NemioMX Model ss-590A Fundamentals Operation Manual Ver A

Introduction This operation manual describes the operating procedures for the diagnostic ultrasound system SSA-590A. To ensure safe and correct operation of the system, carefully read and understand the manual before operating the system.

Trademarks Microsoft® and Windows® are trademarks of Microsoft Corporation in the USA and other countries. ApliPure is a trademark of Toshiba Medical Systems Corporation. This manual may include trademarks or registered trademarks of other companies. Note that the trademark symbol "™" and the registered trademark symbol "®" are not used in this manual.

IMPORTANT! 1. No part of this manual may be copied or reprinted, in whole or in part, without written permission. 2. The contents of this manual are subject to change without prior notice and without our legal obligation. 3. The contents of this manual are correct to the best of our knowledge. Please inform us of any ambiguous or erroneous descriptions, missing information, etc.

No. 2B771-022EN*A

Safety Precautions 1.

Meaning of Signal Words

In this operation manual, the signal words DANGER, WARNING, and CAUTION are used regarding safety and other important instructions. The signal words and their meanings are defined as follows. Please understand their meanings clearly before reading this manual.

Signal word

Meaning

DANGER

Indicates an imminently hazardous situation which, if not avoided, will result in death or serious injury.

WARNING

Indicates a potentially hazardous situation which, if not avoided, could result in death or serious injury.

CAUTION

Indicates a potentially hazardous situation which, if not avoided, may result in minor or moderate injury. Indicates a potentially hazardous situation which, if not avoided, may result in property damage.

CAUTION

2.

Meaning of Safety Symbols Symbol

Description Type-B applied part *

Type B when Type-B applied part is connected. The PCG sensor that can be connected to this system is a Type-B applied part.

Type-BF applied part *

Type BF when Type-BF applied part is connected. Reference signal cable that can be connected to this system is a Type-BF applied part.

"Attention" (Refer to the operation manual.)

No. 2B771-022EN*A S-1

3.

Safety Precautions

Please observe the following precautions to ensure EMC and the safety of the patient and the operator when using this system.

3.1 Safety precautions in the operation manual <<Fundamentals volume>> The following four precautions are related to EMC. •

WARNING No. 10 on page S-4

CAUTION No. 2 on page S-6 • • CAUTION No. 1 on page S-16 • CAUTION No. 2 on page S-16

DANGER:

Do not use flammable gases such as anesthetics or flammable liquids such as ethanol near this product. Doing so may cause an explosion. This product is not intended for use with oxygen or in an oxygen enriched atmosphere.

WARNING: 1. Warnings concerning electric shock, fire, and burns (1) If an abnormal smell or noise, or smoke occurs, immediately turn the system breaker OFF and disconnect the plug from the power outlet. Continuing to use the system with such an abnormality may result in a fire etc. When using the system, ensure that there is enough space for access to the breaker. (2) To prevent fire or electric shock, observe the following instructions regarding the power cable and plug. • Do not forcibly bend the cable. • Do not modify the power cable or plug. • Do not damage the power cable or plug. • Do not pull the power cable to disconnect the plug from the outlet. • Be sure to connect the power plug to a two-pin (with dual earth terminal) outlet meeting the ratings indicated on the rating nameplate. If this type of outlet is not available, contact your TOSHIBA representative. (3) Do not allow this system or other equipment to come into contact with the patient. If this system or other equipment is defective, the patient may receive an electric shock. (4) Do not connect transducers other than those specified by TOSHIBA to the system. (5) Do not use a defective transducer. (6) Do not remove the covers or panels of the system. (7) When in the patient environment, the operator must not touch any exposed connectors. In addition, if the system covers have been removed for some reason, the operator must be extremely careful not to touch any part where the voltage exceeds 25 VAC or 60 VDC and the patient at the same time.

