Document No.: 985-007011
Revision: A
Effective Date: 08/07/2012
Odyssey
Quad HD System Installation
Verification and Testing
Page 4 of 19
“WARNING: This is a revision controlled document. Verify revision is correct prior to use.”
Stereotaxis, Inc
Confidential
1. Introduction
This document is intended to verify system functionality of the Odyssey system.
Completion of this document will require a functional companion X-ray system.
2. Site Information and Document Instructions
System Part Number
System Serial Number
System Configuration
(Quad/HD, Quad/Quad)
Installed with Niobe S/N (or Std.
Lab)
Installed with Cinema S/N (or N/A)
X-Ray System
Lab/Room ID #
Lab Phone Number/Extension
Facility Name
Facility Street Address
Facility City, State, Zip
Facility Contact Name
Facility Contact Job Title
Contact Phone Number
This document should be completed in the following manner:
•
Use black or blue ink pens only.
•
Circle P, F, or N/A in the Pass/Fail column for each bulleted step in the test.
•
For each bulleted step in the test enter the tester’s initials in the Initials column adjacent to the entry
in the Pass/Fail column.
•
Record software version numbers in the boxes provided.
•
Sign, date, and print your name in the appropriate spaces on signoff forms.