This is an affordable quality alternative to the more expensive Littmann, I own a Littmann Master Cardiology 3,It was given to me as a gift, so I am not trashing Littmann, I'm just saying that the ADC scopes are quality scopesThat won't break the bank, and their customer services is outstanding. The scope came with a total of three ear piecesAnd a name tag, the name tag was a thin plastic snap on, which broke 5 minutes in to a trauma call. The ear piece came off due to getting caught on something or another , no big deal I had two more sets so the day was not lost.The other thing is the scope is not balanced so it does slide down when wearing it around your neck, but I have gotten used to this, and it is not a deal breaker by any means. The customer service rep Kelly Nichols upon finding out my situation sent me a replacement ear piece, a different name badge, and a clip to hold your scope to your hip, she said she did not send me the replacement parts because I asked her to, she said that ADC would rather have happy customers, and that he company stands behind there products, now that's service
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