MAGAZINE

Expanding testcapacity to

assistUSmedtechsinto Europe

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THE SUNNAASINNOVATIONInnovation has been at the heart of Sunnaas Re-habilitation Hospital in Oslo for over 50 years.Yet, during recent years the hospital felt itneeded to carve out a more focused innovationstrategy.Sunnaas Rehabilitation Hospital is one of the

largest rehabilitation hospitals in Europe. Thehospital has the responsibility for trauma treat-ment and rehabilitation within the South-East-ern Norway Regional Health Authority, and isthe hospital in Norway spending most on R&Dafter Oslo University Hospital – Rikshospitalet.Today the hospital has an extensive portfolio

of R&D projects, including welfare and assistivetechnology and gamification."We have innovated in over 50 years, but we

did not reflect over it. We have routinely visitsfrom a lot of suppliers, and we felt we con-stantly transferred our knowledge to them. Sowe raised the question, what are we left with?, "says Sveinung Tornås, head of innovation atSunnaas.The main pillars in Sunnaas strategy are the

clinic, the R&D and interaction. In 2010 Sun-naas started working more targeted with the

innovation conducted at the hospital, and in 2011 released along term plan.

ONE YEAR FROMIDEA TO PROTOTYPEJust over a year ago, the 30 year old doctor and Ph. D. studentMarte Bratlie had an idea. Today she has a company and a pat-ent pending prototype.Marte Bratlie and the company she started, RemovAid,

shows that even in the development ofmedtech equipment itis possible to take great strides in a short time.Marte Bratlie first got the idea when she had a part time job

MedtechWatch

at the clinic Sex og Samfunn, which is the country's largestcenter for sexual and reproductive health for young adults.While she worked with contraceptive related issues, she

noted that the use of long-acting contraceptives, like birthcontrol implant, has shown strong growth over the recentyears. Based on her experiences, she started questioning theestablished procedures to remove the implants.The implants are inserted into the inner side of the upper

arm. It consists of one (or two) plastic rods, about the size ofa matchstick, which contain long acting, slow-release pro-gestogen and provides safe and effective protection againstpregnancy.The idea is to develop a device which will simplify the

process of removing the contraception rods. Currently, thereare no such devices in the market.

VENTURE CAPITALTO OTIVIO: 5MOslo Medtech member Otivio AS has raised NOK 5 million inventure capital from private investors.Approximately halfwas raised by existing shareholders,

including Otivio CEO Iacob Mathiesen.Otivio develops treatment solutions and instruments based

on technology, originally developed at the University ofOslo,which improves blood flow to the skin of patients. The com-pany develops a product for temperature management ofpatients and one product for wound healing. Both systemsrely on the improved blood flow to the skin.At the end of last year, one of the captains of Norwegian

industry, former Norsk Hydro CEO Egil Myklebust was elec-ted new chairman of the board ofOtivio."He is a strategist with vast experience, and we are very

happy he will spend some of his time and experience helpinga company like ours, " Mathiesen says.With new capital in place, Otivio has financing throughout

the year, during which Mathiesen hopes to obtain a CEmarked product for wound healing and obtain certification ofOtivio according to ISO 13485. Another year is needed tocomplete clinical trials before Otivio’s product hopefully willenter the markets, according to Mathiesen.

A GROWTH HOUSEOslo Medtech expands the services in Medtech Growth Houseby offering 'virtual office' services for Norwegian andinternational medtech companies.Medtech Growth House is a concept developed by Oslo

Medtech in cooperation with Oslo Science Park.Currently there are 10 Norwegian medtech companies

localized together, exploiting synergies, sharing services andworking efficiently.The physical environment and the composition of

businesses provide joint utilization of resources andexpertise. Medtech Growth House encourages newcooperation and innovation projects. The companies in thegrowth house are working together on common issues, shareresources and have discussions on a daily basis.For more information, contact Oslo Medtech and check out

our webpage:http://oslomedtech.no

Oslo Medtech chairman Carl Christian Gilhuus-Moe on the na-tional Norwegian broadcaster TV2 Newschannel, explainingthe rapid development of the medtech industry.

