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Biopsy Instruments: Comprehensive Guide to Types, Uses, Safety, and Market Trends

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Biopsy instruments are central to modern diagnostic medicine because they allow clinicians to obtain high‑quality tissue samples with minimal trauma, fast turnaround, and high diagnostic accuracy. From cancer staging to autoimmune disease workups, the right biopsy forceps, needles, punches, and vacuum systems can be the difference between an early, precise diagnosis and delayed treatment.

Understanding Biopsy Instruments and Their Clinical Role

Biopsy instruments are specialized medical devices designed to remove cells or tissue from the body for histopathology, cytology, and molecular testing. In clinical practice, they are used in oncology, gastroenterology, pulmonology, dermatology, gynecology, urology, interventional radiology, and many other specialties. The choice of biopsy instrument depends on lesion location, size, depth, suspected pathology, and the need for core tissue versus cytologic samples.

In everyday workflows, clinicians rely on core needle biopsies, fine‑needle aspiration needles, endoscopic biopsy forceps, punch biopsy tools, curettes, and trephines to obtain representative samples from solid organs, mucosal surfaces, skin, bone, and soft tissue. Modern biopsy instruments are engineered to maximize sample sufficiency while reducing pain, bleeding, and the risk of complications.

Major Types of Biopsy Instruments and Their Applications

Biopsy instrument selection starts with understanding the major categories and how they support specific biopsy procedures and anatomical targets.

Needle-based biopsy instruments

Needle‑based biopsy instruments are the most widely used class of biopsy tools for deep organs and solid masses. They include core needle biopsy devices, fine‑needle aspiration systems, and vacuum‑assisted biopsy instruments. Core needle instruments remove small cylinders of tissue that preserve architecture, which is essential for tumor grading, receptor testing, and immunohistochemistry. Fine‑needle aspiration needles draw cells and small tissue fragments for cytology, which is useful for thyroid nodules, lymph nodes, and superficial masses.

Vacuum‑assisted biopsy devices add suction to capture larger and more contiguous tissue samples, particularly in breast biopsy procedures guided by ultrasound, stereotactic imaging, or MRI. These vacuum biopsy instruments reduce the need for open surgical biopsies and allow multiple specimens to be collected through a single skin entry.

Biopsy forceps

Biopsy forceps are used in endoscopy, bronchoscopy, cystoscopy, hysteroscopy, and ENT procedures to obtain mucosal or intraluminal tissue samples. Gastrointestinal biopsy forceps retrieve specimens from the esophagus, stomach, small intestine, colon, and rectum during diagnostic endoscopy for conditions such as inflammatory bowel disease, celiac disease, or suspected malignancy.

Bronchoscopic biopsy forceps are designed to navigate the bronchial tree to sample endobronchial lesions and peripheral pulmonary nodules. Cervical biopsy forceps such as Tischler, Kevorkian, or Eppendorfer designs are optimized for colposcopy and gynecologic oncology, where controlled bites and precise sample sizing are critical.

Biopsy punches

Biopsy punches are cylindrical cutting instruments mostly used in dermatology, plastic surgery, and gynecology. They create round full‑thickness skin samples that include epidermis, dermis, and often superficial subcutaneous tissue. Punch biopsy instruments are available as handheld stainless steel devices or disposable plastic punches with integrated handles and blades in diameters ranging from very small sizes for facial lesions to larger sizes for excisional sampling.

Power biopsy punches, which attach to motorized handpieces, can be used in dermatosurgery for faster and more consistent cuts, especially when multiple lesions must be sampled in a single session.

Bone and bone marrow biopsy instruments

Bone biopsy instruments include trephine needles and cutting devices designed to penetrate cortical bone safely while minimizing fracture risk. Bone marrow biopsy needles allow hematologists and oncologists to sample marrow from the iliac crest for leukemia, lymphoma, myeloma, and other hematologic disorders. These instruments must balance sharpness for efficient penetration with structural strength for patient safety.

Specialized biopsy instruments

Specialized biopsy tools have evolved for organ‑specific applications. Liver biopsy needles are designed to reduce bleeding risk and are often used with imaging guidance. Renal biopsy needles capture cortical tissue from the kidney while protecting vessels and collecting ducts. Prostate biopsy instruments integrate spring‑loaded guns and transrectal ultrasound guidance to systematically sample multiple cores from defined prostate zones. In interventional radiology, coaxial biopsy systems allow multiple samples to be taken through a single introducer, reducing trauma.

Disposable vs Reusable Biopsy Instruments

Choosing between disposable biopsy instruments and reusable biopsy tools has significant implications for cost, infection control, workflow, and sustainability.

