Vatech PaX-i3D, PaX-i3D Green, PHT-60CFO User Manual

(PHT-60CFO)
User Manual
Version 1.5.0
E n g l i s h
PaX-i3D Green (PHT-60CFO) User Manual
Notice
Notice
Thank you for purchasing the
PaX-i3D Green
The
TM
is an advanced digital dental diagnostic system that
PaX-i3D Green
TM
extra-oral imaging system.
incorporates PANO, CEPH, and 3D CT imaging capabilities into a single system.
This manual describes how to operate the
PaX-i3D Green
TM
system. It is recommended that you thoroughly familiarize yourself with this manual in order to make the most effective use of this equipment.
Observe all cautions, safety messages and warnings which appear in this manual.
The QR code linked to video le about image capture for the
CEPH Lateral
and
is provided in the manual. The smart phone and pad which
PANO Standard
have the QR code reader application program can be used to watch video.
Due to a constant technological improvement, the manual may not contain the most updated information, subjecting to change without prior notice to the persons concerned. For further information not covered in this manual, please contact us at:
VATECH Co., Ltd.
Phone: +82-1588-9510
E-mail: gcs@vatech.co.kr
This document is originally written in English.
The PaX-i3D Green
Manual Name: PaX-i3D Green
Version: 1.5.0
Publication Date: 2016-05
TM
is referred to as Equipment in this manual.
TM
(Model: PHT- 60CFO)
PaX-i3D Green (PHT-60CFO) User Manual
Table of Contents
Table of Contents
Notice ......................................................
1
1.1
1.2
1.3
2.
2.1
2.2
2.3
2.4
3
3.1
General Information ....................................... 12
Manufacturer's Liability ........................................................ 12
Owner and Operator's Obligations ...................................... 12
Conventions in this Manual ................................................. 13
Warnings and Precautions ............................16
General Safety Precautions ................................................. 16
Electricity-related Safety Precautions .................................. 20
Radiation Safety .................................................................. 21
Warnings ............................................................................. 22
PaX-i3D Green Imaging System Overview ... 26
Introduction .......................................................................... 26
05
3.1.1 System Components.............................................................26
3.1.2 Features ................................................................................26
3.1.3 The PaX-i3D Green Model Series (Optional)........................28
3.1.4 Standards and Regulations...................................................29
3.2
3.3
3.3.1 Control Panel ........................................................................33
3.3.2 Touch Screen ........................................................................34
3.3.3 Emergency Stop Switch ........................................................39
3.3.4 The Exposure Switch ............................................................39
3.3.5 Components and Positioning Accessories ............................40
3.4
Imaging System Structure ................................................... 30
General View of the PaX-i3D Green .................................... 31
Marks and Symbols ............................................................. 41
PaX-i3D Green (PHT-60CFO) User Manual
Table of Contents
4
4.1
4.2
4.3
4.3.1 PANO .................................................................................... 50
4.3.2 CEPH ...................................................................................55
4.3.3 CBCT ...................................................................................57
5
5.1
5.2
5.2.1 Creating a New Patient Record ............................................65
5.2.2 Retrieving Patient Records ...................................................67
5.3
Software Overview ......................................... 44
PC System Requirements (Recommended) ....................... 44
EasyDent / EzDent-i ............................................................ 45
Imaging Software Overview ................................................. 46
Getting Started ............................................... 64
Turning on the PaX-i3D Green ............................................ 64
Running the Image Viewer .................................................. 65
Initiating the Imaging Program ............................................. 69
6
6.1
6.2
6.3
6.3.1 PANO Standard and Bitewing mode ..................................... 82
6.3.2 TMJ Open .............................................................................86
6.3.3 TMJ Close ............................................................................89
6.3.4 Sinus .....................................................................................90
6.4
7
7.1
7.2
7.2.1 Lateral / Full Lateral ............................................................101
7.2.2 Frontal (PA) ......................................................................... 102
Acquiring PANO Images ................................ 72
PANO Imaging Program ...................................................... 72
Setting Exposure Parameters .............................................. 77
Positioning the Patient ......................................................... 81
Initiating X-ray Exposure ..................................................... 93
Acquiring CEPH Images ................................ 96
Setting the Exposure Parameters ........................................ 96
