\. SPECIAL FEATURE PATIENT MON"ORS .l1e patient monitoring industry has witnessed important technological advances over the last decade. Such advancements have culminated in the introduction of a variety of new and innovative patient monitoring solutions. Patient monitors may be pre~configured or modular--':'-they come as single parameter or multi-parameter units. The selection criteria needs to take into account the distrfuution of beds in terms of criticality to be managed. This would determine the monitoring parameters amongst other things. ~I Patient monitors constitute a huge market in the country. In the year 2004-05, the organized market for patient monitors in. India is estimated at 9,500 units. In t~rms of revenue, this market is estimated at Rs. 120 crore. The patient monitoring market may be broadly segmented into high acuity, mid acuity, and low acuity monitoring, on the basis of features and applications. Patients requiring high acuity monitoring are typically undergoing extensive cardiac surgery within large hospitals. These find applications in major operation theaters, post-operative care units, and surgical intensive care units. The high acuity monitors are priced above Rs. 4 lakh, having 6-8 parameters and are generally modular monitors. An estimated 650 units of high acuity monitors have been sold in 2004-05 at an estimated BUYER. OCTOBER-NOVEMBER 2005 .MEDIC
t \ v'alue of Rs. 30 crore. This segment is largely dominated by Philips. The other players having significant presence in this segment include GE Healthcare, cope, Spacelabs (marketed by Kopran and Empire Instrumen. tation), Drager (marketed by HL Medical), Nihon Kohden (marketed by Trivitron), Mindray (marketed by Instromedix), and L&1 Medical. Patients usually advanced ent The total in this as requiring be undergoing features. medium or low that current to that acuity will sufficient however, technology cardiac monitoring this definition is products contributes and L& cope, at but becoming minimal around are Criticare, 42 -1 less in 1~~~ term5 '_~~~r surgery Within the are forced requires market, higher 4-5 GE competitors acuity in terms The provide offer Philips, priCE percent Ninon medium market segment. monitors of revenue. other BPL, with parameters Healthcare, include to T Medical Drager, significant and 1-3 An Schiller. players Spacelabs, Low terms market significant (marketed are cal, active Emco acuity of in Mindray, monitors volume 2004-05. players by in Krishna various parameters 6,150 has GE the constitute low major acuity share BPL, around monitors of the 65 percent have pie, in of been this the sold segment. Schiller, of total in ~~.1.~ the The and sales. L&T include estimated Medical Philips, Medi Healthcare, among the country. and to Criticare, A include among large Mindray, number Maestros others. in the patient Equipments), across others. These Nassan, regional Clarity pockets Meditronics, have a Mediline, Meditek, and mobility In upgrade systems, Concept, become vital emergence Flexibility in the sustain of revenues telemetry monitorii-.~ ~ :~.-I" country. to such and their scenario, development patient solutions, high-end monitors, units. implementation Witl) facilities information monitors of wireless and purchase transport patient same healthcare tions monitors, time, just costs. that allow a a one The patient healthcare market has the freedom can rapidly to to move around several while patients patient still being remotely, monitored. thus softwa.~ rlol"'ro," At worker is also monitor implementing monitoring array station bed ECG of medical professionals With can be on same utilize of the a an unprecedented monitoring tilJle-all monitor; patient various display; data features ... on screen of permutation eter the display number patient monitor. combinations of and critical types bed the advent appl at screen or central same slave arrhythmia detection thereof. ;~' In recent years major advances have been made in the complimentary processing and analysis of biological signals and in particular their application to patient monitoring. Some the most exciting developments are likely to include and incorporate engineered rnrclaro, nanotechnologies/nanostructures, molecular manufacturing and other state-of-the-an gies, such as Bio MEMS (micro-electrical-mechanical systems) microprocessors and ization. The future is predicted to see developments in, and the practical applications of and molecular nanosensors, displacement and motion sensors, force nanosensors sensing, thermal nanosensors, electrical and magnetic sensing, cellular bioscannlll~ macrosensing such as blood pressure/pulse detection and respiratory audition. The emergence of corporate hospitals in the metros and smaller nursing homes in ~~TT areas along with more and more hospitals opting for accreditation are the major faclul~ 12. MEDICAL BUYER. OcrOBER -NOVI:;MII!;K ~uu:
