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Ulthera DS 7-4.5 Transducer: SMAS Imaging Training & ROI For Clinics

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Reading the gray-scale image correctly on the Ulthera System is what turns the DS 7-4.5 transducer from a generic lifting device into a precise SMAS-targeting tool. On-screen, the SMAS-related fibro-muscular layer typically appears as a denser, brighter band below the subcutaneous fat, with bone and mandible as strong hyperechoic lines deeper still. Training your team to consistently identify epidermis, dermis, subcutaneous tissue, and SMAS on the monitor is essential for safe, repeatable lifting treatments and for protecting your investment in Ultherapy.

What the DS 7-4.5 does & who it’s for

  • The DS 7-4.5 is a DeepSEE image/treat transducer that delivers 7 MHz microfocused ultrasound at a nominal depth of 4.5 mm while imaging to 8 mm below the skin surface.
  • At 4.5 mm, it is intended to reach fibromuscular supporting tissue (often described as SMAS or SMAS-adjacent layers) rather than the superficial dermis.
  • It is typically used for non-invasive dermatologic aesthetic treatments like brow, lower face, submental and neck lifting within the Ulthera System’s cleared indications.
  • Ideal buyers are clinics and medspas that already operate, or plan to operate, a full Ulthera platform and understand that consistent imaging-based targeting is critical for outcomes, safety, and reputation.

Clinics comparing Ulthera to other tightening technologies (for example, non-imaging HIFU or radiofrequency devices) often decide based on how comfortable they are with image interpretation and staff training obligations. ALLWILL commonly works with such clinics to match new or certified pre-owned DS 7-4.5 inventory, training resources, and maintenance support to their specific volume and staffing model.

Topic core: visually identifying the SMAS line on the Ulthera monitor

The working title and brief focus on ultrasound screen-reading and SMAS identification, so this section centers on real-time imaging and training rather than pricing or supply chain.

Key tissue layers on Ulthera B-mode

On the Ulthera monitor (DeepSEE B-mode), facial soft tissue typically appears in this order from top (probe-facing) to bottom:

  • Epidermis / dermis: A thin, bright superficial line at the very top with immediately subjacent low-to-medium echogenicity.
  • Subcutaneous fat: A thicker, relatively hypoechoic (darker) layer with scattered brighter septae, often appearing as “lobulated” or speckled gray.
  • Fibromuscular / SMAS-related layer: A more continuous, brighter, linear band separating subcutaneous tissue from deeper structures; often less thick than the fat layer, with a more uniform echogenicity.
  • Deep fascia / periosteum / bone: Strong, bright (hyperechoic) line with acoustic shadowing beneath (loss of signal), particularly over mandible and zygomatic arch.

Operators are trained to use this stratification to confirm that the 4.5 mm focal depth of the DS 7-4.5 is sitting within or immediately adjacent to the fibromuscular plane, particularly in thicker lower-face and neck tissue.

Reading the grayscale interface step-by-step

While Ulthera’s manuals do not provide a “SMAS line” label on-screen, they emphasize imaging to ensure appropriate depth of treatment and to avoid bone. A practical training approach usually follows these steps:

  1. Start in SEE (imaging) mode before every line. Confirm a stable, artifact-free cross-section of the treatment area, with clear superficial and deep boundaries.
  2. Locate the skin surface and dermis. Identify the very top bright line, then the thin, slightly brighter band beneath it. This anchors your depth scale.
  3. Identify the subcutaneous fat compartment. Look for relatively darker (hypoechoic) tissue with scattered bright streaks or lobules between dermis and deeper fascia.
  4. Track the brighter fibromuscular layer. Below the fat, a more continuous hyperechoic band will often mark a fascia-like layer corresponding anatomically to SMAS or related fascia in many facial regions.
  5. Confirm bone or deeper structures. Where bone is present, it appears as an intense bright line with posterior acoustic shadowing; treatment depth should be set so the focal point remains superficial to this interface.
  6. Overlay the treatment depth. On the Ulthera interface, use the depth scale and calipers if necessary to confirm that the 4.5 mm focal depth sits at, or just above, the fibromuscular layer in that specific location.
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ALLWILL often recommends that new Ulthera adopters build a small internal atlas: freeze sample images at typical treatment sites (lateral brow, pre-auricular, submental) with depth markers, and use these as visual anchors in staff training. Request a quote from ALLWILL if you want DS 7-4.5 sourcing combined with guidance on setting up such a training library.

