Product Availability

Every effort is made by COOK to ensure each item listed in the catalog is maintained in stock. Due to the breadth of items listed and the dynamic nature of the product line, COOK does not guarantee all items listed are in stock. If you have any questions, please contact us.

Product Warranty

We warrant that at the time of manufacture, products were prepared and tested in accordance with Quality System Regulations specified by the regulatory bodies in the countries Cook serves and were true to label.

Because of biological differences in individuals, no product is 100% effective under all circumstances. In addition, because we have no control of the condition under which the product is used, diagnosis of the patient, the method of use or administration, and handling of the product after it leaves our possession, we do not warrant either a good effect or against an ill effect following the product’s use. The foregoing warranty is exclusive and in lieu of all other warranties either written, oral or implied (including any warranties of merchantability or fitness for purpose). No representative of the company may change any of the foregoing, and the buyer accepts the product subject to all terms hereof.

Design Changes

COOK reserves the right to change or discontinue any product without notice. Additionally, if the product has been discontinued, we can recommend alternatives.

Product Expiration

Most COOK products carry an expiration date on the label. This date is based on concerns for product integrity and sterility maintenance. An unlimited shelf-life cannot be verified by testing; therefore, some limit must be placed on the life of products. COOK attempts to maximize the shelf-life of our products through testing; however, storage conditions utilized by our customers may affect the length of this period.

Product Storage

COOK products should be stored in a dark, cool and dry place. Extended periods of exposure to light have resulted in degradation of some plastic materials and should be avoided. Extended periods of elevated temperature can reduce the shelf-life of a product and should also be avoided.

Sterilization of Reusable Products

It is the responsibility of the institution that is operating sterilization equipment to validate the equipment. In order to sterilize a reusable product using an autoclave, it must first be properly cleaned and/or disinfected, and then packaged using AAMI recommended practices. During product handling, attention should be taken to coil products in an 8 inch diameter or greater. Do not place the original product packaging in an autoclave cycle; it will not withstand the sterilization temperature. Some products may not be autoclaved. Refer to product instruction or contact customer service for specific parameters regarding autoclave cycle sterilization methods.

Autoclave chamber loading should not exceed 10 products per cubic foot of chamber space or exceed the usable chamber space. If any damage to a product is noted, it should be taken out of service immediately.

• Cleaning & Sterilization

  Cook manufactures sterile and non-sterile medical devices.

  Cook's in-house sterilization facility uses an environmentally friendly mixture of ethylene oxide (ETO), as a sterilant. ETO is used because of its compatibility with a wide variety of manufacturing materials, including Tyvek® sealed packaging.

  Over the years, Tyvek has proven to be an excellent microbial barrier in maintaining product sterility over shelf life, as long as the package seal is intact and not exposed to hostile environmental storage conditions, including temperatures above 104°F (40°C), a relative humidity above 90% RH, and condensing humidity.

  Cook's use of Tyvek sealed packages in our validated industrial sterilization process allows for the efficient processing of the quality products you have come to depend upon as well as our innovative new products. As with most industrial sterilization processes, the sterilization parameters used cannot be duplicated by most institution sterilizers. It is for this reason that we have developed and tested sterilization cycles to achieve a sterility assurance level of 10° for institutions based on AAMI recommended practices for use with our products. AAMI stands for the Association for the Advancement of Medical Instrumentation.

  If AAMI Standards and Recommended Practices for sterilization are not available at your institution, you can contact AAMI at 703-525-4890 or 800-332-2264, ext. 217.

  Validation is a documented procedure for obtaining, recording, and interpreting the results needed to show that a process will consistently yield a product complying with predetermined specifications.

  Tyvek® is a registered trademark of E.I. DuPont® de Nemours & Co.

