International Affair

Americans enjoy the luxury of being able to buy just about any product they want from anywhere in the world, and they are rarely told that something is not available in the United States. But, that is exactly what Tonie Edwards, director of surgical services at North Carolina’s Spartanburg Regional Medical Center, was told during a 1999 trip to the German headquarters of healthcare equipment manufacturer Maquet.

Edwards was searching for new operating tables when she found the company’s complete operating room system: a stainless steel panel system with pop-out walls to allow for repairs and upgrades, sliding doors for easy access and instruments suspended from the ceiling.

The system has been installed in more than 2,000 locations around the world, but never in the United States. Edwards was sufficiently impressed with the quality of the product.

“I knew we had to have it,” Edwards says.

Patients are transported via the Alphamaquet or Magnus table to the operating room where the table slides easily into place onto a fixed column in the middle of the room.

The tables are fully flexible and can be moved into a variety of positions via remote control, avoiding potential injury and extra labor for staff.

The tables are like a massage chair on steroids, with sectioned pieces that can be added or removed for an easy custom fit. Automatic stirrups, side positioning, and various arm and head positions are just a few of the available features.

Stainless steel walls pop on and off for easy maintenance. They can withstand the beating of crashing carts and tables typically found in an operating room, and they are unlikely to be damaged to the point of serious repair, which reduces the typical downtime experienced in standard operating rooms, according to Maquet.

All instruments hang from the ceiling, eliminating the panoply of cords littering the floor and simplifying clean up.
Anti-infection enhancements include a forced air system above the table that constantly blows clean air into the room, and sliding doors that provide a tight seal to reduce the flow of air from unsterilized sources.

Edwards was sold on the system but the nagging issue remained.

Trial by Fire

Maquet has produced operating room equipment for more than 100 years in Europe and around the world, but never in the United States.

The stainless-steel modular system is built in Germany and shipped to the installation site and can be fully operational in a few weeks.

After Edwards return from Germany, she determined the system was within her budget and started the process of investigating how to bring it system to code in the United States.

Preliminary meetings with local and state building officials highlighted five points of concern: fire and smoke walls, flame-spread ratings, grounding, UL requirements and structural requirements for seismic ratings.

After pouring through manuals and specification books, her team determined that, with modifications, the requirements could be met, but they were still left with a major decision.

Changes that were outlined with all levels of inspectors had to be accepted by Maquet, which had to alter the manufacturing process of the system for the American market.

Electric motors used for the doors and blinds were replaced with UL-listed motors. The fittings were shipped to Germany so that the manufacturer could assess their look and feel and determine any modifications for installing them into the modular wall system.

To meet fire safety standards, airtight barriers were added to all doorways and more support studs were added to the design to meet seismic standards.

Installation of the first phase of the Maquet operating room system came in on time and on budget at Spartanburg and interest in the product has grown substantially in the U.S. since the installation, according to the company.