Developments in International Commercial Mediation: USA, UK, Asia, India and the European Union By Danny McFadden LLM, FCIArb This paper will look at some of the major developments in international commercial mediation to date but the author would ask the reader to bear in mind that the picture is constantly changing which reflects the adaptability and dynamism of mediation in the modern era.
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ThE nEw AlphAmAqUET
The Gold Standard Surgical Workplaces OTESUS 3
DEDicATED TO DElivEring vAlUE
committed to helping hospitals enhance their work-
continuous improvement: MAQUET has an open ear to
flows and improve patient outcomes: MAQUET is one of
customers' requirements – and leverages their feedback to the world's leading providers of medical products for oper‑ enhance its products on an ongoing basis. In developing ating rooms, cath labs, and intensive care units. The compa‑ OTESUS, MAQUET introduced a host of new features to its ny comprises three divisions: Cardiovascular, Critical Care highly popular ALPHAMAQUET operating table system. The and Surgical Workplaces. A one‑stop provider of complete new table system is now even more closely aligned with the operating suite solutions, MAQUET stands for innovation and needs of surgeons, nurses, and technicians. And best of all, technological progress. It is a subsidiary of the Swedish it is compatible with all ALPHAMAQUET 1150 table tops and GETINGE GROUP, a publicly traded company.
accessories – enabling hospitals to make the most of their existing resources. MAQUET – The Gold Standard.
4 OTESUS Surgical Workplaces
BlAzing nEw TrAilS
whilE mAximizing cUSTOmErS' invESTmEnT
Developed in line with real-world needs: OTESUS 1160
Benefits at a glance:
is the result of a continuous improvement journey span‑ Fully compatible with all existing ALPHAMAQUET 1150 ning many decades. Based on the popular ALPHAMAQUET and many 1140 table tops and accessories, as well operating table system, it features a number of key enhance‑ as 1120 and 1150 base plates ments developed in collaboration with OR teams. At the Improved positioning possibilities thanks to an expanded same time, OTESUS retains many tried‑and‑trusted features range of angles for combinations of Trendelenburg/reverse of its predecessor – minimizing the need for training. Trendelenburg and lateral tilts Lower table positions – enhancing ergonomics, and pro‑ new opportunities for existing equipment: today's hos‑
viding better access to bariatric patients and patients in pitals are under increasing cost pressure – so replacing an beach chair and lateral positions entire operating table system is not always a viable option. Smooth, precise and controlled table movements for Against this background, MAQUET firmly focused on com‑ greater accuracy during intraoperative re‑adjustments patibility. OTESUS' innovative column, hand control, and User‑friendly bi‑directional hand control with many work‑ transporter are fully compatible with all ALPHAMAQUET flow‑enhancing features such as pre‑programmable 1150 and many 1140 table tops and accessories. This means you can completely renew or gradually replace your Maximum weight capacity of 380 kg / 838 lbs prepares equipment while getting more from your existing resources – you for extreme situations and without straining your budget. The new column is compatible with all ALPHAMAQUET 1150 table tops and accessories – so you can continue to make full use of your existing resources.
Surgical Workplaces OTESUS 5
Full compatibility: 1140 table top with the OTESUS 1160 column
6 OTESUS Surgical Workplaces
inTElligEnT, mODUlAr AnD fUTUrE-prOOf:
ThE OTESUS OpErATing TABlE SySTEm
A versatile solution: the modular OTESUS operating table
Moreover, accommodating new technologies, procedures or system comprises a column, a hand control, a user‑friendly disciplines is as simple as acquiring a new table top or transporter and a wide variety of table tops and accessories. accessory – making OTESUS a future‑proof investment that This means surgical staff can tailor the table to each surgery grows with your hospital's changing requirements. and patient by simply swapping a few modules. Expanded range of tilt angles:
OTESUS supports an even wider range of angles for combi‑
nations of Trendelenburg/reverse Trendelenburg and lateral
tilts – significantly expanding the patient positioning possi‑
bilities. This delivers benefits across all disciplines, and
opens up new opportunities for laparoscopic procedures
such as sigma resection.