• Sterilization of Disposable and Reusable Products Using Ethylene Oxide

  It is the responsibility of the institution that is operating sterilization equipment to validate that equipment. In order to sterilize a reusable Cook product using ETO, it must first be properly cleaned and/or disinfected according to product instructions and then packaged using AAMI recommended practices. During product handling, attention should be taken to coil products in an 8 inch diameter or greater. Disposable products either accidentally opened and not used and/or ordered non-sterile may be sterilized one time only. Some products may not be ETO sterilized. Refer to product instructions or contact customer service for the proper sterilization method. Table 1 shows the recommended ETO sterilization cycle parameters:

  TABLE I - ETO CYCLE PARAMETERS
  PARAMETER	SET POINT
  Pre Vacuum Pressure	2.0 psia (-25.9" Hg Vac)
  Relative Humidity	60% RH
  Humidity Dwell	20 minutes
  Chamber Temperature	54.4°C (130°F)
  Exposure Pressure	To Be Determined (1)
  Exposure Dwell	2 hours
  ETO Concentration	600 mg/L
  Post Vacuums	3
  Post Vacuum Pressure	2.0 psia (-25.9" Hg Vac)
  Air Wash (2)	5 minutes
  Aeration Temperature	54.4°C (130°F)
  Aeration Dwell	12 hours
  Air Changes During Aeration	90 per hour

  ETO sterilizer chamber loading should not exceed 11 products per cubic foot of chamber space or exceed the usable chamber space. If any damage to a product is noted prior to sterilizing, it should be taken out of service immediately.

• Sterilization of Reusable Products Using An Autoclave

  It is the responsibility of the institution that is operating sterilization equipment to validate that equipment. In order to sterilize a reusable Cook product using an autoclave, it must first be properly cleaned and/or disinfected according the product instructions and then packaged using AAMI recommended practices. During product handling, attention should be taken to coil products in an 8 inch diameter or greater. Do not place the original product packaging in an autoclave cycle; it will not withstand the sterilization temperature. Some products may not be autoclaved. Refer to product instructions or contact customer service for the proper sterilization method. Table II shows the recommended autoclave cycle parameters for Cook reusable products.

  TABLE II - AUTOCLAVE CYCLE PARAMETERS
  PARAMETER	SET POINT
  Cycle Type	Pre Vacuum
  Pre Vacuum Pressure	2.5 psia (-24.8" Hg Vac)
  Chamber Exposure Temperature	132.2°C (270°F)
  Chamber Exposure Pressure	41.8 psia (27.1 psig)
  Exposure Dwell	5 minutes

  Autoclave chamber loading should not exceed 10 products per cubic foot of chamber space or exceed the usable chamber space. If any damage to a product is noted prior to sterilizing, it should be taken out of service immediately.

• Questions & Answers

  A number of questions are frequently asked by customers concerning the sterilization or re-sterilization of Cook products. Some of these questions are answered below.

  Disposable Products

  Question: Under what conditions should a sterile product labeled as “Disposable - Intended for One-Time Use” / “Disposable - Single Use Only” not be sterilized?

  Answer: Cook does not recommend the sterilization of “Disposable - Intended for One-Time Use” / “Disposable - Single Use Only” products that have been used, stored beyond labeled expiration date, or subjected to hostile environmental storage conditions, including temperatures above 104° F (40° C), a relative humidity above 90%, and condensing humidity.

  Question: If a sterile product labeled as “Disposable - Intended for One-Time Use” / “Disposable - Single Use Only” is accidentally opened and then not used, can it be sterilized?

  Answer: Yes, the product can be sterilized using a validated ethylene oxide sterilization cycle. However, the product must be repackaged using AAMI recommended practices prior to sterilization.

  Question: Can “Disposable - Intended for One-Time Use” / “Disposable - Single Use Only” product ordered as non-sterile be sterilized?

  Answer: Yes, the product can be sterilized utilizing a validated ethylene oxide sterilization cycle if the product is supplied in a Tyvek pouch or Tyvek sealed tray. Otherwise, it must be repackaged using AAMI recommended practices prior to sterilization.

  Question: Can Cook advise me of the ethylene oxide sterilization cycle to use on one of its “Disposable - Intended for One-Time Use” / “Disposable - Single Use Only” products either accidentally opened and not used and/or ordered non-sterile?

  Answer: Yes. The cycle parameters for sterilizing disposable products are shown in Table 1 of the ethylene oxide sterilization section of Cleaning and Sterilization and may be used one time only.

