Replacing or Upgrading a LINAC? Here’s What You Need to Know

Radiotherapy is a critical treatment process used in hospitals and clinics for patients with cancer. Therefore, it is extremely important to ensure that you are using the right equipment to gain the highest quality of care. Linear accelerator (LINAC) systems are one of the most expensive assets in terms of medical equipment today. Choosing to replace or upgrade LINAC equipment is a significant matter as it impacts the facility’s operations, doctor’s decisions, and the patient’s health. There are four main categories that equipment can fall into that are based on a hospital or clinic’s needs and capabilities.

Newer Equipment with Full Upgrades

Being able to provide the best level of care for patients should be the highest goal for any medical facility. Thus, having new equipment with upgraded features offers the best of the best in terms of care. If a clinic needs to move, it would still be cost-effective to pay the relocation charges, which can be over $100k in expenses, instead of purchasing a new replacement LINAC system.

Newer Equipment with Fewer Upgrades

Choosing a LINAC system with fewer upgrades can save money and might be more appropriate for smaller clinics that see fewer patients. However, specific technologies, like portal imaging, may be beneficial for those who want higher-quality devices. There is a good chance that a facility will be continuing to use this equipment for a while before it depreciates. The best advice is to determine which upgrades would be most appropriate for your office.

Older Equipment with Full Upgrades

If your LINAC system is older than 20 years, it’s likely your machine has paid for itself even after additional upgrades. Older equipment can still be reliable, but as technology progresses, they soon will end up costing you more money and become less efficient. Also, if a company needs to relocate, the relocation costs may end up costing you more than a new machine.

Older Equipment with Fewer Upgrades

This remaining category should generally be looked upon as the last consideration. In most cases, equipment will no longer perform the necessary tasks required for treatments. Replacement parts will continue to become sparse and more costly as new machines come into the marketplace, rendering older versions obsolete.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Beams Used in Radiation Therapy

The use of external beam radiation therapy is one of the most common forms of cancer treatments that a doctor or oncologist will recommend. This method involves radiotherapy equipment such as a linear accelerator that aims radiation from outside of a patient’s body and directly targets local areas of a cancer site. Various types of cancers can be treated with external beam radiation therapy, and depending on the unique characteristics of the tumor, a selection of systems and treatments will be formed for the best outcome. Not only are there different types of machines that can be used, but also the radiation beam used in external radiation therapy can come from three kinds of particles called photons, protons, and electrons.

Photons

The majority of radiation therapy machines use ionizing photon beams since they can reach tumors deep in the body. Photons are also used in x-rays, although they consume a much lower dose of the particle in comparison. The radiation that is delivered during photon treatment will damage the DNA of tumors and healthy cells alike. Radiation therapists aim to maximize the dose targeting the tumor while minimizing the radiation to nearby healthy tissues by creating different paths with multiple fields. To avoid overexposure to healthy cells, the treatment is generally given in stages over repeated scheduled sessions so that the healthy cells have time to repair.

Protons

Charged particle radiotherapy is an alternative method of radiotherapy that uses beams of protons or other positively charged particles such as helium, carbon, or other ions that are not photons. These types of beams can also reach tumors deep inside the body, but they perform differently than photons as they do not scatter radiation on their path and will stop once they reach the targeted tumor. Due to the physical characteristics of charged particles, it may be possible to cover the tumor area with only one radiation field, creating an advantage over the use of photons to spare more healthy tissues and cells. Clinical trials are continuing to compare the usage of these two energy types. There are cancer centers that are beginning to use proton beams in radiation therapy, but they have higher costs and require a larger space to fit the increased size of the equipment.