No. 2B771-022EN*A S-2

WARNING: 2. Information concerning the terminal to which the potential equalization conductor is to be connected (

):

To use another medical device in combination with this system, an equipotential wire for connecting to an equipotential bus must be supplied. For more information, contact your TOSHIBA representative. * Be sure to connect the potential-equalization lead wire before inserting the equipment power plug into the receptacle. Also, be sure to remove the equipment power plug from the receptacle before disconnecting the wire to avoid electrical shock. 3. Information concerning the functional earth terminal (

):

Use of the functional earth terminal as protective earth is not allowed. The system should be connected according to local requirements and should not conflict with IEC60601-1 requirements. 4. Connect the earth conductor only before turning ON the system. Disconnect the grounding cable only after turning OFF the system. Otherwise, electric shock may result. 5. Do not connect this system to outlets with the same circuit breakers and fuses that control current to devices such as lifesupport systems. If this system malfunctions and generates an overcurrent, or when there is an instantaneous current at power ON, the circuit breakers and fuses of the building's supply circuit may be tripped. 6. A separate power outlet of the specified rating must be provided to supply power to the diagnostic ultrasound system. Refer to the "Specifications" subsection for the power requirements of the diagnostic ultrasound system. Do not connect the diagnostic ultrasound system to the same power outlet as another device. Doing so may cause the power circuit breaker of the facility to trip, the fuses to blow, or a fire or electric shock to occur. 7. Do not push the system from the side. If the system is pushed from the side, it may fall down and cause injury. 8. When the optional reference signal cable is used, the following measures are required. (1) To prevent electric shock, check the following items before operation. • There must be no abnormality of the reference signal cable. • The reference signal cable must be connected correctly.

No. 2B771-022EN*A S-3

WARNING:

(2) Connect the reference signal cable to the system before attaching the ECG electrodes to the patient. After the electrodes are attached to the patient, be careful not to allow them to come into contact with ground or other electrically live parts. If the reference signal cable connector or an electrode comes into contact with ground or other electrically live parts, the patient may receive an electric shock. (3) Do not place the ECG electrodes in direct contact with the patient's heart. Cardiac arrest may occur. * The ECG electrodes are of the BF type and are not designed to be placed in direct contact with the heart. (4) To reduce the risk of electric shock or burns, use only the cable and patient leads supplied with the reference signal unit. (5) The ECG electrodes used should be commercially available products provided by the customer. 9. Before using equipment such as an electric scalpel, highfrequency therapy equipment, a defibrillator, etc., remove the ECG electrodes from the patient. In addition, do not allow ultrasound transducers or PCG microphones to come into contact with the patient. The patient may be burned or receive an electric shock. 10. The use of transducers and cables other than those specified, with the exception of transducers and cables sold by Toshiba Medical Systems Corporation as replacement parts, may result in increased emissions or reduced system performance. 11. Cautions regarding the biopsy procedures (1) To perform biopsy procedures while observing ultrasound images, a thorough understanding of ultrasound diagnosis and adequate training in biopsy procedures are required. Biopsy procedures are safer when performed using image observation than when performed without images. However, 100% safety and reliability cannot be assured even when performing biopsy procedures using image observation. If biopsy procedures are performed without proper knowledge or training, they may be performed incorrectly and cause various patient side effects. (2) In the situations listed below, the biopsy needle may fail to reach the target. Incorrect biopsy may cause various patient side effects. • A biopsy procedure is performed without adequate skills. • A biopsy adapter other than that specified is used. • The biopsy adapter is mounted at an incorrect position. • A biopsy needle that is unsuitable for the purpose of the biopsy is used.

No. 2B771-022EN*A S-4

WARNING:

• A biopsy needle that is unsuitable for the biopsy adapter is used. • The image is frozen but it goes unnoticed, and the biopsy procedure is continued. • The position of the biopsy needle end is misinterpreted on the image. (3) Before and after a biopsy procedure is performed, confirm that there are no abnormalities with the biopsy adapter. If an abnormal biopsy adapter is used, the patient may be injured. (4) During a biopsy procedure, the needle may deviate from the desired course due to the tissue characteristics or the type of needle. In particular, needles with small diameters may deviate to a greater degree. Always monitor the target region and the needle end while performing a biopsy procedure. (5) Sterilize the transducer and biopsy adapter before and after an ultrasound-guided biopsy procedure. Failure to do so may result in the transducer and adapter becoming a source of infection. (6) The needle mark displayed on the ultrasound image does not indicate the actual position of the biopsy needle. It should only be used as a reference. (7) Do not freeze the image when performing a biopsy procedure. Biopsy procedures may be performed incorrectly on frozen images. (8) Confirm that the selected needle mark angle matches the angle indicated on the biopsy adapter to be used. (9) The biopsy target may shift due to unexpected patient motion when the biopsy needle is inserted, or else due to respiratory movement. Always monitor the target region and the needle tip while performing a biopsy procedure. 12. When a transducer is applied to a patient with a high body temperature, the rate of heat dissipation from the transducer may be lower than normal. Take care not to cause a burn during examination (especially during surgery or an intracavitary examination). If the surface temperature of the transducer becomes abnormally high, stop using the transducer and contact your service representative. 13. Prolonged and repeated use of keyboards can result in hand or arm nerve disorders in some individuals. Observe the local institution work safety/health regulations on keyboard use. 14. This system is provided with a lossy data compression function for images. Although this function helps reduce the size of stored images, it can cause image deterioration. The amount of compression, therefore, must be limited so that the image quality is maintained at a level which does not adversely affect image viewing.

No. 2B771-022EN*A S-5

WARNING: 15. For the safety precautions regarding the use of contrast medium etc. in CHI mode, refer to the operation manual, Application volume. 16. Prepare a backup system when an urgent examination is to be performed, for example during an operation or for an emergency case. If a severe problem should occur with the system, the normal operation of the system may not be recovered by turning the power OFF/ON and the examination may not be able to continue. 17. Do not use this transducer to examine the eyeball. Also do not use this transducer in examinations that may cause ultrasound beams to pass through the eyeball. 18. Do not use the controls, adjusters, or operating sections of the DVD/CD unit in a manner other than specified. Incorrect use may cause hazardous beams to be radiated.

CAUTION: 1. Precautions concerning clinical examination techniques (1) This operation manual is intended for users who are wellversed in the principles and basic techniques of ultrasound. (2) This system must be used only by medical personnel fully trained in clinical examination techniques. (3) This operation manual does not describe clinical examination techniques. Selection of the proper clinical examination technique must be based on specialized training and clinical experience. 2. Malfunctions due to radiowaves (1) Use of radiowave-emitting devices in the proximity of this kind of medical electronic system may interfere with its operation. Do not bring or use devices which generate radio waves, such as cellular telephones, transceivers, and radio controlled toys, in the room where the system is installed. (2) If a user brings a device which generates radio waves near the system, they must be instructed to immediately turn OFF the device. This is necessary to ensure the proper operation of the system.

No. 2B771-022EN*A S-6

CAUTION: 3. Precautions concerning installation and movement of the system (1) Be sure to install the system on a level floor and lock the casters. If this is not done, the system may move, injuring the patient. (2) When the system is moved over a sloped surface, it must be moved by two persons. Otherwise, the system may slide unexpectedly and cause a serious injury. (3) Do not sit on the system. The system may move, causing you to lose your balance and fall. (4) Do not place any objects on top of the monitor. They may fall, causing injury. (5) Confirm that movable sections such as the LCD arm are locked before moving the system. Otherwise, the movable sections may move unexpectedly and cause injury. (6) Confirm that the peripheral units are secured before moving the system. Otherwise, the peripheral units may fall and cause injury. (7) If the reference signal cable is connected, disconnect it before moving the system. Otherwise, the cable may get caught in the casters or someone may trip over the cable and injury may result. (8) When the system is moved over a step, be careful not to allow the system to fall. When holding the system at the bottom to help move it over a step, take special care to prevent hand injuries. 4. In normal diagnostic ultrasound mode, there is no danger of a lowtemperature burn; however, keeping the transducer on the same region of the patient may cause such a burn. 5. Do not rub the LCD surface with a hard material or apply strong pressure to the LCD surface. Doing so may cause scratches on the LCD surface or result in damage to the monitor. 6. Terminals and connectors on the system rear panel (1) Only the specified device must be connected to the USB connector or other connectors. Otherwise, smoke or an electric shock may result. (2) Only equipment that conforms to the safety standards must be connected to the ETHERNET terminal on the rear panel. Otherwise, smoke or an electric shock may result. (3) Turn OFF the system power before connecting or disconnecting the cable from the ETHERNET terminal. If the cable is connected or disconnected with the system power ON, the system may not operate properly. (4) When a HUB is used, turn ON the system power only after tuning ON the power to the HUB.

