WCO Explanatory Notes reproduced for reference. © World Customs Organization. Verify against official WCO publication.
90.18 Instruments and appliances used in medical, silrgical, dental or veterinary sciences, including scintigraphic apparatus, other electro-medical apparatus and sight-testing instruments (+). - Electro-diagnostic a paratus including a paratus for functional exploratory examination or for c ecking p ysiologica parameters) : R 9018.12 9018.13 90 18.14 P - - Ultrasonic scanning apparatus - - Magnetic resonance imaging apparaius - - Scintigraphic apparatus - - Other 90 18.20 - Ultra-violet or infra-red ray apparatus 9018.19 - Syringes, needles, catheters, cannulae and the like : 90 18.31 - - Syringes, with or without needles 90 18.32 - - Tubular metal needles and needles for sutures 90 18.39 - - Other - Other instruments and appliances, used in dental sciences : 9018.41 - - Dental drill engines, whether or not combined on a single base with other dental equipment 9018.49 - - Other 9018.50 - Other ophthalmic instruments and appliances 9018.90 - Other instruments and appliances which, in the vast majority dentists, veterinary or to operate, etc. dissection, etc., are also included, (see Part @) below). The instruments of the heading may be made of any material (including precious metals). The heading does not cover : (a) Sterile cat t and other sterile material for surgical sutures, sterile laminaria and sterile laminaria tents (hea& 30.06). (b) Diagnostic or laboratory reagents of heading 38.22. (c) Hygienic or pharmaceutical articles of heading 40.14. (d) Laboratory, pharmaceutical or hygienic glassware of heading 70.17. (e) Sanitary ware of base metal (in particular, headings 73.24,74.18 and 76.15). (f) Manicure or pedicure sets and instruments (heading 82.14:). (g) Carriages for disabled persons (heading 87.13). (h) Spectacles, goggles and the like, corrective, protective or other (heading 90.04). (ij) Photographic cameras (heading 90.06) unless incorporated permanently in the instruments or appliances of this heading. (k) Microscopes, etc., of heading 90.11 or 90.12. (1) Disc calculators used for calculating lung function, body mass index, etc., of heading 90.17. (m) Mechano-therapy, oxygen therapy, ozone therapy, artificial respiration, aerosol therapy, massage apparatus, etc., of headlng 90.19. (n) Ortho aedic appliances, artificial parts of the body and fracture appliances, including those for animps (beading 90.21). (0) X-ray apparatus, etc., (whether medical or not) of heading 90.22. (p) Clinical thermometers (heading 90.25). (q) Instruments and ap liances used in laboratories to test blood, tissue fluids, urine, etc., whether or not such tests serve in $agnosis (generally heading 90.27). use (operating tables, examination tables, (r) Medical or surgical furniture, including that for veteri hospital beds), dentists' chairs not incorporating~ental appliances of this heading, etc. (heading 94.02). On the other hand, this heading includes specialised measuring instruments used exclusively in professional practice, such as cephalometers, dividers for measuring cerebral lesions, obstetrical pelvimeters, etc. It should also be noted that a number of the instruments used in medicine or surgery (human or veterinary) are, in effect, tools (e.g., hammers, mallets, saws, chisels, gouges, forceps, s atulae, etc.), or articles of cutlery (scissors, knives, shears, etc.). Such articles are classi!lierS ed 1; tfis headin only when they are clearly identifiable as being for medical or surgical use by reason of eir special shape, the ease with which they are dismantled for sterilisation, their better quality manufacture, the nature of the constituent metals or by their get-up (fie uently packed in cases or boxes containing a set of instruments for a particular treatment : chi dbirth, autopsies, gynaecology, eye or ear surgery, veterinary cases for parturition, etc.). f ? The instruments and appliances classified here may be equipped with optical devices; they may also make use of electricity, either as motive power or for transmission, or as a preventive, curative or diagnostic agent. This heading also covers instruments and appliances operated by laser or other light or photon beam processes and ultrasonic instruments and appliances. (I) INSTRUMENTS AND APPLIANCES FOR HUMAN MEDICINE OR SURGERY This group includes : (A) Instruments which may be used under the same names for several purposes, for example : (1) Needles (for sutures, ligatures, vaccination, blood tests, hypodermic needles, etc.). (2) Lancets (for vaccination, blood-letting, etc.). (3) Trocars (for puncturing) (gall-bladder, general purpose, etc., types). (4) Surgical knives and scalpels of all kinds. (5) Sounds (prostatic, bladder, urethral, etc.). (6) Specula (nasal, mouth, laryngeal, rectal, vaginal, etc.). (7) Mirrors and reflectors (for examination of