Revenue and operational impact of better SMAS imaging

  • When operators can reliably identify dermis, subcutaneous fat, and SMAS-related fascia on the monitor, they can position energy more consistently, which supports more predictable patient experiences and fewer retreatment discussions.
  • Better imaging skills reduce the likelihood of inadvertently treating too shallow (primarily dermis) or too deep (close to bone or major neurovascular structures), which in turn may reduce certain side effect risks highlighted in the IFU.
  • For the clinic, this translates into smoother treatment days, fewer escalations and complaints, and decreased risk of unplanned schedule gaps caused by device misuse investigations or incident review.

How imaging training influences payback

  • A clinic that builds a culture of SEE.PLAN.TREAT—using imaging to plan line-by-line placement before treating—can often run sessions more efficiently, lowering average chair time without compromising caution.
  • Over a year, even a modest reduction in operator hesitation or re-imaging time can translate into more bookable treatment slots per day, especially for high-volume submental and full-face protocols.
  • From a procurement perspective, this makes the DS 7-4.5 transducer and the Ulthera platform more attractive investments than non-imaging options, provided the buyer also invests in adequate staff training and periodic skill refreshers.

Why SMAS imaging differentiates Ulthera in a crowded market

  • Ulthera’s DeepSEE technology combines B-mode imaging with therapy, enabling real-time visualization of tissue layers to confirm coupling and depth, something not all microfocused ultrasound or RF systems provide.
  • Clinical literature and manufacturer materials emphasize that thermally induced coagulation points (TCPs) are deposited at fixed depths determined by the transducer, making correct depth selection and image verification central to the procedure’s risk-benefit profile.
  • Competing technologies without imaging rely more heavily on surface landmarks and standardized maps, which can be efficient but offer less direct feedback about local anatomy variations, thickness, or prior interventions.

For buyers, the DS 7-4.5 transducer is part of a higher-ticket rationale: you invest not only in hardware but in the ability to see where energy is being placed. ALLWILL’s role is to help ensure that the system you buy—new or certified pre-owned—arrives with the documentation, condition transparency, and support needed so your team can fully leverage this imaging capability.

Practical training framework: Ulthera SMAS Imaging Skills Ladder

Because this topic falls under “clinical training and protocols,” the most useful decision aid is not a cost table or maintenance checklist but a structured training framework your team can adopt. The following ladder helps clinic owners and medical directors organize ultrasound screen-reading competency around the DS 7-4.5.

Ulthera DS 7-4.5 SMAS Imaging Skills Ladder

Skill level Operator profile Key competencies on the Ulthera screen Typical training actions for clinic leadership
Level 1 – Orientation New to Ulthera and aesthetic ultrasound Recognizes basic tissue stack (skin line, subcutaneous fat, deep bright line over bone); understands depth scale and probe orientation. Provide manufacturer IFU and official training materials; run supervised sessions on volunteers; capture and review still images from standard sites.
Level 2 – Layer identification Has completed initial Ulthera training and a small number of supervised cases Reliably differentiates dermis vs subcutaneous fat; identifies fibromuscular/SMAS-related band in at least three standard facial zones; confirms bone and major “no-go” areas. Implement case review meetings; ask operators to annotate images to identify layers; require imaging verification before each treatment line.
Level 3 – Depth adaptation Comfortable with routine Ulthera cases Adjusts perception of SMAS-related depth based on region and patient thickness; uses calipers to confirm 4.5 mm focus positioning consistently; recognizes artifacts such as gel pockets. Introduce structured log of challenging cases; cross-train staff on neck vs midface imaging; pair with senior operator for complex anatomies.
Level 4 – Complex anatomy Experienced user treating diverse faces and histories (implants, previous surgery, fillers nearby but not in zone) Integrates imaging with medical history and palpation; recognizes atypical layer patterns (e.g., thin patients, scarring); confidently avoids bone, thyroid, and major vessels using imaging landmarks. Formalize criteria for which patients must be treated only by Level 4 operators; document protocols for high-risk zones; consider external Ulthera-focused workshops.
Level 5 – Trainer / supervisor Leads protocol development and onboarding Audits image quality and interpretation across the team; designs internal image atlases by region; correlates imaging patterns with clinical feedback and follow-up photographs. Assign as internal Ulthera champion; include in procurement decisions for new or CPO DS 7-4.5 transducers; involve in vendor discussions to align technical specs with training needs.
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Clinic owners can use this framework as an internal credentialing structure—deciding, for example, that only Level 3+ operators may treat full-face at 4.5 mm. Request a quote from ALLWILL if you want DS 7-4.5 transducers and Ulthera systems sourced with a training-oriented onboarding plan that reflects this skills ladder.

