1. Rotigs 4.0 Brad NaPier MD

2. Introduction Brad NaPier MD, Otolaryngologist Developed a dental device that facilitates bronchoscopic intubation. Marketed for anesthesiologists. Currently sold by Richards Medical in Chicago. Rotigs 4.0 is a modification of this platform to provide web based videolaryngoscopy for ER physicians, ENTs, and anesthesiologists.

3. Rotigs 4.0 Rotigs platform plus LED/CCD Camera with USB or Bluetooth connectivity Image emailed to ENT physician or anesthesiologist

5. Purpose To provide laryngoscopy without a flexible or rigid laryngoscope in the ER setting Provide Rapid Accurate Triage Eliminate unnecessary CAT Scans Eliminate unnecessary radiation to the patient

6. Purpose Provide visualization to ENT physician at home and ensure accurate diagnosis and treatment. Improve cost effective treatment by eliminating unnecessary xrays and CAT scans. Patient comfort. No need to perform a transnasal approach. Eliminate epistaxis in patient who are anti coagulated. There is no gagging.

7. Indications Sore throat, tonsillitis, peritonsillar abscess Globus pharyngeus, GERD, foreign bodies, fishbones Epiglottitis, angioneurotic edema Airway evaluation

8. Specialty Interest Pediatric ENT and general ENT Rural ER Pulmonologists Primary care physicians Anesthesia pre op airway evaluation

9. Improve Quality of service Quality of care Cost effectiveness

10. Physician Buy In ER docs will appreciate information without effort, time, and skill required for endoscopy. ER docs will shift responsibility for diagnosis and follow up to ENT specialist. ENT will appreciate directing care from home and billing for their evaluation.

11. Market 5,000 ERs in the US 5,000 operating rooms in the US Double these numbers if you include Europe

12. Path forward Modify existing LED/CMOS/ USB micro video camera Consider Bluetooth or Wifi connectivity Revise injection molding to accommodate camera Find existing companies that would benefit from this product with existing distribution system

13. Proof of concept image Mannekin

14. Laryngeal Image with Rotigs 4.0 Without topical anesthesia

15. Summary Rotigs 4.0 will improve awake airway evaluation in an ER setting without endoscopy Improves quality of service, care, and is cost effective Will be supported by ER, ENT, and Anesthesia.