MEDTECH NEWS ON NATIONAL TV

Editor­in­chief:Kathrine Myhre

CEO Oslo Medtech+47 930 69 634kathrine.myhre@oslomedtech.no

Cecilie NordbøMarketing Communications

Manager+47 930 31 593cecilie.nordbo@oslomedtech.no

Lars RønnStrategic Market Advisor

+45 24627514lars.ronn@

oslomedtech.no

Tone YrvumAdvisor Healthcare Innovation

+ 47 413 14 891tone.yrvum@

oslomedtech.no

Egil UtheimInnovation Advisor

+47 97502170egil.utheim@

oslomedtech.no

Adress: Oslo MedtechGaustadalléen 21

0349 Oslo, Norwaymail@oslomedtech.no

EDITOR'S LETTER

A MAGAZINE PRODUCED BY

Kathrine Myhrekathrine.myhre@oslomedtech.no

Published by Oslo Medtechwww.oslomedtech.no

Chairman:Carl Christian Gilhuus­Moe

ccgmoe@neomed.net

MAGAZINE

PRINTED IN OSLO BYCopyCat AS

Norway's minister ofHealth and Care Services, Jonas Gahr Størepresented in the spring 2013 the white paper “The future health-care”.Støre addresses the major challenges within the health and care ser-vices in the years to come.

The demographic changes with an aging population will put tre-mendous pressure on the existing healthcare model, and governmentbudgets. To meet these challenges Støre invites businesses to takepart in developing the new technology, solutions and services neededto create more efficiency in the health sector.

The Norwegian governmentputs some important founda-tions in place to further de-velop the health and caresector into a well functioningmarket, which is a prerequisitefor the business sector taskedto develop the new solutionswe all need.

Oslo Medtech welcomesthese new initiatives. Ourmembers are intensely in-

volved in developing new welfare technology that can solve thechallenges in the health care. The major challenges ahead of us createnew and exciting opportunities, not least the opportunity to build astrong and vibrant medtech sector in Norway.

And this is not just a national concern, we need to include and co-operate with international businesses. Back in the early 1970s, thesuccessful oil and gas industry was built with the help from Americancompanies, and many of them are still doing profitable business inNorway.

The future

healthcare.

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EXPANDSTHEOSLOTESTBED

THE HOSPITAL TOOLBOX: - We have noticed that there is agreat interest from the medtech industry to take advantage ofThe Intervention Centre as a testbed, says Jacob Bergsland,MD, Ph.D, at Oslo University Hospital. The testbed is beingdeveloped together with Oslo Medtech, a 160 member strongcluster of companies and research organizations.The Intervention Centre is a special department at Oslo

University Hospital, established in 1996 to facilitate R&D, andto develop and test new procedures and technology."The centre is expanding its capacity to assist US medtech

companies into Europe, and will increase its staff and provide abetter organization, focusing on the needs ofUS medtechcompanies, "says Oslo Medtech chairman Carl ChristianGilhuus-Moe.The centre was established to create a link between clinical

practice, applied and basic research. As it was organized as anindependent unit within the hospital, it has been possible toconduct cross-disciplinary research in a unique way.The centre is like a toolbox for the hospital, it is a multi dis-

ciplinary facility created to take advantage of all the variousdepartments in the hospital."The Intervention Centre is a core facility, and we work with

multiple departments at the Oslo University Hospital andother hospitals as well. This means that we can leverage all theR&D, technology and knowledge available, " Jacob Bergslandsays.

LONG EXPERIENCE: With 20.000 employees the hospital isone of the largest in northern Europe, and a leading hospital incancer treatment, transplant surgery, pediatric medicine andsurgery, neuro and cardiac surgery and medicine.The Intervention Centre already has a long experience as a

development and test centre for medical devices for manymultinational medtech companies. Attractive European legis-lation allows for faster and simpler procedures for approval ofmedical devices, thus creating the potential to shorten the of-ten expensive time-to-market phase.The Intervention Centre offers advanced and technologically

cutting edge surgical facilities approved for both human andanimal studies." The combination of early phase development and the ability

to perform almost any type of clinical trials on both animalsand humans makes The Intervention Center one of a very fewin the world," says Jacob Bergland.A highly competent staff includes employees from 15 differ-

ent countries who bring leading medical and technological ex-pertise from around the world. The staff at the centre includedoctors, nurses, physicists, radiographers and engineers.Since the establishment by the pioneers Erik Fosse, MD,Ph.D

and Frode Lærum, MD, Ph.D, the centre has published over400 scientific articles and over 25 Ph.Ds have earned their de-grees through research at the Intervention Centre. Since 1996,the centre has conducted around 10.000 human and 1000 an-imal procedures.