  Reusable Products

  Question: Can the original package in which Cook provides its “reusable” products be ETO sterilized?

  Answer: Product provided in a Tyvek pouch or a Tyvek sealed tray may be ETO sterilized. Other Cook packaging configurations must be repackaged using AAMI recommended practices prior to sterilization.

  Question: Can the original package in which Cook provides its “reusable” products be placed in an autoclave?

  Answer: No, original Cook packaging materials utilized for “reusable” products cannot withstand autoclave cycle parameters.

  Question: Can Cook advise me of the proper ethylene oxide sterilization cycle to use on its “reusable” products?

  Answer: Yes, Cook has validated an ethylene oxide sterilization cycle that can be used in an institutional setting. However, the product must be properly cleaned and/or disinfected according to product instructions and then packaged using AAMI recommended practices (AAMI, ST41) prior to sterilization.

  Question: Can Cook advise me of the autoclave cycle to use in its “reusable” products?

  Answer: Yes. Cook has validated an autoclave cycle that can be used in an institutional setting. However, the product must be properly cleaned and/or disinfected according to product instructions and then packaged using AAMI recommended practices (AAMI, SSSA) prior to sterilization.

  Question: Can Cook “reusable” products be disinfected by means of cold disinfectants?

  Answer: Yes. Cook “reusable” products can be disinfected using cold disinfectants. Refer to cold disinfectant manufacturers instructions for recommended use.

Product Labels

The information provided below is an explanation of reference symbols that can be found on a product label.

•   Symbol that appears adjacent to the "Catalog/Reorder Number"
•   Symbol for sterilization using ethylene oxide
•   Symbol that appears adjacent to the "Manufacturer's Lot Number"
•   Symbol that appears adjacent to the "Date of Manufacture"
•   Symbol that appears adjacent to the "Expiration Date"
•   Symbol that signifies "Do Not Reuse/Single Use Only" for disposable one-time use products
•   Symbol for "Attention, See Instructions for Use" included

MRI Compatibility

• Zenith Flex® AAA Endovascular Graft

  The MR safety and compatibility of the Zenith® AAA Endovascular Graft (a previous version of the device) has been evaluated through bench testing in MRI systems with static fields of ≤1.5 Tesla, gradient magnetic fields of ≤20 Tesla/second and whole body averaged specific absorption rate (SAR) of 1.2 W/kg for 30 minutes of imaging. The Zenith® AAA Endovascular Graft was found to exhibit significant deflection and torque of the stainless steel metallic component of the endovascular graft and therefore did not meet standard 'MR Safe' bench test criteria.

  Adverse events have not been reported clinically in patients who have undergone MRI. However, sufficient data are not available to demonstrate MRI safety and there may be potential risks (e.g., device migration, vessel damage) that could be associated with forces applied to the metallic components of the Zenith® AAA Endovascular Graft. Therefore, a careful assessment of these potential risks and the potential benefits to the patient should be completed prior to use of MR imaging. In addition, the facility for MRI should be appropriately selected to allow for prompt intervention if necessary.

  The Zenith AAA Endovascular Graft may affect the image quality (image artifact) depending on the pulse sequence that is used for MR imaging.

  Zenith Flex® MRI Compatibility Download

• Zilver® Self-Expanding Stent

  MRI CONDITIONS

  Non-clinical testing has demonstrated that the Zilver Self-Expanding Stent is MR Conditional. It can be scanned safely under the following conditions:

  • Static magnetic field of 3 Tesla or less
  • Spatial gradient field of 720 Gauss/cm or less
  • Whole body averaged specific absorption rate (SAR) of 1.5 W/kg (for a single stent at 1.5 Tesla) and 3 W/kg (for a single stent at 3 Tesla and a pair of overlapping stents at 1.5 and 3 Tesla) for 20 minutes (for a single stent at 1.5 Tesla) and 15 minutes of scanning (for a single stent at 3 Tesla and a pair of overlapping stents at 1.5 and 3 Tesla), respectively.