Compliance and asset-protection considerations

  • The Ulthera System is cleared as a non-invasive dermatologic aesthetic device for specific indications such as brow lift, submental and neck lifting, and décolleté line improvement; imaging is indicated for ensuring coupling and avoiding bone, not for diagnostic use.
  • The IFU underlines that incorrect treatment technique (for example, tilting the transducer, incorrect line spacing, gel pockets) can contribute to burns and potential scarring, making training and supervision a central part of risk management.
  • Clinics must verify current regulatory status (FDA, CE or local equivalents) of any Ulthera unit or DS 7-4.5 transducer they acquire, particularly if purchasing certified pre-owned units that may have been first sold into another jurisdiction.

From an asset-protection standpoint, misinterpretation of images that leads to adverse events can expose the clinic to complaints, negative publicity, and regulatory scrutiny. ALLWILL helps mitigate this by prioritizing authentic hardware, clear documentation, and encouraging clients to formalize training and incident-reporting workflows around Ulthera use.

Procurement risks to avoid + ALLWILL Expert View

  • Risk 1 – Treating Ulthera like a “plug-and-play” device: Underestimating the training required to correctly interpret grayscale images and locate SMAS can result in inconsistent treatments and increased side-effect complaints.
  • Risk 2 – Buying hardware without training alignment: Acquiring DS 7-4.5 transducers (new or CPO) without a clear internal plan for who can operate at which sites and depths may create uneven quality across providers.
  • Risk 3 – Incomplete documentation for CPO units: Purchasing pre-owned Ulthera systems or DS 7-4.5 cartridges without full traceability, service history, and clear line-count/expiration status complicates both safety verification and any future resale or audit.

ALLWILL Expert View: Turning SMAS imaging into a measurable business asset

Many clinics focus heavily on “having Ultherapy” as a line on their menu, but the most resilient Ulthera practices treat SMAS imaging as a core competency, not a side note. Over time, this mindset shows up in fewer cancellations, smoother consultations, and lower escalation rates—operators can point at the screen and explain what they are targeting, which reassures patients and clarifies the logic behind their treatment plan.

From a procurement perspective, this means hardware decisions should be paired with a realistic assessment of your team’s current imaging skills and the support you receive from your supplier. When ALLWILL sources Ulthera systems and DS 7-4.5 transducers for clients, discussions often cover not just price and condition but also who will be the internal “Ulthera champion,” how new staff will reach Level 2 or 3 on the imaging ladder, and what documentation is needed for regulators or insurers. Request a quote from ALLWILL if you want your Ulthera procurement to include this type of lifecycle thinking—from first cases through long-term utilization and potential trade-in.

Frequently Asked Questions

What is the typical cost range for a DS 7-4.5 transducer?

Market prices vary by region, line count, and remaining shelf life, but DS 7-4.5 generally sits in a similar premium band to other DeepSEE transducers, often in the low-to-mid four-figure range per unit for new stock. Certified pre-owned or surplus units may be available at lower cost depending on condition and expiration. Request a quote from ALLWILL for current pricing and availability.

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How does better SMAS imaging affect my clinic’s ROI?

When staff consistently identify the correct layer and avoid bone or “no-go” zones, treatments tend to run more predictably, with fewer escalations and repeat visits due to operator error. This stability lets you schedule with greater confidence and maintain pricing integrity, which supports payback on both the Ulthera platform and the DS 7-4.5 consumables over time.

Is there a difference between new and certified pre-owned DS 7-4.5 transducers from a safety perspective?

