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I agree with Dr. Mulligan. This is an excellent OEM replacement. The picture is very misleading.
I have had my Hewlett Packard Rappaport Sprague stethoscope since I finished med school in 1974. I have used it through out my continuing career as a cardiologist. Given its age every part has been replaced at least once. Other tubing in the past had inferior acoustics. This tubing compares favorably to the original.