No. 2B771-022EN*A S-7

CAUTION: 7. Physio panel (option) (1) Only medical equipment that conforms with the IEC60601-1 standards must be connected to AUX. Otherwise, an electric shock may result. (2) When external signals are input to AUX of the Physio panel, the signal level that can be input is restricted. Contact your TOSHIBA representative for details. 8. Main panel switch configuration (1) The switch configuration on the main panel of this system can be changed. The switch settings may therefore differ depending on the system. Confirm the switch configuration of your system before use. For details, refer to subsection 3.2 "Main Panel". (2) The descriptions in this operation manual are based on the standard switch configuration. If the switch configuration has been changed, the differences between the current configuration and the standard configuration must be understood before use. 9. Back up the stored data (image data and exam history) periodically and delete unnecessary data. 10. Do not turn OFF the power supply of the system during printing, data saving, or invoking. Doing so may result in failure of saving or printing or damage to the data. In addition, doing so during access to media may damage the media. 11. Entry of patient ID (1) Before examining a new patient, press

to delete the patient

information and data recorded in the image memory for the previous patient. Otherwise, the new data may be confused with the data of the previous patient. Note that when the patient information is modified by pressing the F2 key, the patient information for the data already recorded in the image memory is also modified (the data recorded in the image memory is not deleted). Thus if the data recorded in the image memory is that for the previous patient, images for the different patients will have the same patient information, and this may cause confusion. (2) Confirm that the patient to be examined is the same as the patient ID. There is a possibility of recording images with incorrect patient IDs. (3) In systems in which the UIDM-590A is installed, confirm that "ADM Ready" is displayed at the bottom left of the screen after the power is turned ON, and then press the F2 key and enter the patient ID.

No. 2B771-022EN*A S-8

CAUTION: 12. Position of the biopsy target on the image and the biopsy needle Even though the biopsy target and the biopsy needle are identified on the image, a biopsy may not always be successful due to dispersion of the ultrasound beam. This is especially relevant when a biopsy procedure is to be performed for a tubule or a very small region. To avoid biopsy failure, follow the instructions below. (1) Do not rely solely on the echo of the needle end on the image. Pay careful attention to the target, which should shift slightly when the biopsy needle comes into contact with it. (2) Perform biopsy only after confirming the size of the target and the likelihood of biopsy success. 13. Measurements (1) The measured data is lost when image freeze is released during measurement. (In the case of application measurements, the data loss depends on the preset settings.) (2) The measured data is lost when the system is turned OFF or is pressed. 14. Do not display or print the data imported from other devices in this system. Such data may not be able to be displayed or printed correctly. 15. Peripheral units (1) To prevent electric shock, do not connect the peripheral units (printer, video recoding device, etc.) to an external outlet. Peripheral units should be connected to the service outlet of the system. For the connection procedures, contact your TOSHIBA representative. (2) Do not connect non-recommended peripheral devices to the service outlet as the power capacity may be exceeded and leakage current may increase. (3) Some printers cannot detect print errors. Use the actual printout to confirm whether the data is printed correctly. (4) Do not turn OFF the power to the printer during printing. This may result in system malfunction. (5) Do not turn the power to peripheral devices ON or OFF during the system startup or shutdown process. This may result in system malfunction. (6) When printing is executed, do not turn the system power OFF before all the images are printed. The data in the print queue may be lost. (7) When the color printer is to be used for printing, make sure that its power is ON. If printing is executed when the printer power is OFF, a system malfunction may result.

