_ _ _
FOR CITY CLERK ONLY
Council Meeting:
Disposition:
SAN RAFAEL CITY COUNCIL AGENDA REPORT
Department: Fire
Prepared by: Abraham Roman, Fire Chief
Jason Hatfield, EMS Battalion Chief
Thomas Wong, Sr. Mgmt. Analyst
City Manager Approval:
TOPIC: EMS EQUIPMENT REPLACEMENT
SUBJECT: AUTHORIZE THE CITY MANAGER TO PURCHASE THIRTEEN CARDIAC MONITORS,
TWO POWER LOAD GURNEYS, AND FIVE STAIRCHAIRS IN AN AMOUNT NOT TO EXCEED $678,237
RECOMMENDATION:
1. Authorize the City Manager to purchase thirteen cardiac monitors, two power load gurneys, and five stairchairs through a cooperative purchase agreement from Stryker in an amount not to exceed $678,237.
2. Authorize a budget appropriation from the Emergency Medical Services Fund (Fund 210) for the purchase of the equipment.
BACKGROUND:
The San Rafael Fire Department (SRFD) regularly replaces equipment to ensure a safe and effective emergency response. This life safety equipment has limited life spans, and replacements have been suggested at specific intervals. SRFD evaluates all equipment and, if it is safe to do so, extends the life of certain equipment based on each item and the risk of failure. SRFD worked on a comprehensive plan to address the equipment replacement needs over the next three to five years, and they determined the following items were most critical.
Cardiac Monitors: Twelve-lead capable cardiac monitors are a critical component of SRFD’s Emergency Medical Services (EMS) program, enabling paramedics to detect life-threatening conditions such as STelevation myocardial infarctions (STEMIs). These devices provide detailed 12-lead heart images, allowing paramedics to identify STEMIs in the field and initiate rapid transport to a cardiac catheterization lab. The early detection of STEMIs is crucial, as patients benefit most from procedures such as arterial stent placement, which can only be performed in a cardiac catheterization lab.
By identifying STEMIs early, our paramedics can alert the cardiac catheterization lab team in advance, ensuring they are prepared to treat the incoming patient. In many cases, our paramedics can transport STEMI patients directly to the catheterization lab, significantly reducing the “door-to-balloon” time—the interval between the patient's arrival and the start of treatment. This rapid intervention maximizes the Agenda Item No: 4.c
Date: November 18, 2024
SAN RAFAEL CITY COUNCIL AGENDA REPORT / Page: 2
patient’s chances of survival and recovery.
In addition to detecting STEMIs, cardiac monitors serve multiple vital functions on all medical emergency calls. They allow paramedics to continuously monitor key patient vitals, including blood pressure, pulse oximetry, heart rate, and carbon monoxide (CO) and carbon dioxide (CO2) levels. With SRFD responding to over 12,000 calls annually—approximately 70% of which are medical - our current 12-lead capable cardiac monitors are indispensable tools used daily in the field.
SRFD provides Advanced Life Support (ALS) from each fire engine, truck, and ambulance. This includes 13 different apparatus, all staffed with paramedics and capable of delivering ALS care. The cardiac monitors are part of the essential equipment required by Marin Emergency Medical Services for ALS units, ensuring we can meet the needs of our community.
In 2017, SRFD purchased the cardiac monitors that are currently in use. Over the past eight years, these monitors have been used extensively on medical calls and are approaching the end of their service life.
To continue delivering the highest standard of care and comply with required ALS equipment standards, we must replace these aging devices with new, reliable models.
This investment will ensure that SRFD can continue providing life-saving advanced cardiac care and remain compliant with operational standards, all while enhancing patient outcomes in our community.
Power Load Gurneys: SRFD currently operates a fleet of six ambulances, each equipped with an electronically powered gurney that allows for the raising and lowering of the cot with the press of a button.
These power load gurneys, which were introduced approximately 20 years ago, have become the industry standard for both patient and paramedic safety. By reducing the physical strain on paramedics and improving the stability of patient transfers, these gurneys play a crucial role in minimizing injury risks and enhancing the overall efficiency of emergency medical services.
With the addition of two new ambulances in October 2024, SRFD will retire its two oldest ambulances, each equipped with 12-year-old power gurneys. These gurneys are now at the end of their service life and have begun to require frequent service and repair, which is costly and operationally inefficient.
Replacing these aging gurneys with new models will ensure compatibility with the power load systems in our new ambulances and provide enhanced reliability and safety for both patients and paramedics.
ANALYSIS:
SRFD has conducted a comprehensive evaluation of cardiac monitors, stairchairs, and gurneys from several leading manufacturers, including Stryker, Zoll, Phillips, and Ferno. After careful consideration, it has been determined that continuing with our current medical device provider, Stryker, will provide operational and financial efficiencies for SRFD.
