h

c
rd
F
s
n
m
ie
S

SIREMOBIL Compact / L
SP

Maintenance Protocol
System
Compact L and Compact Ser. Nr.:02001
Customer:

Address:

Fax / E-Mail:
Fax / E-Mail:

Department: Room:
Material-No.: Serial-No.:
Contract-No.: Expire date:
Order-No.: System - ID:
© Siemens, 2008

The instructions SPR2-135.831.01.02.02 are required for © Siemens, 2008

All documents may only be used for rendering
this protocol services on Siemens Healthcare Products. Any
10409105
03780629
03776494
document in electronic form may be printed
once. Copy and distribution of electronic docu-
ments and hardcopies is prohibited. Offenders
will be liable for damages. All other rights are re-
served.

Print No.: SPR2-135.832.01.02.02 English

Replaces: SPR2-135.832.01.01.02 Doc. Gen. Date: 05.09
CS PS SP
n.a.

2008
Protocol Date: Serial-No.:

Evaluating the Condition of the System / Component

1Protocol

The system / component has no deficiencies. The image quality

test resulted in no differences from required reference values.
The system / component has slight deficiencies that have no affect
on continued operation of the system. However they should be
corrected preventively. The image quality test resulted in no differ-
ences from required reference values.
The system / component has serious deficiencies. For safety rea-
sons, continued operation of the system is permitted only after
successfully correcting the deficiencies.

After completing all work steps, an evaluation was performed.

Signature:

Date: Name:

The customer or a representative has taken note of the assessment of the

system condition (only if required in the country).

Signature:

Date: Name:

Remarks
e.g. Additional activities to be performed, customer wishes

Further Processing and Archiving of the Protocol

The protocol is a document and thus must be archived. After completing the test, it must
be filed in the corresponding register in the “System Owner Manual“ binder.

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 2 of 12 © Siemens, 2008

05.09 CS PS SP
Protocol Date: Serial-No.:

Remarks Regarding the Protocol 1.1

The protocol is valid as proof of quality for one check that must be performed on the system
/ component.
The check must be performed in the specified intervals.
The results of the check are entered in this protocol.
The chapter numbers in front of the checkpoints indicate the corresponding chapters in the
particular instructions (see cover page).
The protocol must be completely filled out by the Customer Service Engineer, i.e.:
• All boxes must be filled out. If a box does not apply to the system or if no entry needs to
be made, check the “n.a.“ box.
• Enter the Serial no.: and the date of the check in the header of each page so that each
page can be allocated to a check date.
• The measurement values for the measurements that must be performed during the
check must also be entered in the open spaces / tables provided for them.
• After completing the check, Page 2 of this protocol must be filled out and signed.

Explanation of Abbreviations in the Protocol 0

Abbrev. Explanation Abbrev. Explanation

SI Safety Inspection PMF Preventive Maintenance, Operating
Value Check, Function Check
SIE Electrical Safety Inspection Q System Quality, Image Quality
SIM Mechanical Safety Inspec- QIQ Image Quality
tion
PM Preventive Maintenance QSQ System Quality Check
PMP Periodic Preventive Mainte- SW Software Maintenance
nance
PMA Preventive Maintenance CSE Customer Service Engineer
Adjustments

© Siemens, 2008 SPR2-135.832.01.02.02 Page 3 of 12 SIREMOBIL Compact / L

05.09 CS PS SP
Protocol Date: Serial-No.:

Measuring Equipment and Measuring Instruments Used 1.2

Measuring instruments and measuring devices (phantoms, MR coils etc.) may not be
entered in the table if they have already been entered in the mobile device.

Measuring equipment / -instruments Serial No. Date used

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 4 of 12 © Siemens, 2008

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
1 General Information

2 Inspection of exterior and surroundings

2.1 Visual inspection of exterior
PMP Damage to the system
PMP Damage to the network connection

2.2 Inspection of surroundings

2.2.1 Power outlets
SIE Damage
SIE Line voltage
SIE Internal line resistance

Maintenance in this section was performed by:

Signature:

Date: Name:

3 Safety inspection
3.1 Mechanical safety
SIM Cover panels
SIM Cable deflectors
SIM Cassette holder (if present)
SIM Foot brake
SIM Brakes
SIM C-arm
SIM Wheels
SIM Lifting column
SIM Emergency stop switch (Compact / L)
3.1.1 External I.I. laser light localizer (if present)
SIM Mechanics
SIM Function
3.1.2 Integrated I.I. laser light localizer (if present)
SIM Mechanics
SIM Function
3.1.3 Integrated laser light localizer, close to tube - (if present)
SIM Mechanics
SIM Function
3.1.4 DICOM bridge (if present)
SIM Attachment

