WARNING – All used products should be properly decontaminated prior to handling. External fixation devices removed in a clinic or operating room are contaminated unless properly decontaminated by trained hospital personnel who follow the procedures outlined in the Cleaning and Sterilization Methods for Smith & Nephew, Inc. Orthopaedic Medical Devices, available from S&N Customer Service (800-238-7538) or online at http://global.smith-nephew.com/us/DECONTAMINATION.htm.

STEP 1
Verify that the used products for which reprocessing is desired are listed on the Jet-X^◊ Bar Recertification Request Checklist.

STEP 2
Decontaminate all used products prior to shipping or handling. Follow the instructions in the Cleaning and Sterilization Methods for Smith & Nephew Orthopaedic Medical Devices.

STEP 3
Complete the Decontamination Compliance Form and the Jet-X^◊ Bar Recertification Request Checklist.

STEP 4
Place no fewer than fifty (50) units of used Products along with the Decontamination Compliance Form and the Jet-X^◊ Bar Recertification Request Checklist into a shipping container.

STEP 5
E-mail the tracking number, PO number, and electronic copies of the Decontamination Compliance Form and the Jet-X^◊ Bar Recertification Request Checklist to recertification@smithnephew.com . Smith & Nephew will acknowledge receipt of the information.

STEP 6
Ship hard copies of the forms and used product to:

Orthopedic Repair Department
Smith & Nephew, Inc
1450 Brooks Road
Memphis, TN 38116

ATTENTION:
All Hospital Central Processing Units and
Smith & Nephew Inc. Distributors

Decontamination Instructions for
Smith & Nephew, Inc., Orthopaedic Division
Jet-X Bar External Fixation Components
to Be Returned for Recertification

Please decontaminate all Products that will be returned to Smith & Nephew, Inc., Orthopaedics Division (“S&N”) for recertification. It is the Customers sole responsibility to ensure that Product being returned are decontaminated.

Please verify that proper decontamination has been carried out by signing and dating this form.

Note: Validated decontamination instructions can be obtained from S&N customer service (Cleaning and sterilization methods for Smith & Nephew Inc., Medical Devices, Part # 7198-0826) or via the internet at http://www.smithnephew.com/ortho/.

For questions concerning this matter, please call 1-800-821-5700, Smith & Nephew Orthopaedic Repair Department. Thank you for your cooperation.

Sincerely,

Smith & Nephew, Inc., Orthopaedic Division Repair Department.

______________________________       ______________
Signature / Job Title                              Date

CUSTOMER’S NAME: _________________________________________________

PURCHASE ORDER NUMBER: _________________________________________

ITEM NUMBER AND QUANTITY TO BE RECERTIFIED

CONTACT NAME: _______________________    DATE: ____________________

TELEPHONE NUMBER: _______________________________________________

EMAIL ADDRESS: _____________________________________________________

TRACKING NUMBER: __________________________________________________

HAS DECONTAMINATION COMPLIANCE FORM BEEN COMPLETED?   YES / NO

As part of the recertification program Smith & Nephew, Inc. offers the following materials for collection and shipment of components:

• The collection container should be ordered to hold decontaminated product until ready for shipment.  
• The shipping box and bubble wrap is available to ship product to Smith & Nephew, Inc. for recertification.
• The bubble wrap contains a package of 50 individual pouches designed to hold one clamp per pouch.  This will prevent damage during shipping. 
• The shipping box is available as an option, although any shipping box will be sufficient. Shipping instructions are included in Instructions for Returning Used Products to Smith & Nephew for Recertification
• To place an order for any of the items listed above contact Smith & Nephew Customer Service at 1-800-238-7538 or you can order through your normal ordering channel