionix under the
Agreement or arising out of the purchase, lease, license and/or use of the Equipment by Customer or others exceed the purchase
i price of the Equipment. Limitations of liability regarding the Software are contained in the click-through license contained in the

| Software.

Disclaimer Surgery should be performed only by licensed surgeons who have developed adequate skills to perform the tasks }
_ associated with each procedure and received specific training. Simbionix educational products are focused on specific skills and are
not meant to teach surgery. Simbionix educational products do not replace the necessary medical training and experience required

Surgical Science / Simbionix Products
811 Ist Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM Fax: 1-216-229-2070

surgicalscience

to perform surgery. Simulated training models may significantly differ from real life behavior. Simbionix makes no claims as to the
competency, training, or licensing of physicians :

"Installation and service Simbionix will Install the Equipment, provide on-site training of approximately 1 1/2 days and provide any

| remedial and preventive maintenance which ts required to keep the Equipment in good operating condition during the warranty

: period, unless otherwise stated in the Agreement. Installation and any remedial and preventive maintenance will be performed by
_ Simbionix or its authorized designee during normal business hours. Simbicnix and Customer will cooperate to satisfy any Customer

security requirements and still allow full and free access to the Equipment. Customer will provide computer time for any remedial
and preventive maintenance or installation at no cost to Simbionix. Simbionix will accept responsibility in the event thatdamages = |
are caused by the negligence of its employees or de signees while they are on Customer's premises in the course of performing
installation or servicing purposes.

Title, risk of loss and delivery Simbionix shall ship the Equipment within 45-60 from approval of Customer's purchase order. If
conditions arise which prevent compliance with delivery schedules, Simbionix will not be liable for any damage or penaity for delay
in delivery, or for failure to give notice of delay. However, Simbionix will use all reasonable efforts to give notice of delays. Delays
will not be grounds for cancellation. Delivery occurs Ex Works on the actual shipping date, and title and the risk of loss transfer to
Customer upon shipment. Freight and insurance will be invoiced unless otherwise specified on the face hereof.

Payment Unless otherwise stated in the Agreement, payment terms shall be net plus 30 days. The price of the Equipment and the

Software is denominated in US Dollars and does not include any applicable sales tax, use tax duties and other fees and taxes, which

shall be payable by the Customer, On overdue accounts, Customer shall pay interest at the rate of 1 1/2% per month (or the highest |
legal interest rate, if lower). The Customer shall provide Simbionix with a copy of tax exemption certificate, direct pay certificate or
resale certificate for the "Ship to" location if exemption from sales or use taxes is claimed ‘

Patents If anyone claims the Equipment or Software infringes their U.S., European Union or Japanese patent, copyright, trade secret |
or other proprietary right, Simbionix will indemnify and hold Customer harmless from any damages, judgments or settlements
(including costs and reasonable attorney's fees} resulting from the claim if Customer promptly notifies Simbionix in writing of the
claim and permits Simbionix to elect to take over the defense of the action. if Simbionix takes over the defense, it may select the
counsel and have the sole right to defend or settle the matter. Simbionix may substitute comparable non-infringing Equipment or
Software, or modify the Equipment or Software (which still must meet the specification) to make it non-infringing, or obtain a right

| for the Customer to continue using the Equipment or Software {all at Simbionix’ expense), or, if the above are impractical and its

, rental value for its use at Simbionix’ lowest standard lease or rental rate for the Equipment when originally delivered to Customer.

continued use is enjoined, buy the Equipment or Software back from the Customer for the original purchase price less a reasonable

This indemnification does not apply to claims resulting from non-Simbionix modifications to the Equipment or Software or use with |
other devices added by the Customer.

Security interest in equipment & software Customer grants Simbionix a priority security interest in all Equipment and Software
delivered until payment in full for such Equipment and Software has been received by Simbionix. Customer hereby grants Simbionix
the right to file such protective financing or similar statements to confirm and record Simbionix’ security interest in all Equipment
and Software.

Export compliance Customer shall not export, re-export, or otherwise transmit, directly or indirectly, any Equipment or Software
except in full compliance with all U.S, export control laws and regulations. These obligations shall survive the termination of the

Agreement.

Force majeure Neither party will be flable to the other for delays in performing any obligations under the Agreement due to
| circumstances beyond its reasonable control, including but not limited to revolts, insurrections, riots, wars, acts of enemies, national

Surgical Science / Simbionix Products
814 1st Ave, Suite 408, Seattle, WA 98104
Phone: 1-803-326-9050 WWW.SIMBIONIX.COM — Fax: 1-216-229-2070