No. 2B771-022EN*A S-9

CAUTION: 16. Cine When performing examination of a new patient, press

to delete

the recorded data in the image memory. Otherwise, the new data may be confused with the data of the previous patient. 17. Acoustic power (1) The FDA allows ultrasound equipment to output acoustic power level TRACK3, which is higher than TRACK1, provided that MI/TI values are displayed on the system. This means that users have a higher degree of responsibility for safety than manufacturers. Against this background, users are required to understand the ultrasound bioeffects and their causes. (2) It is strictly required that acoustic output be set based on the ALARA (As Low As Reasonably Achievable) principle. However, not all examinations can be performed with an extremely low level of acoustic energy. Controlling the acoustic level at an extremely low level leads to low-quality images or insufficient Doppler signals, adversely affecting the reliability of the diagnosis. However, increasing the acoustic power more than necessary does not always contribute to an increase in quality of information required for diagnosis, rather increasing the risk of generating bioeffects. Users must take responsibility for the safety of patients and utilize ultrasound deliberately. Deliberate use of ultrasound means that output power of ultrasound must be selected based on ALARA. (3) Set the ultrasound output as low as possible when a fetus is to be exposed to ultrasound. (4) Note that there are switches on the operating panel and the pop-up menu other than the ACOUSTIC POWER switch, and the MI/TI value may change in a direction not intended for these switches. 18. If preventive maintenance is performed by the user, special care must be taken to ensure safety. 19. If any abnormality of the system is found as a result of inspection, stop using the system and contact your TOSHIBA representative for repair. 20. In no event shall TOSHIBA be liable for problems, damage, or loss caused by inspection performed by personnel other than TOSHIBA service personnel or those designated by TOSHIBA. 21. This system uses Windows XP as the OS. Do not change the settings of the OS. 22. Problems that typically occur in personal computers may also occur in this system. Important data must be stored on external storage media. 23. Only software authorized by TOSHIBA should be installed in this system. Otherwise, system failure or malfunction may result. Contact your TOSHIBA representative for details.

No. 2B771-022EN*A S-10

CAUTION: 24. The doctor's judgement should be used when using contrast medium. For the procedures for using contrast medium, contact the manufacturer of the contrast medium. 25. Refer to the operation manual Applications volume for precautions regarding the use of measurement functions, optional software, etc. 26. Before cleaning the system, be sure to disconnect the system power cable from the outlet of the facility. If the system has been defective, an electric shock may occur. 27. Do not spill or spray liquids such as water onto the system or peripheral units. If a liquid such as water enters the system or peripheral units, an electric shock may occur. 28. Clean the reference signal cable regularly. (1)

Do not allow clips to wet. The ECG is not displayed correctly.

(2)

Do not soak the connector in the water. Wipe the connector with dry cloth only. The water may enter the connector inside, possibly resulting in failure.

(3)

Do not use solvents (such as paint thinner, benzine, or alcohol) for cleaning the reference signal cable.

29. Cleaning the LCD monitor (1)

Do not hit or apply strong pressure to the LCD surface during cleaning. Doing so may damage the monitor.

(2)

Never use a stiff or hard cloth to clean the LCD monitor. Doing so may damage the monitor cover or LCD surface.

(3)

If stains on the LCD surface are difficult to remove, wipe it gently with a soft cloth slightly moistened with water. Detergents or chemical agents should not be used because they may damage the monitor.

(4)

Do not attempt to clean the LCD monitor with organic solvents such as benzine, paint thinner, and alcohol or abrasive cleaners. Such agents may damage the monitor cover or LCD surface. Also, do not use mild detergent to clean the LCD surface.

(5)

Do not allow liquid droplets to remain on the LCD surface. The droplets may cause small stains when they dry or may enter the LCD surface, possibly resulting in failure.

No. 2B771-022EN*A S-11

CAUTION: 30. Cleaning the trackball (1)

Be extremely careful when removing dial.

(2)

Do not touch the encoding rollers. If foreign matter has adhered to the encoding rollers, contact your Toshiba service representative.

(3)

Set the dial so that it is seated securely. If the ring is locked with the dial not seated securely, the palm switch may be damaged.

31. If there is any possibility of secondary infection, cover the entire system with a sterile cover. To obtain a sterile cover, contact your TOSHIBA representative. 32. Malicious software (1)

If this system is connected to a network for which any of the following conditions is true, the system can be infected with malware (malicious software, such as a computer virus or worm, that harms computers). The user must establish security measures to prevent the system from being infected. •

Security control is not established for the network.

•

There is a risk of malware invasion in the network.

•

System for which any of the following conditions is true is connected to the network.