Safety depends on authenticity, storage, line count, expiration date, and physical integrity rather than simply “new vs used.” Certified pre-owned transducers can be appropriate if they come with verifiable documentation and inspection, and if they are used within labeled shelf life and IFU guidelines.

What should I insist on from a supplier when buying an Ulthera System or DS 7-4.5?

You should ask for serial number tracking, proof of origin, service and maintenance history, regulatory status in your jurisdiction, and clear details on warranty and support. For transducers, request written confirmation of line count, expiration date, and any refurbishment/testing performed.

How long does it take to train staff to read the Ulthera screen confidently?

Timeframes vary, but many clinics see operators reach basic layer recognition (Level 2 on the skills ladder) after a small number of supervised cases and structured image review sessions. Achieving higher-level independence in complex anatomies typically requires more experience, ongoing mentoring, and periodic case audits by a senior Ulthera user.

References

  1. Ulthera System – Instructions for Use (DeepSEE Technology for Ultherapy)
  2. “Ultherapy adds a whole new category to the aesthetics industry…” – Ulthera System Clinical & Technical Overview
  3. UT-3 DS 7-4.5 Transducer – Be Her Product Description
  4. Ulthera DS 7-4.5 Ultherapy Transducer Anchors ALLWILL’s New Supply Strategy
  5. Ulthera Training and Treatment Manual – Customer Workbook
  6. 510(k) Summary – Ulthera System (K134032 and related)
  7. Medical Ultrasound Safety – AIUM Guidance
  8. Introduction of the 1.5 mm Shallow Transducer – Ulthera White Paper
  9. Noninvasive Skin Tightening Using Focused Ultrasound – PRS Global Open Review
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        9.  DISCLAIMERS; NO OTHER WARRANTY. EXCEPT TO THE EXTENT AS PROVIDED IN SECTION 8(c)(i)(D), BUYER ACKNOWLEDGES THAT MRP IS NOT BOUND BY ANY WARRANTY THAT MAY BE SET FORTH IN A MANUFACTURER’S WRITTEN MATERIALS THAT WOULD HAVE APPLIED HAD BUYER PURCHASED THE EQUIPMENT DIRECTLY FROM THE MANUFACTURER IN ITS UNUSED STATE. BUYER ACKNOWLEDGES THAT BUYER HAS NOT RELIED UPON ANY WARRANTY OTHER THAN AS SET FORTH IN THIS AGREEMENT. IN ADDITION, BUYER ALSO HEREBY ACKNOWLEDGES AND AGREES THAT ANY ORAL OR WRITTEN STATEMENTS CONCERNING USE AND REGULATION OF MEDICAL DEVICES SOLD BY MRP ARE AND SHALL BE CONSTRUED AS FOR INFORMATIONAL PURPOSES ONLY AND WITHOUT WARRANTY OR ASSURANCE BY MRP AS TO THEIR ACCURACY OR VALIDITY. MRP ALSO HEREBY DISCLAIMS ANY AND ALL WARRANTIES REGARDING OTHER MEDICAL CARE OR HELP, INCLUDING THE SELECTION OF AESTHETIC AND MEDICAL PROCEDURES AND PRODUCTS FOR, OR CARE OF, PATIENTS. THE LIMITED WARRANTIES OF THIS AGREEMENT, IF APPLICABLE TO ANY EQUIPMENT OR SERVICE FURNISHED UNDER THIS AGREEMENT, CONSTITUTE THE ONLY WARRANTIES MADE WITH RESPECT TO THE EQUIPMENT AND/OR SERVICE AND ANY DEFECT, DEFICIENCY OR NONCONFORMITY. TO THE EXTENT PERMITTED BY LAW, SUCH WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED BY LAW, COURSE OF DEALING, COURSE OF PERFORMANCE, USAGE OF TRADE OR OTHERWISE, INCLUDING, BUT NOT LIMITED TO, ANY EXPRESS OR IMPLIED WARRANTY OF MERCHANTABILITY, TITLE, NONINFRINGEMENT OR FITNESS FOR A PARTICULAR PURPOSE.