eye, larynx, ear, etc.). (8) Scissors, shears, forceps, pliers, chisels, gouges, mallets, hammers, saws, scrapers, spatulae. (9) Cannulae, catheters, suction tubes, etc. (10) Cauteries (thermo, galvano, micro, etc.). (11) Tweezers; dressing, swab, sponge or needle holders (including radium needle holders). (12) Retractors (lip, jaw, abdominal, tonsil, liver, etc.). (13) Dilators (laryngeal, urethral, oesophageal, uterine, etc.). (14) Wire uides used for the placement of catheters, needles, tissue dilators, endoscopes and at erectomy devices. f (15) Clips (suture, etc.). (16) Syringes (glass, metal, glass and metal, plastics, etc.), of all kinds, e. injection, puncture, anaesthesia, irrigation, wound washing, suction (with or witkut pump), eye, ear, throat, uterine, gynaecologcal, etc. (17) Surgical staplers for inserting staples to close a wound. (B) Special diagnostic instruments and apparatus. These include : (1) Stethoscopes. (2) Instruments to measure rate of breathing (to determine basal metabolism). (3) Sphygmomanometers, tensiometers and oscillometers (to measure blood pressure). (4) Spirometers (to assess lung capacity). (5) Cephalometers. (6) Pelvimeters. (C) Ophthalmic instruments. These fall into various categories : (1) Surgical instruments such as corneal trephines, keratomes. (2) Diagnostic instruments such as ophthalmosco es; binocular loupes with head-bands and binocular- pe microscopes, consisting o a microscope, an electric lamp with a slit, and a heatrest, the whole being mounted on an ad-ustable support, for the examination of the eyes; tonometers (for testing the intra-ocul'ar tension); eye specula. !' (3) Orthoptic or sight-testing apparatus including amblyoscopes, retinoscopes, skiascopes, strabometers, keratometers. keratoscoves. eve measurement meters designgd to measure the- distance between the pufiils', 6ial-cases (of lenses) and trial-frames (for carrying the trial lenses), optometric scales, test charts. However, optometric scales and charts on paper, paperboard or plastics, used for colour perception tests, are excluded (Chapter 49). --- --- This heading also covers electrically heated compresses for the eyes, and electro-magnets designed for removing metallic particles from the eyes. (D) Ear instruments, e.g., auriscopes. However, tuning forks, whether or not for medical use, are excluded (heading 92.09). (E) Anaesthetic apparatus and instruments (face masks, face-piece harness, intratracheal tubes, etc.). (F) Instruments for nose, throat or tonsil treatment : clamps (for straightening the nasal cartilage); transillumination apparatus (for sinuses and nasal fossae); tonsilotomes and guillotines; direct laryngoscopes; laryngeal brushes, etc. (G) Pharyngeal, oesopha eel, stomach or tracheotomy instruments : oesophagoscopes, bronchoscopes, stomac pumps, intubation tubes, etc. i Urinary canal or bladder instruments : urethrotomes, lithotrity instruments, bladder-grit suction apparatus, instruments for prostatectomy. (IJ) Artificial kidney (dialysis) apparatus. (K) Gynaecological or obstetrical instruments : va inal retractors; hysterectomy instruments; obstetrical stethoscopes; specialised optica instruments for examination of the genital or ans; force s; perforators; embryotomy instruments for dissection of the foetus); cepha otribes an cranioclasts (instruments to crush the hea of a child which has died in the uterus); instruments for taking internal measurements; etc. f k t' (L) Portable pneumo-thorax apparatus, blood transfusion apparatus, artificial leeches. The heading also covers sterile hermeticall sealed containers of plastics, from which air has been evacuated but containing a smal quantity of anti-coagulant and fitted with an integral donor tube and a hlebotomy needle, used for the collection, storage and transfusion of human whole Y7lood. However, special blood storage bottles of glass are excluded (heading 70.10). Y (M) Chiropodists' electric grinders. (N) Acupuncture needles - gold, silver, steel. (0)Endoscopes : gastroscopes, thoracoscopes, peritoneoscopes, bronchoscopic telescopes, cystoscopes, urethroscopes, resectoscopes, cardioscopes, colonoscopes, nephrosco es, laryngoscopes, etc. Many of these have an operating channel large enough to pe o m surgery via remotely controlled instruments. However, endoscopes for non-medical purposes (fibrescopes) are excluded (heading 90.13). (P) Apparatus incorporating an automatic data processing machine and designed solely for calculating the dose and distribution of therapeutic radiation. (Q) Hyperbaric. chambers (also known as decompression chambers) which are specially e upped pressure vessels to administer oxygen at elevated atmospheric presswe levels. T%I ey are used for the treatment of conditions such as decompression sickness, air embolism, gas gangrene, carbon monoxide poisoning, refractory osteomyelitis, slun grafts and flaps, actinomycosis and exceptional blood loss anaemia. (R) Lam s which are specially