2014-09-11T19:01:00-05:00 2013-12-31 562382653 Northwest CPA Group PLLC 1333 Columbia Park Trail Ste 210 Richland WA 99352 990 2013-01-01 911952283 SIGN Fracture Care International SIGN 5093711107 451 Hills Street Suite B Richland WA 99354 Jeanne Dillner Chief Executive Officer 5093711107 2014-08-28 1 Alison C Gebers P00423745 5097351300 2013 2015-11-30 17:44:51Z SIGN 451 Hills Street Suite B Richland WA 99354 6083301 0 X www.signfracturecare.org X 1999 WA Build orthopedic capacity in developing countries by providing orthopedic training and implants. 10 10 41 121 0 0 2954086 3973566 1380648 1433865 81608 137547 -72149 -123600 4344193 5421378 0 0 0 0 1212292 1177838 0 0 143362 2997970 3852074 4210262 5029912 133931 391466 5844377 6555273 211744 296681 5632633 6258592 X See Schedule O 0 0 385708 38517 Provide access to orthopaedic training and education to surgeons in developing countries - This is accomplished through onsite visits by North American and European surgeons, local surgeons, email communications with SIGN headquarters, the review of cases submitted by local surgeons and orthopaedic surgeons on the SIGN Board, and the annual international orthopaedic conference held at SIGN headquarters.The onsite training goals were: 1) ensure SIGN surgeons understand the surgical technique for the SIGN products in their hospital; 2) provide training on current orthopaedic principles; and, 3) provide training in orthopaedic and trauma procedures such as pediatric, hand, and pelvic.The training objectives for the 2013 SIGN Conference held at headquarters were: - understand results from treatment of femur fractures;- assess squat and smile picture as predictor of bone healing;- increase knowledge of basis of limb deformity;- learn the technique of using different modalities to accomplish correction of limb deformity;- understand the indications for antegrade and retrograde approach to femur fractures;- assess the outcomes between hollow and solid nail in treating tibia fractures;- understand the indications and outcomes of using cement in treating long bone fractures with osteomyelitis;- assess the results of treating pediatric femoral fractures;- understand treatment of acute epiphyseal fractures;- understand reconstruction after physeal arrest;- learn about treatment of elbow injuries;- increase knowledge of treatment of comminuted fractures;- learn principles of treatment of infected fractures;- understand the mechanics of retrocalcaneal fusions;- increase knowledge in treatment of proximal femur and hip fractures;- increase knowledge of treatment of pelvic fractures;- learn methods of treatment of displaced acetabular fractures;- assess different methods of flap coverage in soft tissue defects;- increase understanding in treatment of pilon fractures;- increase understanding of treatment of tibia plateau fractures;- assess different treatments of bone tumors; and,- assess the different types of treatment of orthopaedic injuries in different parts of the world.To further our educational materials, an animated video was developed to help the surgeon visualize the anatomy of the bone and how the implants and instruments inter-relate. This video helps the surgeon to understand the reasoning behind the prescribed technique of inserting the nail and the sequence of use of the instruments. 4262118 1395348 Distribute appropriate orthopaedic technology - The SIGN IM Nail and Interlocking System is designed for use in hospitals in developing countries where C-arms and regular power are not available. SIGN engineers continually develop new orthopaedic instruments and implants in response to the needs described by the local surgeons. New programs are supplied only with the SIGN IM Nail System, which is used to repair severe fractures in the femur, tibia, and humerus. Once the program has demonstrated their ability to report their cases, including adequate follow-up which confirms their results comply with our expectations, they become eligible to receive additional SIGN products, as well as in-kind donations received from for-profit orthopaedic implant companies.24 new programs were started in 2013 in the following countries: Afghanistan, Benin, Cambodia, Cameroon, Democratic Republic of the Congo, Haiti, Iraq, Kenya, Lao People's Democratic Republic, Malawi, Mozambique, Pakistan, Rwanda, Sudan, Tanzania, Turkey, Zambia, and