The Smart Surgical Partnership

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About ASC

ASC was launched in 1985 with a product portfolio directed towards the neurosurgical
market. In the decade that followed, ASC aggressively developed and marketed new
products to address the evolving needs of neurosurgeons.

In October 2009, ownership of the company changed. The new team is focused on
making ASC the market leader. Since 2009, ASC has been reshaped with a number
of upgrades in technology, manufacturing, and customer service. This has resulted in
launching revolutionary new manufacturing technologies, the implementation of a Six
Sigma program, and the development of proprietary new products. Additional
manufacturing capabilities and processes are planned for implementation under the
objective of continual improvement.

ASC has become a global technology company focused on developing and selling
creative, innovative, and smart medical technologies. We recognize the challenges of
medical procedures and meet them by working directly with physicians, operating room
personnel, and partnering with other companies.

ASC’s products are used across several specialties, including neurosurgery, general
surgery, head and neck surgery, oral surgery/dentistry, orthopedic surgery,
otolaryngology, pediatric surgery, plastic and reconstructive surgery, trauma, vascular
surgery, and veterinary medicine.

ASC has established a global presence with distribution in 6 continents. ASC’s

manufacturing facility and corporate headquarters are located in Salem, Massachusetts.

All ASC products are made in the USA.

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Table of Contents

Focus Products: An overview of ASC’s key product lines:

Ray-Cot®, Delicot®, Telfa®, Americot®, Specialty
(ENT) Products, ArmourSorb®.

Selling ASC: Call points, sales cycle, and probing questions.

Competitive Advantage: The performance benefits of ASC’s product

offerings compared to the leading competitor.

Competition: Understanding of Codman, Medtronics, Deroyal.

ASC’s Ray-Cot® part numbers compared to the
competition.

Current Accounts: A List of current ASC accounts in the territory and

key target opportunities for large volume
conversions.

Other ASC Products: An overview of additional ASC product offerings:

UniqcotTM, UltracotTM, PolicotTM.

Marketing Materials: Sample copies of all marketing materials as well as

important websites.

Admin Documents: Contact information and administrative documents.

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Product Comparison

AMERICOT®
™
Greatest Absorbency ULTRACOT
The capacity of a surgical patty to absorb and retain fluid. TELFA®
LEADING COMPETITOR

DELICOT®
®
TELFA
Best Pliability RAY-COT®
The degree of flexibility of the patty to freely bend,
mold, or otherwise be shaped to conform to tissue. UNIQCOT™
LEADING COMPETITOR

AMERICOT®
Longest Moisture Retention ULTRACOT™
How long a patty retains fluid before it dries, clings, TELFA®
and potentially damages tissue upon removal.
LEADING COMPETITOR

POLICOT™
™
UNIQCOT

Strongest AMERICOT®
The ability of a patty to resist tearing when moist. DELICOT®
Measured by tensile strength.
RAY-COT®
LEADING COMPETITOR

DELICOT®
POLICOT™
Best Fluid Aspiration RAY-COT®
The ability to filter fluids through the patty via
suction to protect delicate structures. UNIQCOT™
LEADING COMPETITOR

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Product Overview

Ray-Cot® - The “standard” pattie, targeted for large volume hospital wide
business.

Delicot® - Designed for micro-surgical procedures. Low volume, premium

product targeted to Neurosurgeons and ENT surgeons performing Skull
Base Key-Hole procedures.

Telfa® - Replacement for current practice of cutting large Telfa® sheets.

Unlike the larger sheets, ASC’s precut Telfa® provides superior countability
and x-ray detectability.

Americot® - High absorbency and softness for surgeons accustomed to

working with cotton. Targeted to surgeons experienced with cotton.

Specialty (ENT) Products - Variety of specialty products designed for ENT

surgeons. Cotton Balls also are an improved replacement for standard
cotton balls, as they provide x-ray detectability and are available with and
without locator strings. Cotton Balls, Peanuts, and Kittners are ideal for
spacing during procedures.

ArmourSorb® - Revolutionary tissue protection around instruments.

Targeted to Neurosurgeons and Neurotologists performing Skull Base
Key-Hole procedures and, potentially, Spine Foraminotomy procedures.

Telfa® is a registered trademark of Covidien plc

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Ray-Cot

Ray-Cot® Summary:

Made from 100% rayon.

Comparable thickness to competitor products while offering superior

softness, strength, and pliability.