Electrons

Particles with a negative charge are electrons. Electron beam radiation therapy is designed to treat cancers like lymphoma and other tumors near the surface since these electrons do not go deep into the body. These therapy options can be done in two different ways:

  1. Spot treatment – This method is used for one or more cancerous spots on the body that needs treatment.
  2. Total Skin Electron Beam Therapy (TSEB) – This method is used when the entire surface of the skin needs to be treated. Other treatments called compensation treatments can be part of the treatment plan to guarantee that every area of the skin receives the proper dose required.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment. Radparts provides high quality, user-friendly, and low-cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Solutions for Cooling Systems of a LINAC

LINACs are a type of particle accelerator that increases the kinetic energy of a particle that can be used in a variety of different areas such as scientific research or during radiation therapy to remove cancer cells of a patient. As with most medical and lab-related equipment, particle accelerators are negatively affected by thermal changes, especially with an increase of heat. It is of most importance to maintain temperature control of the equipment components to guarantee the integrity, performance, and reliability of the system. A solution that helps maintain temperature control is using a custom liquid cooling system. We will further discuss this option below so you can adequately care for your LINAC equipment.

How A LINAC Works

A medical linear accelerator (LINAC) produces and delivers a radiation beam using high energy x-rays or electrons to a targeted area to destroy cancer cells while carefully not damaging the surrounding normal and healthy tissues nearby. The medical equipment accelerates electrons in part of the accelerator called the waveguide and then allows the electrons to collide with a heavy metal target to create the high-energy x-rays. The radiation beams are shaped as they exit the machine to conform to the shape of the patient’s tumor. The patient lies on a movable treatment couch and the lasers are designed to be sure that the patient is in the correct position. The couch can move in a variety of directions along with the gantry – the part of the accelerator in which the radiation beam comes from.

Cooling System Needs

When using a LINAC during IMRT (intensity-modulated radiation therapy), the thermal consistency is necessary to maintain beam energy and stability. All the parts inside the equipment such as the tungsten target, waveguide, acceleration chamber, and the magnets need accurate thermal control to eliminate heat buildup and to allow the temperatures to remain the same for optimal usage for operation. Some of the parts within the machine, like the waveguide and filament material, require temperatures within .5 degrees Celsius. The solution to this is to install a liquid cooling system as the best option. In an IMRT system, the cooling path can be complicated. The water starts by cooling the charging drawer and oil pump. It then leads to the liquid cooling system that will decrease the temperature of the entire system, including the linear accelerator.

Types of Liquid Cooling

Liquid cooling systems are ideal for temperature control and stabilizing. They are designed to remove large amounts of heat that is generated in a densely packed electronic environment of a linear accelerator. It may cause concern that liquid coolant is so near all these electrical products but if the cooling system is designed and assembled correctly, there should be no issues. A few reasons these systems are more beneficial opposed to air-based heat exchangers is the ability to provide faster cooling, runs more quietly, and is more reliable with less downtime. Three options for cooling systems are:

  1. Liquid – Air Heat Transfer Configuration – a high-pressure pump that recirculates the liquid coolant and an air heat exchanger to remove heat in the liquid system
  2. Liquid – Liquid Configuration – the pump recirculates the coolant and the facility water is used for a liquid heat exchanger to remove heat from the higher temperature side
  3. Compressor – Based Chiller System – the pump recirculates coolant that is chilled to well below standard temperature

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user-friendly, low-cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Why Buying a Refurbished Linac Makes Sense for a Clinic

When deciding to add or upgrade a facility’s medical linear accelerator (Linac) many factors need to be thoroughly examined such as budget, location, time frames, and other personal impacts. One major decision to make is if to purchase a new or used/refurbished Linac and determining which will offer the best benefits long term. Depending on your situation sometimes a new Linac is required but most often a refurbished option will work perfectly, allowing you to save money as well. Below, are a few reasons to choose a refurbished linear accelerator for your next purchase.