        10.  LIMITATION OF LIABILITY. NOTWITHSTANDING ANYTHING TO THE CONTRARY IN THIS AGREEMENT, UNDER NO CIRCUMSTANCES SHALL MRP BE LIABLE FOR ANY INDIRECT, PUNITIVE, INCIDENTAL, CONSEQUENTIAL, EXEMPLARY OR SPECIAL DAMAGES, ARISING FROM, RELATED TO OR CAUSED, DIRECTLY OR INDIRECTLY, WHETHER FORESEEABLE OR NOT, BY THE EQUIPMENT AND/OR THE SERVICES, THE USE OR INABILITY TO USE THE EQUIPMENT, THE RESULTS GENERATED FROM THE EQUIPMENT AND/OR THE SERVICES, THIS AGREEMENT, ANY OTHER ACT OR OMISSION OF MRP, OR BASED UPON ANY OTHER LEGAL THEORY. IN NO EVENT SHALL MRP BE LIABLE FOR ANY LOSSES OF REVENUE, USE, BUSINESS OPPORTUNITY, PROFIT, SAVINGS OR ANY OTHER DAMAGES DUE TO ANY CAUSE WHATSOEVER, EVEN IF MRP OR ITS AGENTS HAS BEEN ADVISED OF THE POSSIBILITY THEREOF. THE FOREGOING IS A SEPARATE, ESSENTIAL TERM OF THIS AGREEMENT, AND SHALL BE EFFECTIVE UPON THE FAILURE OF ANY REMEDY, EXCLUSIVE OR NOT. IN NO EVENT WILL MRP’S TOTAL LIABILITY UNDER THIS AGREEMENT EXCEED THE PURCHASE PRICE ACTUALLY PAID TO MRP BY BUYER FOR THE EQUIPMENT AND/OR THE SERVICES GIVING RISE TO THE CLAIM FOR WHICH DAMAGES ARE BEING SOUGHT. NO SUIT OR ACTION MAY BE BROUGHT BY BUYER, ITS SHAREHOLDERS, DIRECTORS, MANAGERS, EMPLOYEES OR AGENTS FOR ANY BREACH OF THIS AGREEMENT MORE THAN ONE (1) YEAR AFTER THE ACCRUAL OF SUCH CAUSE OF ACTION. IT IS AGREED THAT MRP’S LIABILITY IS SO LIMITED. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, BUYER ASSUMES ALL RISK AND LIABILITY FOR THE RESULTS OBTAINED BY THE USE OF ANY EQUIPMENT IN THE PRACTICE OF ANY PROCESS, WHETHER IN TERMS OF OPERATING COSTS, GENERAL EFFECTIVENESS, SUCCESS OR FAILURE, AND REGARDLESS OF ANY ORAL OR WRITTEN STATEMENTS MADE BY MRP, BY WAY OF TECHNICAL ADVICE OR OTHERWISE, RELATED TO THE USE OF THE EQUIPMENT.

        11.  BUYER’S REPRESENTATIONS AND WARRANTIES. Buyer represents and warrants to MRP that: (a) Buyer is duly organized, validly existing, and in good standing in the jurisdiction of Buyer’s formation; (b) Buyer is duly qualified to do business and is in good standing in every jurisdiction in which such qualification is required; (c) Buyer has the full right, power, and authority to enter into this Agreement and to perform Buyer’s obligations under this Agreement; (d) the execution of this Agreement by the person whose signature is set forth at the end hereof has been duly authorized by all necessary corporate action of Buyer; (e) when executed and delivered by each of MRP and Buyer, this Agreement will constitute the legal, valid and binding obligation of Buyer, enforceable against Buyer in accordance with its terms; (f) Buyer is in compliance with all applicable laws relating to this Agreement, the Equipment and the operation of Buyer’s business; (g) Buyer is not insolvent and is paying all of its debts as they become due; and (h) all financial information that Buyer has provided to MRP is true and accurate and fairly represents Buyer’s financial condition.