Zimbabwe. Twenty thousand patients were treated with SIGN implants in 2013.Distribution can take the form of disaster response - SIGN volunteers from North America and Europe respond to disasters in countries where SIGN programs currently exist or where SIGN programs would be beneficial. Often, where SIGN programs currently exist, it is the local surgeons who provide the disaster relief using the SIGN equipment already in the country. In these cases, our response is to send SIGN equipment replenishments along with other materials they request. Otherwise, it is North American surgeons who are carrying in SIGN equipment as well as other supplies. They provide the extra hands needed in surgery as well as train the local surgeons and volunteers to use the SIGN implants.Establishing Regional Trauma Courses is another means of distributing appropriate orthopaedic technology - The SIGN Orthopedic Conference held at headquarters has been a tremendous experience for the SIGN surgeons. However, the conference is limited to 150 participants and with the cost of airfare continuing to rise, it has been a long term goal of SIGN to establish regional trauma courses. In 2013, we partnered with other organizations to start a regional trauma course in Port au Prince Haiti and one in Dar es Salaam Tanzania. The Haiti course was organized in conjunction with Project Hope, Partners in Health, and SIGN Fracture Care International. Faculty came from surgeons that volunteer with SIGN and with Partners in Health. Lectures were also given by the local Haitian surgeons. The event was well received and nearly every Haitian orthopaedic surgeon attended. Plans were made to continue the conference in 2014.A similar format was implemented at Muhimbili Orthopedic Institute in Dar es Salaam. SIGN Fracture Care International partnered with the Institute for Global Orthopedics and Global Traumatology (IGOT) to develop the curriculum and attract faculty. The course was promoted to hospitals throughout Tanzania and East Africa. It was attended by 90 surgeons from several East African countries. This conference was also well received and plans were made to hold it again in 2014. 4647826 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 7 0 1 41 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AR CA CO DC FL GA HI IL KS KY MA MD MI MN MS NH NJ NM NV NY NC OH OK OR PA SC TN UT VA WA WI X Deborah Maier 5093711107 451 Hills Street Suite B Richland WA 99354 John Staeheli MD Member 2.00 X 0 0 0 Lewis G Zirkle MD President/Founder 72.00 X X 0 0 0 David Whitney MD Member 2.00 X 0 0 0 Randall Huebner Member 10.00 X 0 0 0 Carla Smith MD PhD Member 5.00 X 0 0 0 Frederic Wilson MD Member 4.00 X 0 0 0 Cindy Johnson Treasurer 2.00 X X 0 0 0 Stephen Schwartz Member 1.00 X 0 0 0 Bette Cooper Member 2.00 X 0 0 0 Teresa Ford Member 1.00 X 0 0 0 Jeanne Dillner Secretary / CEO 75.00 X 132996 0 0 132996 0 0 1 0 0 0 0 410772 3562794 1734110 3973566 Implant Revenue 339110 1395348 1395348 Other Revenue 541900 22417 22417 Training Conference 611430 16100 16100 1433865 38919 38919 112418 177213 -64795 -64795 -64795 430511 27000 358883 0 71628 27000 98628 98628 67022 410772 125827 -58805 -58805 5421378 1433865 0 13947 132996 111694 21302 1044842 785721 181536 77585 8036 8036 30817 12853 15436 2528 18301 16195 1147 959 51737 50332 13 1392 82102 82102 53869 48360 402 5107 5438 4812 341 285 Supplies 1735821 1702481 3305 30035 Cost of Product Distrib 1676495 1676495 Shipping 74161 74161 Minor Equipment 36869 35868 61 940 78428 38716 36483 3229 5029912 4647826 238724 143362 104811 111121 1197973 1763983 4000 8970 68133 210186 1464219 1301862 46094 43014 3104810 1523683 1635940 1581127 1304341 1517212 18866 17798 5844377 6555273 211244 295411 500 1270 211744 296681 X 5557979 6207939 74654 50653 5632633 6258592 5844377 6555273 391466 234493 0 X 0 1 X 1 0 X 2337831 6180564 2930527 3002918 4040588 18492428 861382 1127977 1052375 1380648 1433865 5856247 3199213 7308541 3982902 4383566 5474453 24348675 1013005 2795744 1716135 779946 777208 7082038 1187036 907152 2094188 1013005 2795744 1716135 1966982 1684360 9176226 15172449 187769 193420 202907 193025 151337 928458 187769 193420 202907 193025 151337 928458 3386982 7501961 4185809 4576591 5625790 25277133 0.60020 0.58970 0.03670 