BD BACTEC FX - Page 123

5 – Reference
125
Figure 5-21 – Sample Maintenance QC Report
Instrument - 1
Software Version - 1.00X Date/Time - 04/15/2009 09:18 a.m.
Upper Serial Number LJK001
A Pass Fail B Pass Fail
Temperature 35.0 (33.5 - 36.5) Temperature 35.0 (33.5 - 36.5)
QC Thermometer Reading ________ ______ ______ QC Thermometer Reading ________ ______ ______
Internal Green LEDs ______ ______ Internal Green LEDs ______ ______
Internal Red LEDs ______ ______ Internal Red LEDs ______ ______
Lower Serial Number LJK002
C Pass Fail D Pass Fail
Temperature 35.0 (33.5 - 36.5) Temperature 35.0 (33.5 - 36.5)
QC Thermometer Reading ________ ______ ______ QC Thermometer Reading ________ ______ ______
Internal Green LEDs ______ ______ Internal Green LEDs ______ ______
Internal Red LEDs ______ ______ Internal Red LEDs ______ ______
Unusable/Blocked Stations*
A B C D
F01 F02 G01 G02
*All stations have been verified for proper operation since the last automatic QC report except those listed above, if any.
Pass Fail
External System Yellow Indicator A______ ______
B______ ______
C______ ______
D______ ______
External System Red Indicator A______ ______
B______ ______
C______ ______
D______ ______
External System Green Indicator A______ ______
B______ ______
C______ ______
D______ ______
Audible Alert ______ ______
Filters Checked - Yes ______No ______ Date ______________________
Filters Changed - Yes ______No ______ Date ______________________
Comments ______________________________________________________________________________________________________________
Technologist ______________________________________Date _____________________
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Maintenance QC Report