REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 20, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Purchase Agreement with Abbott Laboratories Inc. for the Purchase of MitraClip and TriClip Devices
End
RECOMMENDATION(S)
Recommendation
Approve Agreement with Abbott Laboratories Inc., including non-standard terms, for the purchase of MitraClip and TriClip devices, in the not-to-exceed amount of $2,400,000, for the period of November 1, 2026 through October 31, 2029.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $2,400,000 is funded by State Medi-Cal, federal Medicare, private insurance, and other departmental revenue. The cost is based on estimated annual usage of 12 MitraClip devices at $33,000 each and 12 TriClip devices at $36,000 each, for an estimated annual cost of approximately $828,000. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of the Agreement (Agreement) with Abbott Laboratories Inc. (Abbott), will allow ARMC to purchase 12 MitraClip and 12 TriClip devices for use in ARMC’s Structural Heart Program to treat mitral and tricuspid regurgitation.
ARMC is currently expanding its Structural Heart Program. To support the planned expansion, a new service line is needed to treat mitral and tricuspid regurgitation. The MitraClip and TriClip devices provide this clinical capability by clipping valve leaflets together, reducing the amount of blood leaking backwards through the valve.
The proposed Agreement is Abbott’s standard commercial agreement, negotiated by the parties, which includes terms that differ from the standard County contract as follows:
1. Abbott may assign the Agreement to one of its affiliates without the County’s consent, but with notice to the County. In the event this happens and the affiliate is an entity the County is legally prohibited from doing business with, the County has the right to terminate the Agreement without further obligations.
• The County standard contract requires that the County must approve any assignment of the contract.
• Potential Impact: Abbott could assign the Agreement to a third party or business affiliate with which the County is legally prohibited from doing business due to legal issues such as a conflict of interest, without the County’s knowledge. Should this occur, the County could be out of compliance with the law until it becomes aware of the assignment and terminates the Agreement.
2. The County is required to indemnify Abbott from third-party claims arising out of (1) bodily injury or property damage caused by the County’s negligence or willful misconduct; (2) the County’s material breach of the Agreement; or (3) the County’s or its personnel’s violation of law in performing the Agreement.
• The County standard contract does not impose an indemnity obligation on the County.
• Potential Impact: By agreeing to indemnify Abbott, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time-limited, or expense-limited could be brought against Abbott without such limitations, and the County could be responsible to defend and reimburse Abbott for costs, expenses, and damages, which could exceed the total Agreement amount.
3. Abbott’s indemnity obligations are limited to claims arising out of (1) bodily injury or property damage caused by its negligence or willful misconduct; (2) material breach of the Agreement; or (3) its violation of law in performing the Agreement.
• The County standard contract general indemnity provision requires the contractor to indemnify, defend, and hold County harmless from third party claims arising out of the acts, errors or omissions of any person.
• Potential Impact: Abbott’s indemnity obligation is more limited compared to the standard County general indemnity obligation. In the event a claim arises that falls outside the scope of Abbott’s limited indemnity obligation, the County could be financially responsible for the defense of the claim and any resulting judgment/settlement.
4. Venue for disputes arising under the Agreement is in California state or federal courts.
• The County standard contract requires venue for disputes in the Superior Court of California, county of San Bernardino, San Bernardino District. However, this is an acceptable revision under County Policy 11-05.
• Potential Impact: A venue provision that permits disputes to be brought anywhere in California, rather than limiting venue to San Bernardino County, may result in additional expenses incurred that might not otherwise have been incurred if venue was in San Bernardino County.
5. The County may terminate the Agreement without cause with 90 days’ written notice.
• The standard County contract permits the County to terminate the contract with 30 days’ written notice.
• Potential Impact: The County will need to be mindful of the extended notice period in the event it seeks to terminate the Agreement without cause.
6. Payment will be due net thirty (30) days from the date of invoice.
• The standard County contract requires that payment will be net sixty (60) days with no interest or late penalties.
• Potential Impact: County standard processing time is 60 days or more. Failing to pay net 30 days may result in a material breach of the Agreement, which could allow Abbott to terminate the Agreement and seek other legal remedies
7. Abbott limits its warranties to those expressly provided in the Agreement but disclaims all other express or implied warranties.
• The County’s standard contract requires vendors to fully warrant the products and services provided to the County.
• Potential Impact: The County’s warranty protections are limited to the specific warranties provided by Abbott and the County may be limited to pursue warranty claims beyond those stated in the Agreement.
ARMC recommends approval of the Agreement, including non-standard terms, to support the continued expansion of its Structural Heart Program. The MitraClip and TriClip devices will enable ARMC to provide procedures for patients with mitral and tricuspid regurgitation, enhancing the services available to patients and supporting the delivery of quality patient care.
PROCUREMENT
Abbott manufactures MitraClip and TriClip and does not have a distributor network for these devices; therefore, they must be purchased directly from Abbott. The devices meet the clinical and procedural requirements of ARMC’s Structural Heart Program, and staff are trained and experienced in their use. Additional quotes cannot be obtained because the devices are sold directly by the manufacturer. The Purchasing Department supports this non-competitive procurement based on manufacturer direct justification.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Anushka Silva, Deputy County Counsel, 387-5455) on September 16, 2026; Risk Management (Arrissia Beaven, Staff Analyst II, 386-9030) on September 17, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on September 16, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on October 16, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on September 29, 2026.