Fewer Patients Being Treated

If your company is new or smaller in size, purchasing a refurbished Linac could be very beneficial. Pre-owned or refurbished Linac’s cost less and have lower monthly lease payments than choosing new equipment. Having fewer than 8 to 10 patients a day is generally considered a small medical facility. With fewer patients equals less money to help cover the costs of equipment fees so taking it low and slow maybe a better business option to guarantee that your clinic continues to grow at a steady pace, allowing quality and effective treatments for all patients. Veterinarian clinics or research facilities may also benefit from a refurbished Linac as they generally do not require all the advanced technologies provided in newer models. The use of linear accelerators may not always be for medical use; instead for industrial uses to image materials.

 Operating with Only One Linac or Want a Backup

Often a dilemma will arise when a company is moving into a new location and cannot afford to have a machine down during the relocation process, which can take about 3 to 4 weeks for the transition. An option to avoid this situation is to purchase a refurbished replacement that is like the existing equipment and have it installed in the new location. Once the new facility is complete and open for business, the patients can receive treatment with the newly refurbished equipment and you can either keep the original linear accelerator as a backup or sell it. This solution prevents companies from losing patients from a lack of available machines.

Other Factors to Consider in Budget

Purchasing a used or new linear accelerator is only the first step in getting the proper equipment setup for your business. Other services that should be researched with your Linac is the warranty, service and maintenance plans. This information will help you decipher which options are best for your facility and meet your needs. Also, remember to consider the costs of equipment removal and disposal. The purchasing and planning process of linacs can be very overwhelming which is why choosing the right company for the job is key for a successful addition/upgrade to your facility.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Should I Buy a Used Linac Over a New System?

Medical-grade Linear accelerators are investments, not an impulse buy. That being said, a linear accelerator is an essential tool in any oncologist office. Owners of a medical oncologist clinic have the option of purchasing a new linac system or invest in a used system, and there are advantages and disadvantages for both. You can essentially break the parameters into three (or more) situations:

Your Office Space

The space and size of your medical office or clinic is a good factor when deciding to go either used or new for a linac system. Smaller clinics will benefit from a used system, especially those with a small client-base that don’t move through more than a handful of patients a day. This also pertains to offices that are new and just getting started, or established offices that are small in space. Offices and clinics just starting up can go with a used system at first and upgrade to a brand-new system when the profits call for it.

Your Intentions

Not all offices and clinics revolve heavily around the use of a linac, but rather use it sparingly. This is a simple reason to go with a used system over a new one. Operating these systems can get expensive, and offices that heavily use a linac system with all the bells and whistles accompanying it have better use for a shiny new device. Conversely, those offices or clinics that only use it sparingly can go with a used model that is more stripped down to a model precisely tuned for their needs. You also may be a new office with the intention of having a higher-level model in the future, but current-day budgets don’t allow it, which calls for a more budget-friendly used system.

Your Experience

Is your office or clinic moving? Do you have any intention of moving in the next year or so? Are you generally a busier clinic with many patients? New linac systems are great for busier and more modern clinics but for those with the need for backup units, a used system is better to keep on hand for when a new system breaks down, especially with all the parts that go into such a device. Similarly, if you’re a clinic that has plans to move everything it may be easier for the future if you go with a used system that will be installed only to be uninstalled for a big move. Even higher-tiered clinics can find themselves moving, so this is something to keep in mind when setting up a clinic initially when starting up.

Medical grade linear accelerators are a product in which all oncologist clinics should be investing. That being said, making a purchase can be smarter when going with a used system rather than new; it just depends on your office space, intentions with the system, and overall experience of running your clinic.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user-friendly, low-cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Knowing the Ins and Outs of Linac Repairs Part 1

Understanding the complexities of linear accelerators can be rather difficult since these machines are such large, expensive machines. A linear accelerator operates by delivering external beam radiation treatments to patients fighting cancer, but they also include additional imaging systems that are attached such as portal dosimetry or onboard imaging which too add to the complexity. Due to such precise functionality of such a variety of parts inside the unit, it is crucial for any clinic to have the proper expertise on-site to work on these machines and know exactly what these systems do.

