(a) appropriate engineered sharps are not available in the market;
  (b)  the use of sharps without engineered sharps injury protections is
essential to the performance of a specific medical procedure; or
  (c) based on objective  product  evaluation,  sharps  with  engineered
injury  protections  are  not  more  effective  in  preventing  exposure
incidents than sharps without engineered injury protections.