Preventive Maintenance Dialog+ Evo Light

A. DATA INFO

CUSTOMER RSUD dr. Adjidarmo TANGGAL RENCANA 9 Des 2022

DESKRIPSI Dialog+ Evo Light TANGGAL PELAKSANAAN 8 Des 2022

ARTICLE NO. 710200I JAM PELAKSANAAN 18:41:35

NO. SERI 512302 TEKNISI Zuliansyah Ismail

SOFTWARE 9.1B  

B. ALAT UKUR YANG DIGUNAKAN

NO. NAMA ALAT MEREK TIPE NO. SERI

1 Hemodialysis Meter IBP HDM 97 BO 3030310103000802
2 Timbangan Digital
3 FSU Ver. 2.00
4 Multi Meter Digital
5 Pressure Guage
6 Flow Meter

C. KONDISI RUANGAN

PARAMETER TERUKUR
Suhu 26 °C
Kelembapan Nisbi 55 %

D. AKSESORIS

NO. DESKRIPSI ARTICLE NO. NO. SERI P/F

1 Applied Accessories/Disposables : Applied line system Name (blood line)

E. PEMERIKSAAN KONDISI FISIK DAN FUNGSI ALAT ( QUALITATIVE TASKS )

NO. DESKRIPSI P/F

1 Disinfection/Decalsification was Performed
Machine : clean/complete; no damages/moisture influences or loose assemblies; no moveable parts
2
touching tubings or wires; casters are moveable; type plate legible
3 Clean interior space and exterior surfaces
4 Suction tubing for disinfection and concentrate exchanged
5 O-rings at suction rod exchanged
6 Balance chamber – no visible leakages
Check tight seat and damages of mains supply (power supply cord, strain relief), potensial equalisation
7
cable, staff call/data lines (if prsent) and connectors
8 Tubing connectors , clamps and couplings (internal/external) are assembled correctly
9 O-rings and tubings at the dialyzer couplings exchanged
10 Tight seat of boards and connectors (incl. mains connection in switch mode power supply)
11 Exchange dust filter of fan (rear door)
12 Filter (FVD, FB, FK, FBK1/2, FBIC, FEP) exchanged
Filter level regulation module (HFA, HFV, HFE (HFS if present)) exchanged Option present {Filters are not
13
included in the maintenance kit, if necessary order separately.}
14 BIC Cartridge Holder (Option present)

15 BIC Cartridge Holder : O-rings exchanged

Battery on PC motherboard exchanged (after operating period of 4 years) {Battery is not included in the
16
maintenance kit, if necessary order separately.}
17 Monitor : no restriction of motion of rotation; touch membrane/keyboard membrane not damaged
18 Check non-return valve RVDA (at approx. 400 mbar +/- 50 mbar or 300 mmHg +/- 37 mmHg)
19 Check non-return valve DDE (at approx. 400 mbar +/- 50 mbar or 300 mmHg +/- 37 mmHg)
20 Check non-return valve RVFPE (at approx. 1300 mbar +/- 50 mbar or 975 mmHg +/- 37 mmHg)
21 Check non-return valve RVFPA (at approx. 1300 mbar +/- 50 mbar or 975 mmHg +/- 37 mmHg)
22 ENDLF sensor : Visual inspection
23 BICLF sensor : Visual inspection
24 BIC piston pump : Visual inspection
25 KP piston pump: Visual inspection
26 UF piston pump: Visual inspection
27 Blood leak detector BLD test passed
28 Check blood leak detector and calibrate if necessary {BLD version 3 or version 4}
29 Set summer/winter time {TSM, Treatment Support, System Configuration, if applicable in this country}
30 Blood Pump : Check function, movability, noise rating
31 Blood Pump : Check roller/one-way bearing; clean and lubricate shaft slightly if necessary
32 Blood Pump : Alarm cover switch
33 Venous Tubing Clamp SAKV : Function/gap checked, set gap 1.4 (+ 0.1 mm) if necessary
34 Switch on machine : Self test passed
35 Power Fail Function : Check function, duration of a constant audible alarm > 1 minute
36 Safety Air Detector SAD : Test alarm function (visual/audible) passed
37 Monitor : Function of the keys, display illumination, OSDs (for Dialog+) and touch screen OK
38 Monitor : Image display OK
39 Battery Option (Option present)
Battery Option : Activate audible alarm {The machine must be in therapy mode. Disconnect mains plug:
40 the buzzer from the SMPS-MC gives three signaling tones as an indication that the machine is running in
battery mode.}
41 Disinfection : Performed by responsible organization {user, inform responsible organization}
42 Disinfection : Performed by service technician
Customer specific parts or information on the machine (e.g. stickers/labels) were removed during the
43
technical service inspection/preventive maintenance or repair
44 New labeling must be performed by responsible organization (user)