(a) The security of the system is not controlled by the user. (b) The system can be accessed by persons not authorized by the user. (c) The system is capable of wireless communication. (2)

The following instructions must be observed in order to prevent this system from being infected with malware (malicious software, such as a computer virus or worm, that harms computers). If the system is infected with malware, the data stored in the system may be lost, tampered with, or accessed by unauthorized persons; the system may operate incorrectly; or the system may become a source of malware infection. •

Do not connect this system to a network for which security control is not established.

•

Do not connect this system to the Internet.

•

When an external storage media (such as a CD or USB flash memory) is to be used, confirm in advance that the media is not infected with malware.

•

Do not perform any other actions that may result in infection.

No. 2B771-022EN*A S-12

CAUTION: 33. When discarding any part of this system, follow all applicable local regulations. 34. When this system is used to examine an elderly patient or an infant, an attendant should be present as required. 35. The displayed reference signals should be used for reference only. They should not be used for diagnosis or monitoring. In patients with cardiac pacemakers, an implantable electro stimulator, or arrhythmia, the heart rate or other parameters may not be displayed correctly. 36. Confirm that the LCD monitor arm is locked before moving the system. Otherwise, the LCD monitor arm may move unexpectedly, resulting in personal injury. 37. Do not place your hand on the LCD monitor arm or under the LCD monitor when adjusting the monitor angle. There is a risk of hand injury. 38. DVD/CD unit (1)

Do not use lens cleaner to clean the disk. Lens cleaner will damage the drive.

(2)

Do not place adhesive labels on the disk. They may cause read errors or scratches on the disk.

(3)

Do not eject the media by pressing the [Eject] button during writing to the media. The data on the media may be damaged.

(4)

A disk that has been purchased in a spindle package may have protective sponge material applied to its surface. If such sponge material enters the internal mechanism of this unit, a malfunction may result. Confirm that there are no traces of sponge material on the disk before loading it into the unit.

(5)

The tray slides out approximately 15 cm when it is ejected. Keep the area in front of the tray clear. If the tray hits an obstacle, the tray may be damaged.

(6)

Do not leave the tray open. Dust may enter the unit and cause a malfunction, or a person may hit the tray and be injured. Open the tray only when necessary.

39. Do not connect any device to the USB connector other than a USB flash memory for storing and reviewing image data. 40. Do not press two or more switches on the system simultaneously. System malfunction may result. 41. During the system startup or shutdown process, do not attempt to operate the system (for example, turning a peripheral device ON/OFF, placing media into or removing media from the drive, or pressing a switch on the system). System malfunction may result.

No. 2B771-022EN*A S-13

CAUTION:

1. Do not use this system in locations subject to intense electric or magnetic fields (near transformers, for example). In such locations, the monitor will be adversely affected. 2. Do not use this system near devices generating high frequencies (such as medical telemeters and cordless telephones). The system can malfunction or adversely affect such devices. 3. To prevent damage to the system, do not use it in: • Locations where it may be exposed to direct sunlight • Locations where it may be subject to sudden changes in temperature • Locations that are dusty • Locations where it may be subjected to vibrations • Locations near heat generators • Locations where the humidity may be high • Locations where the air filter of the system is blocked by walls, etc. (a space at least 10 cm wide and 20 cm deep is required.) 4. Turn ON the system only after the power has been OFF for more than 5 seconds. If the system is turned ON immediately after being turned OFF, the system may malfunction. 5. Power ON/OFF (1) Make sure that no recording media is present in the corresponding drives before the system power is turned ON. Otherwise, the media may be damaged or a malfunction may result. (2) Do not turn the system power OFF while a recording media is being accessed. If the system power is turned OFF during access to the hard disk or DVD/CD disk, the disk may be damaged and recorded data may be lost. (3) If the power cannot be turned OFF by the normal procedure, press and hold down for at least 5 seconds. If the power is still not turned OFF, turn OFF the main switch on the power supply panel at the rear of the system. These methods should not be used under normal conditions. They may damage the system. (4) If the power is not turned OFF by following the normal procedures, 2D mode images may not be displayed when the system power is turned ON again. This does not indicate system failure. Turn OFF the main switch on the power supply panel on the rear of the system, wait at least 15 seconds, and then turn ON the main switch again. When the STANDBY LED starts blinking, turn ON the power switch. 6. For some transducers, the specified operating and storage conditions are stricter than those for the diagnostic ultrasound system. Refer to the operation manual provided with the transducer and check the specified environmental conditions for operation and storage. 7. Turn OFF the system or stop transmission by setting [Transducer] in the [Other] menu to OFF before connecting or disconnecting a transducer. If a transducer is connected or disconnected with an image displayed, the system and/or the transducer may malfunction.