The Importance Of Treatments

Investing in proper expertise is a very serious matter for the oncology department to consider due to the fact that patients receiving the treatment must continue a regular schedule with as little amount of downtime as possible because of the cumulative effect that radiation has on the cancer cells and if treatment is stopped, the entire treatment process will have to be restarted all over again.

In-Depth Training

A clinical engineer not only needs to know how to complete a repair on a broken or damaged part of a linear accelerator but needs to understand the actual process of how the equipment is designed to work during treatments. Troubleshooting can be very difficult if not familiar with the problem that is being described by the clinic operators. It is part of the technician’s job to be able to translate what an issue could be related to a piece of software or hardware component. Developing this skill set and the understanding of linear accelerators takes a great deal of time and not always be taught in just a few sessions of training during a treatment occurring. Training alone is not effective enough when needing technicians to perform repairs at clinics. Vendor service schools can range anywhere from $20,000 to $30,000 or even possibly higher depend on the level of expertise. The portion for training on linac is roughly 6 weeks of school during a 2-year period however additional schooling can be done for onboard imaging as well. The entire process could take 3 to 4 years to complete which will include hands-on experience.

Finding The Right Time for Repairs

Linac parts are regularly checked during preventative maintenance visits which are generally recommended by the manufacturer to occur 3 to 4 times each year. Each maintenance visit requires detailed checklists and the individualized machines also have onboard alert systems programmed to shut off a device if a problem is found to prevent safety concerns. The most difficult question that needs to be solved is when can time be taken to actual repair the Linac equipment? In many facilities, patients are scheduled every 15 minutes throughout an 8-hour period, 5 days a week. With the importance of continuing treatments for a clinic’s patients, downtime is the worst part of the day. If possible, a technician will bypass the issue and continue limping along, treating patients when possible. Much service work is then performed after hours or on nights/ weekends. Some clinics choose to have a backup machine when these instances occur and one needs repair but this adds on additional costs and still extended hours added to a facility.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Pre-planning Linac Maintenance

Medical linear accelerators have continued to make progress through history since the late 1950’s and pave new ways for curing a variety of different cancers that once were not an option to treat. The design of the equipment combines the use of hardware and software that together gives the advantage of precision and overall success of today’s cancer treatment worldwide. Manufacturing and design continue to evolve and become a better tool for future use in reliability and efficiency but as with all mechanical systems, dysfunction and failures still exist. Having unplanned accelerator downtime and failures can impact a company and its patients very negatively. The scheduled treatments need to be performed at precise times given by the cancer specialists for an effective procedure while fighting against cancer. To avoid these situations from occurring, proper testing and maintenance of the radiology equipment must be done.

Steps During Maintenance

  1. Deliver a daily quality assurance (QA) treatment
  2. Automatically move and examine the log files that are created
  3. Create baselines, then perform daily operating and performance values to statistical process control (SPC) for examination
  4. Investigate if any alarms have been activated
  5. Inform the facility and system service engineers

Trained Professionals

Medical physicists will typically receive basic training of the principals of linear accelerators functionality, but much hands-on experience will be lacking since there is a limited access to linacs that’s are in clinical use but more importantly because these devices can only be adjusted with small set of parameters to maintain. For actual technicians, training for service personnel is generally one of the largest components to a person early on in employment. The process can be lengthy and costly and require unique training from the manufacturer of linear accelerator company.

Scheduled Maintenance and Repairs

Typically, Linac machines will be under an annual service contract that will provide scheduled, preventative maintenance throughout the year to keep the radiotherapy machines running optimally. Keep in mind, older equipment may reach their “end of life” period and may no longer be supported or even worse parts can become sparse or unavailable which may be a reason to start to look for replacement linear accelerators. Extending the life of your current systems with upgrades will be the most cost-effective option for your business. By repairing or upgrading the system this will also not only save money but save precious down time that will need to be taken if having to remove and install new equipment is needed. Not having a machine functioning will mean no treatments being performed which could cost you losing valuable patients.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Installment One – The Process Of Treating Cancer Using Radiation

What is radiation therapy anyway?