Surgical Workplaces OTESUS 7
the angle indicator clearly displays the angles of Trendelen‑
burg/reverse Trendelenburg, lateral tilt, and the position of
the back plate. Furthermore, it provides orientation, facilitates
communication in the OR with regard to patient positioning,
and aids with documentation.
MAQUET's Easy‑Click interface makes adding and removing
modules simple, efficient and intuitive. This minimizes the
time required for patient setup, and for tailoring OTESUS to
as a safety feature, selected accessories that can be
mounted on the leg plate mounting points are equipped
with special transponders. OTESUS tracks the
transponders, and issues a warning when the accessories
are on a collision course with the column or floor – even
if the table top is positioned in reverse.
The electrolyte finish of the stainless steel surface reduces
the adhesion of bacteria and makes it easier to remove
Simple machine cleaning:
various transporters, table tops and accessories may be
machine decontaminated, ensuring the highest hygiene
Note: Hygienic Design does not replace existing cleaning and disinfection procedures or protocols.
8 OTESUS Surgical Workplaces
DESignED TO EnhAncE yOUr wOrkflOwS:
ThE nEw cOlUmn AnD TrAnSpOrTEr
A range of improvements: the new OTESUS stationary
and mobile columns were designed to enhance workflows
in today's modern operating rooms. A number of innovative
features improve ergonomics, create new patient positioning
opportunities, and boost patient safety.
Wider range of lateral tilt (now 28°) and Trendelenburg (now 45°) angles Expanded range of angles for combinations of Trendelen‑burg/reverse Trendelenburg and lateral tilts (now 30° / 20°) Greater range of stroke height: 540 mm / 21" Four speeds for smooth, precise, and controlled table movements Excellent column stability, even when extension plates are used Lithium‑ion battery located inside the mobile column, allowing a flatter foot plate 1159 mm / 46" Bi‑directional communication with the hand control impressive height range: the height of the OTESUS column
can be adjusted from 619 mm to 1159 mm / 24‑45". This cre‑
619 mm / 24" ates a more ergonomic working environment for surgeons, allowing them to operate either standing or seated. In addi‑tion, very low table settings provide better access to bariatric patients and patients in beach chair and lateral positions.
User-friendly and efficient: the new OTESUS transporter
was designed for even greater ease of use and enhanced
ergonomics. It features large wheels for excellent maneuver‑
ability, and allows for precise positioning with minimal physi‑
The table tops can be transferred from the transporter
to the table column from the head or foot position. For the
transfer, OR staff can use the intelligent hand control or the
foot pedal that frees up their hands for other tasks.
Surgical Workplaces OTESUS 9
10 OTESUS Surgical Workplaces
Surgical Workplaces OTESUS 11
Brimming wiTh inTElligEnT fEATUrES:
ThE nEw hAnD cOnTrOl
Everything in one place: the new hand control places all
User‑friendly and intuitive key table operations right at your fingertips. And thanks to Large, easy‑to‑read display bi‑directional communication with the column, it provides Backlit buttons – perfect for darkened operating rooms real‑time information on the position of the table and the tilt Battery status indicated at all times in upper‑right corner angles, indicates battery charge status, and displays status Bi‑directional communication with the column Available as a corded and cordless IR version Pre-programmed positions: the Status messages: the hand control OTESUS is pre-programmed with a displays various status messages number of standard table positions, indicating, for example, that the including flex, reflex, beach chair, transporter's position needs to be and horizontal. The positions can corrected, or that the table has be selected at the touch of a but- been placed in zero position with- ton, saving valuable time. out leg plates. In addition, it shows the battery charge status of the column and hand control. User-defined positions: users can Zero position settings: OTESUS save up to ten custom positions, makes it possible to set four pre- such as individual surgeons' pre- programmed table settings for the ferred settings. In an eleventh zero position in line with the prefer- memory slot, it is possible to save ences of surgeons and anesthesi- the table's current position: so if a ologists. These can be selected at patient needs to be repositioned in the touch of a button – increasing case of an emergency or for imag- efficiency in the OR. ing, you can quickly return to the saved setting. Table and column lock: the table Smooth, controlled movements: lock function locks the position the table's motorized movements of all plate modules. The column are smooth, controlled, and highly lock blocks all movements originat- precise. Four speeds are available. ing in the column such as height This increases patient safety during adjustment and Trendelenburg and intraoperative repositioning during lateral tilting. This increases patient neurosurgery, microsurgery, and safety, for example during neuro- spine procedures. 12 OTESUS Surgical Workplaces