PICTURE:Jacob Bergsland, MD, PhD, Oslo University

Hospital, The Intervention Centre.Photo: Gorm K. Gaare

The Intervention Centre inOslo expands its capacity and

services to US companies,offering to use Norway as a

gateway to Europe.

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SERTIFICATIONASSISTANCE:" In collaboration with The

Intervention Center, we canhandle most parts a cus-tomer needs," says SteinarMegaard, Vice President atNemko. DNV Nemko Presafeis a global testing and Certi-fication Company special-ized in the medicalindustries.Megaard explains how

DNV Nemko Presafe canhelp secure access to theEuropean markets throughthe Intervention Center atOslo University Hospital. Toachieve a CE certification ofmedical devices that provideaccess to EU markets, theproducer and the productneed to meet the require-ments in one of the three EUdirectives; MDD (MedicalDevice Directive) , IVDD (InVitro Device Directive) andAIMDD (Active ImplantMedical Device Directive) .

" In order to achieve compliance, a wide range of support-ing standards can be used in addition to the MEDDEV docu-ments, " explains Megaard.The directives describe several ways to secure certifica-

tion, but in the most common route, the manufacturer andthe product must meet the Quality Assurance (QA), whichsets the requirements for the manufacturer's internal qualitysystems, and Technical file, which is the technical docu-mentation related to the product."To comply with the QA, the requirements in the EU Dir-

ectives must be met, preferably also the ISO 13485: 2012standard, "Steinar Megaard says.Technical file is built by risk analysis, clinical data, Labels

and instruction for use, and applicable technical document-ation (for instance test reports, sterilization reports,biocompatibility documentation etc. )DNV Nemko Presafe offers a combined audit of the Quality

system and the medical device technical file which is man-datory for having the device CE-marked. If the customerwant ISO 13485 certification as well, this can be combined. -"We use local teams of experts for this audit. The appliedcertificates will be issued in Norway after final technical re-view," says Megaard.In the USA, Nemko is present with their laboratories in

both San Diego and Dallas.

ONE-STOP-SHOP: "Together with NEMKO, as a notifiedbody, CROs like LINK Medical and Oslo Medtech, The Inter-vention Centre offers services as a one-stop-shop for medtechcompanies to facilitate their test needs, and an attractive routeto the European markets, " Bergsland says.Bergsland also pinpoint Oslo University Hospital as the most

advanced in Norway, and a foundation for scientific credibil-ity. Thus, the test results generated at the center are trust-worthy."Another important aspect is our patients. They have a high

degree of trust in Oslo University Hospital as an institution,and the willingness to take part in trials is high. That’s not al-ways the case at other similar institutions around the world,"Bergsland says. Of course all testing and research is done ac-cording to strict safety- and ethical standards established inNorway."Going forward, we will expand our facilities with more op-

erating theaters including hybrid rooms, giving us more fa-cilities to test and develop new and better medicaltechnology," Bergsland adds.

Securesaccessto EU­

markets

Text: PER GJØRVADper.gjorvad@oslobusinessmemo.no

Photo: GORM K. GAAREgorm.gaare@oslobusinessmemo.no

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EXPANDSTHEOSLOTESTBED

EUROPEAN CRO: "We have to be able to operate throughoutEurope. That is vital to us, " says Ola Gudmundsen, LINK Med-ical CEO and founder. The company is a CRO (contract re-search organization) complementing the testbed andcertification facilities of The Intervention Centre at Oslo Uni-versity Hospital and DNV Nemko Presafe."We are an international full service CRO with 60 employees

based in the Scandinavian countries, " says Dr. Gudmundsen,Ph.D.

A GROWING SECTOR: Established in 1995, the company wasoriginally built servicing the pharmaceutical industry, but hasover a number of years expanded the business to include themedtech sector."The medtech sector is very interesting in a number ofways.

It’s growing, the number of businesses is increasing and wealso experience more international medtech companies enter-ing Norway. Also, the regulatory regime is getting tighter.