Disposable biopsy devices are pre‑sterilized, used once, and discarded. They reduce the risk of cross‑contamination and eliminate the need for complex reprocessing, making them attractive for high‑throughput ambulatory centers and smaller clinics that lack advanced sterilization infrastructure. Single‑use biopsy forceps and needles provide predictable performance, and their total cost is easy to forecast because there are no hidden repair or maintenance expenses.

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Reusable biopsy instruments are manufactured for many cycles of use and reprocessing. They typically offer higher initial build quality and sharper cutting edges at first use, which can translate into cleaner cuts and better sample integrity. Over time, however, repeated sterilization can dull blades, introduce microscopic damage, and increase the risk of mechanical failure or incomplete closure in forceps. Reusable devices require rigorous cleaning, disinfection, and sterility testing protocols to prevent infection transmission.

Hospitals and large diagnostic centers often conduct cost‑benefit analyses that factor in purchase price, expected lifespan, reprocessing labor, sterilization consumables, storage, and repair costs to determine the real per‑procedure cost of reusable versus disposable biopsy instruments. Many institutions adopt hybrid models, using reusable biopsy tools for high‑volume procedures and disposable devices for high‑risk, infectious, or complex cases.

Core Technology in Modern Biopsy Instruments

Technological innovation in biopsy instruments focuses on improving diagnostic yield, patient comfort, ergonomics, and procedural safety.

Mechanical engineering advances have refined spring‑loaded biopsy guns to provide consistent firing speeds, adjustable throw lengths, and smoother needle trajectories. This reduces patient discomfort and sampling errors. Vacuum‑assisted biopsy systems integrate motorized vacuum pumps and rotating cutting cannulas to capture larger contiguous tissue volumes, which is especially important in breast biopsy when multiple histologic assessments are needed from a single lesion.

In biopsy forceps, miniaturization and articulation enhancements allow tools to reach difficult anatomical areas while maintaining grip strength and cutting precision. Coated jaws and optimized cup geometries are designed to reduce crush artifact and improve tissue orientation for pathology analysis.

Material science is another critical component. High‑grade stainless steel, tungsten carbide tips, and advanced polymers are used to balance sharpness, flexibility, biocompatibility, and durability. In disposable biopsy instruments, manufacturers must engineer blades that remain reliably sharp for a single use but are cost‑effective for mass production.

Digital integration is emerging as a defining trend. Smart biopsy devices can record the number of uses, log force applied, and communicate with electronic medical records for traceability. In digital pathology workflows, biopsy instruments are increasingly designed with pre‑labeled cassettes, barcode systems, and specimen tracking features that reduce labeling errors and misidentification risk.

Market Trends, Growth Drivers, and Regional Insights

The global market for biopsy devices and biopsy instruments is expanding steadily, driven by rising cancer incidence, aging populations, and the growing emphasis on early detection across healthcare systems. Market research analyses project the biopsy devices segment to reach multi‑billion dollar valuations over the next decade, with compound annual growth rates in the mid‑single to high‑single‑digit range as imaging‑guided and minimally invasive biopsies become standard of care.

Needle‑based biopsy instruments hold the largest share of the market due to their widespread adoption in oncology, radiology, and interventional specialties. Vacuum‑assisted biopsy technologies are showing particularly strong growth in breast cancer screening and diagnosis, where they reduce the need for open surgical excisions and improve patient satisfaction.

North America currently accounts for a major share of global biopsy instrument revenue, supported by strong reimbursement structures, advanced hospital infrastructure, and high screening rates for breast, colorectal, prostate, and lung cancers. Europe closely follows with robust investments in cancer centers and screening programs. Asia‑Pacific represents the fastest‑growing regional market as healthcare access improves and awareness of cancer screening accelerates in China, India, and Southeast Asia.

Hospitals remain the dominant end users of biopsy devices, but diagnostic laboratories, ambulatory surgery centers, and specialty clinics are increasing their share as care shifts closer to the community and outpatient procedures become more common.

Safety, Sterilization, and Regulatory Considerations

Biopsy instruments play a critical role in patient safety, and their design and use are tightly regulated by health authorities to ensure quality and performance. Regulatory approvals typically require stringent testing for biocompatibility, mechanical reliability, sterility, and repeatability of function.

In daily practice, strict adherence to sterilization and handling protocols is essential for reusable biopsy instruments. This includes thorough manual cleaning to remove organic material, appropriate disinfection or sterilization cycles, and inspection for dullness, corrosion, or mechanical faults. Single‑use biopsy instruments lower the burden of reprocessing but require proper storage, integrity checks before use, and safe disposal in accordance with medical waste regulations.