It SPECIAL FEATURE PATIENT MONITORS the growth of the patient monitoring market in the country. A paradigm shift is being witnessed the awareness level. amongst doctors to monitor basic parameters in a critical situation and the mode of monitoring from cardiac monitoring to anesthesia monitoring with parameters anesthesia multigas, EtC02 (capnography) or cardiac output. Increased affordability, higher ing capacity due to mediclaim insurance, medical reimbursements through employers and increasingly affluent and health cautious middle-class population are providing a boost to . market. The market is expected to grow at the rate of 15 percent in the coming years. BPL BPL is one of the major players in the Indian patient monitors market. The company offers a wide range of patient monitors in the country. The model Ultima offers valueadded featureslike 8 trace with 12.1inch screen, advanced software packagesfor arrhythmia,drug dose, dynamic Bp, cardiac output, multi gas monitoring, and capable of 7parameter monitoring. The model Centrais a central station with twoway communication and data export. Accura is an advanced 6-parameter monitor with arrhythmia calculations and Viva is the 5parameter monitor with wide 7-inch TFT screen.The model Aegis offered by the company is a 3-parameter color monitor, whereas the model Maxima is a monochrome 3parameter monitor. The company also offers NIBP and ~pO2monitor Spectra, and ECG and SpO2monitor Endura.Agentais the ECGmonitor offered by the company. The company's major customers for patient monitors in the last fiscal include Imperial Hospital, Bangalore; Sagar Apollo Hospital, Bangalore; Kukreja Hospital, New Delhi; EMS Co-Operative Hospital, Perinthalmanna; Sahakarana Hrudayalaya,Kannur; LNJP Hospital, New Delhi; GangaramHospital, New Delhi; AFMSD, rune; and South EastRailway, Hyderabad. The company has an ISO 90012000 certif manufacturing base at Palakkad, Kerala, that offers integrated facility for assembly, test- ins, and dispatch. BPL also exports patient monitors to SAARCnations and Middle-East countries. The company has over 120 dealers across the country to cater to the needs of its customers. dia. Compact .. and light weight, Krishna Medi Equipments has t up with 8ionet from Korea and distributes its patient monitoring product range in India. The company offers 8M 3 and 8M 3 Plus models in the patient monitoring segment. ProvidingECG, SpO2'N18p,respiration, and temperature, 8M 3 is designed to meet a wide range of applications. 8M 3 offers color LCD screen display for outstanding visibility, remote alarm and central monitoring system, operated with built-in-battery or direct DC input, it offers speedy transport facility. Its built-in two-channel 'thermal printer facilitates documentation of the data. The model 8M 3 Plus offers valueadded features like color monitor with ECG, N18p,SpO2'respiration, and temperature, built-in battery , works on AC 100V-240V and 12V DC in vehicles, built-in 3 channel printer, monitoring from neonates to adults, VGA output connecting to an external monitor directly, and central monitoring system up to 16beds. BIONET (KRISHNA MEDIEQUIPr~spiration, and nurses call MENTS) tor adult, pediatrics,and The innovative user interfCtce tures simplif menus and cated function keys for set-ups. It offers ECG, NIBp, DOX SpO2'HR, ' face connection. The model offers optional CO2, COjO2 ' analysis, and printer. The Scholar III patient -~-:.- fered by the company monitors five critical ECG, NIBP,SpO2' heart rate, temperature on a broad range products-from neonate to ~-The model also offers built-in chargeable battery to provide interrupted patient. during transport or power COPE CORPORATION copeis one of the leaders patient monitoring worldwide -, is a pioneer in the industry. company's products are known for quality and cope offers monitoring tions from individual bedside tors to seamlesspatient net\'(orks for all types of facilities. The .8-waveform color monitor ECG, SpO2'NIBp, respiration, ... eters and modules. Passport2 6-waveform color monitor ECG,respiration, NIBp, SpO2' perature and other optional ~ eters. The model TRIO is CRITICARE Criticare offers the Poet Plus and Scholar III patient monitors in In- OcrOBE, NOVEMBER20l ,~UYER.
