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DEPARTMENT OF THE ARMY SUPPLY BULLETIN

Army Medical Department Supply Information Headquarters, Department of the Army, Washington, DC 20310-2300 20 June 2014

Effective until rescinded or superseded

DISTRIBUTION STATEMENT A: Approval for public release; distribution is unlimited.

Printing of this information does not constitute endorsement of the product, manufacturer, or the use of any related item thereof by the US Army.

REPORTING ERRORS AND RECOMMENDING IMPROVEMENTS

You can improve this publication. If you find any mistakes, or you know a way to improve it, please let us know. Mail your letter or DA Form 2028 (Recommended Changes to Publications and Blank Forms) directly to the US Army Medical Materiel Agency, ATTN: MCMR-MMO-M, Fort Detrick, MD 21702-5001. If you prefer using email, please address it to usammacrm@amedd.army.mil.

Table of Contents Page CHAPTER 1 - Medical Maintenance Support Information ............................................................ 1-1 CHAPTER 2 - TMDE Utilization Information .............................................................................. 2-1

APPENDIX A - External Standard Operating Procedures, Medical Maintenance Operations Division,

Hill AFB, UT ................................................................................................. A-1 APPENDIX B - External Standard Operating Procedures, Medical Maintenance Operations Division,

Tobyhanna, PA ............................................................................................ B-1 APPENDIX C - External Standard Operating Procedures, Medical Maintenance Operations Division,

Tracy, CA ..................................................................................................... C-1 APPENDIX D - Special Purpose Test, Measurement, and Diagnostic Equipment (TMDE-SP) Tables ..... D-1 APPENDIX E - Battery Failure for Draeger Fabius Tiro/Tiro M.......................................................... E-1 APPENDIX F - Medical Equipment MMQC Message Content and Biomedical Equipment Repairer

Responsibility For Action................................................................................ F-1 Index - ..................................................................................................................... IN-1

Special Notice

This Supply Bulletin is dedicated entirely to the US Army Medical Materiel Agency,

Medical Maintenance Information - including the Depots

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CHAPTER 1. MEDICAL MAINTENANCE SUPPORT INFORMATION 1-1. THE UNITED STATES ARMY MEDICAL MATERIEL AGENCY (USAMMA) MEDICAL MAINTENANCE MANAGEMENT DIRECTORATE (MMO-M) CONTACT INFORMATION

The Medical Maintenance Management Directorate (M3D) oversees the strategic planning, policy development and execution of lifecycle maintenance for medical materiel in support of deployable (Table of Organization and Equipment [TOE]) and fixed (Table of Distribution and Allowances [TDA]) healthcare subcomponents worldwide. The M3D is comprised of the Office of the Director, the Maintenance Operations Division (MOD) and the National Maintenance Program (NMP). Points of contact are:

Director M3D (DSN 343-4365, commercial 301-619-4365) Deputy Director (DSN 343-4383, commercial 301-619-4383) Senior Maintenance NCO (DSN 343-2908, commercial 301-619-2908) USAMMA Mailing Address:

US Army Medical Materiel Agency ATTN: MCMR-MMO-M 693 Neiman St Fort Detrick, MD 21702

1-2. MAINTENANCE OPERATIONS DIVISION (MOD) CONTACT INFORMATION

The MOD serves as an Army Medical Department (AMEDD) focal point for multiple aspects of medical materiel maintenance. The MOD is made up of the Office of the Chief with depot-level medical maintenance operations divisions (MMODs) at Hill AFB, UT; Tobyhanna, PA; and Tracy, CA. Points of contact are:

Chief, MOD (DSN 343-9780, commercial 301-619-9780) Chief, MMOD, Hill Depot (DSN 586-4947, commercial 801-586-4947) Chief, MMOD, Tobyhanna Depot (DSN 795-7744, commercial 570-895-7744) Chief, MMOD, Tracy Depot (DSN 462-4556, commercial 209-839-4556) USAMMA Mailing Address:

US Army Medical Materiel Agency ATTN: MCMR-MMO-MO 693 Neiman St Fort Detrick, MD 21702

1-3. NATIONAL MAINTENANCE PROGRAM (NMP) CONTACT INFORMATION

The NMP serves as the Army Medical Department’s (AMEDD) principal agent for enterprise-level strategic medical maintenance analysis and policy review and development. Points of contact are:

Chief, NMP (DSN 343-4407, commercial 301-619-4407) Deputy, NMP (DSN 343-4464, commercial 301-619-4464) Maintenance NCO (DSN 343-9157, commercial 301-619-9157) The e-mail address for NMP general e-mail is: us.army.detrick.medcom-usamma.mbx.nmp@mail.mil

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USAMMA NMP Mailing Address:

US Army Medical Materiel Agency ATTN: MCMR-MMO-MN 693 Neiman St Fort Detrick, MD 21702

1-4. MEDICAL EQUIPMENT MAINTENANCE SUPPORT

a. The appropriate equipment and customer information is critical for the timely

processing of your equipment and providing the best customer support. When shipping medical equipment for services at any one of the USAMMA Maintenance Divisions please include the following information:

Owner UIC: Owner DODAAC: Unit Name: Branch of Service: (Regular Army, National Guard, Air Force, Navy) Shipping Address: City: State: Zip Code: Point of Contact: Commercial Telephone Number: DSN: FAX: E-mail Address:

b. See Appendices A, B, and C for copies of each medical maintenance operation’s

External Standard Operating Procedures. These procedures provide specific guidance to assist you with receiving medical maintenance support.

c. For Army Reserves, please coordinate support with your Regional Training Site -

Medical (RTS-MED).

d. The three Medical Maintenance Operations Divisions provide medical equipment maintenance and technical support for the states indicated below:

Hill AFB, UT - DSN: 586-4947 Commercial: 801-586-4947

AK ID MT WY UT CO ND SD NE KS MN IA WI MO IL MI IN KY

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Tobyhanna, PA - DSN: 795-7744 Commercial: 570-895-7744

TN AL GA FL SC NC VA WV OH VT PA NY NH ME MA RI CT NJ DE MD

Tracy, CA - DSN: 462-4556 Commercial: 209-839-4556

WA OR CA NV

AZ NM TX OK

AR LA MS HI

e. Contact the Maintenance Division that supports your area for questions regarding support. Information is also available at http://www.usamma.amedd.army.mil.

1-5. ADDRESSES OF MAINTENANCE DIVISIONS

a. MMOD Hill AFB

(1) Mailing address: US Army Medical Materiel Agency Medical Maintenance Operations Division ATTN: MCMR-MMO-MH 6149 Wardleigh Road Building 1160 Hill Air Force Base, UT 84056-5848

(2) Freight address

US Army Medical Materiel Agency 6149 Wardleigh Road Building 1160, Bay 1 Hill Air Force Base, UT 84056-5848

b. MMOD Tobyhanna

(1) Mailing address US Army Medical Materiel Agency Medical Maintenance Operations Division ATTN: MCMR-MMO-MT Tobyhanna Army Depot 11 Hap Arnold Boulevard Tobyhanna, PA 18466-5063

(2) Freight address

US Army Medical Materiel Agency Medical Maintenance Operations Division Warehouse 4, Bay 1 Tobyhanna Army Depot Tobyhanna, PA 18466-5063

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c. MMOD Tracy (1) Mailing address

US Army Medical Materiel Agency Medical Maintenance Operations Division ATTN: MCMR-MMO-MR P. O. Box 960001 Stockton, CA 95296-0970

(2) Freight address

US Army Medical Materiel Agency Medical Maintenance Operations Division Tracy Site, Building T-255 25600 S. Chrisman Road Tracy, CA 95304-9150

1-6. INSCRIBING EQUIPMENT

Please do not permanently inscribe local and unit information onto your medical equipment. When equipment is turned in to the USAMMA, every effort is made to rebuild the equipment to a like-new condition. Inscribing unit information on the equipment significantly increases the cost of refurbishing these items for re-issue. To mark your equipment, please use a label.

