UNIT 23 EQUIPMENT MANAGEMENT-

MAINTENANCE, REPAIR AND

DISPOSAL

Structure
23.0 Objectives
23.1 Introduction
23.2 Definition
23.3 Existing Situation
23.4 Maintenance and Repair Facilities
23.4.1 Need for repair and maintenance centre
23.4.2 Outline of the plan of Biomedical engineering operations for Maintenance
23.4.3 Maintenance and repairs
23.5 Condemnation and Disposal
23.6 Let Us Sum Up
23.7 Answers to Check Your Progress.

23.0 OBJECTIVES
After studying this unit you should be able to:
•• discuss the existing situation of hospital equipment;
•• describe the essential features of timely maintenance and repair
procedures; and
•• explain condemnation (discard policy) and disposal of equipment

23.1 INTRODUCTION
Hospital equipment are based on sophisticated and high cost technology,
involving huge funds;the vast number of medical equipment available
complicates prioritization, selection and procurement and most of the
times clinicians and general administrators are not much aware about the
complexities and technicalities involved in the ideal/ correct procurement
procedure i.e. appropriate specifications, terms and conditions in the tender
document, proper maintenance cover, installation, utilisation, maintenance
and repair of these equipment.
The situation is even worse when it comes to, condemnation and disposal
of hospital equipment. As a result, hospitals end up procuring equipment
which neither have ideal specifications as per standard govt. norms nor have
an appropriate maintenance cover. Above it, end up paying more.
Maintenance and repair of these sophisticated equipment becomes the
biggest challenge. Studies have shown that non-functional equipment
are one of the major factors of wasteful expenditure in govt. healthcare
institutions. This not only leads to long down time but also affects patient
care adversely.
289

MHH-101 Volume-02.indd 289 12/10/2022 12:52:04 PM

 Total word Essentials of Timely maintenance and repair of the hospital equipment therefore assume
Logistic and Equipment vital importance. This unit will offer some guidelines on the complex
Management
problem and also on the condemnation and disposal of the equipment.

23.2 DEFINITIONS
Important definitions are as follows:
Medical Devices: As per the Medical devices rules-2017, these are defined
as follows:
•• “Active Diagnostic Medical Device” means any active medical device
used, whether alone or in combination with other medical devices,
to supply information for detecting, diagnosing or monitoring, or to
provide support in the treatment of, any physiological condition, state
of health, illness or congenital deformity.
•• “Active Medical Device” means a medical device, the operation of
which depends on a source of electrical energy or any other source of
energy other than the energy generated by human or animal body or
gravity
•• “Active Therapeutic Medical Device” means any active medical
device used, whether alone or in combination with any other medical
device, to support, modify, replace or restore biological functions or
structures, with a view to the treatment or alleviation of any illness,
injury or handicap.
Equipment Maintenance: It is set of activities conducted to keep
an equipment in optimum working condition and consists of periodic
inspection, preventive maintenance, and corrective maintenance.
Maintenance Types & Definitions:
•• Preventive Maintenance: this is the maintenance carried out at pre-
determined intervals/ specific durations, according to prescribed
criteria (as per make and model of equipment), intended to reduce the
probability of failure of equipment part or the equipment as a whole.
•• Corrective/ Breakdown Maintenance: this is the maintenance
carried out post fault occurrence. It is a maintenance task performed
to identify, isolate, and rectify a fault so that the failed equipment,
machine, or system can be restored to an operational condition within
the tolerances or limits established for in-service operations.
Uptime and Downtime:
•• Uptime: It is the measure of the time in which the machine is functional
•• Downtime: It is the time for which the equipment remains dysfunctional
Condemnation and Disposal:
•• Condemnation: when any equipment cannot be repaired either due to
it being obsolete or has to be discontinued in case its repair cost goes
beyond economically feasible.
•• Disposal: process to dispose of the equipment/ device which has been
declared as condemned.

290

MHH-101 Volume-02.indd 290 12/10/2022 12:52:04 PM

 Equipment Management
23.3 CURRENT INFRASTRUCTURE -Maintenance, Repair and
Disposal
Biomedical Equipment Management & Maintenance Program (BMMP)
Hospital cannot function smoothly unless the various medical devices
and equipment in it are under appropriate maintenance. Medical Devices
availability and upkeep is one of the key interventions for mass access to
diagnostics, preventive, assistive and therapeutic services.
As an initiative Ministry of Health and Family Welfare, Govt. of India,
through National Health Mission has launched Biomedical Equipment
Management & Maintenance Program (BMMP). The program provides
support to state governments to outsource medical equipment maintenance
comprehensively for all facilities so as to improve the functionality and
life of equipment’s, simultaneously improving healthcare services in public
health facilities- reducing cost of care and improving the quality of care.
The aim is to ensure upkeep time for medical equipment in PHC/CHC/DH
at 85%, 90% and 95% respectively.
Salient features of Programme
These are as follows:
24 × 7 Toll free number for reporting breakdown
•• Medical Equipment Management Information data for planning and
monitoring performance of medical equipment
•• Preventive maintenance
•• Corrective maintenance
•• Calibration and User Training.
With the formation of SEMU (State Equipment Management Unit) a
beginning has been made towards addressing the maintenance issues of
Medical Equipment.
Check your progress 1.
i. What is BMMP initiative of Govt. of India?
ii. List the Salient features of Program.
iii. What is the aim of the program?

