Basic training © 2010 Case Medical, Inc.

Case Medical Innovative designer and manufacturer of high quality sterilization containers and instrument chemistries Sterilization containers validated for all sterilization processes providing custom and modular options Instrument chemistries composed of high levels of synergistic enzymes and chelating agents. Validated and environmentally friendly New modern and integrated facility in South Hackensack, NJ All of our products are manufactured under our roof in the USA. FDA Registered, ISO Certified, WBE and Corporate Member of AAMI. 2

Basic Principles Our focus is to provide sustainable solutions to both SPD and OR We need to be knowledgeable We need to be consultants We need to listen to our customer’s needs We need to provide them with sustainable products that meet their needs

The Case Medical Story It is time to promote and sell sustainable solutions. We have the validated products for decontamination and sterilization. That truly last over time and are cost effective. Customers recognize this. We have all major GPO contracts. That gets you in the door. We have the world’s only universal container system. That is ideal for standardization No one wants to wrap! Everyone is using low temperature sterilization. We are compatible. We have validated, pH neutral, super concentrated, liquid, environmentally friendly, cleaning products with dose control. And our products are proven in the field.

Now is the time. Compete with excellent products Provide factual Information Utilize our contracts And focus on committed, dual source, and pending single source agreements

Searching for Sustainable Solutions Cost versus price. Sell the value. Customers want solutions to their problems. Become their consultant. Meet their needs. This will help you sell ours and your other products, too.

SteriTite Sealed Containers State-of-the-art system Universal Steam EO Ozone STERRAD Flash Steris Amsco V-Pro1 Durable and validated Sell value

MediTray Products for Organization This is the furniture for our house. Become the architect, designer and interior decorator. Provide protection. Sell value.

SteriTite Disposables The annuity. Get contracts for monthly deliveries from us to them. Make your commission an annuity.

SuperNova Value, a little goes a long, long way Super concentrated means more product for use Small size means more storage space Sealed dispensing means safe handling, no spills, no contact Automated dispensing to reduce errors and cut costs No handling injuries or ergonomic issues

SuperNova Value PH neutral means non-corrosive, Best components safe for containers safe for devices safe for the environment safe for people Best components High quality enzymes and surfactants High purity water Validation gives assurance

SteriTite: The Case for Sterilization 12

The universal container Perforated bottom for gravity steam and pre-vacuum steam. Perforated bottom for STERRAD. Validated for all…steam, EO, gas plasma, ozone and hydrogen peroxide. SteriTite, the only sealed container with 510k for all current sterilization methods. Including sealed flash sterilization with FlashTite valve plate for gravity and pre-vacuum steam. Pre-vacuum flash with paper filter and filter retention plate. 13

Truly Compatible Their “S” Ours

The SteriTite Basics 12 sizes or 24 models of SteriTite containers. Standard line 4, 6, 8” tall, minis or endo 3” tall. Wide, long container for Bookwalter and bariatric sets. 5” tall. Solid bottom for pre-vacuum steam and EO with vacuum. Perforated bottom, the universal container. When using baskets within the container, leave one inch for clearance. Always use pH neutral detergents. Container is easy to disassemble for cleaning. 15

Mini container 16

Half-size container 17

Mid-size container 18

Full-size container 19

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Features & Benefits Durable heat treatable anodized aluminum alloy Nesting dimples for stable transport Tightly sealed construction with knife edge fit Maximum interior space Designed to facilitate instrument protection and organization Only1” clearance required for contents 21

Features & Benefits Rivet-less case assembly Off set filter plate to prevent puncture Lift loops on lids for aseptic removal Secure latching mechanism Interchangeable component parts Standard (DIN) sizing Ideal for containerizing loaners 22

Designed to package your instrument sets 23

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MEDITRAY, UNIVERSAL COMPONENTS: Can be used in all systems Modular parts make new sets Place to add more instruments Easy to change layout of tray Containerize in SteriTite containers or wrap Adapts to all systems, including STERRAD 29

