The present invention provides a gastrostomy or jejunal device for extended insertion into an abdomen of a patient. The system enables an offer message, offering for purchase an RBT and including a reply-to telephone number, to be generated and sent to a mobile device. The ceramic output coupler may be a ceramic substrate with a dimpled light emitting surface which reduces Fresnel and critical angle optical losses. This invention describes a system for rendering these media components synchronously on multiple devices by demultiplexing the media into media sub components at one destination, sending the components to all destinations and synchronizing the rendering at each device.