0.04170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1102311 284500 817811 1760531 1050167 710364 241968 189016 52952 1581127 Deposits 1270 1270 6133012 234493 221257 -8036 447714 5685298 -263920 -263920 5421378 5507053 221257 303040 524297 4982756 47156 47156 5029912 Part XI, Line 2d - Other Adjustments: Investment fees -8,036. Part XI, Line 4b - Other Adjustments: Rental expenses -177,213. Direct fundraising expenses -125,827. Donated auction items 39,120. Part XII, Line 2d - Other Adjustments: Rental expenses 177,213. Direct fundraising expenses 125,827. Part XII, Line 4b - Other Adjustments: Investment fees 8,036. Donated auction items 39,120. Central America and the Caribbean 0 0 Program Services Orthopaedic Implants 90922 East Asia and the Pacific 0 0 Program Services Orthopaedic Implants 650978 Europe (Including Iceland & Greenland 0 0 Program Services Orthopaedic Implants 119020 Middle East and North Africa 0 0 Program Services Orthopaedic Implants 29409 Russia & the Newly Independent States 0 0 Program Services Orthopaedic Implants 5383 South America 0 0 Program Services Orthopaedic Implants 14168 South Asia 0 0 Program Services Orthopaedic Implants 217197 Sub-Saharan Africa 0 0 Program Services Orthopaedic Implants 590745 0 0 0 0 0 0 1717822 0 1717822 0 0 0 0 0 0 Tri-Cities Benefit 316134 285590 30544 25830 4080 12263 1500 14281 Portland Benefit 103052 87778 15274 6077 1610 11654 1250 10974 1 58608 37404 21204 7213 6500 16803 5792 477794 410772 67022 39120 12190 40720 2750 31047 125827 -58805 X 4 5210 X 30863 Fair value X 19043 X 4 30486 Fair value X 31 7149 Fair value X 27 1625388 Fair value X Travel Packag 23 10468 X Office Suppli 4 5293 Fair value X Services 1 210 Fair value 0 0 0 Form 990, Part III, Line 1 SIGN's mission is to build orthopaedic capacity in developing countries by providing ongoing training and education to the local orthopaedic surgeons, which is augmented by providing a sustainable supply of orthopaedic implants designed for use in primitive local hospital conditions. The majority of the implants and instruments provided to programs have been designed and manufactured by SIGN personnel. In-kind donations of products not manufactured by SIGN are distributed to some of the busier programs. According to the World Health Organization, the epidemic of injuries caused by road traffic accidents, work injuries and conflicts affects 20 to 50 million people every year. Ninety percent of the people injured live in developing countries where access to adequate care is limited. SIGN's mission to build the orthopaedic capacity within these countries will support the local surgeons in providing appropriate and timely care to the injured poor. At least 4000 surgeons in nearly 300 hospitals in 55 developing nations have benefited from SIGN training and the provision of implants and instruments. SIGN also responds to disasters in locations where SIGN has existing programs or where SIGN programs need to be developed. Form 990, Part VI, Section B, line 11 A draft of Form 990 is provided to SIGN's CEO. The Form 990 is presented for review to the board of directors at a board meeting. Any changes are then directed to the return preparer and addressed before the final return is filed. Form 990, Part VI, Section B, line 12c The conflict of interest policy is monitored and reviewed by the Chief Compliance Officer. The Chief Compliance Officer requests annual conflict of interest statements from each board member. The statements are reviewed with the CEO/Secretary and dispositioned. The President is briefed on findings along with the full board. Form 990, Part VI, Section B, line 15 An annual performance review is conducted for all employees including the CEO. The entity's size, industry, type of organization, and position of responsibilities are considered in determining compensation adjustments. According to the Organization's by-laws, the President is authorized to conduct the CEO's annual review and determine compensation. Form 990, Part VI, Section C, line 19 The public may contact the Organization at it's physical location to request copies of its governing documents, conflicts of interest policy, and financial statements. Interlocking Associates LLC 451 Hills Street Suite B Richland WA 99352 753089184 Commercial Rental WA -54877 2398017 SIGN Fracture Care International