Deep knowledge about the regulatory regime and governmentrelations are important parts of our services, " says Gudmund-sen." If you want to enter the European markets through the In-

tervention Centre at Oslo University Hospital and VeritasNemko Presafe, we are a natural partner," he says, pointing atthe company's presence in Norway, Sweden and Denmarkwith separate offices. In additon it has established partner-ships in Finland, Iceland, the Baltic and a number of otherEuropean countries.

MEDTECH TEAM: The company has built a separate medtechteam, with employees assigned to both the regulatory side andclinical operations.Gudmundsen estimate that approximately 10 percent of

LINK Medicals business today is within medtech, and expectthis to grow."We have invested considerable resources in building highly

competent medtechteams," says Randi Riise,Director Quality Assur-ance at LINK Medical.It has also forged a close

cooperation with OsloMedtech and its members.Riise acknowledge the

enormous product rangewithin the medtech sec-tor." That’s why we believe

in close cooperation,where we build ourknowledge together withour customers, " she says.

EXPLORINGAPPS

& GAMING

­ To operatethroughout

Europeis vital!

Ola Gudmundsen, CEO LINKMedical.

LINKMedicalheadquarter,Oslo,Norway.

Randi Riise,Director Quality

Assurance.

Text: PER GJORVADper.gjorvad

@oslobusinessmemo.no

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CHALLENGES THE MEDICATION: Could working memorytraining with computer games be an alternative to stimulantmedication for children and adolescents with concentrationdifficulties and epilepsy?This question is about to be answered in a test project led by

Charlotte Lunde, assistant MD and researcher at Oslo Uni-versity Hospital. The testing of patients will start this year,and 90 patients will have been tested by the end of April2016.“Epilepsy patients have considerable exposure to a range of

pharmaceuticals, and therefore it would be an importanttreatment advance if these patients could be treated withnon-pharmaceutical,” Charlotte Lunde says.

HEALTH GAMING GROWTH: "Taking a bird eye view,learning and self service solutions are the key drivers in thedevelopment and implementation of game technology in thehealth sector, " says Egil Utheim, innovation adviser and headof the Oslo Medtech Game, Simulation & Robotics group.Gamification is an important tool in planning and develop-

ing new hospitals, like the new USD 1 billion hospital to bebuilt by Østfold Hospital Trust, southeast ofOslo."By using game technology to simulate the new hospital

and its functions, we are able to let the hospital staff into thevirtual building and create a virtual learning environment,which enable them to practice, interact and provide import-ant feedback to the planners, " says Utheim.Self service solutions is another fast growing area within

the gamification sector. Game technology can provide train-ing and stimulation to both cognitive and motoric skills.Game technology is highly motivating and with distinct so-cial features."Game technology can enable the user to take a greater

proportion of the treatment, provide more motivating train-ing and also counteract the “forgetting curve”, which is pre-valent in the more traditional training methods," saysUtheim.

GREAT NORWEGIAN CONDITIONS: In Utheim's opinion,Norway provide great conditions for the development and

EXPLORINGAPPS

& GAMING

The developmentand implementationof game and welfare

technology isgrowing rapidly in

the Norwegianhealth sector.

ResearcherCharlotte Lunde,

MD.

Screen dump of aRoboMemo game.

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implementation of game technology in the health sector: Thehospital trusts are knowledgeable about the innovation pro-cess, there is available capital to early stage projects and thepopulation is highly accustomed to technology."The combination of public instruments like grant mech-

anisms, the hospital trusts and the early stage developmentcompanies, creates a well functioning innovation hub andgreat opportunities for innovative actors, " says Utheim.He also points to the education of young game developers."We educate almost four times as many game developers as

there are available jobs. Combine that with available capitaland projects and potential well paying customers, and I be-lieve the mix is very attractive," says Utheim.What is your estimate of the market size for health related

game technology?" I expect it to be USD 50 to 70 million in 5 to 10 years time."

Utheim sees the Norwegian market as a potential bridgeheadto the bigger European markets."We have a large undergrowth of SMEs that need to partner

up with larger corporations to get access to the markets, "Utheim says.