23.4 MAINTENANCE AND REPAIR FACILITIES

The delivery of the best healthcare services depends heavily on medical
equipment, whether for life support, for diagnosis, for patient monitoring,
or for the delivery of therapies or teaching and research purpose. The risks
associated with the use of medical equipment can only be controlled by
managing the whole life-cycle of the equipment.
The Life cycle of a Medical Equipment is as follows:

291

MHH-101 Volume-02.indd 291 12/10/2022 12:52:04 PM

 Total word Essentials of Planning: Assessment,
Logistic and Equipment Specifications & Budgeting
Procurement: with
Management
maintenance plan
Condemnation &
Disposal

Inspection

Maintenance:
checks Inventory &
documentation

Monitoring
Commissioning & approval Installation

Fig.23.1: Life cycle of a Medical Equipment

23.4.1 Need for Repair and Maintenance Centre
Repair and maintenance centres are of utmost important to facilitate hospital
equipment maintenance at preventive and breakdown levels.
The Ministry of Health and Family Welfare, Govt. of India in August, 2019
issued a Biomedical Equipment maintenance manual, wherein establishment
of State Equipment Management Unit (SEMU) is mentioned.
These centres aims to achieve the following objectives:
•• To provide repair and maintenance facility to hospitals, medical
institutions and dispensaries in the State;
•• To provide consultancy on electro-medical equipment in the area of
pre-installation and operation of equipment to hospitals and medical
institutions; and ,
•• To arrange for training of medical and paramedical personnel
handling the equipments.
•• The SEMU have the following functions:
•• Devices used within the Public Health System in the entire state will
be inspected prior installation.
•• Maintenance of Medical Equipment and proper usage of new
equipment.
•• Some of the specialized equipment viz. CT scanner, MRI, Blood
Gas Analyser, Auto analyser, Laparoscopes etc. will need company
maintenance for which AMC/ CAMC will need to be signed.
•• Unit will maintain the basic medical equipment for repair and
Calibration at the central workshop at the head office, the divisional
workshops at four divisions and in the District hospital Workshops
and appropriately will also maintain the equipment at hospital by
sending repair team.
•• Medical equipment of different District hospital and hospital which
the unit cannot repair due to non-availability of spare parts (internal
components), maintenance manual & circuit diagram and technical
skill will be repaired through private companies/vendors under the
supervision of Biomedical Engineer at the head office and other

292

MHH-101 Volume-02.indd 292 12/10/2022 12:52:04 PM

 divisional offices. The SEMU will appoint Certified Technicians and Equipment Management
Engineers for maintenance and calibration. -Maintenance, Repair and
Disposal
23.4.2 Guidelines for maintenance of biomedical engineering operations
The following guidelines are useful for the development of effective
maintenance services in a hospital:
•• Estimation of types & number of equipment requirements-Based on
estimated patient load needing the equipment, hospital size, types of
services etc. list the specifications of the equipments and the sources
of procurement of these equipment.
•• Estimated use coefficient for the equipments-Based on the likely
workload estimate the use coefficient for the equipments, especially
those which are very costly.
•• Budget allocation for maintenance of equipments-For the high-tech
expensive equipments you should also keep enough budget for their
maintenance in the hospital budget plan.
•• Preventive maintenance-For increasing the life of equipment and
its efficient and effective functioning, the preventive maintenance
is important. For the new equipment ensure that these are under
warranty for a sufficient period to test its performance.
Policy designing and monitoring committee
In the discussions so far, it is clear that a well drafted and specialist guided
equipment maintenance plan is of utmost importance for continuity of
uninterrupted patient care in any healthcare Institute. For this every hospital
should have a Policy designing and monitoring committee. The structure of
committee is as follows:
•• The Chief Medical Superintendent/ Medical Superintendent
(Chairperson)
•• Hospital Administrator (Member Secretary)
•• The head of the concerned department
•• Head of maintenance/ Biomedical engineer (If, Posted)
•• Representative from Finance Department
•• Hospital Store In-charge
•• Nursing Superintendent
The mandate of the committee is as follows:
•• Maintaining updated record of current status of the medical equipment
•• Analysis of the records such as Breakdown Register, Preventive
maintenance Register Check
•• Assessing the user about the usage and performance of the equipment.
•• Suggesting measures to optimally utilize the equipment for quality
health services
•• Reviewing the maintenance plans in built in the procurement terms
and conditions of the equipment and drafting terms and conditions so
as to provide equipment’s with optimum maintenance cover.
293