Available in 24 different sizes ranging from 6 x 6mm to 89 x 152mm, with a

radiopaque marker and a locator string.

Packaged in boxes of 200. 20 pouches of 10 patties positioned on a unique

counting card.

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Ray-Cot
Target:
Any surgeon that uses a neurosurgical pattie. Ray-Cot® is ASC’s version of
the standard pattie and should be your first option for hospital wide usage
and competitive bid situations.

Used in Orthopedics, ENT, Spine, and Craniotomies.

Why Switch to ASC:

- Superior softness, not “scratchy”

- Greater pliability allowing for easier contouring to delicate tissue
- X-Ray detectable and equipped with a sewn locator string

Ray-Cot® uses a special rayon material that offers superior flexibility,

softness, and absorbency. The locator string is sewn onto the sponge rather
than welded.

Product Positioning:
Ray-Cot® is comparable to the standard neurosurgical pattie but offers
superior strength, softness, pliability, and absorption properties.

ASC offers volume based discounts allowing for greater cost savings in
hospital wide conversions.

Important to have a “champion” to assist in converting the hospital wide

pattie business and help move it through the process.

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ASC vs Codman
NOTE: Ray-Cot should always be the first alternative to Codman
(also to Medtronics or Deroyal)

Codman Claims ASC Difference ASC Product Offered

Over 30 Years of providing Over 30 years with little change in their core Absorbency - Americot, Ray-Cot
quality products. neurosurgical pattie. Whereas ASC adapts to new Pliability - Delicot
surgical techniques with a variety of solutions. ASC Strength - Policot
believes there is not one solution for all situations. Low Adhesion - Telfa

Codman surgical patties & strips
provide the neurosurgeon with
softness, gentleness, protection, and
absorbency to meet demands of
delicate intracranial and spinal
surgery.
It’s difficult for one pattie to provide softness and
gentleness, while also maintaining strength. Codman
switched to synthetic rayon because it adds strength
to the pattie compared to cotton. Many customers
complain, especially children’s hospitals, that the
Codman pattie is stiff and scratchy and have switched
to ASC’s 100% US Cotton Americot.
Americot - 100% Premium US Cotton
provides better softness and absorbency
than the traditional Codman pattie.
Ray-Cot - ASC’s improved Ray-Cot
material adds superior softness and
absorbency to the standard pattie.

Absorbency - Patties and Strips
absorb more than 5 times their
weight in less than a second.
Precision Cut - Patties and Strips are
precision cut to provide smooth
edges and help to prevent linting.
Soft and Gentle - Sutureweld’s strong
bond holds the indicator string to
the pattie so the surface, which lies
next to the tissue, is completely
smooth and free of stitches.
Cottonoid Material - Compressed
rayon provides the natural
softness, absorbency, and
pliability of cotton. A special
process interweaves individual rayon
fibers to reduce shedding, stretching,
or linting - wet or dry.
Pliable and Porous - Cottonoid
material offers the advantage of
being porous so patties and strips
easily conform to intricate contours
of delicate tissue. Yet, you can safely
suction through them without
aspirating the tissue or the pattie or
strip.
X-Ray Detectable - Marking is where
it should be, on the pattie or strip.
Unique Packaging - A transparent,
sterile envelope shows the size and
shape of the patties and strips, and
the Count Verification Card instantly
shows how many patties you started
with and how many were used.
ASC’s Americot absorbs over 11 times its dry weight, Americot, Ultracot, Ray-Cot
Ultracot absorbs nearly 10 times its dry weight,
Ray-Cot absorbs up to 12% more than Codman.
ASC product is also precision cut with further All Products
improvements made through our newly
engineered manufacturing equipment.
ASC’s string is stitched to the pattie rather than All Products
welded to ensure that the string will not come lose
from the pattie.
The Cottonoid brand name insinuates, and many Ray-Cot - Made from an improved rayon
customers believe, that the Codman pattie is material providing superior performance.
cotton. It is actually a synthetic rayon.
Delicot - Market leader in pliability.
Americot - Made from 100% Premium US
Cotton.
All ASC material provides for aspiration. We have Delicot. With its thin profile and hybrid
material such as Delicot that is designed to work in material, Delicot allows for optimal
intricate countours and around delicate tissue. pliability and aspiration.
Codman incorporates two separate radiopaque All products.
marker lines on their standard pattie, which reduces
pliability. ASC has a single radiopaque marker, which
is smooth and allows for greater
flexibility.
ASC also offers transparent pouches and an improved All products.
Count Verification Card that not only makes it clear
which products were used, but can also stand on its
own on the operating tray thereby taking up less room
and making count reconciliation during procedures
easier to perform.