Stack multiple trays within the container for full instrument sets 30

ENDOF1

Insert boxes replace peel pouches 32

FlashTite® 33

FlashTite, a filter-less flash container An accessory to the SteriTite container The SteriTite container with FlashTite valve plate approved for sealed gravity displacement flash and sealed pre- vacuum flash Meets AAMI and AORN parameters for flash sterilization Eliminates the open flash pan Goes into the autoclave sealed and comes out sterilized and sealed With FDA 510k Complies with JACHO requirement for sealed flash 34

SteriTite Sealed Containers 35

Assembly for Use Place the lid on top of base. Secure the closure by latching the lid to the base. Push the bottom section of the latch over the lock holder. Place the appropriate ID tags in the label holders. Thread the tamper evident seal with indicator facing forward through the lock holder. 36

Post-Sterilization To minimize the potential of condensate formation within the sealed container Crack the door. Allow to cool on the sterilizer cart. Then, distribute as needed or place in sterile storage. 37

FlashTite Simply remove the disposable filter and filter retention plate from the SteriTite container and replace with the FlashTite valve plate for flash sterilization. In gravity flash, be sure that the perforated bottom container is used and all vents have FlashTite valve plates in place. No filter is used! 38

FlashTite Decontamination The FlashTite container system should be cleaned with a neutral pH detergent only. Rinse thoroughly after each use and dry all components. Set up SuperNova at the sink for manual cleaning and decontamination of Flashed items as well as the FlashTite container.

Flashing Procedures In gravity flash, use a minimum exposure of 5 to 10 minutes based on size of load, type of device and condition of steam and sterilizer. Verify with a one hour rapid readout biological and appropriate flash indicators. Verify at 10 minutes, then reduce time. No dry time is required, but 2 to 3 minutes will give you drier contents. 40

FlashTite at Point of Use Transfer container using a glove or dry towel. Open container. Check seal on valve. Check indicator color. Check arrow indent.

Verification Check the hospital sterilizer. Follow hospital procedures. Try our product in the sterilizer. In-service the staff. 42

Case Solutions SuperNova System 43

Technological Breakthrough Environmentally Friendly Dose Control Flow Control Built in sealed dispensing Product and process validation Previously recorded studies showed maximum 3 to 4 Log reduction! We demonstrated 6 Log reduction in bioburden and >99.9% reduction in organic soil No need for caustic cleaners to achieve results 44

Standardization Recommended three step process Utilizing the same pH neutral product for manual and automated cleaning And the same NPHD detergent for the cart and utensil washers PentaPrep, five enzyme pre-cleaner for point of use and decontamination SchmutzOff -stainless steel cleaning applications including instrument reconditioning, surface cleaning, and removal of rust and scale on walls of autoclave and automated washers (ACID) 45

SUPERNOVA.1 MULTI-ENZYMATIC CLEANER Highest concentrated, liquid, multi-enzymatic cleaner for manual and automated cleaning. Contains significant levels (~12%) of protease, amylase and lipase enzymes Validated for soaking and manual cleaning at 0.1 (1/10) oz./gal. May be diluted further in automated washers and in treated water. 10 to 4 times more product! May be diluted to 1/40 oz per gallon based on water quality. 46

SUPERNOVA.25 The same multi-enzymatic detergent set at a specific dilution rate for automatic washers. Validated at 0.25 (1/4) ounce per gallon, the lowest default setting of most automatic machines. Pre-set and ready to go! May be diluted further to 1/10 oz based on water quality 47

SUPERNOVA NPHD DETERGENT Highest concentrated, liquid, pH neutral, detergent for manual, ultrasonic and hot water wash cycle of washer decontaminator. Contains excellent surfactant with significant chelating agents for hard water ion removal. Product formulated for automatic and manual cleaning. Validated at .1 ounce per gallon. May be diluted further. 48