F. PENGUKURAN KESELAMATAN LISTRIK ( SAFETY TEST )

BATAS BATAS
NO. PARAMETER TERUKUR P/F
BAWAH ATAS
1 Measure Mains Voltage (Phase - Neutral) 220 Volt 200 Volt 240 Volt
Protective Earth Resistance at Measurement points -
2 Exterior : Potential equalisation bolt, rinsing bridge (dialyser 0Ω 0Ω 0,3 Ω
inlet and outlet)
Protective Earth Resistance at Measurement points - Interior
3 : Heater body (top), rear door (top left corner), frame 0Ω 0Ω 0,3 Ω
(rear), housing cover (top left), front door (top left)
Protective Earth Resistance at Measurement points - Monitor
4 0Ω 0Ω 0,3 Ω
: one of the screws in the front panel/housing
Equipment Leakage Current : During heat-up phase {all
5 water connections and data lines must be connected during 0 mA 0 mA 0,5 mA
the check of the equipment leakage current}
 6 Patient Leakage Current : Under normal conditions {at 0 μA 0 μA 10 μA
dialyser coupling}, conductivity at 13 - 15 mS/cm
7 Measure Mains Voltage (Phase - Ground) 225 Volt 200 Volt 240 Volt
8 Measure Mains Voltage (Ground - Neutral) 3 Volt 0 Volt 5 Volt

G. PENGUKURAN KINERJA ( QUANTITATIVE TASKS )

SETTING TOLERANSI TOLERANSI

NO. PARAMETER TERUKUR P/F
PADA ALAT BAWAH ATAS
1 Check non-return valve RVDA 400 mbar 400 mbar -50 mbar +50 mbar
2 Check non-return valve DDE 400 mbar 400 mbar -50 mbar +50 mbar
3 Check non-return valve RVFPE 1300 mbar 1300 mbar -50 mbar +50 mbar
4 Check non-return valve RVFPA 1300 mbar 1300 mbar -50 mbar +50 mbar
5 Degassing Pressure Sensor PE -400 mmHg -400 mmHg -10 mmHg +10 mmHg
6 Degassing Pressure Sensor PE -100 mmHg -100 mmHg -10 mmHg +10 mmHg
7 Dialysate Outlet Pressure Sensor PDA -400 mmHg -400 mmHg -10 mmHg +10 mmHg
8 Dialysate Outlet Pressure Sensor PDA 0 mmHg 0 mmHg -10 mmHg +10 mmHg
9 Dialysate Outlet Pressure Sensor PDA 400 mmHg 400 mmHg -10 mmHg +10 mmHg
Heparin Pump : Position {Drive fast forward
10 to end position with 30 ml syringe. Check 80 mm 80 mm -15 mm +15 mm
display position in mm.}
Venous Tubing Clamp SAKV : Function/gap
11 1,4 mm 1,4 mm 1,4 mm 1,5 mm
checked
12 Arterial Pressure PA -400 mmHg -400 mmHg -10 mmHg +10 mmHg
13 Arterial Pressure PA 0 mmHg 0 mmHg -10 mmHg +10 mmHg
14 Venous Pressure PV 0 mmHg 0 mmHg -10 mmHg +10 mmHg
15 Venous Pressure PV 400 mmHg 400 mmHg -10 mmHg +10 mmHg
Temperature : comparison measurement {at
16 37 °C 37 °C -1,5 °C +0,5 °C
dialyser coupling}
Conductivity : comparison measurement {at
17 14,3 mS/cm 14,3 mS/cm -0,2 mS/cm +0,2 mS/cm
dialyser coupling}
Ultrafiltration : comparison measurement at
18 125 ml 125 ml 121 ml 129 ml
15 min with UF rate 500 ml/h

HASIL PEMERIKSAAN

Status PASS
Catatan PASS