When Buying Used Equipment: Ask for a DEMO.

When I know that my customer is considering to buy a refurbished equipment, say his budget is enough only for a refurbished ultrasound equipment, I always advise them to ask for a DEMO. My logic is simple: Would you buy a 2nd hand car without seeing and test driving it? Why should it be different in buying 2nd hand equipment, which is more expensive than 2nd hand cars, then?

Unfortunately, I have seen many customers fall victim to 2nd hand equipment dealers' sweet talk. They bought equipment based mainly on the reputation of the brand rather than the status of the actual product. Dealers lead customers to believe that the brand speaks for itself, and that there is no other consideration. The fact is, the brand should play 3rd fiddle only to the actual status of the specific unit itself and to the reputation of the vendor. One 2nd hand unit is definitely different from another 2nd hand unit, even of the same brand. Similary, not all vendors are alike.

The lack of proper scrutiny by buyers of 2nd hand equipment permits vendors to over-price. For example, many in the country bought the cardiology version of a 2nd hand ACUSON 128XP10 at around US$35,000, while a quick surf at the internet will reveal that it can go for about US$12,500 in the USA. Even the newer ACUSON ASPEN sells at $22,500 in the USA while a customer in the Philippines recently bought a similar equipment at $45,000.

When a customer is lucky, his poorly scrutinized 2nd hand equipment may be expected to be usable for a maximum of 3 years (often less than 1 year). After that, the used equipment is often deemed more expensive to maintain than buying a brand new equipment. If this is taken into consideration, and also considering that the 2nd hand units are sold at a high price in the country, the investment will not be worth it.

Even if the price of 2nd hand equipment is less than half of brand new, I lean towards brand new equipment which will last for a maximum of 10 years. One can do the math and would easily understand my argument. An investment in a poorly scrutinized 2nd hand equipment will seldom be profitable.

To protect buyers from making bad decisions on 2nd hand equipment purchases and to protect their industry, a group of vendors worked together with the US Food and Drug Administration and established IAMERS, or the International Association of Medical Equipment Refurbishers and Servicers. The group follows a code of ethics which aims among others

...to attain and enforce high standards of ethical, professional "practices" within the industry.

When purchasing 2nd hand equipment, it would be wise to at least ask the vendor if they are a member of the IAMERS. Also, there are a lot of information that could help that may be found on the internet such as from this site by a vendor (BMI Med) in the USA. One can even easily check the prices from the sites I have linked above. But most importantly, buyers should ask for a DEMO of the specific machine they are buying. Without a DEMO, any 2nd hand equipment purchase should never be made.

Esaote Technos Ultrasound

We have been trying to sell the Technos locally for quite some time now with little success. Although, ESAOTE is one of the top 5 (Esaote is right there just behind the giants GE, Philips and Siemens, and shares the 4/5 rank with Toshiba) among the more than 30 different ultrasound manufacturers, the brand is less known in the Philippines (where Hitachi, Shimadzu and Medison are better known brands).

The Technos is one of the best ultrasound machines I have ever seen (consider that I have more than 16 years experience in Ultrasound). I believe that it has the best trans-vaginal probe in the world. The images from its linear probe are more than outstanding. Its abdominal probe provides good images both in the near and far fields. Yes, it doesn't have the nice-to-have features of other brands' top-of-the-line machines such as voice command and touch menu screen, but isn't image quality the most important feature?


The Technos

I know ESAOTE is also not that well known in the USA, although they have some nice installations there, where they are known as Biosound Esaote. So I am pleasantly surprised to see one blogger to have featured the Technos in his post (The Thyroid Blog). The blogger, a thyroid specialist from California, USA, is so generous with his praise of the Technos Ultrasound Machine as quoted below:

It is 2 months since I became the 7 th thyroidologist in the USA to own the Technos Partner Biosound Esaote Small Parts ultrasound, made in Italy. The machine is awesome. I can see and biospy 5 mm suspect cancer nodes, inject saline, and alcohol in thyroid cysts,and analyze nodules for cancer characteristics. Irregular borders, vascular invasion in the nodule, as well as size and echogenicity. The picture quality is as good as the $200,000 all purpose machine they make. I am finding more suspicious neck nodes with this machine, and can biopsy them as well. The guided needle into the node can be sent for cytology, but also washed into saline for Cancer markers,thyroglobulin, and calcitonin.Small suspect parathyroid masses, and cysts can be biopsied, and needle washed for parathyroid hormone. The nodule evaluation is more refined with this machine. For example, if one faces a patient with a goiter with 6 nodules, the cancer may not be the biggest or dominant one by size.This is the one we all would have biopsied in the past. By evaluating the factors most suggestive of tumor, by ultrasound, we can pick out the nodule most likely to harbor cancer, or the "real" dominant nodule. The lower risk nodules can be followed and only biopsied if they grow. The new age of thyroid evaluation for thyroid cancer by high resolution ultrasound is here. Moved to the back bench, is the old mainstay of thyriod cancer follow up, the Total Body I/131 Scan.

Dr.G.