MHH-101 Volume-02.indd 293 12/10/2022 12:52:04 PM

 Total word Essentials of •• Establishing a maintenance Cell in the hospital, where entire records
Logistic and Equipment
and documentations related to hospital equipment are maintained.
Management
•• Organising user end trainings to facilitate users in better handling of
equipment/ devices
•• Developing a back-up plan to minimise disruption of patient care in
case of sudden breakdown of essential equipment, eg. Liaising with
nearby hospitals or registered suppliers
Template for maintenance record
The template is as follows:
Equipment Details

Name Of Equipment Code/ Make

Name of Company/Supplier Location
Model: Frequency of Calibration:As per manufacturer guidelines/user
manual/service manual:
Date of Installation Frequency of Preventive Maintenance (PM): As per
manufacturer guidelines/user manual/service manual:

Reference ID as per hospital inventory: Warranty Details:

Start date: DD/MM/YYYY
End Date: DD/MM/YYYY
Maintenance Record
Sl. Date & Fault List of spares Date & Cost Remark Name, Name, Designation
No. time of details replaced or used time of incurred Designation & & Sign. of Area
Complaint in preventive Fault in RS. Sign. of Service In-charge
maintenance resolution agent

1.
2.
3.
4.

In the era of digitalisation it will be good to maintain digital Data of the

Maintenance records.
In fact various modules of Hospital Information System and other
independent programs can be used as a reminder for periodic maintenance,
equipment approaching expiry of the warranty, etc.
Ministry of Health and Family Welfare, Govt. of India in August, 2019
issued a Biomedical Equipment maintenance manual, the same can also be
used as a guide/ reference.
23.4.3 Maintenance and repairs
Maintenance as well as repairs are the two terms which are closely related
to each other. Broadly classified the equipment maintenance and repairs
include the following:
Preventive Maintenance
This is the maintenance carried out at pre-determined intervals/ specific
durations, according to prescribed criteria (as per make and model of
equipment), intended to reduce the probability of failure of equipment part

294

MHH-101 Volume-02.indd 294 12/10/2022 12:52:05 PM

 or the equipment as a whole. There are 2 types of preventive maintenance Equipment Management
contracts/ agreements. -Maintenance, Repair and
Disposal
•• Annual Maintenance Contract (AMC): An annual maintenance
contract is an agreement with a service provider for repair and
maintenance for one year from the date of purchase of equipment/
property by the buyer. It can also include service to the building,
the land, parking lots, etc. this is generally a service contract where
replacements and spare parts are not covered.
•• Comprehensive Maintenance Contract (CMC): A CMC is more than
one year like 3 to 5 years or more, as agreed to by the parties. A CMC
includes prompt service for repairs and replacements of faulty parts
or machines. A CMC costs more than an AMC because it includes the
costs of the replacements on top of the maintenance service.
Corrective/ Breakdown Maintenance
This is the maintenance carried out post fault occurrence. It is a maintenance
task performed to identify, isolate, and rectify a fault so that the failed
equipment, machine, or system can be restored to an operational condition
within the tolerances or limits established for in-service operations.
As regards to preventive maintenance of all expensive and sophisticated
equipment is concerned, care should be taken that the new equipment or
machines are under warranty for a sufficient period to test its performance.
The essential spares should be obtained along with the equipment is a part
of the configuration and the integral part of the Purchase contract to last for
sufficiently long duration say 5 to 10 years. The equipment should also be
under service contract after five years. Appropriate penalty clause must be
included in the Purchase contract to this effect.
The process for fresh maintenance contract (AMC/ CMC) of the equipment
should be initiated 3(three) Months before the expiry of the warranty period/
AMC/CMC.
The necessary concurrence from the finance department of the Institution
required for renewal of contract/fresh contract shall be taken well in advance
so that equipment remains functional and downtime is minimized.
Also, the service provider’s registered office should be located preferably
within the city limits.
Insurance: In case there are Costly Equipment’s which are somehow not
covered under AMC/CMC, then they should be separately insured so that if
any breakdown occurs the expenditure incurred for the same can be claimed
from the Insurance Provider.
For electronic equipment necessary safeguards should be carefully observed
which may include:
•• Voltage stabilizers, built-in otherwise
•• In high priority areas like operation theatre, ICU, CCU Diagnostic
services, etc. voltage stabilisation should be done area wise preferably
through an uninterrupted power supply that is UPS system
•• Separate line should be laid where voltage fluctuation is considerable