INSTRUCREME LUBRICANT CONCENTRATE Formulated for machine use. Set automatic washer lubrication setting at 0.1 (1/10) to 0.25 (1/4) oz./gal. Lubricates critical areas. Rinses free on surfaces. 49

Theirs Ours 50

PACKAGING All Case Solutions products are packaged in a case containing two (2) 2.5-gallon totes or four (4) 1 gallon bottles that equal approximately 15 to 55 gallons of current cleaners on the market. One case of SuperNova can be shipped directly to your facility without special handling or use of a forklift! 51

SuperNova Cleaning Steps

Case Solutions CSR Ink and adhesive remover SchmutzOff stainless steel, acid based re- conditioner and descaler InstruCreme instrument lubricant Instrument cleaning brushes Multi-enzymatic cleaners

Pre-Cleaning Steps Use PentaPrep ready to use foam or spray for point of use, transport or holding area in decontam Use PentaZyme concentrate for soaking and for manual cleaning at the sink. Has rust inhibitor for extended soaking Dilute at 0.50 fl oz/gallon May be used for automated washers

SuperNova Manual Cleaning Instructions “Pink is for the sink.” Check to see that the SuperNova.1 container of multi-enzymatic cleaner with pink label is on its pink stand in cabinet under the sink. Turn on both hot and cold water equally. Press green button on the right of the faucet proportioner inward for clear water. Press red button inward on the left side of the proportioner for the multi-enzymatic detergent (soap). Do not pour or add any other products. There is no need to measure. The proportioner or aerator will automatically dispense the correct amount of diluted cleaner. Remember to rinse well before placement into the automated washers.

SuperNova Instructions for Sonic Cleaner “Purple is for the sonic.” Check to see that the SuperNova.25 container of multi-enzymatic cleaner with purple label is on its purple stand. Do not pour or add any other products. There is no need to measure. The sonic washer will automatically dispense the correct amount of diluted cleaner.

SuperNova for Automated Washers Purple is for the Multi-Enzymatic Cleaning Step. Check to see that the SuperNova.25 container of multi- enzymatic cleaner with purple label is on its purple stand. Blue is for the Hot Water Detergent Wash. Check to see that the SuperNova.25 container pH Neutral detergent with blue label is on its blue stand. Green is for the Lubricating Cycle. Check to see that the SuperNova.25 container of Lubricant Concentrate with green label is on its green stand.

SuperNova for the Cart Washer Blue is for the Detergent Wash Cycle. Check to see that the SuperNova.25 container of pH Neutral detergent with blue label is on its blue stand. Orange is the Agent that Facilitates Quick Drying. Check to see that the SuperNova container of CaseDry with orange label is on its orange stand.

For Ambulatory and Out-Patient Clinics An abbreviated process Less product Small set ups

SuperNova Manual Cleaning Instructions “Purple is for the sink.” Check to see that the SuperNova.25 container of multi-enzymatic cleaner with purple label is on its purple stand in cabinet under the sink. Turn on both hot and cold water equally. Press green button on the right of the faucet proportioner inward for clear water. Press red button inward on the left side of the proportioner for the multi-enzymatic detergent (soap). Do not pour or add any other products. There is no need to measure. The proportioner or aerator will automatically dispense the correct amount of diluted cleaner. Remember to rinse well before placement into the automated washers. Process for Ambulatory Centers

SuperNova Instructions for Sonic Cleaner “Blue is for the sonic.” Check to see that the SuperNova.25 container of detergent with blue label is on its blue stand. Do not pour or add any other products. There is no need to measure. The sonic washer will automatically dispense the correct amount of diluted cleaner. Follow with a thorough rinse using deionized, distilled or RO water. Note: If there is no automated washer, set up second sink with neutral pH SuperNova.25 detergent with Chelating agents as final wash step. Then, rinse thoroughly. Process for Ambulatory Centers

Super Concentrated Products Contribute to major cost savings. Validated, safe, cost effective products results in better patient outcome and frees staff for needed patient care. 65

Thank you Final thoughts and comments