Positioning the Patient ....................................................... 100
7.2.3 SMV ....................................................................................104
PaX-i3D Green (PHT-60CFO) User Manual
Table of Contents
7.2.4 Waters View ........................................................................105
7.2.5 CARPUS .............................................................................106
7.3
8
8.1
8.2
8.3
8.3.1 Starting imaging with the SCOUT feature ...........................121
8.3.2 SCOUT Viewer ...................................................................123
8.4
9
10
10.1
10.2
Initiating X-ray Exposure ................................................... 107
Acquiring CT Images ................................... 112
Setting the Exposure Parameters .......................................11 2
Positioning the Patient ........................................................116
Acquiring a SCOUT Image ................................................ 121
Initiating X-ray Exposure ................................................... 124
Troubleshooting ........................................... 128
Cleaning and Maintenance .......................... 130
Cleaning ............................................................................ 130
Maintenance ...................................................................... 131
10.2.1 Regular Maintenance ..........................................................131
10.2.2 Maintenance Task Checklis ................................................132
11
12
12.1
12.2
12.3
12.4
Disposing of the Unit ................................... 134
Technical Specications .............................. 136
Mechanical Specications ................................................. 136
Technical Specications .................................................... 140
Electrical Specications ..................................................... 145
Environmental Specications ............................................ 145
PaX-i3D Green (PHT-60CFO) User Manual
Appendices
Table of Contents
1
2
2.1
2.2
2.3
3
Recommended X-ray Exposure Table ........ 148
X-ray Dose Data ............................................ 150
DAP Table .......................................................................... 150
X-ray Leakage Dose .......................................................... 152
X-ray Scatter Dose ........................................................... 153
Electromagnetic Compatibility (EMC)
Information .................................................... 156
4
Acquiring image for the pediatric dental
patient ............................................................ 161
4.1
4.2
Age group: classication table .......................................... 161
Positioning the pediatric dental patient ............................. 161
4.3
4.4
5
Setting exposure values to the age group ........................ 162
The references pertinent to the potential risks for the pediatric
patients ............................................................................. 162
Abbreviations ............................................... 164
1
General Information
1.1
1.2
1.3
Manufacturer's Liability ........................................................ 12
Owner and Operator's Obligations ...................................... 12
Conventions in this Manual ................................................. 13
PaX-i3D Green (PHT-60CFO) User Manual
1 General Information
1 General Information
1.1
Manufacturer's Liability
The manufacturers and/or retailers of this equipment assume responsibility for the safe and normal operation of this product
■The equipment has been installed by a VATECH authorized technician.
■The equipment has been installed in accordance with all of the cautions and conditions for installation.
■Genuine VATECH approved equipment and components have been used at all times.
■All maintenance and repairs have been performed by a VATECH authorized agent.
■The equipment has been used normally in accordance with the user's manual.
■The equipment damage or malfunction is not the result of an error on the part of the owner or operator.
only when:
1.2
Owner and Operator's Obligations
■The owner of this equipment shall perform constancy tests at regular intervals in
■The owner of this equipment shall perform regular inspection and maintenance of
order to ensure patient and operator safety. These tests must be performed in accordance with local X-ray safety regulations.
the mechanical and electrical components in this equipment to ensure safe and consistent operation (IEC 60601-1). The owner of this equipment shall ensure inspection and cleaning works are performed in accordance with the maintenance schedule outlined in
Chapter 10 Cleaning and Maintenance.
PaX-i3D Green (PHT-60CFO) User Manual
1 General Information
1.3
Conventions in this Manual
The following symbols are used throughout this manual. Make sure that you fully understand each symbol and follow the instructions which accompany it.
To prevent personal injury and/or damage to the equipment, please observe all warnings and safety information included in this document.
WARNING
CAUTION
X-ray
Indicates information that should be followed with the utmost care. Failure to comply with a warning may result in severe damage to the equipment or physical injury to the operator and/or patient.
Indicates a situation that demands prompt and careful action, a specific remedy, or emergency attention.
Indicates a possible danger of exposure to radiation.
IMPORTANT
NOTE
SINGLE USE
Indicates a situation or action that could potentially cause problems to the equipment and/or its operation.
