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Ship To:  
AVISENA HOLDING SDN BHD
No 4, Jln Ikhtisas, Seksyen 14
Shah Alam
Malaysia
Test and Verification Report
Case Number: 0120705015
Work Order: WO-07159832
WORK DETAILS
Engineer Name: Afiq Husaini Bin Khairudin Event Type: Predictive / Preventative Maintenance
Device Status: Pass Service Activity: Preventative Maintenance
EQUIPMENT DETAILS
Product Name: Affiniti 70 Ultrasound System Serial Number: USN18F1356
Product Number: 795210 Installed Product: 74285664
UDI: (01)00884838056251(21)USN18F1356
  Min Max UoM Measurement Result Comments

Planned Maintenance
System Information
  Software Version 3.0.3
  Hardware Version B.0
Inspection & Cleaning
  Query Customer Performance Issues Pass
  Inspect Exterior Periph. & Power Cords. Pass
  Inspect & Clean Trackball Pass
  Inspect & Clean Monitor Pass
  Inspect/Clean Control Panels & Keyboard Pass
  Footswitch, Key- & Remote Control Pad Not Applicable
  Inspect Casters & Brakes Operation Pass
  Clean/Check System Filters & Fans Pass
  Check Articulation motion.(monitor, etc) Pass
  Check System Battery Pass
Performance & Peripherals
  Execute Full Set of System Diagnostics Pass
  Check, Download & Clear Logs Pass
  Perform Hard-disk Maintenance Pass
  Backup of System Settings and Configs. Pass
  Check Operation All User Ctrls. & Lights Pass
  Check Operation of Major Applications Pass

 
   

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Work Order: WO-07159832
  Min Max UoM Measurement Result Comments

Planned Maintenance
Performance & Peripherals
  Test Printers Pass
  Test VCR Operation & Clean Not Installed
  Check Operation Dig. Recording Devices Not Installed
  Confirm remote connectivity Not applicable
System Safety General
  Protective Earth resistance (<= 200 mOhm) 200 mOhm 199 Pass
  Earth Leakage Current. NC, Highest val. (<= 500 µA) 500 µA 3 Pass
  Earth Leakage Current. SF. Highest val. (<= 1000 µA) 1000 µA 2.85 Pass
Transducer Body - BF
  Transducer model C5-1
  Transducer serial number B2T40P
  Transducer Cables, Connectors & Lens PASS
  XDR Leakage Current "Normal Condition" (<= 100 µA) 100 0.6 Pass
  XDR Leak Curr. Highest SF or 2SF reading" (<= 500 µA) 500 0.7 Pass
  XDR Isolation, ISO/MAP "Sink" (<= 500 µA) 500 0.6 Pass
  Run Transducer Test PASS
Transducer Heart - CF
  Transducer model L12-5 50
  Transducer serial number B2TN0T
  Transducer Cables, Connectors & Lens PASS
  XDR Leakage Current "Normal Condition" (<= 10 µA) 10 0.5 Pass
  XDR Leak Curr. Highest SF or 2SF reading (<= 50 µA) 50 0.7 Pass
  XDR Isolation, ISO/MAP "Sink" (<= 50 µA) 50 0.5 Pass
  Run Transducer Test PASS
Transducer Heart - CF
  Transducer model C8-5
  Transducer serial number B2WY1B
  Transducer Cables, Connectors & Lens PASS
  XDR Leakage Current "Normal Condition" (<= 10 µA) 10 0.5 Pass
  XDR Leak Curr. Highest SF or 2SF reading (<= 50 µA) 50 0.7 Pass
  XDR Isolation, ISO/MAP "Sink" (<= 50 µA) 50 0.5 Pass
  Run Transducer Test PASS
Transducer Heart - CF
  Transducer model S8-3
  Transducer serial number B2PXNC
 
   

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Work Order: WO-07159832
  Min Max UoM Measurement Result Comments

Planned Maintenance
Transducer Heart - CF
  Transducer Cables, Connectors & Lens PASS
  XDR Leakage Current "Normal Condition" (<= 10 µA) 10 0.6 Pass
  XDR Leak Curr. Highest SF or 2SF reading (<= 50 µA) 50 0.8 Pass
  XDR Isolation, ISO/MAP "Sink" (<= 50 µA) 50 0.6 Pass
  Run Transducer Test PASS
 

Philips Representative Signature:    
 
Engineer Name: Afiq Husaini Bin Khairudin
Date: Feb 8, 2023