295

MHH-101 Volume-02.indd 295 12/10/2022 12:52:05 PM

 Total word Essentials of •• Automatic switch over for emergency should be provided with a
Logistic and Equipment generator.
Management
The requirements of electricity, water, space and atmospheric conditions
should also be taken into account. For example for certain lifesaving
equipment a 3 phase supply of electricity should be provided. Such
equipment should also be protected from the vagaries of weather in order to
minimise breakdown and enhance the life of equipment.
As regards the routine equipment or instruments such as sphygmomanometer,
suction apparatus, centrifuge, incubator, hot air oven, ECG machine etc. the
maintenance cell workshop should have the required facilities in terms of
skilled and trained manpower required spares and infrastructural facilities.
Illustrations on how maintenance failures can result in adverse events
Illustration 1: Poor alarm management
Hospitals have to continuously monitor in-house patients. For this reason,
critical equipment like ventilators have alarms integrated with them to alert
medical staff in the event of an emergency. A quick response in such a
situation is critical in avoiding complications.
But in a busy ward, these sounds can get lost in the clutter of buzzers and
beeps. If an alarm is going off every couple of minutes, attendants are bound
to start ignoring it at some point and delay treatment. This effect is known
as alarm fatigue and it desensitizes attendants to alarms and makes them
overlook critical warning signs.
Alarm fatigue is a top hazard to patient safety; it is important to mention
that 566 alarm-related deaths have been reported to have occurred in a
duration of 3 years in developed countries.
Another study by John Hopkins revealed that medical staff receives around
350 alarms a day per patient.
To avoid such mishaps, configure equipment alarms to go off only in
clinically critical events which require immediate action. You can also
prioritize alarms and assign them codes to optimize response times. Always
ensure that all alarms are funnelled to the concerned personnel so they don’t
pile up.
Illustration 2: Equipment failure Data
Equipment failure – In a study done in 8 public hospitals in Western Australia
reported that 107 (0.4%) of 26,325 clinical incidents between February 2014
and August 2016 were caused by medical equipment failure or malfunction.
Two of these were incidents where serious harm or death could have been
caused. Over a similar period, they reported that 94 theatre cases and
586 imagery appointments were cancelled due to equipment failure or
unavailability (less than 1% of the total number of cases and appointments).
We were unable to assess if these rates are high 4 as hospitals do not use
targets as a tool for monitoring and reducing the frequency of failure.
Master Maintenance Plan
The master maintenance plan should be drawn in consideration to the load
of the user departments including the following aspects of the equipment
maintenance and repairs:
296

MHH-101 Volume-02.indd 296 12/10/2022 12:52:05 PM

 •• Recruitment of skilled manpower Equipment Management
-Maintenance, Repair and
•• Arranging regular training programs on maintenance and repairs of Disposal
equipment of the technicians and other concern personal
•• Establishing a bank of spare parts and crucial component
•• Establishing detailed records of the Purchase, procurement and
maintenance of equipment
•• Periodic checks and repairs
•• Monitoring of the annual maintenance contract of equipment
•• Developing a Maintenance Cell for maintenance and repair
•• Establishing a nucleus of communication between this cell and the
supplier of the equipment
•• Follow-up of the maintenance and repair services.
Repair of equipment
It is necessary to have basic in-house facilities for the routine repairs of the
common equipment. It has been generally seen that many times the hospital
equipment are not working for want of simple repair such as faulty switches
and plugs, loose wiring and sparkling, fuse problems, lack of spare parts,
lack of training of staff in handling of sophisticated equipment and many
other factors.
The in-house repair facility should be recognised keeping the following in
mind:
•• Head of maintenance cell (workshop) should be completely
accountable and responsible for the task under his control
•• Availability of skilled manpower for the repairs
•• Provision of a bank of spare parts and crucial components
•• Technician and other workers, handling important equipment should
be provided with a separate toolkit consisting of all essential items
required for repair and maintenance.
•• The repair procedures must include the following:
•• Repairing and servicing of sophisticated equipment only under the
guidance of a qualified and skilled person
•• This cell should also evolve and develop the procedures for re-
questioning repair services if break down happens again due to the
same/ repaired fault
•• The downtime of each equipment should be specified and adhered to
by the maintenance cell
•• The technical personnel involved should be trained either by the
established Institutions or by the manufacture/ registered supplier.
Staff and Organisational structure: The staff and organisational structure
for equipment management would vary depending on the nature type and
size of a hospital. However for a district hospital following staff may be
recommended:
•• A junior engineer (electrical or mechanical)
•• Two Technologies (electrical and mechanical)
297

MHH-101 Volume-02.indd 297 12/10/2022 12:52:05 PM

 Total word Essentials of •• Support staff
Logistic and Equipment
Management The structure of maintenance cell for typical district hospital is given below:

Medical Superintendent

Head of Maintenance Cell (junior engineer)

Technologist (Electrical and Mechanical)