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Delicot

Delicot® Summary -

Developed in association with Dr. Takanori Fukushima specifically for

application in Skull Base Key-Hole procedures.

Delicot® offers the surgeon a product that is very thin (0.33mm), presenting a
low profile, thereby not impeding visibility in tight operating areas. Without
sacrificing product strength, it is also extremely pliable, making it ideal for
wrapping delicate tissue.

ASC recently created a 2 x 20mm Delicot® pattie (P/N 63x00) ideal for
protecting the facial and cochlear nerves during the Resection of the Internal
Auditory Canal (IAC) mass of the Acoustic Neuromas.

Available in 11 different sizes ranging from 2 x 20mm to 30 x 70mm.

63x00 is packaged in boxes of 100. 10 pouches of 10 patties positioned on a

unique counting card.

All other sizes packaged in boxes of 200. 20 pouches of 10 patties

positioned on a unique counting card.

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Delicot
Target:
Neurosurgeons performing micro-neurosurgical procedures such as Skull
Base Key-Hole, Endovascular, or Acoustic Neuromas. Delicot® was
developed to be used in tight spaces and delicate procedures.

Note: 2 x 20mm (63x00) was designed primarily for protecting Cranial

Nerves VII and VIII during Acoustic Neuroma Resections. Only pattie on the
market that is 2mm wide.

Why Switch to ASC:

Due to limited space, the standard neurosurgical pattie is too thick thereby
obstructing the view under a microscope. A standard pattie is also too rigid
and not delicate enough for micro-neurosurgical procedures.

Delicot® is extremely pliable, making it ideal for conforming to varying

surfaces allowing for improved protection, wrapping, and the identification
of important structures (i.e. Cranial Nerves VII and VIII).

Product Positioning:
Delicot® is the market leader in pliability and, due to its thin profile, Delicot®
is ideally suited to neurosurgeons performing delicate micro-surgical
procedures.

Delicot® is a surgery specific, premium product. As it is lower volume than

the standard pattie, pricing should not be a factor in the decision to use the
product. Also, since it is a specialty product, it usually does not have to go
through an evaluation committee.

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Telfa

Telfa® Summary -

Utilizing Covidien’s Telfa® material, our Telfa® patties provide optimal

absorbency while providing reduced adherence to the underlying tissue.

Commonly placed under retractors by surgeons who wish to provide extra

cushioning and protection to underlying delicate tissue, ASC’s Telfa® patties
provide a safer alternative to surgeons who currently create their own
Telfa® strips by cutting larger sheets. ASC’s Telfa® patties are equipped with
a locator string and a radiopaque marker to allow for x-ray detection should
a pattie be misplaced, thereby reducing the potential for gossypiboma.

Available in 12 different sizes ranging from 13 x 13mm to 25 x 152mm, with a

radiopaque marker and a locator string.

Packaged in boxes of 200. 20 pouches of 10 patties positioned on a unique

counting card.

Telfa® is a registered trademark of Covidien plc

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Telfa
Target:
Neurosurgeons performing craniotomies. The primary market is surgeons
performing craniotomies, but Telfa® may also be suited for spine procedures.

Telfa® can also be presented to OR Nurses who are not satisfied with the
current practice of cutting larger sheets. ASC’s Telfa® provides the nurses
with easier handling (no cutting required) and improved traceability to
reduce the potential for gossypiboma and to aid in post-procedural
counting.

Why Switch to ASC:

ASC’s precut Telfa® patties and strips are the same material as the large
sheets already in the Operating Room, but are precut to 12 different sizes;
each x-ray detectable. All Telfa® patties have a locator string to aid in
locating and counting during and after procedures.

ASC’s precut Telfa® patties and strips allow for the product to be left
in-situ for a longer period of time due to the non-adherent layer on the
outside of the pattie. The soft cotton core provides ideal protection, often
used as cushioning between a retractor blade and delicate tissue.

Product Positioning:
The product is a superior alternative to the current practice of cutting
larger Telfa® sheets. ASC’s precut Telfa® patties and strips provide the same
features and benefits of the larger Telfa® sheets with the added benefit of
not having to cut strips during procedures and the superior traceability
provided by the locator strings and x-ray detectability.