No. 2B771-022EN*A S-14

CAUTION:

8. The user can record ID registration and user registrations (with a function to permit user-specific items such as the hospital name to be registered). Be sure to back up such information on external storage media. Data stored in the system may be lost due to improper operation or an accident. 9. Observe the following precautions before moving the system to prevent system malfunctions. (1) Turn OFF system.

and the main switch on the power panel on the rear of the

(2) Store the transducer in the transducer holder and hang the cable on the transducer cable hook. (3) When moving the system, use the handle. Do not push delicate sections such as the panel. 10. Move the system by the handle. If the user pushes or pulls other sections, such as the panel, the system may be damaged. 11. When moving the LCD monitor, be careful to avoid hitting the monitor against the TEE transducer hanger. The components may be damaged. 12. Do not press or use force on the main panel. It may damage the system. 13. Do not boot the system while the air filters are removed. The system may malfunction. 14. The filters on both sides of the system must be cleaned once a year. If the filters are clogged, the internal temperature will rise, shortening the service life of the system. For inspection and cleaning by service personnel, contact your TOSHIBA representative. 15. Do not use solvents (such as paint thinner, benzine, or alcohol) or abrasive cleansers for cleaning the system. These substances may cause deterioration in the monitor. 16. Deterioration of electrical and mechanical safety characteristics (such as generation of a leakage current or deformation/abrasion of mechanical parts) and of image sensitivity and resolution may occur over a period of time. A maintenance service contract is recommended to avoid accidents and erroneous diagnosis and to maintain system performance. 17. If the main switch is tripped, be sure to consult your TOSHIBA representative. If the main switch is turned ON again without checking the problem, the system or the device may be damaged more seriously. 18. Manage the system properly to prevent it from being infected with computer viruses.

No. 2B771-022EN*A S-15

CAUTION:

19. When the DVD is not being used, remove the disk from the drive. The disk may be damaged if the system fails. 20. There may be some missing dots or light-emitting dots on the LCD monitor screen. This does not mean that the LCD monitor is defective. 21. The service outlet on the main unit provides power to recommended external options only. (Refer to subsection 2.3 "Compatible Peripheral Devices".) Do not connect other devices or the power capacity may be exceeded, and the system may malfunction. 22. Do not stop the moving system using the total lock function except in emergencies. The casters can be damaged and abnormal operation can result. 23. Do not connect or disconnect a transducer during the system startup or shutdown process. This may result in system malfunction.

No. 2B771-022EN*A S-16

3.2 Safety precautions in the operation manual <<Applications volume>> WARNING: 1. Using a contrast medium (1) Handle the contrast medium as described in the operation manual supplied with the contrast medium. TOSHIBA is not liable for any damage or injury resulting from misuse of contrast media. (2) Check the side effects of the contrast medium used with the manufacturer of the contrast medium. (3) If there is an abnormality with the patient during use of the contrast medium, stop the examination and perform appropriate treatment. (4) Cavitation may occur due to interactions between the ultrasonic waves and the contrast medium. Always perform examination using the ALARA (as low as reasonably achievable) principle. The acoustic power can be changed using the ACOUSTIC POWER dial on the main panel. 2. TEE transducer (1) If the temperature detection function of the TEE transducer becomes abnormal, the message below is displayed.

In this case, stop the examination immediately, make the angle free, return the transducer to a neutral angle, and then withdraw the transducer carefully. Then, contact your Toshiba service representative.

No. 2B771-022EN*A S-17

WARNING:

(2) During scanning using the TEE transducer, the following message is displayed if the temperature at the transducer end exceeds 43°C for two minutes or more.

In this case, stop the examination immediately, make the angle free, return the transducer to a neutral angle, and then withdraw the transducer carefully. The diagnostic ultrasound system must be restarted in order to perform examination again. 3. Refer to the Operation Manual (Basic Volume) for precautions regarding the use of this system.

No. 2B771-022EN*A S-18