Pre-Shaped Cranial Mesh ImplantsSPECIALLY MADE TO FIT YOUR PATIENT’S NEEDS

SPEEDOur cranial mesh implants reduce operating time because they are pre-shaped and ready to implant.

SIMPLICITYImplantation is easy with Medtronic’s 1.6mm self-drilling or 1.5mm self-tapping screws from our titanium system.

STRENGTHTitanium offers proven biocompatibility and strength.

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Preoperatively shaped cranial mesh implants offer speed, simplicity and strength. Each implant is specially made for your patient, which can save valuable OR time. Our cranial mesh features low-profile countersunk holes which may provide a more natural cosmetic result.

Save precious OR time with a specially made cranial mesh implant for your patient.

Here’s how the process works:

Pre-Shaped Cranial Mesh Implants

1Send order form and disc.

2The data is used to create an anatomical model of your patient’s defect.

3The skull models are the basis for shaping the mesh implant.

4The patient’s cranial meshimplant and skull model willbe shipped based on therequested delivery time.

CRANIAL MESH IMPLANT ORDER FORM

TURNAROUND TIMEPlease note: pricing varies based on turnaround time.

CLINICIAN/HOSPITAL INFORMATION

________________________________________________ Clinician Name

________________________________________________Clinician Signature

________________________________________________Hospital Name where product will be shipped

________________________________________________Shipping Address where product will be shipped

________________________________________________City

________________________ _________________ State Zip Code

________________________________________________Phone Number (including area code)

________________________________________________Primary Contact Person (if different than aboove)

________________________________________________Primary Contact E-Mail

SPECIAL IMPLANT INSTRUCTIONS (IF ANY)

________________________________________________ ________________________________________________

________________________________________________ ________________________________________________

________________________________________________ ________________________________________________

________________________________________________ ________________________________________________

PLEASE INDICATE THE LOCATION OF THE DEFECT ON THE ABOVE ILLUSTRATIONS

For patient treatment, please see reverse side of this form for CT scan requirements and submission options.

PURCHASE ORDER #(P.O.#):

PATIENT INFORMATION

______________________________________________ Patient Name

SCANNING INFORMATION

______________________________________________Name of Scanning Facility

______________________________________________Contact Number (including area code)

______________________________________________Contact Person

FOR INTERNAL USE ONLY

______________________________________________Date Received

______________________________________________Received By

______________________________________________MNT Sales Associate

______________________________________________Cell Phone Number

_________________ _________________Lot Number Drop Ship Date

Quoted Price $

Sales Rep Quoted Pricing

Yes NO

3 WEEKCMESH-3WK

2 WEEK CMESH-2WK

1 WEEKCMESH-1WK

For more information, contact your Medtronic Neurosurgery sales representative or refer to www.MedtronicNeurosurgery.com.

Medtronic Neurosurgery125 Cremona DriveGoleta, CA 93117-5500 USA(800) 468-9710 USA/Canada(901) 344-0645 International(800) 468-9713 FAX(901) 396-2698 FAX International

International Telephone NumbersAdriatic Region 385-1-488-1120Australia 1-800-668-670Baltic Region 37-1-67560226Belgium 32-2456-09-09Canada 1-800-217-1617China 86-21-50800998Czech Republic 420-2-9657-9580France 33-155-381-700Germany 49-2159-8149-209Greece 30-210-67-79-099 Hong Kong 852-2919-1312Hungary 36-30-5052987India 91-22-26836733Israel 972-9-972-4400

Italy 39-02-24137-324Japan 81-3-6430-2017Korea 82-2-3404-3600Lebanon 961-1-370-670Luxembourg 32-2456-09-09Netherlands 31-45-566-8800Poland 48-22-465-6900Portugal 351-21-724-51-28 Russian Fed. 7-495-580-73-77South Africa 27-11-466-1820Spain 34-91-625-05-40Taiwan 886-2-2183-6000UK 44-1923-205-168USA 1-901-344-0645

Follow These Easy Steps to Order

1. Provide CT scan data. The data provided must meet the following CT scan requirements:

• Axial slices • 1mm slice thickness • No gantry tilt • Square matrix 512 x 512 • Normal adult-size head • Contiguous, non-overlapping slices (no gap, no overlap)• Circular (or square) FOV — the smallest FOV to encompass the entire area of interest

2. Fill out the order form completely.A) Your order cannot be processed without a Purchase Order # (P.O.#), patient, hospital and scanner information completed on the order form. B) Select your turnaround time. Your choices are 1,2,3 weeks.

The process begins the 1st business day after all information (CT scan data and completed order form) is received. If you do not have a blank order form, please contact your Medtronic Sales Representative.

3. Send the completed order form with P.O.# and CT data using one of these three methods: A) Ship the completed form, P.O. and CT data to: Medtronic Neurosurgery Attention: Specials Department 125 Cremona Drive, Goleta, CA 93117B) Fax order form to (651) 367-8986 or email order form to rs.custommesh@medtronic.com, and ship CT data to the above address.C) Please do not schedule a surgical date, until you receive confirmation from the Medtronic Neurosurgery Specials Department

Note to Non-U.S. Physicians: In providing us with the patient information, you (i) confirm that you have obtained valid consent of the patient and that his/her data is forwarded to Medtronic MNS in the U.S. for the purpose of designing a pre-shaped device, and (ii) warrant that all applicable data protection laws of the country of the patient’s residence have been followed and adhered to.

Product Number Description016-200 200 mm x 200 mm016-152 152 mm x 152 mm016-128 128 mm x 79 mm 016-120 120 mm x 120 mm 016-100 100 mm x 100 mm

Unformed mesh is also available