1-7. STORAGE AND SHIPPING CONTAINERS

a. Many of the reusable containers used to store and ship medical equipment and test,

measurement, and diagnostic equipment (TMDE) contain foam products that deteriorate due to age or other factors. Over periods of time and with use, the foam begins to break down into tiny flakes. This condition can render the TMDE and other medical equipment useless or have an impact on the full mission capability of the equipment and/or calibration verification.

b. If you cannot replace the foam inside your re-usable containers, we highly

recommend that you place the TMDE/medical equipment items in a plastic bag prior to placing it into the case. This will prevent contamination of the equipment.

c. The MMOD at Hill AFB, Utah, has made arrangements with ADR Packaging to

manufacture the inserts used in different cases. They use polyethylene foam supplied in gray at 0.9 lb density, in green at 1.2 lb density, and in blue at 1.7 lb density.

d. The USAMMA has had very positive results with the green polyethylene. The cost of

the 1.2 lb density is approximately $0.50 - $0.60 per board foot (12" x 12" x 1") plus scrap that results in the forming of the pieces.

e. ADR Packaging can be contacted at 400 North Geneva Rd, #C, Lindon, UT 84042.

The telephone number is 801-796-3700; fax number is 801-796-3800. 1-8. AVAILABILITY OF MAINTENANCE PUBLICATIONS

a. Every maintenance shop has a library of technical documentation related to the

medical equipment that they support. Over time, some of those publications either wear out or are misplaced and need to be reordered. Before you reorder, you may want to check whether the specific material is available from the US Army Publishing Directorate (APD) or from USAMMA.

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b. Search for the Technical Manual (TM) at APD. To check whether a TM is active, its availability, and if it comes in hard copy or electronic versions use the following directions:

- From your browser, go to the APD website at: www.apd.army.mil - On the top left of the screen, look for the rotating "DA Pam 25-30/Product

Catalog". A ‘Quick Search’ screen will come up. - In the ‘Search for’ box, enter the TM number or just the TM series, i.e., TM 8.

Click on submit. The TM or group of TMs will be shown on the screen. - Under the "Name" (next to the TM #), click on the "View" button. Look at the

‘publication status’. It is either active or inactive (obsolete). - If the document is active look at the ‘Unit of Issue’ block to show one of the

following: • EA indicates ‘hard copy’, • EMO indicates ‘electronic media only’

1-9. LINE-VOLTAGE AND LINE-LOSS PROBLEMS

a. Anytime we operate electrical equipment in the tactical environment, a new variable

enters the equation of operation. It’s called line drop. It is the loss of voltage at the connected load due to the resistance of the wire and of the connections that are integral to the power conductors.

b. Higher power medical equipment, such as X-ray, Computed Tomography (CT), and

autoclaves use significant power, and when they are located some distance from the source of electrical power (diesel generator), the operating voltage is frequently less than optimum. This article addresses the “Line loss problem” and what we can do to improve operation of the equipment by having the correct voltage at the equipment.

c. We all know that the conductors supplying the electricity have some inherent

resistance, so we use larger gauge wire at the generator to its connection to the Power Distribution Panel (PDP). That wire (250MCM) has a very low resistance so does not lose more than 3% of any applied voltage at the rated current (about 400 amperes) to the point of use.

d. In turn, the output connectors of the PDP are rated to support either the 60 Ampere

or 100 Ampere loads. The conductors (wires) are also sized to not lose more than 3% at rated load as well.

e. The wire size at the generator set starts at the maximum appropriate wire gauge,

and progressively drops in AWG (American Wire Gauge) as the connected load gets smaller. The overall combination of power conductors and connectors that eventually provides power to the load contributes some amount of resistance and as the length of the conductors increase, the resistance will increase.

f. From Ohms law, Voltage (E) is equal to current (I) times Resistance (R); E= IR.