© Siemens, 2008 SPR2-135.832.01.02.02 Page 5 of 12 SIREMOBIL Compact / L

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
3.1.5 Codonics printer (if present)
SIM Mechanics
SIM Function

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 6 of 12 © Siemens, 2008

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
3.1.6 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIM Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.1.6 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIM Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.1.6 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIM Monitor(s) / displays

© Siemens, 2008 SPR2-135.832.01.02.02 Page 7 of 12 SIREMOBIL Compact / L

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK

Maintenance of this section was performed by:

Signature:

Date: Name:

3.1.6 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIM Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.1.7 Labels
SIM Warning labels
SIM Identification labels

3.2 Electrical safety

SIE Cables and plugs
SIE Fluoroscopic timer
SIE Audible warning signal
SIE Radiation displays
SIE Radiation release switch
SIE Compulsory radiation switch-off
SIE Dose rate
SIE Iris collimator
SIE Dose area product meter (if present)
SIE Air kerma meter (if present)
SIE Codonics printer - cable breaks (if present)

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 8 of 12 © Siemens, 2008

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
3.2.1 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIE Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.2.1 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIE Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.2.1 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIE Monitor(s) / displays

© Siemens, 2008 SPR2-135.832.01.02.02 Page 9 of 12 SIREMOBIL Compact / L

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK

Maintenance of this section was performed by:

Signature:

Date: Name:

3.2.1 Monitor(s) / displays

Present: Yes: Material No.:

No: Serial no.:

Signature:

Date: Name:

SIE Monitor(s) / displays

Maintenance of this section was performed by:

Signature:

Date: Name:

3.3 Operation
SIE Check the operating functions.

3.4 Conductive rubber

SIE SIREMOBIL stand voltage discharge rubber
SIE Monitor trolley voltage discharge rubber

3.5 Measurements
SIE Protective conductor test (performed under "Final work steps")
SIE Leakage current (performed under "Final work steps")

Maintenance in this section was performed by:

Signature:

Date: Name:

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 10 of 12 © Siemens, 2008

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
4 Maintenance, operating values and funct. inspect.
4.1 Maintenance
PMP Cleaning the system
PMP System ventilation
PMP Memoskop ventilation
4.1.1 DICOM bridge (if present)
PMP Ventilation
4.1.2 Codonics printer (if present)
PMP Ventilation
PMP Cleaning

4.2 Operating values, inspection

PMF Error memory

4.3 Functional inspection

PMF Video printer (if present)
PMF Video recorder (if present)
PMF Sneaker Net laser camera system (if present)
PMF DICOM bridge (if present)
PMF DICOM Connect (if present)
PMF Codonics printer, manual control panel (if present)
PMF 4 View (if present)
PMF Laser camera connection (if present)
PMF Image rotation
PMF Slot diaphragm
PMF Monitor display of the iris collimator aperture
PMF Monitor display of the slot diaphragm positions

Maintenance in this section was performed by:

Signature:

Date: Name:

5 Final result / quality inspect. & general maint.

SIE Image quality (IQ) quick test
SIE DICOM bridge IQ test (if present)
SIE Codonics printer IQ test (if present)
PMP Upkeep

© Siemens, 2008 SPR2-135.832.01.02.02 Page 11 of 12 SIREMOBIL Compact / L

05.09 CS PS SP
Protocol Date: Serial-No.:
OK not n.a.
OK
5.1 Final work steps
SIE Protective conductor test
SIE Protective conductor resistance

Measuring circle according to VDE

0751-1, figure:
TP 1: Ω
TP 2: Ω
TP 3: Ω
TP 4: Ω
TP 5: Ω
TP 6: Ω
TP 7: Ω
TP 8: Ω

SIE Leakage current

Measuring circle according to VDE

0751-1, figure:
Measured value: mA
Line voltage: V
Corrected value: mA

Maintenance in this section was performed by:

Signature:

Date: Name:

6 Changes to Previous Version

SIREMOBIL Compact / L SPR2-135.832.01.02.02 Page 12 of 12 © Siemens, 2008

05.09 CS PS SP