designed for diagnostic, probin , irradiation, etc. purposes. Torc es, such as those in the shape of a en are excluded heading 85.13) as are other lamps which are not clearly identifia le as being for medical or surgical use (heading 94.05). f E (19 DENTAL INSTRUMENTS AND APPLIANCES In addition to those common to this and the previous group (such as masks and other dental analgesic apparatus), the main instruments and appliances included in this category are : (1) Surgeons' finger-guards (whether or not articulated) and gags; cheek or Lip retractors, tongue depressors and clips. (2) Forceps of all kinds, elevators, tweezers of all kinds (to remove exposed teeth, aligning p~votteeth, etc.), cutters (for dissecting, dressing, filling and gouging, etc.), root forceps. (3) Instruments for endodontic treatment (broaches, reamers, files, pluggers, spreaders, etc.). (4) Bone scissors and files; gouges and mallets for resecting the jaw and the maxillary sinus; raspatories; scalpels; special knives and scissors; special dentists' tweezers; '' excavators " and probes. (5) Special instruments for cleaning gums and sockets; scalers for treating dental tartar; scrapers and enamel chisels. ; needles (abscess, hypodermic, suture, cotton-wool, etc.); (6) Miscellaneous cotton-wool hol ers and swab holders; insufflators; dental mirrors. J (7) Gold-fdling instruments (plug ers, mallets, etc.); filling instruments (cement or resin spatdae, amalgam stoppers an mallets, amalgam-carriers, etc.); impression compound trays. B (8) Dental burrs, discs, drills and brushes, specially designed for use with a dental drill engine or handpiece. The heading also covers tools and instruments of a kind used in prosthetic dentis either by the practitioner himself or by a dental technician, for example : knives; spatu ae and other modelling tools; miscellaneous pliers and tweezers (for fixing clamps and crowns, cutting pivots, etc.); saws; shears; mallets; files; chisels; scra ers; burnishers; metal formers, for the manufacture, by beating, of metal dental crowns. {he heading also covers dental casting machines, dental milling machines, and dental trimmers for t r i m n g models of dentures. The heading does not, however, include tools or other articles of general use (furnaces, moulds, soldering tools, melting ladles, etc.); these are classified in their respective headings. '7 The following also fall in this heading : (i) Dental drill engines with swivel arm, whether on a separate base, for wall-mounting, or for fitting to the equipment described under (ii) below. (ii) Complete dental equipment on its base (stationary or mobile unit). The main usual features are a frame carrying a compressor, a transformer, a control panel and other electrical a aratus; the following are also often mounted on the unit : swivel arm drill, s ittoon an mouth rinser, electric heater, hot air insufflator, spray, cautery instrument tray, cl%lbsed lighting, shadowless lamp, fan, diathermic apparatus, X-ray apparatus, etc. !? Some types of this equi ent are designed to operate by the use of abrasive materials (usually aluminium oxi e ) instead of with a dnll; the abrasives are usually projected against the teeth by compressed gas (e-g., carbon dioxide). L Y (iii) Spittoon mouth rinsers whether on a base, stand or on swivel arms. They are usually combined with warm water supply and warm water syringe. (iv) Polymerisation devices (light or heat), amalgamators, ultrasonic scalers, electrosurgery equipment, etc. (v) Devices for dental treatment which operate by the use of lasers. (vi) Dentists' chairs incorporating dental equipment or any other dental appliances classifiable in this heading. The heading does not, however, include dentists' chairs not incorporating dental appliances of this heading; these dentists' chairs fall in heading 94.02 whether or not fitted with equipment such as lighting fittings. It should, however, be noted that the heading excludes certain items of dental equi ment mentioned in magraph (ii) above, when they are presented separately; these are classified in &eir own respective psadmgs, for example, compressors (hending84.14), X-ray, ek., apparatus (heading 90.22). heading 90.22 also covers X-ray, etc., apparatus designed for a separate stand, or for wall-mounting in dental sur eries. Separately resented diathermy a paratus is, however, classified with the e~ectm-me8ca1apparatus ofthisReading (see Part (IY) beyow). It should be noted that dental cements and other dental fillings fall in heading 30.06; the reparations known an " dental wax 'or as " dental impression compounds ",put up in sets, rn packin s 8 r retail sale or in plates, horseshoe sha es, sticks or sunilar forms, and other preparations for use in fentistry, with a basis of plaster (of calcine gypsum or calcium sulphate), fall in heading 34.07. (110 VETERINARY INSTRUMENTS AND APPLIANCES This grou includes a number of articles