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reserved.
English
Doc. Gen. Date: 02.06
2002
Page 2
Cust.-No.: Date: Protocol
1Protocol
SIEMENS Office:
Address:
Region:
Country:
Contact person:
Tel.:
CSE in charge:
Tel.:
Remarks Regarding the Protocol:
The protocol is valid as proof of quality for one check that must be performed on the system / component in one year.
The check must be performed in the specified intervals.
The results of the check are entered in this protocol.
The chapter numbers in front of the checkpoints indicate the corresponding chapters in
the particular instructions (see cover page).
The protocol must be completely filled out by the Customer Service Engineer, i.e.:
•All boxes must be filled out. If a box does not apply to the system or if no entry needs to
be made, check the “n.a.“ box.
•Enter the customer number (Cust. No.:) and the date of the check in the header of each
page so that each page can be allocated to a customer and to a check date.
•If there are complaints, the IVKs for the component about which a complaint has been
made as well as the type of complaint must be entered in the “Open Points“ table provided for this. Correction of these open points also must be documented in this table
with the date and a signature. If there are no open points, check “No“ and document this
with the date and a signature.
•If movable components (also test phantoms that are part of the system) that can be
used in different systems are used for the check, they must be entered in the “Movable
Components“ table provided for this.
•The measurement values for the measurements that must be performed during the
check must also be entered in the open spaces / tables provided for them.
•After completing the check, Page 3 of this protocol must be filled out and signed.
MAMMOMAT 1000/3000 Nova SPB7-230.105.02.05.02Siemens AG
02.06CS PS SP
Page 2 of 8
Medical Solutions
Page 3
ProtocolDate: Cust.-No.:
Further Processing and Archiving of the Protocol
The protocol is a document and thus must be archived. After completing the test, it must
be filed in the corresponding register in the “System Owner Manual“ binder. If needed, a
copy can be handed to the customer.
System:
Serial No.:
Software Version:
Number of the Service Contract:
Type of Maintenance:
Evaluating the Condition of the System / Component
The system has no deficiencies. The image quality test
resulted in no differences from required reference values.
The system / component has slight deficiencies that have
no affect on continued operation of the system. However
they should be corrected preventively.
The image quality test resulted in no differences from
required reference values.
The system / component has serious deficiencies. For
safety reasons, continued operation of the system is permitted only after successfully correcting the deficiencies.
After completing all work steps, an evaluation was performed.
Signature:
Date:Name:
The operator or a person assigned for this has taken note of this evaluation.
(if national regulations require this)
Signature:
Date:Name:
Siemens AGSPB7-230.105.02.05.02MAMMOMAT 1000/3000 Nova
Medical Solutions
Only activities that are not described in the instructions for the system / component need
to be listed.
Date:
Additional activities performed:
OKnot OKn.a.
Open Points:
Yes:No:Signature:
Date:Name:
If “Yes“, enter the component with the IVK and the open point (only the number) in the
table. After completing maintenance, record this in the table.
IVKComponentOpen PointsCompleted
DateSignature
MAMMOMAT 1000/3000 Nova SPB7-230.105.02.05.02Siemens AG
02.06CS PS SP
Page 4 of 8
Medical Solutions
Page 5
ProtocolDate: Cust.-No.:
Measuring Devices queried electronically:
Yes:No:Signature:
Date:Name:
If the measurement devices are queried electronically, for example with a Scout Mobile
Device, entry of the measuring devices in the table can be skipped.
Measuring DevicesTypeSerial No.Date Used Next Cali-
bration
Due
Movable Components:
Yes:No:Signature:
Date:Name:
If “Yes“, enter the movable component with which the check was performed along with the
with the Serial No. in the table.
Movable components (also test phantoms that are part of the system) are parts that can
be used on different systems).
ComponentSerial No.
Siemens AGSPB7-230.105.02.05.02MAMMOMAT 1000/3000 Nova
Medical Solutions
02.06CS PS SP
Page 5 of 8
Page 6
Cust.-No.: Date: Protocol
OK not n.a.
OK
1General information
1.5Text emphasis
2System
2.1Checks
PMPRadiation protection
SIMSwivel arm/PPS tube attachment
SIMBasic table
SIMFlying wing (MAMMOMAT 3000 Nova only)
SIMLevel
PMPFace shield and compression plate
2.2Preparations
SIECables
3Column stand
3.1Checks
SIMSteel ropes
PMAOil and grease
SIELimit switches
PMFVertical travel
SIMSafety catch and rotation safety catch
SIMBall bearings
SIMMounting for the X-ray tube
PMAGrease the grid spindle
4Compression and system movements
4.1Testing the "Compression" function
4.1.1Switching off
PMFPresetting
SIEMax. value switch off
PMFOPCOMP
4.2Testing the "Decompression" function
4.2.1Switching off
SIESafety switch
4.2.2Travel
PMFCompression travel
4.2.3Applying oil and grease
PMAApply oil and grease to the compression unit
MAMMOMAT 1000/3000 Nova SPB7-230.105.02.05.02Siemens AG
02.06CS PS SP
Page 6 of 8
Medical Solutions
Page 7
ProtocolDate: Cust.-No.:
OK not n.a.
OK
4.3Compression thickness display
PMFThickness indicator
4.4Checking miscellaneous system movements
4.4.1Checking miscellaneous system movements
SIESwitch off
PMFRotation movements
SIMBlocking rotation and vertical travel
5Test exposures
5.1Evaluating test values
PMFAnode acceleration
PMFkV and mA
PMFmAs selection
PMFmAs value displayed
PMFGrid voltage
PMFSignal lamp
5.2Testing the dose rate control
PMFDose rate control
5.3Testing the radiation field/light field
PMFFormat collimation
5.4Testing image quality
PMFAutomatic decompression
5.5Evaluating the films
QIQPhantom exposures
6Miscellaneous
6.1Blocking exposure release
PMFBlocking
6.2Checks
SIEEmergency STOP
PMFIndicators
PMPError memory
PMPRecord the error memory.
PMPDelete the error memory.
PMFAuxiliary voltages
PMFCassette locking
Siemens AGSPB7-230.105.02.05.02MAMMOMAT 1000/3000 Nova
Medical Solutions
02.06CS PS SP
Page 7 of 8
Page 8
Cust.-No.: Date: Protocol
OK not n.a.
OK
PMFOPDOSE
PMFStereo unit (Mammomat 3000 Nova only)
PMAUIs and SPEED info
6.3Final tests
PMFOperating problems
PMPCovers
SIEProtective conductor test
PMPCleaning/damaged paint
QSQFinal test exposure
MAMMOMAT 1000/3000 Nova SPB7-230.105.02.05.02Siemens AG
02.06CS PS SP
Page 8 of 8
Medical Solutions
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