Radiation therapy is one of the most common ways to treat cancer.  Depending on the type and nature of cancer being treated will depend on what method radiation is delivered to your tumor.  Most commonly, a linear accelerator is used to deliver external beam therapy.  LINAC machines deliver radiation directly to your tumor, externally.

How does radiation therapy work?

When radiation is delivered using a linear accelerator it is delivered to both cancerous cells and healthy cells. Radiation affects cancerous cells more than healthy cells.  The highest possible dose of radiation is delivered to kill off the cancerous cells.  Smaller doses can be delivered when the aim of treatment is to reduce the size of the cancerous tumor and relieve the symptoms.

Who plans and delivers your treatment?

Cancer oncologists will create a plan of treatment for patients.  When the treatment that is planned requires radiation, a radiation oncologist will oversee the treatment and delivery of radiation.  A team of cancer experts including nurses, specialists, counselors, dieticians, and assistants will help guide you throughout your treatment.

How is your treatment planned?

All cancer treatments are designed with the patient, the type of, and size of cancer.  Radiation therapy is no different.  Before radiation treatment is given patients will visit the facility to go over the plan of treatment that has been designed specifically for them.  Radiation oncologists and radiation therapists will develop a plan based on x-rays and scans from simulators.  Marks are then placed in strategic locations to pin point the areas to be treated.  These marks will be placed each and every visit as the cancerous tumor changes.  For cancers that are in the head, a guidance mask is created from a mold of the patients heads and is used to stabilize and pin point treatment due to the sensitivity of the area.

Does radiation therapy require hospitalization?

Radiation therapy is most often done on an outpatient basis however in some situations your radiation oncologist may recommend that you be admitted if they think it would enhance the success of your treatment.  This is rare and usually does not occur as long as you are able to travel to and from the hospital for treatment.

What tests are performed in conjunction with radiation therapy?

Over the course of radiation treatment your oncologist will want to perform a number of follow up scans and x-rays to make sure the cancer is reacting to the radiation as expected.  Occasionally additional lab work is required and is considered normal and nothing to worry about.

In our next installment on radiation therapy we will look deeper into what you can and cannot do during treatment and ways to combat side effects and more.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

 

 

The Lifespan of a Linear Accelerator Parts

A linear accelerator has a wide range of built-ins that are designed to ensure patients are only given the recommended dose of radiation.  The dosage recommended by the physician should never be ignored or changed as each treatment dosage is unique to each patient.  Linear accelerators are comprised of several parts and mechanisms that age over time.  This article will go over what facilities can expect when it comes to the average lifespan of the parts on LINAC systems, CT scanners, and other radiation oncology devices.

The Lifespan of Linear Accelerator Parts

The lifespan of linear accelerator equipment comes down to two major elements: usage and maintenance.  On average medical facilities can expect that large scaled radiation equipment, such as linear accelerators, to last around 5 to 10 years before they begin to break down.  Regular maintenance of your LINAC system keeps it running smoother, longer.

Examples of medical equipment lifespans are:

  • High use parts like Magnetron and iView detectors can last upwards of two to three years and with average use around four to six years.
  • X-ray tubes with high use last about eighteen months however with low usage can last if four years.
  • XVI detectors can last up to ten years within linear accelerators that have low usage whereas with high usage XVI parts last around five years.
  • Thyratron tubes have a lifespan of anywhere between three to five years.

Age and Usage of LINAC Parts

The average life expectancy of most linear accelerator parts depends on the legitimacy of the parts and the amount they are used. There are some parts that need to be replaced yearly with increased use, like the electron gun, however with low usage can last upwards of six years.

Environmental factors cannot be ruled out as it also affects the ion chamber of a linear accelerator, high humidity can cause a reduced lifespan. While an average ion chamber will only need a replacement after four years, one in an environment with high humidity will need a replacement after a year.

