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
Agreements with Boston Scientific Corporation for WATCHMAN FLX Pro Left Atrial Appendage Closure Technology
End
RECOMMENDATION(S)
Recommendation
1. Approve Purchase Agreement with Boston Scientific Corporation, including non-standard terms, for the purchase of WATCHMAN FLX Pro Left Atrial Appendage Closure Technology Products, in the not-to-exceed amount of $2,664,000, from December 1, 2026 through November 30, 2029.
2. Approve non-financial Consignment Agreement with Boston Scientific Corporation, including non-standard terms, for the consignment of WATCHMAN FLX Pro Left Atrial Appendage Closure Technology Products, from December 1, 2026 through November 30, 2029.
(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 Consignment Agreement is non-financial in nature. The cost of the purchase agreement, in the amount of $2,664,000, is based on an estimated 48 procedures annually at $18,500 per procedure over the three-year agreement term and is funded by State Medi-Cal, Federal Medicare, private insurances, 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
The agreements with Boston Scientific Corporation (Boston Scientific) will allow ARMC to establish and support a WATCHMAN Left Atrial Appendage Closure (LAAC) Program utilizing the WATCHMAN FLX Pro device platform and related access systems for qualifying patients with non-valvular atrial fibrillation who require an alternative to long-term anticoagulation therapy. The WATCHMAN LAAC Program will introduce left atrial appendage closure as a new service at ARMC. Currently, patients requiring this procedure are referred to outside providers. The estimate of 48 procedures annually is based on patients currently seen at ARMC who would be candidates for the procedure.
The consignment agreement will enable Boston Scientific to consign the WATCHMAN FLX Pro Left Atrial Appendage Closure Technology products at ARMC to ensure availability without delay. Once the products are used at ARMC, the terms of the purchase agreement will apply.
The WATCHMAN FLX Pro technology is designed to reduce the risk of stroke in patients with atrial fibrillation by permanently closing the left atrial appendage through a minimally invasive procedure. As part of ARMC’s ongoing efforts to expand specialized cardiovascular services and improve patient outcomes, the WATCHMAN LAAC Program supports the safety, health, and social service needs of County residents by providing advanced treatment options for patients at increased risk of stroke and bleeding complications associated with long-term anticoagulation therapy. The agreements will support continuity of patient care, procedural efficiency, and timely access to necessary devices and related support services.
The agreements are based on Boston Scientific’s standard commercial agreements, negotiated by the parties, which deviate from the standard County contract terms as follows:
1. The payment terms for the Purchase Agreement is Net 30 days.
• County standard payment terms are Net 60 days with no interest or late payment 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 Boston Scientific to terminate the Agreement and seek other legal remedies.
2. Boston Scientific limits its general indemnity obligation in the Consignment Agreement to claims arising out of its negligence. Boston Scientific limits its general indemnity obligation in the Purchase Agreement to claims that result from their breach of an applicable law, defect in their products, or their negligence or intentional acts.
• 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: Boston Scientific’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 Boston Scientific’s limited indemnity obligation, the County could be financially responsible for the defense of the claim and any resulting judgment/settlement.
3. Boston Scientific is required to comply with only some of the standard County insurance requirements.
• 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: If the contract does not include all of the County’s standard insurance requirements, the County may have less insurance protection than it ordinarily requires, potentially increasing the County’s financial exposure if a claim or loss arises.
ARMC recommends approval of the agreements with Boston Scientific, including the non-standard terms, to support the implementation of the WATCHMAN LAAC Program and ensure access to the necessary devices, consignment inventory, clinical support, and related services required for these procedures. The agreements will provide ARMC with a mechanism to maintain inventory availability, support physician training, and deliver specialized cardiovascular care services that benefit County residents.
PROCUREMENT
Purchasing supports this non-competitive agreement based on functional specifications. The WATCHMAN FLX Pro is required for ARMC’s new left atrial appendage closure procedure based on its unique design and performance characteristics. The unique features include HEMOCOAT™ Technology to improve the healing process, radiopaque markers for precise device placement, and a new 40 mm size for larger appendages. Alternative LAAC products do not provide the same combination of required functional characteristics for the planned procedure. Therefore, comparable alternatives do not meet the required functional specifications.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on October 22, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on October 22, 2026; Department of Risk Management (Noel Cantrell, Admin Supervisor, 386-8890) on October 23, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on October 23, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on October 27, 2026.