Emphasizes important information or provide useful tips and hints.
Indicates a component which must be replaced for each new patient.
2
Warnings and Precautions
2.1
2.2
2.3
2.4
General Safety Precautions ................................................. 16
Electricity-related Safety Precautions .................................. 20
Radiation Safety .................................................................. 21
Warnings ............................................................................. 22
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
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2. Warnings and Precautions
Be sure to strictly observe all warnings and safety
RNIN
instructions included in this manual.
2.1
General Safety Precautions
Operator qualications
This equipment may only be operated by personnel fully trained in its operation.
■To operate this equipment, all operators must:
-have read and understood the user's manual
-be familiar with the fundamental structure and functions of this equipment
-be able to recognize irregularities in the operation of this equipment and implement appropriate measures to remedy such irregularities.
General safety precautions
■Follow the instructions specied in this manual to ensure the safety of both the patient and the operator.
■The operator must maintain visual contact with the patient at all times during imaging.
■Do not open or remove the cover panels on this equipment. Always have a trained and authorized service technician carry out inspection and maintenance of this equipment.
■Do not place foreign objects on this equipment at any time.
■Do not place any objects within this equipment's eld of operation.
■Do not push or pull the equipment. If equipment overbalances, resulting in the risk of physical injuries or property damage.
■Operators must ask the patient to remain still until the equipment arm has stopped moving and the reset motion is complete.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
CAUTION
■Observe all local re regulations. Always keep a re extinguisher near the equipment.
■The operator of this equipment must be familiar with this equipment's emergency protocols.
■Ensure that this equipment is kept away from water, moisture, or foreign substances at all times.
■If this product is exposed to water, moisture, or a foreign substance, immediately turn off all power to the equipment and contact your VATECH technical support representative.
■Immediately cease all operation of this equipment if there are signs of oil leakage and contact you VATECH technical support representative.
Ventilation
■Do not obstruct the equipment's ventilation for air opening. Improper ventilation could result in the equipment overheating due to a lack of air circulation.
■Do not spray any type of liquid or aerosol on this equipment as this may penetrate the system and damage the electrical and mechanical components inside.
■Always leave a sufcient amount of space around the PC to allow for proper ventilation.
Hygiene
Always disconnect the equipment from the power outlet
when disinfecting the surfaces of the equipment.
■All removable patient support components (bite block, chin support, temple supports) can be cleaned using alcohol-based cleaning solutions.
■Patient support handles can be cleaned using alcohol-based cleaning solutions.
■Other surfaces of the equipment, including the touch screen, can be cleaned using a soft cloth dampened with a mild cleaning solution.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
■Disinfect the components (bite block, temple supports etc.) of the equipment
■New hygiene cover must be provided for each new patient to prevent the
IMPORTANT
Condensation
■Extreme fluctuations in temperature may cause condensation to develop
that come into contact with the patient or the operator after each exposure.
transmission of communicable disease.
Do not use aerosol or spray cleaning agents directly on the
surface of the equipment.
inside the equipment. Do not turn on the equipment until it has reached room temperature.
Cooling
■ Allow the proper amount of cool down time (for the X-ray tube to cool down) to elapse between each image acquisition.
-Mode of operation: Continuous operation with intermittent loading.
-Exposure time: Max. 20.2 s / Resting time: 5 min.
-Column operation time: 1 min / Resting time: 9 min
■ If the temperature inside the tube head reaches 60 °C, X-ray exposure will cease and an error message will be displayed. Normal X-ray capabilities will resume after the generator reaches 58 °C (136.4 ℉).
■ If the fan (optional) is installed, it operates automatically when the
temperature surrounding the tube head reaches the pre-dened level: 40 ℃
(104 ℉). The set point temperature is congurable.
Turning the equipment on / adjusting the height of the equipment
■Do not position the patient in the equipment while it is initiating as the patient could be injured if the equipment malfunctions.
■Ensure that the patient is kept clear of the mechanism while adjusting the
height of the equipment.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
Emergency stop
■If a problem occurs during image acquisition, press the red emergency stop button to immediately stop all moving parts and cut off all power to the equipment.
Trouble-free operation
■ Never use this equipment in an environment that is susceptible to explosion.
