Mindray BeneView T5 - Page 203

A-11
A.9 Scheduled Electrical Safety Inspection
For scheduled electrical safety inspection, test items 1, 2, 3, 4, 5, 6, 7, and 8 included in the
ELECTRICAL SAFETY INSPECTION FORM shall be performed.
ELECTRICAL SAFETY INSPECTION FORM
Location: Technician:
Equipment: Control Number:
Manufacturer: Model: SN:
Measurement equipment /SN: Date of Calibration:
INSPECTION AND TESTING Pass/Fail Limit
1 Power Cord Plug
2 Device Enclosure and Accessories
3 Device Labeling
4 Protective Earth Resistance ____Ω Max 0.2 Ω
Normal condition
(NC)
____μA
5
Earth
Leakage
Single Fault
condition (SFC)
____μA
Max:
NC: 300μA(refer to
UL60601-1) *
NC: 500μA(refer to
IEC60601-1) *
SFC: 1000μA
□BF____μA
Normal condition
(NC)
□CF____μA
□BF____μA
6
Patient
Leakage
Current
Single Fault
condition (SFC)
□CF____μA
Max:
CF applied part:
NC:10μA, SFC: 50μA
BF applied part:
NC:100μA, SFC:
500μA
□BF____μA
7 Mains on Applied Part Leakage
□CF____μA
Max:
CF applied part: 50μA
BF applied part:
5000μA
□BF____μA
Normal condition
(NC)
□CF____μA
□BF____μA
8
Patient
Auxiliary
Current
Single Fault condition
(SFC)
□CF____μA
Max:
CF applied part:
NC:10μA, SFC: 50μA
BF applied part:
NC:100μA, SFC:
500μA
Note: The equipment sold to the United States shall comply with the requirement of
UL60601-1; others shall comply with the requirement of IEC60601-1.
Name/ Signature: __________________________ Date:_____________________________