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Clinicians and biomedical engineers work together to establish instrument tracking systems to monitor usage counts and maintenance histories. Such systems help prevent overuse of reusable tools beyond their validated life and reduce the risk of adverse events like instrument breakage or incomplete tissue retrieval.

Buying Guide: How to Choose the Right Biopsy Instruments

Selecting the optimal biopsy instrument set for a hospital, surgery center, or specialty clinic involves clinical, economic, and operational criteria.

Key clinical factors include target anatomy, lesion size, access path, and imaging modality. For example, thyroid fine‑needle aspiration biopsy needs thin, flexible needles compatible with ultrasound guidance, whereas bone biopsy may call for heavy‑duty trephine systems designed for CT‑guided procedures. Dermatology practices may prioritize a full range of punch biopsy sizes and user‑friendly handles for fast rotation and control.

From an economic perspective, procurement teams evaluate total cost of ownership, including per‑case cost, reprocessing requirements, warranty coverage, and availability of local service. Lower‑priced disposable biopsy instruments might appear cost‑effective initially but may not deliver the same precision or durability as higher‑end devices, which can impact diagnostic yield.

Operational considerations include compatibility with existing endoscopes and imaging systems, ease of training, and integration with specimen labeling and tracking processes. Many facilities standardize on specific biopsy instrument families to simplify training, inventory management, and quality assurance.

ALLWILL operates at the intersection of these decisions, helping practitioners navigate brand selection, device lifecycle management, and service logistics through a smart, data‑driven approach that reduces downtime and optimizes capital investment.

Top Biopsy Instrument Categories and Use Cases

The most frequently used biopsy instrument categories can be grouped by anatomy and clinical workflow.

Core needle biopsy sets for breast, liver, kidney, and soft tissue are designed to work with ultrasound, CT, or MRI guidance. They provide consistent core lengths, echogenic tips, and depth markings that help physicians control sampling.

Endoscopic biopsy forceps for GI and pulmonary use come in standard, large‑cup, alligator, and hot biopsy variants. Some models support electrocautery to simultaneously cut and coagulate tissue, which is useful in polypectomy and hemostasis.

Dermatologic biopsy punches range from tiny precision punches for delicate facial lesions to larger tools suited for suspected melanoma or inflammatory dermatoses where full‑thickness samples are needed. Their simplicity, low cost, and effectiveness make them indispensable in outpatient dermatology.

Gynecologic biopsy instruments include cervical punches, uterine curettes, and endometrial biopsy devices that provide sufficient tissue with minimal discomfort. In colposcopy, specific forceps designs help clinicians obtain targeted biopsies from transformation zones identified by acetic acid or Lugol’s iodine staining.

Bone marrow biopsy needles are engineered with ergonomic handles, trocar tips, and stylets for stable insertion and reliable sample capture. Their design aims to maximize patient comfort while ensuring adequate core length and intact marrow architecture.

Competitor Comparison Matrix: Key Biopsy Instrument Features

When evaluating biopsy instrument suppliers, healthcare organizations often compare several critical attributes, from clinical performance to lifecycle support.

Supplier Type Product Focus Key Advantages Typical Users Lifecycle Considerations
Global OEM manufacturers Comprehensive biopsy device portfolios Advanced engineering, strong regulatory track record, integration with imaging systems Tertiary hospitals, academic centers Strong warranties, proprietary parts, premium pricing
Regional medical device companies Niche biopsy instruments or localized ranges Competitive pricing, adaptation to local needs, flexible distribution Regional hospitals, growing clinics Variable service availability, mixed portfolio depth
Specialty biopsy tool manufacturers High‑precision niche instruments (e.g., dermatology, bone marrow) Very targeted designs, high sharpness and ergonomics Dermatology, hematology, oncology specialists High unit cost per device but strong clinician loyalty
Distributors and private‑label brands Broad assortment across multiple manufacturers One‑stop sourcing, volume discounts, mixed quality tiers Group purchasing organizations, multi‑hospital systems Differing support levels depending on origin manufacturer

This kind of comparison helps clinical and procurement teams balance quality, cost, support, and compatibility when building a comprehensive biopsy instrument lineup.

Real Clinical Use Cases and ROI from Biopsy Instrument Optimization

Optimizing biopsy instrument selection and usage can generate measurable returns on investment while improving patient outcomes.

For example, a breast center that transitions from surgical excisional biopsy to vacuum‑assisted breast biopsy systems can reduce operating room time, shorten hospital stays, and perform more procedures in an outpatient setting. This shift lowers direct costs, decreases patient morbidity, and often improves patient satisfaction scores, which can influence reimbursement in value‑based care environments.