Support staff
Maintenance Cell should be an integral part of the hospital and hospital
authorities must also ensure appropriate budget in the Hospital Maintenance
Head.
Equipment Audit:
Equipment audit is a periodic evaluation system to measure the quality
of performance of the medical equipment. At any given point of time, a
substantial number of equipment in the hospital may be non-functional.
The reasons for the same could be:
•• Want of Minor repairs
•• Lack of Maintenance
•• Lack of essential Spares
•• Electrical Faults
•• Unfavourable environmental conditions
•• Mishandling of equipment by untrained and unskilled manpower
•• Purchase of equipment without justifiable demand etc.
•• False Reporting, Wilful Damage and Overuse than rated
For this, there is a need for periodic evaluation of the quality of performance
of the equipment in a hospital. If such an audit is performed, it will be
an advantage to the Hospital so that not only better utilization of medical
equipment is ensured but also it contributes to the improvement in the
quality of patient care.
Periodic Equipment Audit should be done by the committee constituted for
the purpose (Equipment Audit Committee) at Hospital Level on half yearly
basis. The Equipment Audit Committee should have:
•• The Medical Superintendent/designated medical officer of the hospital
•• The head of the concerned department
•• Head of maintenance (If Posted)
•• Representative from Hospital Administration
•• Representative from Finance Department
298

MHH-101 Volume-02.indd 298 12/10/2022 12:52:05 PM

 •• Hospital Store In-charge Equipment Management
-Maintenance, Repair and
•• Nursing Superintendent Disposal
Focus of the Audit is to:
•• Check the current status of the medical equipment
•• Analysis of the records such as Breakdown Register, Preventive
maintenance Register
•• Questioning the user about the usage and performance of the
equipment.
•• Suggesting measures to optimally utilize the equipment for quality
health services.
•• Advantages of the equipment audit are:
•• Evaluation the performance and utilization of the equipment
•• To Provide an objective method for planning of equipment procurement
in future
•• To Analyze various inadequacies (including downtime) in the
utilization of an equipment and recommendation of remedial measures
(including training to the users) so as to maximize the efficiency and
effectiveness of the equipment.
Training and Development
For the safety of the patient and the user, proper training is critical for both
the user and the technical staff. Training and education is not a one-time
activity but a continuous process.
Training may be:
•• In-House
•• At recognized institutions
In-House Training
•• For operating the equipment – to be given by Manufacturer/Supplier
periodically and preferably to be mentioned in Tender Enquiry
Document.
• To deal with routine maintenance and repairs
o Use of tool kit
o Knowledge about common and recurrent causes of failure of
the equipment and how to rectify minor causes of failure
o Calibration of the equipment
Training outside at recognized institutions – workshops etc.
a. For operating the equipment (if required)
b. To deal with routine maintenance
Important Elements in Training of Technicians
•• Training the technicians in quality management
•• Education of technicians on the repair maintenance policy objectives
and concepts of patient satisfaction
299

MHH-101 Volume-02.indd 299 12/10/2022 12:52:05 PM

 Total word Essentials of •• Awareness programs for new entrants
Logistic and Equipment
Management •• Procedures for specifying and verifying the technicians receive
suitable training
•• Teamwork and communication methods
•• Assessing carefully the technicians requirements and subsequently
providing assistance and encouragement
•• Performance evaluation of technicians to assess their development
needs and potential.
This training may be provided in different modules, some of which may be
of the following types:
•• Use and practice of equipment including proper handling equipment
•• Preventive maintenance and troubleshooting
•• Following the instructions of the user manual in day to day use of the
equipment
•• Use of toolkit
•• Knowledge about common and recurring cause of breakdown
•• Identification of common spare parts which are responsible for
breakdowns such as users watches, nuts, bolts, etc.
•• Inspection and routine maintenance: daily/ periodic checks/ servicing
schedule with information of all aspects of inspection- removing,
dismantling, cleaning, examining, lubricating, assembling, adjusting,
testing and reassembling of equipment/ system where required
•• Calibration
•• Testing and safety guidelines
•• Basic concepts of Physics and electronics as relevant to hospital
equipment
•• Technology upgradation
To sum up suitable mechanism should be developed with requisite
infrastructure for evaluating the maintenance plan, procurement, utilisation,
maintenance and repair of the equipment. The feedback arising out of
evaluation should be recorded and made use of in improving the quality
related activities of the equipment management in future.
Check your progress 2
i. List the advantages of preventive Maintenance?
ii. What are the Essential Components of Equipment Maintenance
record sheet?
iii. List the contents of a Master Maintenance Plan
iv. What is Equipment audit?
v. What is the focus of Equipment audit?
vi. List the important elements in training of technicians.