UNIQUE TEST OPPORTUNITY: “Working memory training

using computer games has been shown to help people withADHD and other attention disorders. Children with ADHDhave deficiencies in these functions and measurable im-provements in working memory are associated with im-provements in the symptoms ofADHD,” Charlotte Lundesays.“We intend that patients admitted to the Section for Chil-

dren and Youth with Epilepsy (SSE) at Oslo University Hos-pital will be continuously included in our study, according toinclusion criteria, and then randomized to, respectively,game training and methylphenidate treatment groups,”Lunde says.“We have a unique opportunity to conduct clinical trials in

children and adolescents who require daily monitoring, be-cause patients are often hospitalized for several weeks andbecause we have multidisciplinary expertise,” Lunde says.Enrolment of patients begins in the spring of 2013 and it is

intended that 3 patients will be recruited per month for 10months per year completed April 2016. Data processing,analysis and the publication of articles will be completed inApril 2016, followed by a Ph.D thesis in 2017.Swedish-based CogMed has developed the computer game

RoboMemo, which in several studies has been shown to havea positive effect on concentration difficulties in children.

Healthtechnology

prolongindependent

livingEgil Utheim, head of the OsloMedtech Game, Simulation & Ro-botics group. Photo: NRK

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RoboMemo consists of a series of exercises in which the dif-ficulty increases depending on the individual's level of profi-ciency, so that the child is always working at maximum level.The child uses the program for 30 minutes per day, 5 days perweek, over a period of about 5 weeks. The Swedish tool wasdeveloped in collaboration with Pearson Group and is one ofthe first "medical" games currently being marketed.

PROLONGING INDEPENDENCE: With inspiration from New-ham, UK and knowledge and research from user interaction,the assistive technology company Dignio, is ready for the USmarket."We believe that how we treat the elderly in Norway, with

dignity and flexibility, also will play well with the Americ-ans, " says Lars Dahle, CEO ofDignio.Norway based Dignio is a company with knowledgeable

enthusiasts who aim to be the leading provider of telehealthtechnology solutions by providing “technology in context” .The terms are often confused. Telecare is personal and en-

vironmental sensors in the home that enable people to re-main safe and independent in their own home for longer.24/7 monitoring ensures that should an incident occur, theinformation is acted upon immediately and the most appro-

priate response put in action. Thebest-known service is the panicalarm.Telehealth is medical devises

that monitor vital health signsremotely. The readings are auto-matically transmitted to a med-ical trained person who canfollow the results and decide tointervene sooner, without thepatient always needing to attenda clinic."Telecare is by far the most

mature technology, while most ofthe telehealth services are underpilot and testing," says Dahle.

US STEP BY STEP: Dignio startedin 2010 after more than a year of

market research and preparatory work.Dignio offers a renewed model of care that provides the

users higher quality of life and the public a more sustainableway of taking care of the elderly. Dignio will also help im-proving the quality of services from a user perspective. TheDignio team includes health professionals, designers, tech-nologists and people with experience in change managementand process work."UK is the most mature market for telecare and telehealth

in Europe. In general, the health systems in Europe are moredirectly government funded versus the US where the gov-ernment buy the health services from competitive market ofhealth institutions. "Dignio will approach the American market step by step."At the moment we are looking for the best way to address

our target market of seniors with one or more chronic dis-eases, " says Lars Dahle.

Text: INGRID SCHIEFLOE, PER GJØRVAD &

MAGNE OTTERDAL

post@oslobusinessmemo.no

Lars Dahle, CEO of Dignio. Photo:Dignio

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THE BESTWAY IS

PERSON-TO-PERSON

In his embassy office at Henrik IbsenStreet in Oslo, the U.S. Ambassador toNorway, Barry B. White, meets OsloMedtech Chairman Carl Christian Gil-huus-Moe and Oslo Medtech Magazine.AmbassadorWhite is a great believer inperson-to-person contact asa way to create new busi-ness opportunities. He hastaken the initiative to fostercloser cooperation betweenMassachusetts Institute ofTechnology (MIT) in Bostonand the University ofOslo.

- I have been travellingthroughout Norway and Iam impressed with thetechnology I have seen. Youhave top quality research,especially in oil and energyfields, but also within lifesciences and medtech. Mybest advice to Norwegianmedtech and life sciencesbusinesses would be to seekout opportunities to co-

operate with the most successful finan-cial resources, companies and academiain the United States. I encourage yourcompanies to visit the United States, findthe right people and start setting upmeetings. The bottom line is, I believe

direct people-to-people contact is thebest way of creating new business op-portunities, says Barry. B. White.