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A gastroenterology unit that standardizes on high‑quality endoscopic biopsy forceps with improved sharpness may see fewer repeat biopsies due to insufficient samples. This reduces patient recall visits, pathology turnaround time, and overall procedure volume per diagnosis, freeing endoscopy capacity for new referrals.

In dermatology, adopting a wide range of punch biopsy sizes and training providers on optimal selection can reduce the need for re‑biopsies and minimize scarring, enhancing cosmetic outcomes and patient loyalty to the clinic.

From a financial perspective, hospital systems that perform detailed analyses of reusable versus disposable biopsy instruments often discover hidden costs in reprocessing, repairs, and downtime when instruments fail unexpectedly. Moving toward standardized instrument sets, defined replacement schedules, and reliable vendor partnerships can reduce per‑case costs and simplify budgeting.

Future Trends in Biopsy Instruments and Diagnostic Technologies

The future of biopsy instruments is closely tied to advances in imaging, molecular diagnostics, and minimally invasive therapy.

Image‑guided and robotic biopsy platforms are becoming more capable of targeting small lesions in challenging anatomical locations. Integration of real‑time ultrasound, CT, MRI, and fluoroscopy with smart biopsy needles allows clinicians to adjust trajectories dynamically and confirm sample adequacy while the patient is still on the table.

Liquid biopsy technology, which analyzes circulating tumor DNA and other biomarkers in blood or body fluids, does not replace traditional tissue biopsy but complements it. As these tests mature, tissue biopsy instruments may be increasingly used to confirm and subtype disease after initial liquid biopsy screening, ensuring precise treatment selection.

Artificial intelligence and digital pathology are transforming how biopsy samples are processed and interpreted. This creates new demands on biopsy instruments to deliver high‑quality, artifact‑free specimens suitable for automated image analysis, multiplex immunohistochemistry, and genomic sequencing.

Sustainability is also influencing biopsy instrument design. Manufacturers are exploring recyclable materials, reduced packaging, and hybrid “resposable” systems with reusable handles and disposable working tips to decrease environmental impact without compromising sterility or performance.

Practical FAQs on Biopsy Instruments

What is the difference between core needle biopsy and fine‑needle aspiration?
Core needle biopsy removes a cylinder of tissue that preserves structural architecture, which is crucial for grading tumors and performing receptor testing, while fine‑needle aspiration collects cells and small tissue fragments primarily for cytology.

When should a clinician choose disposable biopsy instruments over reusable ones?
Disposable biopsy instruments are preferred when infection risk is high, when reprocessing capacity is limited, or when predictable per‑procedure costs and rapid turnaround are more important than long‑term cost amortization of reusable tools.

How often should reusable biopsy forceps and needles be replaced?
Replacement intervals depend on manufacturer recommendations, usage volume, and local quality checks, but tools must be retired immediately if dullness, corrosion, mechanical faults, or incomplete closure are observed during inspection.

Can advanced biopsy instruments reduce the need for open surgical biopsies?
Yes, vacuum‑assisted systems, image‑guided core needles, and high‑precision endoscopic tools enable minimally invasive biopsies that frequently replace open procedures, reducing patient morbidity and hospital resource use.

What training is required to use modern biopsy devices safely?
Clinicians and staff need procedure‑specific training on instrument handling, depth control, firing mechanisms, sterile technique, complication management, and specimen labeling to ensure accurate, safe biopsies and reliable pathology results.

Conversion Path: From Evaluation to Implementation

For healthcare organizations evaluating biopsy instrument portfolios, the first step is clarifying clinical priorities: which services will grow, where diagnostic delays are occurring, and how minimally invasive biopsies can expand capacity while improving patient experience. This clinical needs assessment should involve physicians, nurses, pathologists, and biomedical engineers.

Next, procurement and clinical leaders can work together to benchmark current instruments against newer options, comparing sample adequacy, complication rates, turnaround time, and per‑procedure cost. Pilot programs using new biopsy devices in a limited scope can generate real‑world data to guide broader adoption decisions.

Finally, successful implementation depends on standardized protocols, staff education, and long‑term partnerships with vendors that offer reliable supply, responsive service, and transparent data on device performance. By aligning biopsy instrument strategy with diagnostic goals and financial constraints, organizations can deliver faster, more accurate diagnoses and better patient care while controlling costs.

For practitioners and health systems seeking to modernize their biopsy instrument fleet, the opportunity lies in combining evidence‑based device selection, structured training, and smart lifecycle management to create a future‑ready, high‑performance diagnostic ecosystem.

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(e) Notice and Inspection. The limited warranties contained in this Section 8 are made on condition that immediate written notice of any noncompliance with the Equipment’s and/or the Service’s warranty be given to MRP, and provided that MRP’s inspection reveals that Buyer’s claim is valid under the terms of such warranty.

        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.