EASy TO USE AnD ErgOnOmic:
BEnEfiTS fOr SUrgicAl TEAmS
Very high and very low table position possible Easy‑Click interfaces for efficient table module Flat mobile column version Expanded range of angles for patient positioning Pre‑programmable table positions minimize positioning Smooth, controlled table movements time Minimal training required thanks to familiar faster positioning and repositioning
ALPHAMAQUET features Frequently used table positions can be saved and Easy‑to‑use and intuitive hand control recalled at the touch of a button Fast documentation of patient positions, as all key Possibility to return to current position after imaging or information, such as the angles, is shown on the emergency repositioning A choice of four zero positions for various preferences minimal physical exertion
improved positioning possibilities
Large transporter wheels for better maneuverability Expanded range of angles for combinations of Minimal physical strength required for transfer Trendelenburg/reverse Trendelenburg and lateral tilts Table top transfer via hand control or transporter foot pedal Smooth, non‑porous stainless‑steel surfaces are easy to clean Various transporters, table tops, and accessories for the washable model may be machine decontaminated Surgical Workplaces OTESUS 13
cOST-EffEcTivE AnD EfficiEnT:
BEnEfiTS fOr ADminiSTrATOrS AnD plAnnErS
mEDicAl plAnnErS AnD ArchiTEcTS
A long‑term, future‑proof investment that grows with Flexible, modular solution can be adapted to changing Fully compatible with all existing ALPHAMAQUET 1150 New disciplines, procedures and technologies can be and many 1140 table tops and accessories easily accommodated Equipment can be added or replaced gradually Existing table tops and accessories can continue to be used Stationary columns (A and B versions) are compatible with Multifunctional table can accommodate multiple 1120 and 1150 base plates disciplines as neededMore streamlined workflows for greater throughput Motivated OR teams Advice from experienced MAQUET room‑planning specialists greater peace of mind
Insights into compatibility, collision avoidance, space Reliable after‑sales service management, and other issues Trusted qualityNumerous patient safety features 14 OTESUS Surgical Workplaces
mOrE flExiBlE ThAn EvEr
nEw pOSiTiOning pOSSiBiliTiES
OTESUS has been designed to provide even more free‑
ergonomic working environment for surgeons and nurses. dom when it comes to table positions. Thanks to expanded What's more, motorized table movements are now smoother angles for combinations of Trendelenburg/reverse Trendelen‑ and more controlled for greater patient safety, and the hand burg and lateral tilts, there are more patient positioning pos‑ control displays all information necessary for efficient docu‑ sibilities. For the first time, very low table settings are also mentation of patient positions.
possible – for excellent access to incision sites and a more Optimized access for laparoscopic procedures such as colon resection. Precise, controlled, and barely perceptible table top movements increase patient safety during neurology and spinal surgery. A wider height adjustment range enhances ergonomics and allows The hand control clearly displays the angles of Trendelenburg/reverse surgeons to work at their preferred height. Trendelenburg, lateral tilt, and the position of the back plate – for efficient documentation. Surgical Workplaces OTESUS 15
A rAngE Of OpTiOnS fOr All prOcEDUrES
pATiEnT pOSiTiOning ExAmplES
high weight capacity: OTESUS is both highly flexible
and highly stable. The operating table can accommodate a
weight of up to 380 kg / 838 Ibs – providing a high degree
of comfort and safety.
Femoral neck surgery with CFC bars and CFC pelvic plate, 360° radiolucent Shoulder procedures in beach chair position Thorax surgery in lateral position Note: all illustrated patient positions are only examples and incomplete from a nursing / medical viewpoint. If required, additional accessories should be used for patient safety, e.g. body support or vacuum mattresses.