Recall from Ohm and a bit of algebra, that as the resistance (R) increases, the available voltage (E) will decrease at the load. The overall current will decrease as well. Here are the formulas; E= IR, R=E/I and I=E/R

g. What is the result of significant line loss? Equipment may shut down or operate

below its allowed range. If this happens, here are some things to check: and clean.

• First. Check the 'Class L' connectors. Make sure they are in good condition • Second. If the equipment performance seems to be less than optimal, check

all the connections. Start with a voltage measurement at the connected load, back through the Power Distribution Panel (PDP), all the way back to the source of electrical power. The

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voltage should increase as you get closer to the generator. Remember the allowed 3% maximum loss for any connection and conductor combination. If there are three connections from the equipment to the generator, you can have an allowed 9% voltage loss – though you may find the equipment is operating marginally or not at all.

• Third. If possible and in consultation with the generator operator, raise the generator voltage by a sufficient amount to provide the correct operating voltage at the connected load.

h. If you intend to have the equipment operate with a minimum of line loss, check the

Class L connections. Over time, electrical connections can and will get loose. The reason is thermal expansion resulting in a decrease of voltage at the equipment. Make inspection of cable ends and connections a part of your Preventive Maintenance Checks and Services (PMCS).

i. What should be inspected at the Class L connection? Look for overheated pin or

sockets on the Class L connector. Any loose or worn out socket typically will not show up as damaged, but the pin will show discoloration. Any brown, black and blue oxidization colors on any pin shows a resistive (overheating) connection.

j. Remember, the pins only wear thinner through use. The sockets get looser inside

through use. The overall effect is a loose connection and higher resistance. Dirt and sand and grit in the Class L connector are not your friend. Foreign materials collect on the pins or sockets and cause a reduction in contact area. Less pin area touching a contact area of the socket means more resistance. REMEMBER - Clean pins, better connection, results in less line loss.

k. Lubricants can be a problem. A very light coating decreases friction, easier to make

the connection, but not necessarily lowering the contact resistance. If any lubricant is used on a pin connection, wipe most of it off.

l. For those of you, who are interested in the technical side of the line loss problem,

feel free to read through the following references.

http://www.epanorama.net/documents/wiring/wire_resistance.html or http://en.wikipedia.org/wiki/American_wire_gauge

m. Here is a typical problem:

(1) Remember that a power cable has a line going to the load, and a line

returning to the power source -- account for the length of any power cable by doubling it in any calculation.

(a) Two (2) AWG is 257.6 thousandths of an inch in diameter. It has a resistance of 0.1563 ohms per 1000 feet. For the 100 foot run, (of a 50’ power cable) the resistance is 0.01563 ohms.

(b) With 100 Amperes load, the voltage drop is E= I * R, 100 * .01563 = 1.56 V drop on a 208 Volt line, the drop is small in %. V nl - V l/ V nl * 100= % line loss. So (208 - 206.4 / 208) * 100 = 0.76%.

(c) Doubling the current to 200 Amperes (as during an X-ray exposure) does affect the voltage drop to 3.12 volts. (208 - 204.8/ 208) * 100 = 1.5%. One important thing to note is the line drop at maximum rated wattage is not terribly bad.

(2) The wire is not the major problem - it is the connectors. They are allowed 30

Milliohms per junction (Pin to socket). Take the single wire circuit again, but add in the 4 connectors, 1) at the power source, 2) at the end of the 50 ' that goes to the load, 3) from the load connector, and 4) at the last connector back to the source. Again, it’s still on single phase.

(3) Now make the 4 junctions max out at 30 mOhms. That’s 0.030 ohms * 4 = 0.12 ohms. That value - combined with the inherent resistance of the wire - adds up.

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(4) Now, look at the same problem - this time with the added Class L connectors.