which, though designed for veterinary use, are similar to those o Part (I) or (II) above, for example : F (A) General urpose instruments (e-g., needles, lancets, trocars, scalpels, specula, sounds, scissors, orceps, hammers, curettes, retractors, syringes). ? (B) Special instruments and appliances, such as, ophthalmoscopes, eye specula, laryngoscopes, stethoscopes, forceps, embryotomes. (C) Dental instruments. The group also includes instruments and apparatus specidised for veterinary use, for example : (1) Instruments and appliances for the udder, e.g., teat dilators and puncturing sounds (to open the teats of cows); appliances for treating puerperal or milk fever in cows. (2) Instruments and appliances for castration : emasculators; castrating clams and clamps (for producing atrophy of the male genital glands); castrating vices and forceps; ovariotomes, etc. (3) Instruments and appliances for parturition : specialised obstetrical cords, straps, head-collars, forceps and hooks, mechanical calfing axds, etc. (4) Miscellaneous instruments : artificial inseminators; tail-dockers; horn-cutters; sprays for enital, etc., organs in animals; treatment of diseases of respiratory, digestive, win special control a aratus, i.e., for preventing a n i 3 ; kom moving during operations kmouth-gags, hob es, etc.); special syringes for applying medicaments and syringes to be lled with an anaesthetic or a medicament (antiserum, vaccine, etc.) for remote projection or pistol operated by compressed at free-roaming animals, for example by means of a gas; appliances for administering pills; special sna es for ingestin drenches; hooks for sand-crack (to close cracks in hooves); endoscopic instruments for ifetermining the sex of chicks, etc. IT fiY The heading excludes trichinoscopes (optical instruments for examination of pork (heading 90.11), orthopaedic ap hances for anlmals (heading 90.21), operamg tables for -1s corresponding xplanatory Note). B ( eading 94.02, see surgeons and blacksmiths are classified in Cha ter 82 (e.g., Tools of a type used equally by vetexi toeing files; nail or hoof clippers; p g i n ! v e s ; pliers; mcers; hammers, etc.); Chapter 8 also covers cattle-branding tools (punches, irons for burning off hoo -rind, etc.) and shearing tools. E P (IV) SCINTIGRAPHIC APPARATUS These are apparatus which scan parts of the body and create images of an or an or a record of its functionlag. It includes apparatus incorporating a scintillation counter the ata from which is converted into analogue si als for the purpose of making medical diagnoses (e.g., gamma camera, scintillation scarmay f (V) OTHER ELECTRO-MEDICAL APPARATUS This heading also covers electro-medical apparatus for preventive, curative or diagnostic purposes, other than X-ray, etc., apparatus of heading 90.22. This group includes : (1) Electro-diagnostic apparatus, which include : (i) Electro-cardio raphs (apparatus which, by means of currents produced by contractions oft e cardiac muscle, record heart movements as electrocardiograms). (ii) Phonocardiographs (specially desi ed to register heart phonocardiograms; they may also be use as electro-cardiographs). CF noises as (iii) Cardioscopes (used in conjunction with the two preceding instruments to enable simultaneous observation of cardiograms and phonocardiograms). (iv) Rheocardiographs (electrical a aratus for measuring changes of electrical resistance due to the functioningoF%e heart). (v) Electroencephalographs (for examination of the brain). (vi) Electrosphygmograghs (for registering arterial pressure and volume). (vii) Electrotonographs (for registering variations in arterial, intravenous or intracardial pressure). (viii)Electroretinographs(for measuring strain in the retina). (ix) Audiometers and similar apparatus (for hearing tests based on frequency variations). (x) Diagnostic apparatus incorporating or operatin in conjunction with an automatic data processing machine for processing an visualising clinical data, etc. % (xi) Ultrasonic diagnostic e uipment used for the representation of organs, e.g., on a display tube, by means o ultrasonic waves. ? (xii) Nuclear Magnetic Resonance (NMR) apparatus used to re resent the characteristics of tissues and or ans inside the human body, using e magnetic properties of body atoms, such as ydrogen atoms. tE ii (2) Electrotherapy apparatus. Apart from its use in dia osis, this apparatus is emplo ed to f' treat diseases such as neuritis, neuralgia, hemiplegia, p lebitis, endocrinal anaemia. d r t a i n of these a liances can be combined with electro-surgical instruments referred to in paragraph below. (3) Iono-therapy apparatus used to administer active medicaments (sodium or lithium salicylate, potassium iodide, histamine, etc.) through the skin by the aid of an electric current. (4) Diathermy apparatus to treat certain diseases which re uire heat (e.g., rheumatism, neuralgia, dental ailments). These operate by the