300

MHH-101 Volume-02.indd 300 12/10/2022 12:52:05 PM

 Equipment Management
23.5 CONDEMNATION AND DISPOSAL -Maintenance, Repair and
Disposal
We have seen till now, that it is imperative for every hospital to develop
proper maintenance and repair facility for hospital equipment in the manner
suggested above to minimise the periodic breakdowns as well as increase
the uptime of the equipment to its maximum. However, every equipment
has a life and in spite of best maintenance, over a period of time, it become
obsolete or beyond economic repair. Non-disposal of these causes increase
in holding costs and decrease in the precious hospital space. Such equipment
needs to be condemned and disposed at regular intervals.
Condemnation: when any equipment cannot be repaired either due to it
being obsolete or has to be discontinued in case its repair cost goes beyond
economically feasible.
Disposal: process to liquidate or dispose the equipment/ device according
to its value, which has been declared as condemned by appropriate authority
There are Condemnation and Disposal Committees at various levels; in
organisations, departments, ministries, etc. and guidelines are issued in this
regard from time to time.
As per GFR-196 Disposal of Goods
•• An item may be declared surplus or obsolete or unserviceable if the
same is of no use to the Ministry or Department. The reasons for
declaring the item surplus or obsolete or unserviceable should be
recorded by the authority competent to purchase the item.
•• The competent authority may, at his discretion, constitute a committee
at appropriate level to declare item(s) as surplus or obsolete or
unserviceable.
•• The book value, guiding price and reserved price, which will be
required while disposing of the surplus goods, should also be worked
out. In case where it is not possible to work out the book value, the
original purchase price of the goods in question may be utilized. A
report of stores for disposal shall be prepared in Form GRF-17.
•• In case an item becomes unserviceable due to negligence, fraud or
mischief on the part of a Government servant, responsibility for the
same should be fixed.
•• It is the responsibility of every institute to have a condemnation &
disposal policy and committee of its own, which assesses the equipment
usage, maintenance cost, its obsolescence and then recommends for
condemnation of hospital equipment’s.
The broad objective of Condemnation and disposal committee are mentioned
below:
•• To develop Institutional mechanism for condemnation and disposal
•• To introduce efficient economic practices for condemnation and
disposal
•• To establish cost effective structure to prolong life cycle of equipment
and ensure optimum resource utilisation & reutilisation.

301

MHH-101 Volume-02.indd 301 12/10/2022 12:52:05 PM

 Total word Essentials of It will be a good practise to make separate condemnation committees for
Logistic and Equipment the following:
Management
•• bio-medical equipment
•• other hospital goods/ assets and a separate committee for
•• e-waste and office equipment.
Structure of the Condemnation Committee
The generic structure of the Condemnation Committee is given below:
•• Chairperson: Head of Institute or nominee
•• Member Secretary: Hospital Administrator or senior person with
procedural knowledge in this regard as nominated by Head of Institute
•• Member: Finance Officer or nominee
•• Member: Head of Department/ In-charge of the area
•• Member: Senior Biomedical Engineer
•• Member: Purchase officer or nominee
•• Member: Store in-charge
•• External expert: Equipment manufacturer or a technical expert of the
equipment
•• Special Invitee: Legal expert
Structure of the Disposal Committee
The generic structure of the Disposal Committee is given below:
•• Chairperson: Head of Institute or nominee
•• Member Secretary: Hospital Administrator or senior person with
procedural knowledge in this regard as nominated by Head of Institute
•• Member: Finance Officer or nominee
•• Member: Head of Department/ In-charge of the area
•• Member: Senior Biomedical Engineer
•• Member: Purchase officer or nominee
•• Member: Officer In-charge for scrap yard/ disposal area
•• External expert: Equipment manufacturer or a technical expert of the
equipment
•• Special Invitee: Legal expert
External experts and special invites maybe increased according to the
financial value of the Equipment to be condemned.
In general minimum criteria to be followed for condemnation and disposal
of equipment are that the equipment becomes:
•• Non-functional and beyond economic repair
•• Non-functional and obsolete
•• Functional but obsolete
•• Functional but hazardous
•• Functional but no longer required
302