Remaining with Stryker offers several key benefits:
• Training Efficiency: Since the proposed equipment operates similarly to our existing Stryker devices, the time and resources required to train firefighters on the proper use of the new equipment will be significantly reduced. This consistency makes our personnel proficient and ensures a seamless transition to the upgraded devices.
• Operational Compatibility: SRFD currently operates seven Stryker power gurneys, all compatible with the power gurney lift mechanisms installed in each of our ambulances. Introducing a gurney from a different manufacturer that is not compatible with these lift systems would prevent us from rotating gurneys between ambulances, which is a critical practice when gurneys are out of service for repairs or maintenance. Maintaining the same manufacturer allows for the flexibility to rotate equipment as needed without disrupting operations.
SAN RAFAEL CITY COUNCIL AGENDA REPORT / Page: 2
By standardizing equipment across SRFD, we also mitigate the risks associated with using multiple platforms, which can create unnecessary complications in both operations and maintenance. This consistency reduces the need for specialized training on different systems and streamlines the supply chain for repairs and parts.
Additionally, the Stryker products are purchased through a Sourcewell cooperative purchase agreement that ensures that the products have been competitively bid and are being acquired at the lowest price. In addition to the Sourcewell pricing, SRFD is maximizing cost recovery through the sale of the existing equipment back to Stryker.
FISCAL IMPACT:
The total anticipated cost of the EMS equipment is $678,237 (Attachment 1). Appropriations of $678,237 are requested for this purchase, from available fund balance within the Emergency Medical Service Fund (210).
OPTIONS:
The City Council has the following options to consider on this matter:
1. Authorize the City Manager to purchase thirteen cardiac monitors, two power load gurneys, and five stairchairs in an amount not to exceed $678,237 and authorize the appropriation of available funding from the Emergency Medical Services Fund (Fund 210) for the purchase of the equipment.
2. Do not approve the purchase and provide further direction to staff.
RECOMMENDED ACTION:
1. Authorize the City Manager to purchase thirteen cardiac monitors, two power load gurneys, and five stairchairs through a cooperative purchase agreement with Stryker in an amount not to exceed $678,237.
2. Authorize a budget appropriation from the Emergency Medical Services Fund (Fund 210) for the purchase of the equipment.
ATTACHMENTS:
1. Quote from Stryker
Quote Summary
Delivery Address Sold To - Shipping Bill To Account
Name: SAN RAFAEL FIRE DEPT Name: SAN RAFAEL FIRE DEPT Name: SAN RAFAEL FIRE DEPT Account #: 20179643 Account #: 20179643 Account #: 20179643 Address: 1375 5TH AVE Address: 1375 5TH AVE Address: 1375 5TH AVE SAN RAFAEL SAN RAFAEL SAN RAFAEL
California 94901-1942 California 94901-1942 California 94901-1942 Equipment Products:
# Product Description Qty List Price Sell Price Total
1.0 70335-000042 LP35,EN-US,MAS-SP/CO,MED-CO2,SUNNIBP,12L,WIFI/CELL/LN/CPRIN,STD,BT13 $51,400.00 $41,120.00 $534,560.00
2.0 650705550001 6507 POWER PRO 2, HIGH CONFIG 2 $38,543.00 $30,834.40 $61,668.80
3.0 11140-000102 LIFEPAK FLEX Battery Charger 11 $3,000.00 $2,550.00 $28,050.00
4.0 11335-000005 LIFEPAK Printer Kit 4 $3,000.00 $2,400.00 $9,600.00
5.0 650700450301 ASSEMBLY, BATTERY CHARGER 2 $1,616.00 $1,292.80 $2,585.60
7.0 650707000002 KIT, ALVARIUM BATTERY, SERVICE 2 $1,129.00 $903.20 $1,806.40
8.0 11335-000001 LIFEPAK FLEX Lithium-Ion Battery 13 $1,000.00 $800.00 $10,400.00
9.0 11996-000520 LNCS-II Reusable rainbow 8-wavelength Pediatric Sensor
13 $978.00 $684.60 $8,899.80
10.0 11996-000519 LNCS-II Reusable rainbow 8-wavelength Adult Sensor 13 $889.00 $622.30 $8,089.90
11.0 11335-000008 LIFEPAK 35 Storage Bag Kit 13 $600.00 $510.00 $6,630.00
12.0 11111-000041 LIFEPAK 3-wire extended precordial ECG cable 13 $120.00 $96.00 $1,248.00