How do you work to encourage U.S.companies to seek out opportunities in

Norway?- U.S. companies tend to

look at Norway as a smallmarket, so you have to takea Nordic approach. For U.S.companies within life sci-ences, in particular pharma,a main concern is the chal-lenging cost structure, andregulatory and reimburse-ment issues, says White. Inthat sense, there is strongcompetition with the otherNordic countries.

You have experience fromthe U.S. venture capitalbusiness. Early stage capitalis not so easily available forlife sciences and medtechstartups in Norway. How

US Ambassador Barry B. White isimpressed with the technology and topquality research he has seen, travelling

throughout Norway.

BARRY B. WHITE

Barry B. White has beeninvolved in the healthcaresector through various po-sitions. As a young com-missioned Lieutenant inthe Public Health Servicehe served as a lawyerworking to implement thenewly established Medi-care and Medicaid programs in the late 1 960s in the U.S.Department of Health, Education and Welfare.With a J.D. from Harvard Law School and based in Bo-ston, Barry B. White practiced law at Foley Hoag LLP for40 years, including 1 3 years as a CEO in the law firm. Hehas strong business and corporate experience, and hispractice consisted of representing startup companies en-gaged in information technology, software and life sci-ences fields, as well as venture capitalists.

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would U.S. venture capital firms considerthese sectors in Norway?- The venture capital business in the

United States has changed, it has lesscapital available and has grown more riskaverse with less capital available for star-tups. But this is cyclical. They are inter-ested, but they also have lots of otheropportunities. I believe they are a bithesitant, and some of them are not quitesure ofwhat they will find here. Theventure capital business is a people busi-ness, and based on trust. So you have gotto meet up with them, and get them toknow you.

White considers Boston his backyard,and talks with great enthusiasm aboutthe feverish startup activity in the area,which serves as a brilliant example ofhow collaboration between universities,finance, companies and government cancreate hundreds of thousands of jobs.- Boston is in many ways similar to

Oslo: Both cities have 600,000 inhabit-ants, the sea, the hills and the recre-ational areas - and with a strong

technology base. Norway has a lot of ex-cellent research, but one important dif-ference is that Norwegians tend not to beso market oriented. I also believe thatyou could encourage your venture capit-al business to be a bit more innovativeand risk taking, he says.

Boston is a major life sciences hub in theUnited States, and has a formidable re-cord of spinning new companies out ofresearch conducted in the area`s aca-demic institutions, in particular MIT andHarvard. According to White, an estim-ated 6,900 companies started by MITgraduates with worldwide sales ofap-proximately USD 164 billion are locatedin Massachusetts alone, and represent 26percent of the sales revenues ofall Mas-sachusetts companies. Another 4,100MIT alumni-founded companies arebased in California and generate an es-timated USD 134 billion in worldwidesales.- MIT has created an environment that

solves the challenge of bringing the cre-ation of knowledge into commercializa-

tion. It has institutionalized the linkagebetween education, research, commer-cialization of research and entrepren-eurship. This provides an importantmodel for universities interested inhelping their students become more ef-fective entrepreneurs, says White.

The MIT experience is the backdropwhenWhite convinced the President ofMIT, L. Rafael Reif, to visit Oslo for theawarding of three Kavli prizes to MITpeople and to visit the University ofOsloin 2012.- The main idea with this initiative is to

create and promote cooperation, to ex-plore possibilities in areas such as thetransfer of technology and lab tech-niques, and promote collaboration in re-search and development. It is aboutgetting people to meet people. Futurewill tell us where this leads, says BarryB. White.

PICTURE: US Ambassador to Norway, Barry B. White. Foto: Terje Pedersen, ANB

INTERVIEW: Per GjørvadOslo Business Memo

At LINK Medical, we provide medical device manufacturers with clinical evidence of efficacy and safety, as well as model development and analysis of health economic parameters. Link Medical has built up expertise within regulation and documentation of medical devices. Also, the experience from many projects enables us to offer our clients all the services needed to document their systems and their devices – on the right level and achieving the agreed targets.

Let LINK MedIcaL guIde your product INto europeWe are an international CRO based in Scandinavia with clients primarily from pharmaceutical, biotech and medical device companies. Give us a call, if you need people and plans for a safe entry of medical devices into the European market.

Call +47 22 58 90 00 – or visit us at linkmedical.no

Visit us atlinkmedical.no

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