16 OTESUS Surgical Workplaces
A rAngE Of OpTiOnS fOr All prOcEDUrES
pATiEnT pOSiTiOning ExAmplES
Genucubital position for intervertebral disc or rectal surgery Struma surgery Gynecology, lithotomy position Urology, lithotomy position Surgical Workplaces OTESUS 17
Spine surgery, lordosis Spine surgery, cyphosis Low foot setting General surgery, supine position Note: all illustrated patient positions are only examples and incomplete from a nursing / medical viewpoint. If required, additional accessories should be used for patient safety, e.g. body support or vacuum mattresses.
18 OTESUS Surgical Workplaces
mEETing ThE nEEDS Of All DiSciplinES
ThE OTESUS TABlE TOpS
high-quality design: ALPHAMAQUET table tops were
Total compatibility: OTESUS is compatible with all ALPHA‑
designed for today's operating rooms. Side rails compliant MAQUET 1150 and many 1140 table tops. This means you with European or US norms, plus side rails for X‑ray cas‑ can replace the column and transporter while continuing to settes, are fitted as standard. The table top pads are avail‑ use your existing table tops. And because the table tops are able in integrated polyurethane foam (PUR) or special foam modular, you can replace them one by one, whenever need‑ core (SFC). Easy‑care PUR pads are suitable for machine ed – without putting unnecessary strain on your budget. decontamination. Thermo‑modulating SFC padding, on the other hand, adapts to the patient's shape in response to weight and temperature, improving pressure distribution. Both types of padding are radiotranslucent, capable of dis‑charging static electricity, and completely latex‑free.
Modular universal surgical table top 1150.30: universal operating table top for a wide range of applications. Comprises a seat section and a lower back plate for modular assembly to suit a number of surgical dis-ciplines. Made of nickel-chrome steel with guide tracks and guide rails for X-ray cassettes. Automatic zero position for all motorized functions. Universal table top for traumatology and orthopedics 1150.20: maximum of ten sections. Back plate may be tilted by approximately 70° using a motorized mechanism. Seat plate with two separate removable corner pieces. Removable leg plate pair, and two extension bars each with two revolving joints, and basic accessories. PUR padding; also available with SFC padding. Surgical Workplaces OTESUS 19
Universal table top 1150.19: single trunk section with SFC padding. Table top for head surgery 1150.25: maximum of five sections with head Motorized adjustment for longitudinal shift of 420 mm / 17˝ and for leg plate, two-part back plate, seat plate and fixed leg plate. Motorized lon- plates/knee crutches, either individually or jointly. gitudinal shift of 275 mm / 11˝, plus motorized back plate for up/down movement. Leg plate may be tilted downwards manually using pressure-assisted brakes. Integrated PUR padding. Operating table top for vascular surgery, interventional radiology, ortho- Table top for urology, orthopedics and vascular surgery 1150.23: two- pedics and traumatology 1150.16: frameless single trunk plate made of section trunk plate with manual pressure-assisted adjustment of back carbon fiber composite (CFC) material on light metal supports. Longitudi- plate by approximately 30°. Table top with power-driven longitudinal nal shift of 1200 mm / 47" and a lateral shift of 200 mm / 8˝. SFC padding. shift of 400 mm / 16˝. SFC padding. Table top for general surgery and MIS 1150.22: six sections with head Table top for orthopedics, vascular surgery and traumatology 1150.15: plate, trunk plate and four-part leg plate/knee crutch combination single-section trunk plate with motorized longitudinal shift of 475 mm / 19˝. MAQUETMATIC. Table top with motorized longitudinal shift of SFC padding. 475 mm / 19˝. MAQUETMATIC is integrated into the table top with four individually removable sections. Single-handed operation for the control of combined up / down movements. Table top for pediatrics 1140.14: two sections with trunk plate and removable leg plate. SFC padding, 365 mm / 14˝ wide, manual longitudinal shift of 440 mm / 14˝. Note: the photographs include special accessories.
