Maintenance Inspection Report

GE Healthcare

Equipment: MAC 500 ECG

Customer: __________________________________________________________________

Equipment Serial Number: _____________________ Software Revision: _______________

System ID : _____________________ Dispatch No. : ___________________

Configuration (
)

Basic _____________________ Meas& Interpretation__________________

Tools Required
1. Leakage tester 4. ESD Kit

2. Standard hand tools 5. ECG Simulator

3. Multimeter (4 ½ digit display) 6. Patient Cable

Visual Inspection (
)

Inspect the following for excess wear and/or any visual signs of damage.

1. General 2. Connectors 3. Cable Insulation

Cleaning (
)
1. External surfaces 3. Print head/Roller

Calibration (
)
(There is no On-site calibration required for this product. Setup should be verified for desired performance.)

1. System Setup 2. Service Set-up

Electrical Safety Checks (
)

1________V Wall Receptacle Test (210 to 230 VAC between the two hot contacts)

2. Ω Ground Continuity (Impedance of protected connection) Test (≤ 0.1Ω or ≤ 0.2Ω w/power cord)

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 3. Leakage Open Closed
Normal Reversed Normal Reversed
Ground (Earth) wire leakage to ground test µA µA NA NA
{Maximum Allowable Leakage Current (µA) – 300}

Chassis (Enclosure) leakage to ground test µA µA µA µA

{Maximum Allowable Leakage Current (µA) – 300}

ECG
Source Risk (Patient cable leakage to ground) Leakage µA µA µA µA
{Maximum Allowable Leakage Current (µA) – 50}

Checkout Procedure

1. Perform the applicable checkout procedure.

Operational Checks

A. Power-up Self-test OK.

B. Record Rhythm OK .
C. Record ECG Functional.

Diagnostic Tests

F. Display Diagnostics.
G. Speaker Tests
H. Keyboard Test
I. Writer Diagnostics

Results / Comments

All the above Checks / Tests has been done and the Device is found to be performed as per the Specifications.

Inspected By: Accepted BY:

Field Engineer Details Customer Details

Name _____________________________________________ ____________________________________________

Signature _____________________________________________ ____________________________________________

Date: _____________________ _____________________

References: 2026938-127 Functional Checkout Procedures Manual - MAC500 ECG

22747035 MAC500 Service Manual
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