  In non-clinical testing, the Zilver Self-Expanding Stent produced maximum temperature rises of 0.1, 3.8, 0.8, and 0.1 degrees C (for a single stent at 1.5 Tesla, a pair of overlapping stents at 1.5 Tesla, a single stent at 3 Tesla, and a pair of overlapping stents at 3 Tesla, respectively) at whole body averaged specific absorption rates (SAR) of 1.5 W/kg (for a single stent at 1.5 Tesla) and 3 W/kg (for a single stent at 3 Tesla and a pair of overlapping stents at 1.5 and 3 Tesla) for 20 minutes (for a single stent at 1.5 Tesla) and 15 minutes (for a single stent at 3 Tesla and a pair of overlapping stents at 1.5 and 3 Tesla) of MR scanning in a 1.5 Tesla/64 MHz General Electric MR scanner, a 1.5 Tesla Magnetom Siemens Medical Solutions MR Scanner (to evaluate a pair of overlapping stents), and a 3 Tesla Excite General Electric MR scanner.

  MR image quality may be compromised if the area of interest is in the exact same area or relatively close to the position of the Zilver Self-Expanding Stent. Therefore, it may be necessary to optimize MR imaging parameters for the presence of this metallic implant.

  Heating in the MRI environment for stents with fractured struts is not known

• Gianturco-Roehm Bird’s Nest® Vena Cava Filter

  MRI-Safe: No additional risk to patients, but may affect the quality of the diagnostic information if scanning in the area of the filter.

  MRI diagnostic procedures should be postponed for 6 weeks following filter implantation to ensure device incorporation into the vessel wall.

• Günther Tulip™ Vena Cava Filter

  The Günther Tulip™ Vena Cava Filter is MRI Compatible with an MR scanner not exceeding 1.5 Tesla.

• MReye™ Needles for Magnetic Resonance Imaging

  COOK’s Interventional MReye™ needles are used for initial puncture and positioning control as well as biopsies and other interventional procedures in combination with Magnetic Resonance Imaging.

  • MReye™ products are created from a non-ferromagnetic material that helps prevent disturbing artifacts.
  • MReye™ needles are recommended for use with MRI scanners not exceeding 1.5 Tesla.

  To see different-sized images of the needle, try these scanner parameters:

  • To see an image of the needle at a ratio of 1:1, select a spin echo sequence (TR/TE 200ms/15ms).
  • To see an image of the needle enlarged approximately 2:1, select a gradient echo sequence (TR/TE/Flip angle 336 ms/15 ms/90°).

• Embolization Coils

  MR COMPATIBLE

  The following embolization coils are considered MR Compatible:

  • Nester Embolization Coils
  • MicroNester Embolization Coils
  • Tornado Embolization Coils
  • MicroTornado Embolization Coils
  • Platinum Detachable Embolization Coils
  • Hilal Embolization Coils

  “MR Compatible” indicates that the device, when used in the MR environment is MR Safe and has been demonstrated to neither significantly affect the quality of the diagnostic information nor have its operations affected by the MR device.

• Vital Ports

  Results of testing to assess MRI safety and compatibility using a 1.5 Tesla scanner provide reasonable assurance that the Vital-Port® system presents no additional risk or adverse effects in patients undergoing MRI. In titanium models, under worst case conditions using a gradient recalled pulse sequence (GRASS), image distortion may occur up to 5 cm within the location of the port body.

• Cook-Swartz Doppler Flow Probe

  WARNING–MR UNSAFE

  Do Not expose patient to an MRI procedure while Cook-Swartz Doppler Flow Probe is implanted. Substantial MRI-related heating of the Doppler Flow Probe may occur. Doppler Flow Probe must be removed prior to any MRI procedure.

Products Containing Latex

Some COOK product packaging contains a Natural Rubber latex warning on the label. These products contain Latex that can be contacted directly or indirectly with normal use of our product. An example of indirect contact is when a fluid contacts the Latex and subsequently comes in contact with the patient. Additionally, we assure that our packaging materials do not contain Latex.

Please contact Customer Service or your local sales representative if you have further questions.