00018999 Rev V

EU DECLARATION OF CONFORMITY
Responsible Laerdal Medical AS
Manufacturer: P.O. Box 377
Tanke Svilandsgate 30
4002 Stavanger
Norway

Manufacturing site: Laerdal Medical (Suzhou) Co. Ltd

No 19 Building, Huoju Road
Science & Technology Industrial Park
Suzhou, Jiangsu, P.R.China

Product Name: Resusci Anne QCPR

Product Options: 171-00160 Resusci Anne QCPR Torso - Rechargeable
171-01260 Resusci Anne QCPR Full Body - Rechargeable
172-00160 Resusci Anne QCPR AW Torso - Rechargeable
172-01260 Resusci Anne QCPR AW Full Body - Rechargeable
173-00160 Resusci Anne QCPR AED Torso - Rechargeable
173-01260 Resusci Anne QCPR AED Full Body - Rechargeable
174-00160 Resusci Anne QCPR AED AW Torso - Rechargeable
174-01260 Resusci Anne QCPR AED AW Full Body – Rechargeable
177-00160 Resusci Anne QCPR HC Torso Torso/HPCPR
178-03160 Resusci Anne QCPR RQI Torso/HPCPR/with arms
178-03161 Res Anne QCPR AED RQI Torso/HPCPR/no arms
178-04160 Res Anne QCPR AED AW RQI Full Body/HPCPR
171-01235 Resusci Anne QCPR CHN Community - Full Body
171-00135 Resusci Anne QCPR CHN Community - Torso

Accessories 206-300xx SimPad PLUS SkillReporter

170-30050 SkillGuide
181-80025 Cable, USB micro AM to CM
171-15000 RAQCPR electr. upgrade Customer Kit 2018
173-15000 RAQCPR AED elect. upgrade Customer Kit 2018

to which this declaration relates is in conformity with

Essential Requirements of EU Radio Equipment Directive (RED) 2014/53/EU and Council Directive
2011/65/EU on Restriction on the use of certain hazardous substance (RoHS)
All supporting documentation is retained by the manufacturer.
The conformity is based on the following standards:
EMC (Article 3.1(b) of RED):
EN 301 489-1 V2.1.1
EN 301 489-17 V3.1
EN 61000-6-1:2007
EN 61000-6-3:2007+A3
Safety (Article 3.1(a) of RED):
EN 62368-1:2014 + A11
EN 60950-1/A11:2009/A1:2010/
A12:2011/A2:2013
EN 62479:2010
Radio (Article 3.2 of RED):
EN 300 328 V2.2.2

Stavanger, 22nd September2022

Regulatory Affairs

F-10378 Rev 2.1 Page 1 of 1

Certificate Of Completion
Envelope Id: 2BDF61FCCBDA4D5597507843649826FE Status: Completed
Subject: Please DocuSign This Document
Source Envelope:
Document Pages: 1 Signatures: 1 Envelope Originator:
Certificate Pages: 1 Initials: 0 Mecildes Dutra
AutoNav: Enabled Tanke Svilandsgate 30
EnvelopeId Stamping: Disabled Stavanger, Stavanger 4002
Time Zone: (UTC+01:00) Amsterdam, Berlin, Bern, Rome, Stockholm, Vienna Mecildes.Dutra@laerdal.com
IP Address: 185.81.100.7

Record Tracking
Status: Original Holder: Mecildes Dutra Location: DocuSign
2022-09-22 | 23:46 Mecildes.Dutra@laerdal.com

Signer Events Signature Timestamp

Mecildes Dutra Sent: 2022-09-22 | 23:46
Mecildes.Dutra@laerdal.com Viewed: 2022-09-22 | 23:46
Laerdal Medical AS Signed: 2022-09-22 | 23:47
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Using IP Address: 51.174.79.228

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Envelope Sent Hashed/Encrypted 2022-09-22 | 23:46
Certified Delivered Security Checked 2022-09-22 | 23:46
Signing Complete Security Checked 2022-09-22 | 23:47
Completed Security Checked 2022-09-22 | 23:47

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