The problem with the connectors changes the picture, radically. (a) The E= I * R now is 100/0.13563 = 13.56 V drop with the same

conditions and equation (208 - 194.4/ 208) * 100 = 6.5% Line loss. That is a significant loss which can be resolved by shortening the power cables and/or decreasing the distance from the load to the source of power.

(b) Note also that we did not consider any resistance increase of the wire conductors or of the pin socket combination due to high temperature.

(5) The USAMMA-NMP appreciates and thanks the staff at the Maintenance Depots for their invaluable input and time given for the comments of the preceding article.

1-10. WHAT IS “MAINS RESISTANCE”?

a. In reviewing the instructions for an installation of some high-power consumption

equipment, the installation instructions frequently indicate the “mains resistance" must be at some level of Milliohms or less. So how does that number get tested, and more importantly, what does it really mean? Let’s explore the term by relating to a product that is deployed in the field.

b. The Brilliance CT scanner operates on an input of 480 Volts Alternating Current

(VAC) which is derived from a step-up/isolation transformer (ISOtran®). The mains which power the scanner should be measured or determined to have a resistance of 200 mOhms (Milliohms) from line to line. However, it is difficult to do that measurement without a source of Direct Current (DC) and some precision voltmeter and resistor. The circuit below describes the 'how to do it', if you had the right instrumentation (taken from http://sound.westhost.com/articles/xfmr3.htm).

c. The easiest way to measure a very low resistance is to inject a known current and

measure the voltage across the device under test. The formula is R= E/I. For example, if you subject a transformer winding, a coil of wire, or an unknown conductive material to (exactly) 1A DC, and measure 448mV across the winding or terminal, its resistance is 0.448Ω. A regulated DC supply and a 10 ohm 5W (1% precision) resistor is ideal for this. Measure its value carefully - if it measures 10.1 ohms, then 10.1V dropped across the resistor means the current is exactly 1A. This is shown in the diagram below.

Measuring Very Low Resistance & Leakage Inductance

d. The “mains resistance” is referring to the power source as a battery with a small resistance in series with it. If the power source was a battery, the appropriate term for the internal resistance would be “Internal Impedance”.

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1-11. MEDICAL EQUIPMENT SERVICE LITERATURE SUPPORT

a. Biomedical technicians that do not have literature or manuals to support their

authorized medical equipment can contact the medical maintenance operation that supports their region and they will provide them a disk that contains the manual. Ensure you have the correct NSN, model, and manufacturer.

b. Additionally, medical equipment operator and service literature is also available from

the USAMMA, Project Management Office Medical Devices, at 301-619-4379. 1-12. MEDICAL MATERIEL QUALITY CONTROL (MMQC) PROGRAM

a. In December 2009 the NMP began improving the MMQC process and making

changes to its website to accommodate the improvements: "To ensure the safety of patients and staff, all BES who are responsible for the management of medical equipment should register and subscribe to USAMMA MMQC and MMI messages.” The website is at: http://www.usamma.army.mil/assets/apps/listserv/messages.cfm. Only email addresses ending in .mil or .gov will be honored.

b. The NMP drafted a paragraph to be included in all MMQC messages that applies to

medical equipment. The paragraph requires the Biomedical Equipment Specialist (BES) to respond to Type I through Type III complaints with pertinent maintenance data. An example of the paragraph reads as follows:

Service/Additional Instructions:

ARMY: Army activities in possession of subject equipment are required to report the status of their work to the USAMMA NMP NLT DD MM YYYY. This can be accomplished by visiting the Army MMQC Equipment Status Reporting website. Complete and submit the on-line form. For questions or comments, contact the USAMMA NMP at:

Email: USARMY.DETRICK.MEDCOM-USAMMA.MBX.NMP-MMQC@MAIL.MIL

Phone (COMM): 301-619-6648/4464/3170

Phone (DSN): 343-6648/4464/3170

**End of Army paragraph example**

**Note: Sometimes there is a manufacturer’s customer letter or FDA recall attached to MMQC messages. Links to these types of attachments are placed at the end of the MMQC message under “Additional Documentation/Attachments.” See attachment in the example that follows…..this attachment happens to be a customer letter from Olympus.