Telfa® is a registered trademark of Covidien plc

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Americot

Americot® Summary -

Created with 100% Premium US Cotton rendering it soft and hypoallergenic

to minimize tissue irritation.

Provides the ideal solution for those concerned with absorption.

Americot® is also more pliable than the leading competitor.

Americot® offers the excellent performance, protection and moisture

retention of 100% natural US Cotton.

Available in 30 different sizes ranging from 3 x 3mm to 89 x 152mm, with a

radiopaque marker and a locator string.

Packaged in boxes of 200. 20 pouches of 10 patties positioned on a unique

counting card.

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Americot
Target:
Americot® products should be positioned to surgeons accustomed to
working with natural cotton. Americot® offer superior absorption
properties, but has to be handled with greater delicacy as there are more
likely to be loose fibers due to the inherent characteristics of natural cotton.

Why Switch to ASC:

ASC is one of the few suppliers of 100% natural cotton patties. Americot®
is manufactured from high quality US cotton, ensuring that it meets certain
FDA quality criteria unlike many foreign sources.

Product Positioning:
Americot® offer superior softness and absorbency than synthetic products.
Due to its thicker profile, Americot® offer superior cushioning between tissue
and instruments.

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Specialty Products

Products developed for a variety of procedures beyond neurosurgery.

Every hospital uses similar products.

Each product has a radiopaque marker.

Cotton Balls
Made from 100% Premium Cotton

Each cotton ball contains a radiopaque marker to allow for x-ray detection
should a cotton ball be misplaced during a procedure, thereby reducing the
potential for gossypiboma.

Available both with, and without, a locator string.

Uses extend beyond neurosurgery. Can be used in ENT procedures,

Orthopedics, or any procedure where small pieces of absorbent cotton are
needed.

Available in 8 different sizes ranging from 3mm in diameter to 51mm in

diameter.

Packaged in boxes of 100. 20 pouches of 5 cotton balls.

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ArmourSorb® Deflection Device
®
DEFLECT TO PROTECT®

ArmourSorb® is our newest advancement in soft tissue protection and was developed to
provide an extra layer between soft neuro tissue and the incidental contact of rotating
instruments by combining the absorbency and moisture retention of traditional sponges on
the proximal side with a proprietary layer on the distal side to protect the tissue. Designed
for procedures such as Craniotomies, Acoustic Neuromas, Spinal Laminoplasties and
Laminectomies, or anywhere soft tissue is exposed to instrumentation.

“Use of the ArmourSorb® device is a simple and safe way of protecting the dura or
soft tissues during skull base surgery. They provide good absorption while
minimizing the risks of using high speed drills for bone removal, during both
craniotomy and opening of the internal auditory canal”

E. Michaelides, MD
Asst. Professor Surgery-Otolaryngology
Yale School of Medicine

Conventional Patties Lack Durability

The destruction of conventional surgical patties may lead to:
- Procedure Failure
- Gossypiboma
- Challenges in the sponge/pattie accounting process
- Increased duration of procedure

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Introducing...
ArmourSorb® Deflection Device
DEFLECT TO PROTECT®
Target:
Neurosurgeons and Neurotologists performing skull based key-hole
procedures and, potentially, Spine Foraminotomy procedures.

Why Switch to ASC:

ArmourSorb® is the only product on the market that allows for the trusted
properties of a neurosurgical pattie to be placed in proximity to a rotating
surgical instrument without fear of the device getting caught by the
rotating instrument.

Product Positioning:
A revolutionary new type of protection that had hitherto not been available
to the surgeon. The placement of the ArmourSorb® device allows not only
for additional protection during the use of a high speed drill, but can open
up the area available for use of the high speed drill by protecting tissue near
which the surgeon, prior to the availability of an ArmourSorb® device, may
have been reluctant to drill.

While a premium product and priced accordingly, the intended volume is

only 3-4 ArmourSorb® pouches in a procedure, therefore the overall added
cost to a single procedure would be $75-$100. In return the surgeon and
patient receive unprecedented tissue protection.

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Uniqcot

UniqcotTM Summary -

Made from 100% Rayon.

At 0.5mm thick, UniqcotTM provides the solution for those looking for a
slightly thinner option than the standard pattie with similar properties to
Ray-Cot®, but for those who do not require the ultra-thin profile of Delicot®.