\ .,. 4-waveform color monitor with The company also offers the DASH ment, anesthesia gas monitoring ECd, SpO2' respiration, tempera- range of patient monitors that inture, NIBP and optional IBp, 2nd cludes the models DASH 2000 Pro .and wireless central monitoring technology, Mindray patient monitemperature. Accutorr Plus is an- Monitor, DASH 3000 Pro Monitor, tors are suitable for use in OR, ICU, other model for highlyreliable NIBP and DASH4000 Pro Monitor. CCU, ER, internal medicine, surgery, and SpO2monitoring in the high pediatrics, and ob-gyn. acuitycare, offered by the company L&TMEDICAL in the patient monitoring segment. L&T Medical offers a wide range of Mindray offers a comprehensive The model Panorama is a central patient monitors in India. Among range of monitors with modular and fixed parameter combinastation with up to 16-bedhardwire, the patient monitoring systems that tions. The various models offered telemetry or both, networkable, L& T offers are the Micromon N-xt, by Mindray include: and full disclosure,etc. The model an ECG monitor, the Stellar Series, PM-6000. Truly modular monitor Duo is the cost-effective NIBP a range of portable pulsewith individual modules for every spotcheck monitor with optional oximeters, Planet 50, a pre-configparameters with connector less SpO2 and temperature. ured portable monitor and Star 50, connections with the module box. The company has a state-of-the-art an upgradeable multi-parameter It comes with an option of 12-inch facility in Mahwah, New Jersey, monitor for monitoring ECG, pulse or IS-inch flat color TFTscreenwith USA, and has installed more than oximetry, invasive and non-invasive display of 8 waveforms.The system 300units till date in India. In the last Bp,etc. accepts modules for ECG/respirafiscal, the company installed pa- The Galaxy is a flexi-display multition/SpO2/NIBP/EtCO2/IBP/ tempi / tient monitors in Apollo Hospital,.Chennai; parameter anaesthesia gas moni- CO/anesthesia gases,recorder, etc. PSG Hospitals, tor and the Skyline is a central PM-9QOO. Pre-configured 12-inch Coimbatore; Holy Family Hospital, nurses station with advanced color TFT monitor with 8 waveforms Mumbai; Northern Railway Hospi- noiseless digital communication tal, New Delhi; BVP Hospital, Kota; for monitoring an 8 or 16-bedded that monitors ECG/respiration/ Apollo Hospitals,Hyderabad; HIHT, ICU.The company also offers Cos- spa 2/NIBP/EtCO ;/IBP /temp/CO/ anesthesiagases. Can be suppl Dehradun; and TNMSC, Tamil mic, an advanced colour modular with built-in optional recorder. Nadu. monitor. PM-lOaD.Pre-configured 10.4-inch The company acquired technolcolor TFT monitor with 8 waveGE HEALTHCARE ogy licences from leading Euro- forms that monitors ECG/respiraGEHealthcareis a leading player in pean firms and has a the Indian patient monitoring mar- state-of-the-art manufacturing fa- tion/SpO2/NIBP/EtCO2/IBP/temp/ ket. The company offers the Solar cility at Mysore. The company ex- CO/anesthesiagases. Can be suppl with built-in optional re8000M patient monitor that ~fers ported around 400 monitors a range of value-addedfeatureslike during April 2004to March 2005 to corder. MEC-IOOO.Pre-configured 10.4- .I OR-specific alarm structure, re- the US, Europe, and Africa. The inch color TFTmQnitorwith 4wave- J mote control and Unity View dis- focus on manufacturing wOr/dforms that monitors ECG/ play configurability allow use,rsto class products has enabled L&T concentrate on the patient, elec- Medical to receive USFDAapproval respiration/SpO2/NIBP/temp. Can be suppl with built-in optional tronically receive up-to-the-minute for its patient monitor models Stelrecorder. lab results at the point of care to lar, Star,and Planet. AIl the monitors can be networked enhance ICU efficiency, and CRG through LAN/wireless with Mindray Plus 24-hour, beat-to-beat trend MINORA Y (lNSTROMEOIX) Hypervisor Central Station. package for neonate monitoring Mindray is a leading patient moni- Mindray monitors are being supincludes heart rate, Sp02' mean ar- tor device designer and manufacterial pressure, TcP02,TcC02, CO2 turer in China and is fast pl in India bylnstromedix (India) Pvt. Ltd. since the last 3 years and respiration waveforms to penetrating into the global markets and have proved to be extremely i evaluate the possible occurrence that cover nearly a hundred counof bradycardia and apnea events tries. Mindray products are being reliable in Indian conditions. and Transcutaneous monitoring sold in USA,UK, Germany, France, PHIUPS combine non-invasive conveItaly,Spain,and Japan. With the innience with highly accurate °2 and corporation of Masimo and Nellcor Philips is a leader in the patient monitoring segment in India. The CO2readings for neonates. SpO2measurement, IBP measure- IntelliVue series of patient monitors 16+M ' , , ! JI(AL BUYER. OCTOBERcNOVEMBER 2005 I