Please see Appendix F for a sample MMQC Message.

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1-13. DEFENSE REUTILIZATION MANAGEMENT OFFICE (DRMO) DRMO facilities across the US are reorganizing. The DLA has an excellent website at http://www.dispositionservices.dla.mil/index.shtml that contains a wealth of information regarding the DRMO process; it also lists the DRMO sites across the country. Visiting this site is worth your time.

1-14. TEST, MEASUREMENT, AND DIAGNOSTIC EQUIPMENT (TMDE) AUTHORIZATIONS

a. The AMEDD Combat Developer continues to work the Operational Requirements

Documents (ORD) and Basis of Issue Plans (BOIPs) to ensure all TOE medical organization with a medical maintenance capacity are authorized the TMDE necessary to provide unit level medical maintenance support.

b. Appendix D of this supply bulletin includes several table listings that will help

identify the appropriate levels of TMDE for your organization. 1-15. AMEDD TWO-LEVEL MAINTENANCE (TLM)

a. Maintenance managers must coordinate the best use of available resources to

repair and return the maximum number of critical items back to the fight. They must maintain close, consistent interaction between maintenance organizations and their Supply Support Activities (SSA) to ensure quick access to repair parts and replacement equipment (float items). Support elements are required to perform maintenance work as far forward as practical within the limitations of the METT-TC and the commander’s priorities.

b. Current maintenance operations are based on the two-level maintenance concepts

described in AR 750-1, AR 40-61, FM 4-02.1, and FM 4-30.3. Benefits of the TLM system are that it streamlines maintenance operations by eliminating duplication of work, reducing the logistics footprint, and decreasing “handling” during replacement. It also takes advantage of expected improvements in reliability, embedded diagnostics, and prognostics resulting in the decreased repair cycle time and increased readiness, flexibility and depth of capabilities. It also facilitates synchronization with sustainment support facilities and the National Maintenance Program. The two levels of medical maintenance are:

Field Support and Sustainment Support Maintenance

(1) Field Support (FS) Maintenance. FS maintenance is the first and most

critical level of the Army maintenance system and is performed at all levels of the Army. FS focuses on the maintenance at the point of failure and requires continuous emphasis by all commanders and leaders. Commanders are responsible for providing resources, assigning responsibility, and operator-level training to conduct Preventive Maintenance Checks (PMC). FS maintenance is characterized by the replace forward and repair & return to user concepts and is comprised of crew maintenance and maintainer maintenance.

(a) Crew maintenance is the greatest enabler of field support maintenance.

Crew maintenance provides the most rapid identification of equipment faults and engagement of the maintenance repair system. The crew will: routinely clean equipment; perform before, during, and after-operation PMC in accordance with the Technical Manual (TM), maintenance allocation chart (MAC), local SOP and manufacturer literature; repair and replace parts, minor assemblies, and subassemblies when authorized by the MAC; and request support from appropriate medical maintenance activities for repairs and services beyond the scope of operator maintenance

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(b) Maintainer Maintenance is performed by a qualified biomedical equipment specialist (BES) and is accomplished by replacing modules, components or subcomponents on the equipment at the point of failure. If they cannot complete the maintenance as a result of a lack of resources (i.e., parts, tools, TMDE, facilities, training or time) or authorization by the MAC, the equipment will be turned in to supply by the user after being condition coded. Concurrently the replace forward function is performed by the supply section through the requisition of the replacement item. Maintainers will: schedule and perform PMC, electrical safety inspections, tests and calibration, verification, and certification services; provide diagnosis and fault isolation; replace unserviceable modules and assemblies; lubricate, clean, preserve, tighten, and make minor adjustments; perform technical inspections; manage and maintain PMI located within their operational area; and repair unserviceable economically reparable equipment as well as other maintenance duties described in AR 750-1, AR 40-61, TB MED 750-1 and TB MED 750-2 and as authorized in the MAC.