■ Always operate the equipment within a temperature range of 10 °C to 35 °C (50 ℉ to 95 ℉) for the safe operation. Image quality may deteriorate if the equipment is operated outside of this range.
■ Always allow the equipment sufcient time to warm up (while switched on) if it has been exposed to temperatures of below 10 °C (50 ℉).
■ Only perform X-rays of patients if system is in full working order.
■ Always ensure that equipment movement is not obstructed by the patient’s clothing, medical device (such as a wheelchair), or the patient themselves.
■ Do not leave the patient unattended around the equipment.
■ Remove all radio-controlled devices, mobile phones, etc. from the X-ray room prior to image acquisition as these objects may cause the equipment to malfunction.
Modifying the equipment
■Modifying the equipment in any way which may affect the safety of the operator, patient or other persons is prohibited by law.
■No part of this equipment is serviceable by the user. All maintenance and repair of this equipment must be performed by a qualified service technician.
■This product may only be operated with original VATECH accessories or third-party accessories expressly approved by VATECH.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
2.2
Electricity-related Safety Precautions
■Check the status of the power source, PC and cables prior to operating the equipment.
■Ensure that the on/off switch is set to off when the equipment is not in use.
■Always disconnect the power supply before cleaning the equipment.
■Always keep electrical cords away from hot appliances or radiators.
■DO NOT place the PC or peripheral equipment connected to the PC in the immediate vicinity of the patient.
■The equipment and PC should be connected to a common protective earth.
■Never overload the equipment’s circuit by sharing it with too many appliances.
■Use the same power circuit for the PC and the equipment.
Combining this equipment with other devices
■Do not connect this equipment to devices which are not part of the system.
■Do not connect this equipment to a Multiple Portable Socket-Outlet (MPSO) or extension cord.
Electromagnetic compatibility
■The PaX-i X-ray unit complies with IEC standard 60601-1-2.
■Medical electrical equipment is subject to special EMC preventive
measures. It must be installed and operated as specied in the
Requirements
■If high-voltage systems, radio link systems or MRI systems are located
within 5 m of the unit, please observe the specifications stated in the installation requirements.
■Portable and mobile RF communications equipment may interfere with
medical electrical equipment. Therefore, the use of mobile wireless phones
in medical ofces or hospital environments must be prohibited.
document.
Installation
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
WA
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WA
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For more details, refer to the document Electromagnetic Compatibility
Information.
ElectroStatic Discharge
Connector pins or sockets bearing ESD warning labels must not be touched or interconnected without observing ESD protective measures.
2.3
Radiation Safety
RNIN
■The operator must remain outside a shielded room during X-ray exposure in order to protect himself/herself from radiation.
■The patient must wear a lead apron with neck and thyroid protection during X-ray exposure.
■Children and pregnant women must consult with a doctor before X-ray exposure.
■This equipment must be housed inside an X-ray shielded room.
■During imaging; the operator must maintain visual contact with the patient from outside the shielded area.
Since rules and regulations concerning radiation safety
differ between countries, it is the responsibility of the
owner and/or operator of this equipment to comply with
all applicable rules and regulations concerning radiation
safety and protection in their area.
■The operator should continuously check the status of the patient and the equipment during imaging.
■The operator must immediately stop imaging if the equipment malfunctions.
As a manufacturer of radiology equipment that conforms
to stringent protection standards around the world, we
RNIN
guarantee the maximum degree of protection against
radiation hazards for our equipment.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
WA
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WA
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2.4
Warnings
The following warning statements should be obeyed with the utmost care. Failure to follow these warnings may cause severe damage to the equipment or physical injuries to the patient and/or operator.
RNIN
RNIN
X-ray equipment is hazardous to patient and the operator
if proper exposure safety measures and/or operating
instructions are not observed.
It is important to read this user manual carefully and
strictly abide by all warnings and cautions stated within it.
● 3D image should not be used for screening examinations.
Each exam must be justified by demonstrating that the
benets outweigh the risk.
● Where it is likely that evaluation of soft tissues will be
required as part of the patient’s radiological assessment,
conventional medical CT or MR should be used instead of
dental cone beam imaging.