MHH-101 Volume-02.indd 302 12/10/2022 12:52:05 PM

 Procedure for condemnation Equipment Management
-Maintenance, Repair and
Obligations of the Individual Department: In case of bigger healthcare Disposal
setups where individual departments have their own extensive structure,
equipment and adequate support staff a Departmental condemnation
Committee should be constituted.
•• Departmental Condemnation committees can have 3 Consultants/
Faculty Members in Head of the Department, in case individual
department has less than 2 faculty, then any faculty member from
allied specialty can be a part of the committee. The engineer/ bio-
medical engineer, will invariably be a part of all the Departmental
Condemnation Committees (DCC).
•• A request will be received from the organisation committee to review
the functional status of equipment in the Departments
•• Subsequently, the HoD will convene a meeting of the DCC, wherein
initial recommendation for condemnation of equipment/ goods will
be made as per rules mentioned above.
•• The duly certified recommendation, minutes of meeting of the
committee and request of condemnation of the Equipment will be
detailed in a separate format (form-C)
•• The minutes of meeting should contain the following:
•• Details of equipment to be condemned as given in form-C below
•• If the equipment has been procured through An external grant/
Corporate Social Responsibility (CSR)/ Donation
•• Service Report/ letter from Manufacturer/ Maintenance Service
Provider certifying (as the case may be): Equipment has completed
its stipulated life/ period/ duration, Equipment is beyond economic
repair, Service cost of equipment, Statement that cost of repair will
exceed procurement cost of new equipment. Inventory of unused
spares, if any, along with their value
•• Residual/ Depreciated value of the equipment (the calculation is to
be made on the relevant guidelines issued by govt. from time to time)
•• The DCC will also explore the possibility of ‘Buy-back’ of the
equipment in prospective procurement cycle and should state the
same in the meeting minutes
•• In case the equipment was procured from an external grant/ extra-
mural project, permission of the condemnation agency granting the
aid will also need to be enclosed
•• In case equipment of any hazardous substances are to be condemned
(eg. Radioactive materials, chemicals and other bio-hazards), details
must be furnished of permission from the regulatory bodies of the
same and must be attached in the minutes of meeting
•• The individual department will make sure that all details asked for
in Form-C are made available to the Organisation Condemnation
Committee

303

MHH-101 Volume-02.indd 303 12/10/2022 12:52:05 PM

 Total word Essentials of •• The DCC will send its original report in duplicate to Chairperson
Logistic and Equipment of the Organisation Condemnation Committee, under copy to the
Management
member secretary
Obligations of Organisation Condemnation Committee (OCC):
•• OCC will review the request of DCC, all enclosures with condemnation
request will be examined, if required, will be send back to the DCC
for completion of details
•• This committee can meet once/ twice a year depending upon the
requirement.
•• After reviewing the same Chairperson of the OCC will submit its
report to appropriate authority with power to approve condemnation
as per rules of the organisation.
Disposal of Condemned equipment/ goods: subsequent to relevant
approvals from the OCC the Disposal Committee will initiate disposal
process for sale of Condemned equipment:
• Open Tender/ GeM bid or Auction
• Buy back from suppliers or 3rd party
• Scrapping
Important points for disposal:
•• In case the equipment contains hazardous material, necessary
precautions must be taken by the individual department and disposal
committee
•• A sale record of the disposed equipment must be maintained and a
copy must be sent to Finance & Stores
•• The amount will be deposited in the designated organisational account
•• It should be ensured by the Disposal committee the disposed
equipment receives the best possible return
Condemnation Form-C: individual form is to be filled for each
equipment
Name of organisation
Name of governing body
Details of equipment recommended for condemnation by departmental
condemnation committee (In case of big organisations)- bigger District
Hospitals and Tertiary Healthcare Centres. In case smaller setups like-
PHC, CHC, FRUs and smaller District Hospitals, there will be only
Organisational Committee

Name of department
Name of equipment
Site of installation
Existing location
Function of equipment

304

MHH-101 Volume-02.indd 304 12/10/2022 12:52:05 PM

 Equipment Management
Equipment details:
-Maintenance, Repair and
• Make Disposal
• Model
• Supply order
• Serial number
• Manufacturer/ supplier (Indian agent, in case of imported equipment)
• Purchase cost
• Date of purchase
• Installation date
• Warranty expired on
• Duration of equipment being non-functional/ out of use
• Funding agency
• Expected functional life and mentioned by manufacturer
• Recommendation of external expert (if applicable)
• Residual/ depreciated value (calculation sheet also to be enclosed)
• Buy-back details, if applicable
• Bio-hazard details, if any
• Store ledger entry
Minutes of meeting of DCC

Reason behind condemnation-

• Non-functional and beyond economic repair
• Non-functional and obsolete
• Functional but obsolete
• Functional but hazardous
• Functional but no longer required
• Any other
Certification that equipment is being condemned for the first-time
Signatures of DCC members
Remarks by the bio-medical engineer
Recommendation of OCC
Signatures of OCC members

23.6 LET US SUM UP

In this unit you have learnt about the existing status of hospital equipment
in the government set up, technicalities and importance of appropriate
maintenance plan, timely repairs, and establishment of maintenance cell,
equipment audit and training of hospital staff. The need and process of
Condemnation and Disposal has also been discussed in detail.
305

MHH-101 Volume-02.indd 305 12/10/2022 12:52:05 PM

 Total word Essentials of In short every government hospital as per its level must have proper
Logistic and Equipment maintenance plan, maintenance cell and condemnation and disposal
Management
committees. So that the hard earned tax-payers money is well utilised and
uninterrupted patient care is provided.