13.0 11260-000073 Shoulder Strap 13 $75.00 $63.75 $828.75
14.0 650700450102 ASSEMBLY, POWER CORD, NORTH AM 2 $37.00 $29.60 $59.20
19.0 6252000000 Stair-PRO Model 6252 5 $5,076.00 $4,060.80 $20,304.00
19.1 6252009001 Stair-Pro Operations Manual $0.01 $0.00 $0.00
19.2 6250001162 In-Service Video (DVD) $0.01 $0.00 $0.00 2024 Upgrade
Quote Number: 11014792 Remit to: Stryker Sales, LLC
21343 NETWORK PLACE
CHICAGO IL 60673-1213
USA
Version: 1
Prepared For: SAN RAFAEL FIRE DEPT Rep: Nate Bollinger Attn: Email: [email protected]
Phone Number: (916) 716-9873
GPO: Sourcewell contract 041823-STY
Quote Date: 11/07/2024
Expiration Date: 02/05/2025
Contract Start:
Contract End:
11/01/2024
10/31/2025
1 Stryker Medical - Accounts Receivable - [email protected] - PO BOX 93308 - Chicago, IL 60673-3308 # Product Description Qty List Price Sell Price Total
19.3 6252026000 Common Components $0.01 $0.00 $0.00
19.4 6250021000 2 Piece ABS Panel Seat $0.01 $0.00 $0.00
19.5 6250160000 Polypropelene Restraint Set(Plastic Buckles) $0.01 $0.00 $0.00
19.6 6252022000 Main Frame Assy Option $0.01 $0.00 $0.00
19.7 6250024000 Standard Length Lower LiftHandles $0.01 $0.00 $0.00
19.8 6252027000 Footrest Option $422.00 $337.60 $1,688.00
19.9 6252025000 IV Clip Option $213.00 $170.40 $852.00
20.0 11330-000026 LP35 Docking Station 4 $3,200.00 $2,560.00 $10,240.00 Equipment Total: $707,510.45
Trade In Credit:
Product Description Qty Credit Ea. Total Credit
TR-LP15H-LP35 TRADE IN LP15 V4 HIGH FOR LP35 13 -$8,000.00 -$104,000.00 TR-SSC-LP35 TRADE IN STRYKER STAIR-PRO FOR LP35 5 -$500.00 -$2,500.00 TR-SPCOT-LP35 TRADE IN STRYKER POWER COT FOR LP35 2 -$4,000.00 -$8,000.00 Data Solutions:
# Product Description Qty List Price Sell Price Total
6.0 11150-000020 LIFEPAK Cellular Modem, North America 13 $1,500.00 $1,200.00 $15,600.00
18.0 81000001 EMS Pro Tier 1: <5,000 annual run volume.
Includes: device set up tools, asset management,
transmission connectivity, ePCR integration,
LIFENET Care app and browser access for
communication, live streaming and post event
analytic tools.
1 $518.00 $492.10 $492.10
Data Solutions Total: $16,092.10
2024 Upgrade
Quote Number: 11014792 Remit to: Stryker Sales, LLC
21343 NETWORK PLACE
CHICAGO IL 60673-1213
USA
Version: 1
Prepared For: SAN RAFAEL FIRE DEPT Rep: Nate Bollinger Attn: Email: [email protected]
Phone Number: (916) 716-9873
GPO: Sourcewell contract 041823-STY
Quote Date: 11/07/2024
Expiration Date: 02/05/2025
Contract Start:
Contract End:
11/01/2024
10/31/2025
2 Stryker Medical - Accounts Receivable - [email protected] - PO BOX 93308 - Chicago, IL 60673-3308 Price Totals:
Estimated Sales Tax (11.070%): $65,646.26
Freight/Shipping: $3,488.00
Grand Total: $678,236.81
Comments/Terms/Signatures
Prices: In effect for 30 days
Terms: Net 30 Days
Terms and Conditions:
Deal Consummation: This is a quote and not a commitment. This quote is subject to final credit, pricing, and documentation approval. Legal documentation must be signed before your equipment can be delivered. Documentation will be provided upon completion of our review process and your selection of a payment schedule. Confidentiality Notice: Recipient will not disclose to any third party the terms of this quote or any other information, including any pricing or discounts, offered to be provided by Stryker to Recipient in connection with this quote, without Stryker’s prior written approval, except as may be requested by law or by lawful order of any applicable government agency. A copy of Stryker Medical's terms and conditions can be found at https:// techweb.stryker.com/Terms_Conditions/index.html.
2024 Upgrade
Quote Number: 11014792 Remit to: Stryker Sales, LLC
21343 NETWORK PLACE
CHICAGO IL 60673-1213
USA
Version: 1
Prepared For: SAN RAFAEL FIRE DEPT Rep: Nate Bollinger Attn: Email: [email protected]
Phone Number: (916) 716-9873
GPO: Sourcewell contract 041823-STY
Quote Date: 11/07/2024
Expiration Date: 02/05/2025
Contract Start:
Contract End:
11/01/2024
10/31/2025
3 Stryker Medical - Accounts Receivable - [email protected] - PO BOX 93308 - Chicago, IL 60673-3308