        12. PROPRIETARY RIGHTS.

(a) Ownership. No sale shall be construed as granting to Buyer any license or other right in, or to, any of MRP’s (i) patents; (ii) trademarks; (iii) internet domain names, whether or not trademarks, registered by any authorized private registrar or governmental authority, web addresses, web pages, websites and URLs; (iv) works of authorship, expressions, designs and design registrations, whether or not copyrightable, including copyrights and copyrightable works, software and firmware, technical data, data files, and databases and other specifications and documentation; (v) trade secrets; (vi) environmental or other testing applicable to the Equipment and/or the Services; and (vii) industrial and other intellectual property rights, and all rights, interests, and protections that are associated with, equivalent or similar to, or required for the exercise of, any of the foregoing, however arising, in each case whether registered or unregistered and including all registrations and applications for, and renewals or extensions of, such rights or forms of protection pursuant to the laws of any jurisdiction throughout in any part of the world (collectively, the “Intellectual Property Rights”).

(b) Prohibited Acts. Buyer shall not (i) take any action that might interfere with any of MRP’s rights in or to Intellectual Property Rights, including MRP’s ownership or exercise thereof; (ii) challenge any right, title, or interest of MRP in or to the Intellectual Property Rights; (iii) make any claim or take any action adverse to MRP’s ownership of the Intellectual Property Rights; (iv) register or apply for registrations, anywhere in the world, for MRP’s trademarks or any other trademark that is similar to MRP’s trademarks or that incorporates MRP’s trademarks in whole or in confusingly similar part; (v) use any mark, anywhere that is confusingly

similar to MRP’s trademarks in whole or in confusingly similar part; (vi) engage in any action that tends to disparage, dilute the value of or reflect negatively on the Equipment and/or the Services or any of MRP’s trademarks; (vii) misappropriate any of MRP’s trademarks for use as a domain name without prior written consent from MRP; or (viii) alter, obscure or remove any of MRP’s trademarks, or trademark or copyright notices or any other proprietary rights notices placed on the

Equipment, marketing materials or other materials that MRP may provide.

        13.  CONFIDENTIAL INFORMATION. Without the prior written consent of MRP,Buyer, directly or indirectly, shall not disclose (and will direct its directors, shareholders, employees and agents not to disclose) any Confidential Information. The term “Confidential Information” means any information of or relating to MRP or the Equipment and/or the Services not generally known to the public (other than as a result of disclosure in violation of this Agreement) in spoken, printed, electronic or any other form or medium, including, but not limited to, business processes, practices, methods, policies, plans, publications, documents, research, operations, services, strategies, techniques, agreements, contracts, transactions, potential transactions, know-how, trade secrets, databases, manuals, records, supplier information, financial information, accounting information, legal information, marketing information, pricing information, payroll information, personnel information, and supplier lists.

        14.  NON-SOLICITATION. Buyer agrees not to solicit or hire any personnel of MRP involved with the delivery of the Services during the provision of such Services and for twelve (12) months after the completion of such Services; provided, however, that Buyer may hire individuals employed by MRP who, without other solicitation, respond to advertisements or solicitations aimed at the general public.

        15.  EQUITABLE REMEDIES. Buyer acknowledges and agrees that (a) a breach or threatened breach by Buyer of any of its obligations under Sections 13 or 14 would give rise to irreparable harm to MRP for which monetary damages would not be an adequate remedy and (b) in the event of a breach or a threatened breach by Buyer of any such obligations, MRP shall, in addition to any and all other rights and remedies that may be available to MRP at law, at equity, or otherwise in respect of such breach, be entitled to equitable relief, including a temporary restraining order, an injunction, specific performance, and any other relief that may be available from a court of competent jurisdiction, without any requirement to post a bond or other security, and without any requirement to prove actual damages or that monetary damages will not afford an adequate remedy. Buyer agrees that Buyer will not oppose or otherwise challenge the appropriateness of equitable relief or the entry by a court of competent jurisdiction of an order granting equitable relief, in either case, consistent with the terms of this Section 15.

        16.  INDEMNIFICATION. Buyer agrees to indemnify, defend and hold harmless MRP and its directors, shareholders, employees and agents (collectively, “MRP Indemnitees”) against any liability, damage, loss or expense incurred by or imposed in connection with any claims, suits, actions, demands or judgments arising out of (a) any breach or non-fulfillment of any representation, warranty or covenant set forth in this Agreement by Buyer or its directors, managers, employees or agents (collectively, “Buyer’s Agents”); (b) any negligent act or omission or willful misconduct of Buyer or Buyer’s Agents in connection with this Agreement; (c) any bodily injury, death of any person or damage to real or tangible personal property caused by Buyer or Buyer’s Agents, including the use of unauthorized parts in or service of the Equipment; (d) any failure by Buyer or Buyer’s Agents to comply with any applicable laws; (e) any fraud or other intentional acts by Buyer or Buyer’s Agents; and (f) the use or operation of the Equipment, including, without limitation, any medical and/or surgical procedures performed by Buyer, and any of Buyer’s Agents, using the Equipment unless said damages are determined by a court of competence jurisdiction to be solely by the gross negligence of MRP or solely as result of a breach by MRP of the limited warranties contained herein.