~ 'f .SPtECIAL FEATURE PA1IENT .OllnDRS offered by the company uses Tunneling Control Engine Technology (TCE) to prioritize mission critical information so that essentialmonitoring information and alarms reach their destination accurately and on time, regardless the amount of network traffic. The monitors offer a wide selection of value-added features like EASIderived 12-leadECGfrom only 5 electrodes, conventional 12-lead ECG, comprehensive multi-lead ST segment analysis based on ST/ARalgorithm, FAST-SpO2' continuos cardiac output via PICCOmethod, transcutaneous gases, automatic identification of ailS anesthetic agents with the anesthesia gas module, bispectral index (BIS) module compatible with Aspect's latest BIS XP platfo,rm, EEG module with CSAdisplay. Another model SureSign C1 is a compact, versatile monitor for transport and low-acuity care. It offers features like SpO2' electronic predictive thermometry, 3-lead ECG, non-invasive blood pressure (NBP), including spot check, interval, and STATmodes, lightweight, extended battery life time up to eight hours, bright TFT color display, and color-coded programmable alarms. . The company also offers HeartStart MRX monitor/defibrillator that includes capabilities like monitoring through defibrillation pads, 3-and 5- leads ECG monitoring through electrodes, ST/AR Basic arrhythmia detection, FAST -SpO2 (Fourier Artifact Suppression Technology) optional, .NBP optional, Microstream Capnography (EtCOJ optional, and 12-lead ECG optional. The telemetry system offered by the company brings high powered UHF digital transmission to its patient monitors by reproducing monitoring-quality ECGwaves and SpO2 values, and by giving patients the freedom to ambulate and not to be tethered to fixed bedside monitors. SCHILLER Schiller India offers a wide range of products in the patient monitoring segment in India. The company offers models like: .Samiksh. Black & white multi-parameter monitor with any of the following configuration like ECG, SpO2 & NIBP. .Samiksh pro. 4 or 5-parameters lIke ECG,SpO2'NIBp,resp, temp. .Argus LCM. Transport monitor with ECG,SpO2'NIBp,resp, temp, EtCO/IBP. These products offer a host of features like strip selection, in-built high capacity re-chargeable battery, interfaces with Solus+ (Schiller Central Station), graphical trends with zoom facility, multiple screen configurations, turn and push rotary knob for quick and simple adjustments, single menu display, audio/visual smart alarm and in-built dual channel thermal recorder (optional). With 12 offices in Mumbai, Delhi, Kolkata, Chennai, Bangalore, Hyderabad, Kochi, Pune, Bhopal, Ahmedabad, Lucknow, and Pondicherry and over 50 dealers~ the company also reaches out to countries such as Bangladesh, Sri Lanka,and Nepal. First level ()f service is available atall Schilleroffices. Fully equipped service centers are located at Bangalore and Pondicherry, manned by high skilled service personnelto cater to the needs of its customers. tions, anesthesia delivery and ventilation systems, pulse oximeters and sensors and bone densitometers selling to hospitals,clinics and physiciansoffices. Additionally, the company provides ECG laboratory servicesto pharmaceutical companies undertaking clinical trials. The company has established brand names in both medical de- "Spacelabs,""Blease" and phin." The company conducts manufacturing and R&D in the UK, and the United States. Spacelabs is represented in ' by Kopran Laboratories in northern and eastern regions, by Empire Instrumentation in western and southern regions. TRIVITRON Trivitron represents Nihon in the Indian patient market. The company offers Lifescope I, Lifescope A, Lifescope L range the country. The patient are equipped multi connectors technology ensures cost-effectiveness, flexible operation, and of parameter selection. feature offered by the models washable and disinfectable ~Probe Blupro (Bright LED weight Probe) .Unique Fitting OR, etc. Other value-added tures include high color LCD touch screen, Pulse Wave Transit Time technology for NIBP if abnormal BP prevails, network. . . SPACE LABS Spacelabs Healthcare is a subsidiary of OSISystemsInc., a US-based company. Spacelabs Healthcare, Inc. is an international developer, manufacturer and distributor of medical equipment and services including patient monitoring solu- eters at a distance, and an oral nasal expiration. stream CO2 sensor for bated patients. Trivitron has a well ,.~._' ..'-. dealer network across the apart from direct staff to cater the needs of its customers. 18. MEDICAL BUYER. ocrOBER- NOVEMBER 2005