RNIN
● PaX-i3D Green system, like other medical equipment,
uses high-frequency electrical signals that can interfere
with implantable devices such as pacemakers and
implantable cardioverter-debrillators(ICDs). If the patient
has such an implantable device, you should be aware of
any interference in its operation and immediately power
off the Dental X-ray system.
● PaX-i3D Green system is designed to withstand the
effects of defibrillation. However, when possible,
disconnect the Dental X-ray systems during debrillation
since a malfunction of the safety controls could otherwise
result in electrical burns for the patient.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
CAUTION
Lasers
■The system incorporates Class 1 laser products. The light localizers used in this product are intended for correct patient positioning and must not be used for any other purpose.
■For maximum safety, advise the patient not to look directly at the laser beam.
■While adjusting the patient, ensure that the laser beam is not directed at the patient’s eyes.
Risk of eye injury!
Do not use this equipment with any other laser sources
and do not make any changes to the settings or processes
that are described in these operating instructions.
Cleaning
■Never expose this equipment to liquids, mists or sprays. Exposing this equipment to liquids may cause an electrical shock or otherwise damage the system.
■Do not use spray cleaners on this equipment, as this could cause a re.
During Operation
■Never use this equipment in an environment that is susceptible to explosion.
■Do not place ammable materials near this equipment.
■Do not operate the PC or Touch screen while the equipment is performing an operation. Failure to comply with this instruction may result in system malfunction.
■Immediately stop imaging if the equipment malfunctions in any way.
■If a problem occurs during imaging, press the red emergency stop button to immediately stop all moving parts and cut off all power to the equipment’s electrical components.
■Never touch the patient while also touching the SIP/SOP connectors.
PaX-i3D Green (PHT-60CFO) User Manual
2 Warnings and Precautions
In case of electrical re
■Use only re extinguishers designed for electrical res to extinguish res on
■Liquid extinguishers, such as those which use water, could damage the
■Unplug the equipment’s power cable before extinguishing any re.
Installation
■In order to avoid improperly balanced equipment, install the device on a at
■If the equipment is not stable, property damage and/or personal injury may
■Do not push or pull the equipment.
■Equipment should only be installed by an authorized technician, complying
this equipment.
equipment and/or cause injury.
surface to maintain stability.
occur.
with proper installation procedures.
3
PaX-i3D Green Imaging System Overview
3.1
3.1.1 System Components.............................................................26
3.1.2 Features ................................................................................26
3.1.3 The PaX-i3D Green Model Series (Optional)........................28
3.1.4 Standards and Regulations...................................................29
3.2
3.3
3.3.1 Control Panel ........................................................................33
3.3.2 Touch Screen ........................................................................34
3.3.3 Emergency Stop Switch ........................................................39
3.3.4 The Exposure Switch ............................................................39
3.3.5 Components and Positioning Accessories ............................40
3.4
Introduction .......................................................................... 26
Imaging System Structure ................................................... 30
General View of the PaX-i3D Green .................................... 31
Marks and Symbols ............................................................. 41
PaX-i3D Green (PHT-60CFO) User Manual
3 PaX-i3D Green Imaging System Overview
3 PaX-i3D Green Imaging System Overview
3.1
Introduction
PaX-i3D Green
The incorporates Panoramic (PANO), Cephalometric (CEPH), and 3D CT imaging capabilities into a single system.
PaX-i3D Green
The cephalometric and CT image of the oral and craniofacial anatomy to provide diagnostic information for adult and pediatric patients. The system uses the advanced sensors to produce the higher quality of image in 2D and 3D of the head region, including the dental/maxillofacial regions.
PaX-i3D Green
The professionals who are licensed to perform X-rays by the law of the region in which it is being used.
is an advanced digital dental diagnostic system that
system is intended for use to take a panoramic,
may only be used by dentists, X-ray technicians and other
3.1.1 System Components
■PaX-i3D Green digital X-ray equipment
■PC
PaX-i3D Green
■EasyDent / EzDent-i: 2D viewer and patient management software
■Ez3D plus / Ez3D-i: 3D viewer
■Imaging software
3.1.2 Features
■A 3-in-1 imaging solution: PANO, CEPH and CBCT imaging combined in single equipment.