        17.  DEFAULTS; REMEDIES. Notwithstanding anything herein to the contrary, should Buyer fail to pay for the order or any other amount, in whole or in part, when due or perform its other obligations under this Agreement or as otherwise mutually agreed in writing between Buyer and MRP (each, a “Default”), then MRP may take any and all actions available under law or equity to collect said amounts with a ten (10) day prior written notice, including, but not limited to, enforcing its security interest, accelerating the payment of and declaring immediately due and payable any unpaid balance of the order, referral to outside collection agencies and/or commencement of legal action. MRP’s rights shall be cumulative, and it shall not be required to have attempted to realize upon to the Equipment before taking any other collection actions. MRP may require that Buyer assemble and return any or all of the Equipment to MRP and, in the event Buyer fails to return such Equipment peaceably, enter upon the premises where such Equipment is located, with or without legal process, and repossess such Equipment. Upon a Default, Buyer agrees to pay upon MRP’s demand: (i) all costs and expenses incurred by MRP or its assignee in connection with the enforcement of any remedies, including all expenses incurred in connection with the return, sale, release or other disposition of the Equipment, including attorneys’ fees and other costs incurred by MRP or its assignee in enforcing or defending its rights and remedies under this Agreement and any other written agreement between Buyer and MRP.

        18.  COMPLIANCE WITH LAWS. Buyer shall (a) carry out the transactions contemplated by this sale and deal with the Equipment in conformity with all applicable laws, rules and regulations of all government authorities, including, without limitation, export laws, (b) obtain all permits and licenses required in connection with the purchase, shipment, installation or use of the Equipment, and (c) be solely responsible to fully understand and comply with laws, rules and regulations. Any information provided is as a convenience only.

        19.  FURTHER ASSURANCES. Upon MRP’s reasonable request, Buyer shall, at its sole cost and expense, execute and deliver all such further documents and instruments, and take all such further acts, necessary to give full effect to this Agreement.

        20.  ASSIGNMENT; SUCCESSORS AND ASSIGNS. Buyer cannot delegate any duties nor assign any rights or claims under this Agreement without MRP’s prior written consent, and any such attempt or assignment shall be void. In the event that Buyer finances its acquisition of any Equipment with a third party, Buyer may direct MRP to transfer title of such Equipment to such third-party financing company, with all remaining terms and conditions of this Agreement remaining in full force and effect. This Agreement is binding on and inures to the benefit of the parties to this Agreement and their respective permitted successors and permitted assigns.

        21.  NO THIRD-PARTY BENEFICIARIES. Subject to Section 16, this Agreement benefits solely the parties to this Agreement and their respective permitted successors and assigns, and nothing in this Agreement, express or implied, confers on any other person any legal or equitable right, benefit, or remedy of any nature whatsoever under or by reason of this Agreement.

        22.  GOVERNING LAW; VENUE. The application of the UN Convention on Contracts for the International Sale of Goods is expressly excluded. The parties agree that any and all claims, demands, disagreements, controversies or disputes arising out of or relating to this Agreement and any agreement or document delivered in connection herewith (collectively, “Claims”) shall be governed by and construed in accordance with the laws of the State of Utah and adjudicated exclusively in the state and federal courts located in or nearest to Summit County, Utah, which courts shall have the sole and exclusive jurisdiction and venue for adjudication of all Claims. The parties hereby agree upon, consent and stipulate to the jurisdiction and venue of the aforementioned courts for the adjudication of all Claims, to the exclusion of all other courts, forums and venues whatsoever.

        23.  NON-DISPARAGEMENT. Buyer shall not disparage MRP or MRP’s trademarks, websites, products or services, or display any such items in a derogatory or negative manner on any website or in any public forum or press release.

