REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 17, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with Integra Lifesciences Sales LLC for Purchase of DuraSorb Products
End
RECOMMENDATION(S)
Recommendation
Approve Agreement with Integra LifeSciences Sales LLC, including non-standard terms, for the purchase of DuraSorb products in the total not-to-exceed amount of $1,750,000, for the period of November 17, 2026 through November 16, 2031.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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 total not-to-exceed cost of $1,750,000 is based on projected utilization and includes a modest allowance for anticipated clinical needs. The cost is funded by State Medi-Cal, federal Medicare, private insurance, and other departmental revenue. 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
This agreement with Integra LifeSciences Sales LLC (“Integra”) will provide ARMC with access to DuraSorb products, including sterile, absorbable synthetic mesh for temporary soft-tissue reinforcement in appropriate surgical procedures. DuraSorb® Monofilament Mesh is constructed from polydioxanone (PDO), a bioabsorbable synthetic polymer designed to provide temporary mechanical support as the healing process progresses, with gradual degradation of the implanted material.
Integra’s DuraSorb product portfolio also includes Integra™ Meshed Bilayer Wound Matrix, a collagen-based wound matrix used for the management of indicated wounds, including burns, ulcers, surgical wounds, and traumatic wounds; and Integra® Meshed Dermal Regeneration Template, a bilayer dermal regeneration matrix used in the management of severe burns and in reconstructive procedures, including scar-contracture treatment, as indicated by the product labeling.
The DuraSorb products covered under the agreement with Integra are designed to support surgical wound management, tissue repair, and temporary soft-tissue reinforcement. DuraSorb® Monofilament Mesh provides a sterile, bioabsorbable synthetic mesh option for temporary reinforcement of weakened soft tissue in appropriate surgical procedures. Integra™ Meshed Bilayer Wound Matrix and Integra® Meshed Dermal Regeneration Template provide additional wound management and dermal regeneration options for clinically indicated applications.
These products provide sterile, ready-to-use treatment options in designated formats, with certain products available in customizable sheet configurations to accommodate the treatment site. Product-specific handling, sizing, fixation methods, and clinical applications are subject to the manufacturer's instructions for use.
The agreement is Integra’s standard commercial contract, which includes terms that differ from the standard County contract and omits certain County standard contract terms. While the parties negotiated certain contract terms to County standards, Integra would not agree to all County standard terms. The non-standard and missing terms include the following:
1. The County is required to indemnify Integra against any claims based upon negligence, breach of warranty, strict liability in tort, contract, or any other theory of law brought by the County, County customers, end users, and auxiliary personnel (such as freight handlers, etc.) or by other parties, arising out of, directly or indirectly, the failure by County to use Integra’s products in accordance with the package labeling or the requirements of the warranty, the County’s failure to perform its obligations under the Agreement, or the failure of the County to comply with applicable law.
• The County standard contract does not include any indemnification or defense by the County of a contractor.
• Potential Impact: By agreeing to indemnify Integra, 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 Integra without such limitations and the County could be responsible to reimburse Integra for costs, expenses, and damages, which could exceed the total Agreement amount.
2. The Agreement does not include certain standard County insurance requirements, including the waiver of subrogation.
• The County standard contract requires contractors to carry appropriate insurance at limits and under conditions determined by the County’s Risk Management Department.
• Potential Impact: No waiver of subrogation may allow Integra’s insurer to bring suit against the County, which could result in expenses that exceed the total Agreement amount.
3. Integra’s maximum liability to the County is limited to $2 million without exclusions.
• The County standard contract does not include a limitation of liability.
• Potential Impact: Claims could exceed the liability cap and the Agreement amount leaving the County financially liable for the excess.
4. Venue for disputes arising under the Agreement is in the courts in the State of Delaware.
• County Policy 11-05 requires venue for disputes in Superior Court of California, County of San Bernardino, San Bernardino District.
• Potential Impact: Having a venue in the State of Delaware may result in additional expenses that exceed the amount of the Agreement.
ARMC recommends approval of this agreement with Integra, including the non-standard terms, to provide the surgical and clinical teams with access to appropriate wound care and soft-tissue reinforcement products that support procedure-specific treatment needs. The agreement will provide continued access to and help establish a consistent source for these products, support operating room and wound care supply planning, and provide clinicians with additional treatment options when medically indicated.
PROCUREMENT
The Purchasing Department supports this non-competitive procurement based on functional specifications, which include fully resorbable PDO monofilament construction, predictable 12-month strength profile, infection-reducing design, ready-to-use product configuration, and versatility across surgical applications. These features are required for procedure-specific treatment and integration into established operating room and wound care workflows. Alternative products do not meet these required functional specifications; therefore, additional quotes cannot be obtained.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on October 28, 2026; Purchasing (Veronica Pedace, Lead Buyer, 387-2464) on October 22, 2026; Risk Management (Arrissia Beaven, Staff Analyst II, 386-9030) on October 28, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on October 22, 2026; and County Finance and Administration (Matthew Dalton, Administrative Analyst, 387-4884) on November 3, 2026.