4.7 ANSWERS TO CHECK YOUR PROGRESS

Check your progress 1
i. What is BMMP initiative of Govt. of India?
BMMP is an initiative by Ministry of Health and Family Welfare,
IMPLEMETED IN August, 2018, to provide support to state
governments to outsource medical equipment maintenance
comprehensively for all facilities so as to improve the functionality
and life of equipment’s, simultaneously improving healthcare services
in public health facilities- reducing cost of care and improving the
quality of care.
ii. List the Salient features of Program.
The salient features of program are :
•• 24 X 7 Toll free number for reporting breakdown
•• Medical Equipment Management Information data for planning
and monitoring performance of medical equipment
•• Preventive maintenance
•• Corrective maintenance
•• Calibration and User Training.
iii. What is the aim of the program?
The program aims to ensure upkeep time for medical equipment in
PHC/CHC/DH at 85%, 90% and 95% respectively. Converted pending
dysfunctional equipment to functional in States/UT following BMMP.
Check your progress 2
i. Advantages of preventive Maintenance?
A. The advantages are:
•• Reduced breakdown and repair time
•• Low maintenance cost
•• Uninterrupted patient care
•• The chance of accidents reduced.
ii.. Essential Components of Equipment Maintenance record sheet?
Refer the template in 4.2.2
iii.. List the contents of a Master Maintenance Plan
The master maintenance plan should be drawn in consideration to the
load of the user departments including the following aspects of the
equipment maintenance and repairs:
•• Recruitment of skilled manpower
•• Arranging regular training programs on maintenance and repairs
of equipment of the technicians and other concern personal
306

MHH-101 Volume-02.indd 306 12/10/2022 12:52:06 PM

 •• Establishing a bank of spare parts and crucial component Equipment Management
-Maintenance, Repair and
•• Establishing detailed records of the Purchase, procurement and Disposal
maintenance of equipment
•• Periodic checks and repairs
•• Monitoring of the annual maintenance contract of equipment
•• Developing a Maintenance Cell for maintenance and repair
•• Establishing a nucleus of communication between this cell and
the supplier of the equipment
•• Follow-up of the maintenance and repair services.
iv. What is Equipment audit?
Equipment audit is a periodic evaluation system to measure the
quality of performance of the medical equipment. At any given point
of time, a substantial number of equipment in the hospital may be
non-functional.
v. What is the focus of Equipment audit?
Focus of the Audit is to:
•• Check the current status of the medical equipment
•• Analysis of the records such as Breakdown Register, Preventive
maintenance Register
•• Questioning the user about the usage and performance of the
equipment.
•• Suggesting measures to optimally utilize the equipment for
quality health services.
vi. List the important elements in training of technicians.
The important elements in training of technicians are:
•• Training the technicians in quality management
•• Education of technicians on the repair maintenance policy
objectives and concepts of patient satisfaction
•• Awareness programs for new entrants
•• Procedures for specifying and verifying the technicians receive
suitable training
•• Teamwork and communication methods
•• Assessing carefully the technicians requirements and
subsequently providing assistance and encouragement
•• Performance evaluation of technicians to assess their
development needs and potential.
Check your progress 3
i. Define Condemnation, Disposal.
•• Condemnation: when any equipment cannot be repaired either
due to it being obsolete or has to be discontinued in case its
repair cost goes beyond economically feasible.
307

MHH-101 Volume-02.indd 307 12/10/2022 12:52:06 PM

 Total word Essentials of •• Disposal: process to liquidate or dispose the equipment/ device
Logistic and Equipment according to its value, which has been declared as condemned
Management
by appropriate authority
ii. List the guidelines for disposal of goods.
As per GFR-196 Disposal of Goods
•• An item may be declared surplus or obsolete or unserviceable if
the same is of no use to the Ministry or Department. The reasons
for declaring the item surplus or obsolete or unserviceable
should be recorded by the authority competent to purchase the
item.
•• The competent authority may, at his discretion, constitute a
committee at appropriate level to declare item(s) as surplus or
obsolete or unserviceable.
•• The book value, guiding price and reserved price, which will
be required while disposing of the surplus goods, should also
be worked out. In case where it is not possible to work out the
book value, the original purchase price of the goods in question
may be utilized. A report of stores for disposal shall be prepared
in Form GRF-17.
•• In case an item becomes unserviceable due to negligence, fraud
or mischief on the part of a Government servant, responsibility
for the same should be fixed.
•• It is the responsibility of every institute to have a condemnation
& disposal policy and committee of its own, which assesses the
equipment usage, maintenance cost, its obsolescence and then
recommends for condemnation of hospital equipment’s.
iii. What are the important points for disposal?
These are:
•• In case the equipment contains hazardous material, necessary
precautions must be taken by the individual department and
disposal committee
•• A sale record of the disposed equipment must be maintained
and a copy must be sent to Finance & Stores
•• The amount will be deposited in the designated organisational
account
•• It should be ensured by the Disposal committee the disposed
equipment receives the best possible return

308

MHH-101 Volume-02.indd 308 12/10/2022 12:52:06 PM