        24.  NOTICES. Any notice, demand, or communication required, permitted or desired to be given hereunder shall be deemed effectively given when personally delivered, when sent by electronic means, when received by overnight courier, or when mailed by prepaid, certified or registered mail, return receipt requested, addressed to the other party at its address set forth on the Quote or to such other address that the receiving party may designate from time to time in accordance with this Section 25.

        25.  PUBLIC ANNOUNCEMENTS. Unless otherwise stated herein, neither party shall issue a press release or otherwise advertise, make a public statement or disclose to any third-party information pertaining to the relationship arising under this Agreement, the existence or terms of this Agreement, the underlying transactions between MRP and Buyer or agent for Buyer or refer to the other party in relation to this Agreement without the other party’s prior written approval.

        26.  ENTIRE AGREEMENT; ADDITIONAL OR INCONSISTENT TERMS. Subject to Section 32, this Agreement constitutes the sole and entire agreement between the parties hereto relating to the subject matter hereof, and any unincorporated representation, affirmation of fact, course of prior dealings, promise or condition in connection therewith, or usage of the trade, shall not be binding on either party. Terms and conditions set forth which differ from, conflict with or are not included in this Agreement shall not be part of any agreement between MRP and Buyer unless both parties specifically accept such terms and conditions in writing.

        27.  WAIVER. No waiver under this Agreement is effective unless it is in writing and signed by the party waiving its right. Any waiver authorized on one occasion is effective only in that instance and only for the purpose stated and does not operate as a waiver on any future occasion. None of the following constitutes a waiver or estoppel of any right, remedy, power, privilege or condition arising from this Agreement: any failure or delay in exercising any right, remedy, power or privilege or in enforcing any condition under this Agreement; or any act, omission or course of dealing between the parties.

        28.  SURVIVAL. Subject to the limitations and other provisions of this Agreement, the representations and warranties of Buyer contained herein shall survive the expiration or earlier termination of this Agreement for a period of twelve (12) months after such expiration o termination and (b) this Section 29 and Sections 10, 12, 13, 14, 15, 16, 17, 21, 22, 23, 24, 26, and 32 of this Agreement, as well as any other provision that, in order to give proper effect to its intent, should survive such expiration or termination, shall survive the expiration or earlier termination of this Agreement. All other provisions of this Agreement shall not survive the expiration or earlier termination of this Agreement.

        29.  RELATIONSHIP OF PARTIES. Nothing in this Agreement creates any agency, joint venture, partnership or other form of joint enterprise, employment or fiduciary relationship between the parties. Neither party has any express or implied right or authority to assume or create any obligations on behalf of or in the name of the other party or to bind the other party to any contract, agreement or undertaking with any third party.

        30.  HEADINGS. The headings in this Agreement are for reference only and do not affect the interpretation of this Agreement.

        31.  ORDER OF PRECEDENCE. In the event of conflict between the Quote, a written agreement by MRP, and these Terms, the order of priority shall be: (1) the written

agreement by MRP, if only if executed by an MRP Officer, (2) the Quote and (3) these Terms, and only to the extent of the direct conflict. Notwithstanding the foregoing, MRP shall not be bound by, and specifically objects to, any terms, conditions or other provisions, both written and oral, which are different from, in addition to or inconsistent with the provisions of this Agreement which are set forth in any purchase order, receipt, acceptance, confirmation, correspondence or otherwise of, or by, Buyer. Fulfillment of Buyer’s order shall not constitute acceptance of any of Buyer’s terms and conditions and does not serve to modify or amend the terms and conditions contained herein.

        32.  SEVERABILITY. If any part of this Agreement is held to be void, illegal or unenforceable, then it shall be deemed to be severed from this Agreement and the remaining provisions shall continue in full force and effect; provided, however, that if any fundamental term or provision of this Agreement is held to be void, illegal or unenforceable, the remainder of this Agreement shall be unenforceable. Upon a determination that any term or provision is void, illegal or unenforceable, the parties shall negotiate in good faith to modify this Agreement to effect the original intent of the parties as closely as possible in order that the transactions contemplated hereby be consummated as originally contemplated to the greatest extent possible.