Available in 24 different sizes ranging from 6 x 6mm to 89 x 152mm.

UniqcotTM also has a radiopaque marker and locator string.

Packaged in boxes of 200. 20 pouches of 10 patties positioned on a unique

counting card.

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Ultracot

UltracotTM Summary -

For those who enjoy the absorption and softness offered by 100% natural
US cotton but are looking for a thinner alternative (0.61mm thin). Due to
its thinner profile, UltracotTM is also more pliable than the standard pattie.
Made from 100% US Cotton, UltracotTM provides greater softness and
absorption than the leading pattie on the market.

Available in 15 different sizes ranging from 4 x 8mm to 70 x 100mm in

diameter. UltracotTM has a radiopaque marker and locator string.

Packaged in boxes of 200. 20 pouches of 10 patties positioned on a

counting card.

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Decision Tree
Neurosurgeon: Represents the majority of the standard pattie sales volume.
Has influence with administration and, if convinced of the
benefits of ASC’s products, can be a valuable and influential
champion in converting the hosptial-wide business.

OR Nurse / They have a good relationship with neurosurgeons. Though

they may not be involved in the final decision, they can
Neurocoordinator: provide assistance in working with the neurosurgeons in
converting them to ASC’s products. They can also help
arrange for product evaluations.

Can be approached directly with ASC’s Telfa® and Cotton

Balls due to the product’s x-ray detectability and locator
strings.

OR Materials Manager: Are concerned more with how we can make their job easier.
Focus on ASC’s ability to be a sole supplier for all their
surgical pattie needs.

Also, they are a good resource for volume of materials

purchased, both for those held in stock and for procedure
trays.

Purchasing: Primarily concerned with pricing and must have approval of

the above prior to presenting.

Focus on ASC as a sole supplier for all their surgical pattie

needs, thereby saving them time and money and making their
purchasing system more efficient. Also, ASC provides
volume and multi-product line discounts thereby saving them
additional money.

Telfa® is a registered trademark of Covidien plc

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Some Questions
General Questions/Ray-Cot® Questions:
What kind of procedures are you performing?
What characteristics are most important to you in selecting a pattie?
What characteristics would make up your “ideal” pattie?
What patties do you use at the moment?
Are you satisfied with their performance and/or quality?

Delicot® Questions:
Do you perform microsurgical procedures, such as skull based key-hole neurosurgical procedures?
Would a thinner profile and improved visibility under a microscope be a benefit to you?
Does a standard pattie offer enough pliability for wrapping delicate tissue?
63x00 Questions:
Do you perform acoustic neuroma resections?
If so, would you benefit from a 2x20mm micro pattie to help identify and protect vital tissue and
structures, such as the Cranial Nerves VII and VIII?
Would the application of such a pattie provide additional protection in your attempts to reduce the
potential for damage and preserve hearing?

Telfa® Questions:
Do you currently cut large Telfa® sheets into individual patties or strips?
If so, are there any concerns in tracking the number used in a procedure?
Would a precut Telfa® pattie that has a locator string and is x-ray detectable mitigate those concerns?
Would it save time and increase operating room efficiency during a procedure.

Americot® Questions:
Do you find the standard pattie to be too rigid or “scratchy”?
Have you used 100% cotton patties before?

ArmourSorbTM Questions:
Do you currently place a pattie in the surgical field when using a high speed drill?
When drilling, are you concerned with the tissue in proximity to the bone or dura?
If there was a pattie that offered the same absorbency as a standard pattie without the risk of it
being caught by the drill burr, would you consider placing it to protect tissue while drilling?
Do you believe a protective pattie that can deflect the drill burr would be beneficial to less
experienced neurosurgeons and resident fellows?

Purchasing Questions:
Are you satisfied with your current supplier of patties?
If you could change one thing about your current supplier what would that be?
Are you interested in same day shipments?
Would a single supplier of all of your neurosurgical patties save you time and money and make your
ordering process more efficient?
What would encourage you to switch all of your neurosurgical pattie business to ASC?
Telfa® is a registered trademark of Covidien plc
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Important Websites

Company Pages:

ASC Website: www.AmericanSurgical.com

ArmourSorbTM Website: www.ArmourSorb.com

Marketing Materials:

Distributor Page: www.AmericanSurgical.com/For-Distributor

Youtube: https://www.youtube.com/channel/UCQtYtmcz4HZyS2olHCnniLw

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