use o high-frequency shortwave, ultrasonic, ultra shortwave, etc.) currents, and employ electrodes m a variety of orms (e.g., plates, rings, tubes). (5) Electric shock treatment apparatus to treat mental or nervous diseases. (6) Cardiac defibrillators for defibrillating the heart by the application of electric current. (7) Electro-surgical apparatus. These utilise high-frequency electric currents, the needle, probe, etc., forming one of the electrodes. They can be employed to cut tissues electrocutting) with a lancet (electric lancet), or to coagulate the blood electrocoagulation). Certain combined instruments may, by the use of control pedals, be made to act interchangeably as electrocutters or electrocoagulators. (8) Actinotherapy apparatus. These employ radiations within, or more generally just outside, the visible spectrum (infra-red, ultra-violet) for treatment of certain diseases or for diagnostic purposes (special lighting to reveal skin diseases). This a paratus generally incorporates lamps, thou h infra-red ray apparatus may be fitted with eating resistances or heating panels with re ectors. i R (9) Artificial incubators for babies. Basically these consist of a transparent cubicle of lastics, electrical heating equipment, safety and warning devices, and ox gen and air Eltering and regulating apparatus. In most cases they are mounted on a trol ey and have built-in baby scales. I' Cases containing electrodes or other devices for use with the apparatus described above are also included in this group. This heading also excludes renatal listening apparatus for non-medical use of heading 85.18 (see the Explanatory Note to that he&ng). PARTS AND ACCESSOlUES Subject to the provisions of Notes 1 and 2 to this Cha ter (see the General Ex lanatory Note), parts and accessories of apparatus or appliances of this eading remain classifie here. B R
1.- This Chapter does not cover : (a) Articles of a kind used in machines, appliances or for other technical uses, of vulcanised rubber other than hard rubber (heading 40.16), of leather or of composition leather (heading 42.05) or of textile material (heading 59.11); (b) Supporting belts or other support articles of textile material, whose intended effect on the organ to be supported or held derives solely from their elasticity (for example, maternity belts, thoracic support bandages, abdominal support bandages, supports for joints or muscles) (Section XI); (c) Refractory goods of heading 69.03; ceramic wares for laboratory, chemical or other technical uses, of heading 69.09; (d) Glass mirrors, not optically worked, of heading 70.09, or mirrors of base metal or of precious metal, not being optical elements (heading 83.06 or Chapter 71); (e) Goods of heading 70.07, 70.08, 70.11, 70.14, 70.15 or 70.17; (f) Parts of general use, as defined in Note 2 to Section XV, of base metal (Section XV) or similar goods of plastics (Chapter 39); however, articles specially designed for use exclusively in implants in medical, surgical, dental or veterinary sciences are to be classified in heading 90.21; (g) Pumps incorporating measuring devices, of heading 84.13; weight-operated counting or checking machinery, or separately presented weights for balances (heading 84.23); lifting or handling machinery (headings 84.25 to 84.28); paper or paperboard cutting machines of all kinds (heading 84.41); fittings for adjusting work or tools on machine-tools or water-jet cutting machines, of heading 84.66, including fittings with optical devices for reading the scale (for example, “optical” dividing heads) but not those which are in themselves essentially optical instruments (for example, alignment telescopes); calculating machines (heading 84.70); valves or other appliances of heading 84.81; machines and apparatus (including apparatus for the projection or drawing of circuit patterns on sensitised semiconductor materials) of heading 84.86; (h) Searchlights or spotlights of a kind used for cycles or motor vehicles (heading 85.12); portable electric lamps of heading 85.13; cinematographic sound recording, reproducing or re-recording apparatus (heading 85.19); sound-heads (heading 85.22); television cameras, digital cameras and video camera recorders (heading 85.25); radar apparatus, radio navigational aid apparatus or radio remote control apparatus (heading 85.26); connectors for optical fibres, optical fibre bundles or cables (heading 85.36); numerical control apparatus of heading 85.37; sealed beam lamp units of heading 85.39; optical fibre cables of heading 85.44; (ij) Searchlights or spotlights of heading 94.05; (k) Articles of Chapter 95; (l) Monopods, bipods, tripods and similar articles, of heading 96.20; (m) Capacity measures, which are to be classified according to their constituent material; or (n) Spools, reels or similar supports (which are to be classified according to their constituent material, for example, in heading 39.23 or Section XV).