■Improved image processing algorithms:
-Magic PAN (Optional): A high quality image reconstructed from the optimal auto-focused images in each segment throughout the panoramic region to correct the improper patient positioning and rotating unit’s trajectory.
■Metal Artifact Reduction: Metal artifacts are minimized to improve image quality.
PaX-i3D Green (PHT-60CFO) User Manual
3 PaX-i3D Green Imaging System Overview
■Fast CEPH: CEPH imaging with low X-ray dose and high speed
■Control Panel: to allow an easy handling of the equipment
■Multi-FOV (Field Of View): FOV is selected, based on the most suitable ROI.
■Provides an auto-switching between 2 sensors for the PANO and CBCT imaging, without the intervention of the operator.
■3D Viewer
Ez3D plus / Ez3D-i:
Enables 3D images to be analyzed
accurately, leading to greater diagnostic precision.
■DICOM le support: The standard le format for medical applications.
PaX-i3D Green (PHT-60CFO) User Manual
3 PaX-i3D Green Imaging System Overview
3.1.3 The PaX-i3D Green Model Series (Optional)
Model Item Sensor FOV (mm)
PANO Xmaru1501CF -
SP
SC
OP
PANO+CBCT
PANO+CBCT +CEPH
PANO+CBCT +CEPH
Xmaru1215CF MP 100 X 80, 80 X 80, 80 X 50, 50 X 50
CT
Xmaru1524CF MP
PANO Xmaru1501CF -
Xmaru1215CF MP 100 X 80, 80 X 80, 80 X 50, 50 X 50
CT
Xmaru1524CF MP
CEPH Xmaru2301CF Scan Type
PANO Xmaru1501CF -
Xmaru1215CF MP 100 X 80, 80 X 80, 80 X 50, 50 X 50
CT
Xmaru1524CF MP
CEPH 1210SGA
160 X 100, 120 X 90, 80 X 80, 80 X 50, 50 X 50
150 X 150, 120 X 90, 80 X 80, 80 X 50, 50 X 50
160 X 100, 120 X 90, 80 X 80, 80 X 50, 50 X 50
150 X 150, 120 X 90, 80 X 80, 80 X 50, 50 X 50
160 X 100, 120 X 90, 80 X 80, 80 X 50, 50 X 50
150 X 150, 120 X 90, 80 X 80, 80 X 50, 50 X 50 One shot Type
12 X 10, 9 X 10, 8 X 8 (inches)
30.48x25.40, 22.86x25.40, 20.32x20.32(cm)
PaX-i3D Green (PHT-60CFO) User Manual
3 PaX-i3D Green Imaging System Overview
0434
3.1.4 Standards and Regulations
Standards:
The PaX-i3D Green is designed and manufactured to meet the following standards:
IEC/EN/UL 60601-1, IEC/EN 60601-1-1, IEC/EN 60601-1-2, IEC/EN 60601-1­3, IEC/EN 60601-2-7, IEC/EN 60601-2-28, IEC/EN 60601-2-32, IEC/EN 60601­2-44, ISO 9001, ISO 13485
NEMA standard publication PS 3.1-3.18, 2008
X-ray source assembly [DG-07C11T2 / DG-07C11C1] IEC 60601-2-28 (1993)
The CE symbol grants this equipment compliance with the European Directive for Medical Devices 93/42/EEC as amended by 2007/47/EC as a class IIb device.
UL symbol grants this equipment compliance with the UL 60601-1 / CAN/ CSA C22.2 No.601.1
Classications (IEC60601-1 6.1):
Protection against the ingress of water: Ordinary Equipment: IPX0
Protection against electric shock: Class 1 equipment, Type B Applied Parts
PaX-i3D Green (PHT-60CFO) User Manual
3 PaX-i3D Green Imaging System Overview
NOTE
3.2
Imaging System Structure
RS232 Interface Cable 10 m (32.8’)
1. Signal input/output at the column up/down switch (optional)
External equipment intended for connection to signal
input, signal output or other connectors, shall comply with
relevant IEC Standard (e.g., IEC60950 for IT equipment
and IEC60601-1series for medical electrical equipment). In
addition, all such combination-system-shall comply with
the standard IEC60601-1 and/or IEC60601-1-1 harmonized
national standard or the combination.
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