XRCISE STRESS ECHO MED
Technical and visual modifications as well as misprints reserved -
© 2017
by ERGO-FIT GmbH & Co. KG
6 7
Registration of medical devices add-in card
Operator:
__________________________________________
__________________________________________
__________________________________________
1.
Designation of the medical device:
_________________________________________________________________
2.
Functional test and introduction:
Functional test carried out
on: ________________ by: _________________________________________
Introduction carried out
on: ________________ by: _________________________________________
Introduces person: ____________________________________________
____________________________________________
____________________________________________
3.
Metrological controlls: at least every two years
next inspection: ______________________________________________
by (person‘s name): ______________________________________________
4.
Maintenance and safety inspection
(subject to MPBetreibV)
: recomm. every 12 months
next inspection: ______________________________________________
by (person‘s name): ______________________________________________
5.
Date, type and consequence of the defect and repeated identical operating fault:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
6.
Reports of incidents to authorities and manufacturer:
________________________________________________________________________
________________________________________________________________________