When to Replace Aging Parts

Replacing aging parts over time is necessary to avoid causing any damages to the equipment. Some corporation has a habit of considering the price of the equipment and the costs involved in changing the parts over time, and as such delayed the immediate replacement of an overdue or overused equipment. But, this is never a good yardstick of profit maximization, in the long run definitely, a breakdown of significant parts of the system may be disastrous to the equipment.

As a Linear Accelerator stays over time and ages, errors can creep in and this will have an adverse effect on the accuracy of the equipment.  It is reasonable to expect a good 5 to 10 years of use out of the linear accelerator, but the maintenance also takes its toll on expenses if it stays much longer.

Companies can often get more usage out of a machine and ensure errors are resolved or controlled just by keeping the software up to date and replacing or upgrading linear accelerator parts as at when needed.  Most importantly it is advisable to choose a reputable company to replace your LINAC’s aging parts as the wrong equipment can end up creating more damage to the machine instead of improving its performance. Most companies who sell linear accelerators and parts will have service contracts available that offer varying levels of support.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Preventive Maintenance Increases the Lifespan of LINAC Systems

LINAC systems are just one of the methods that facilities use to administer radiotherapy to patients with cancer. The high cost of this technology necessitates that preventive maintenance be routinely undertaken to extend the life span of linear accelerator parts and other radiation oncology equipment. Linear accelerator parts should be serviced to ensure high quality service delivery to patients. This will go a long way in helping cancer patients to access quality treatment.

The main parts of LINAC systems consist of linear accelerator wave guide and the beam defining system. Other parts include: handle control, couch with controls, touch guard and wall panel to hide stand. Being that it is electrical equipment and it’s in continuous use, the systems will breakdown if not cared for properly which will lead to system breakdown. Therefore, preventive maintenance should be regularly done to ensure that the system works effectively and efficiently. A complex system such as linear accelerators and ct scanners depends on electrical connections, once there is poor connection the machine will malfunction. All parts work in cohesion and if one of them is faulty it will affect other parts.

Linear accelerator parts are expensive and the cost of purchasing a new one is prohibitive.  Proper preventive maintenance should be carried out from time to time. Most LINAC systems use water cooling because a constant temperature need to be maintained to ensure harmonious operation.  However, there is advanced air-cooled chillers for LINAC cooling. This cooling system is expensive but once it is replaced the system works as if it is a new one.

LINAC parts can be procured from the original equipment manufacturer or through local dealers. There are many advantages to buying parts through companies that offer several parts (and services) instead of a more expensive OEM dealer.  Often these companies offer less expensive, refurbished options and OEM parts with warranties.  If the parts should malfunction within the period of coverage of warranty, they can help.  However, one important decision one must make is that whether one should buy refurbished parts or new OEM parts. Refurbished parts are suitable for repairs and maintenance and the cost is lower than buying new ones. This decision is often mostly decided because of your budget however, just know that refurbished parts are just as reliable and as effective so either way you are getting quality parts.

A lot of factors need to be considered when servicing or maintaining LINAC system. One of such considerations is the response time of maintenance company versus original equipment manufacturer. The response time of maintenance companies tend to be quicker than that of the original manufacturer. Therefore, procuring the service of maintenance company will shorten the downtime of the medical equipment. Associated with this is the high level of expertise of engineers working with servicing and maintenance companies.

In most cases, these engineers were trained by original equipment manufacturers hence, the quality of service delivery. Another advantage of servicing and maintenance of linear accelerator parts is that servicing companies have favorable and flexible contract agreement, and this ensure that servicing of equipment is done comprehensively with minimal costs. This contract agreement includes periodical preventive maintenance without extra costs. Routine service and maintenance of LINAC parts are necessary for optimal functioning of the system and it greatly reduces the amount of downtime of the equipment and elongate its lifespan.

Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com.  To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.