20 OTESUS Surgical Workplaces
mODUlAr AnD flExiBlE:
meeting unique requirements: MAQUET offers a wide range
of modular head plates, upper back plates and leg plates for
a variety of disciplines. Nearly all existing ALPHAMAQUET
accessories can be used with the new OTESUS – helping
protect your valuable investment.
Upper back plates
Surgical Workplaces OTESUS 21
1130.56, 1003.33 22 OTESUS Surgical Workplaces
AnD cOnSTrUcTiOn fEATUrES
OTESUS operating table columns
Built‑in base plate column (A version) Surface‑mounted base plate column (B version)Battery powered column (C version) with lithium‑ion batteries Hygienic Design of all steel components Maximum overall load Advanced transponder technology for recognition of Height without padding (A version) 619‑1159 mm / 24"‑46" individual table top configurations Height without padding (B/C version) 621‑1161 mm / 25"‑46" Clean button allows column movement without table top Lithium‑ion powered mobile column for optimal energy motorized adjustments via hand control
Trendelenburg: head down / foot down All column types are designed in accordance with environ‑ Maximum combined Trendelenburg and mental aspects, and are energy efficient lateral tiltLongitudinal shift (1150.30 table top) Leg plates (1150.30 table top) (individually or synchronously adjustable) Lower back plate (1150.30 table top) Zero position options (four pre‑programmed settings) Stationary column types are compatible with 1150 and Four adjustment speeds: fast, medium, precise, very precise 1120 base plates Angle indicator display: Compatible with all ALPHAMAQUET 1150 and for Trendelenburg, lateral tilt and back plateTwo table lock functions: selected 1140 table tops for column and / or table top Compatible with ALPHAMAQUET transporters Bi-directional hand control
Display of collision warning
Memory function for up to ten table top positions
rAngE Of AvAilABlE OpErATing TABlES
Charging status of column and hand controlService and error messagesPre‑programmed positions: flex, reflex, beach chair and back‑horizontal OTESUS: Stationary built‑in column for 380 kg / 838 Ibs MRT / CT transfer position selectable Table lock for blocking movements Backlight function OTESUS: Stationary surface‑mounted column for 380 kg / 838 Ibs (1160.01B0) Operating table transporter, mechanically washable
OTESUS: Mobile column for 380 kg / 838 Ibs (1160.01C0) Table top transfer possible either by foot pedal or hand control Available in three versions: ALPHAMAQUET: Independently maneuverable column for 225 kg / 496 Ibs (1150.02D0) Trendelenburg adjustment Height and Trendelenburg adjustment Mobile column, C version Surgical Workplaces OTESUS 23
Table top dimensions and height range Trendelenburg / reverse Trendelenburg and lateral tilts Up / down movement of leg plate, back plate, and back modules Stationary column, A version Stationary column, B version -BR-10000834-EN-4 · 05/14 · Subject to modifications due to technical development. , Rastatt · MSW ed trademark of MAQUET GmbH · Copyright by MAQUET for local contact:
Please visit our Websitewww.maquet.com ® MAQUET is a r GETINGE GROUP is a leading global provider of products and systems that contribute to quality enhancement and cost efficiency within healthcare and life sciences. We operate under the three 76437 Rastatt, Germany brands of ArjoHuntleigh, GETINGE and MAQUET. ArjoHuntleigh Phone: +49 7222 932‑0 focuses on patient mobility and wound management solutions. GETINGE provides solutions for infection control within healthcare +49 7222 932‑571 and contamination prevention within life sciences. MAQUET specializes in solutions, therapies and products for surgical interventions, interventional cardiology and intensive care.
United States Court of Appeals For the Seventh Circuit CHRISTINE BJORNSON, MICHAEL J. ASTRUE, Commissioner of Social Security, Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. 10 C 5835—Elaine E. Bucklo, Judge. ARGUED DECEMBER 14, 2011—DECIDED JANUARY 31, 2012 Before POSNER, MANION, and WOOD, Circuit Judges.