(2) Sustainment Support (SS) Maintenance. Sustainment support

maintenance is the second level of the Army maintenance system and typically has structured echelons above the combat brigade at operational, installation, depot, and contractor activities. SS maintenance organizations have more robust facilities, tools, machinery, TMDE, technical skills and manpower with the intent to perform commodity-oriented repairs on all supported items to one standard that provides a consistent and measurable level of reliability. Ideally, SS maintenance activities would support closest to the area of operations, however, the operational tempo (OPTEMPO) and technical requirements may dictate that SS maintenance activities are located in CONUS to provide the required repair support.

(a) Sustainment support maintenance is generally characterized as repair

rear and repair and returns to the supply system and can be employed at any point in the distribution pipeline. Repair Rear means that maintenance occurs away from the point of failure at designated places throughout the battlefield. SS maintenance are actions taken to return end items or components of medical systems to the Army maintenance standard as defined in AR 750-1. SS maintenance is comprised of below depot sustainment maintenance and depot sustainment maintenance.

(b) Sustainment support maintenance personnel and/or activities will:

provide area maintenance support to include technical assistance and on-site maintenance; provide support to field-level maintenance units for unique item support; classify Class VIII equipment for proper disposition; operate cannibalization points; provide repair, overhaul and rebuild of end items and components in support of the wholesale supply system; perform special inspections, tests, and modification program actions as well as other maintenance duties described in AR 750-1, AR 40-61, TB MED 750-1 and TB MED 750-2 and as authorized in the MAC.

(c) Below depot sustainment maintenance is accomplished on an end item,

component, assembly, or other portion either on the system or after it is removed. The replacement or complete repair is possible at the below depot sustainment maintenance level when indicated in the MAC. Items are returned to the supply system after maintenance is performed at this level.

(d) Depot sustainment maintenance is accomplished on an end item,

component, assembly, or other portion either on the system or after it is removed. Depot sustainment maintenance supports the Army supply system by providing combat-ready materiel and also sustains combat forces with technical assistance to Field maintenance units and activities. This level of maintenance will normally be performed by either depot personnel or contractor personnel at TDA industrial-type activities operated by USAMMA through Interdepartmental, interagency agreement or contract. In overseas areas, a depot forward repair activity-medical (FRA-M) may be established forward of the depot to support combatant commanders. Where possible, the FRA-M will provide support for multiple systems or commodities. The replacement or complete repair is possible at the depot sustainment maintenance level when indicated in the MAC. Items are typically returned to the supply system after maintenance is performed at this level.

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1-16. MAINTENANCE MASTER DATA FILE

a. The Maintenance Master Data File (MMDF) contains cataloging descriptions and

technical information on equipment items in a centralized database. The MMDF identifies readiness and maintenance reporting requirements, system and subsystem relationships, and item data relationships for selected Army equipment. MMDF equipment records are limited to equipment with a maintenance or readiness reporting requirement. Although equipment may have a National Stock Number (NSN), it may not meet the requirements to be included in the MMDF. Items can be added to the MMDF as maintenance significant (not necessarily readiness reportable), if they require corrective maintenance services on a recurring basis.

b. The Logistics Support Activity (LOGSA) publishes and manages the data within the

MMDF, which is downloaded into the Standard Army Maintenance System – Enhanced (SAMS-E) systems each quarter (January, April, July, and October). Once loaded to a SAMS-2E, users can modify the file to include and/or identify command-significant equipment; this provides a baseline for each unit’s equipment master file. SAMS-2 sites then push this modified file to their down-trace SAMS-1 sites; operators use the file to perform various reporting and maintenance functions within the system. The MMDF and Reportable Tables are available through the Logistics Information Warehouse (LIW) website at: https://oamcpro.logsa.army.mil/oamcustomlogin/.

c. The US Army Medical Materiel Agency, National Maintenance Program (USAMMA,

NMP) is the Army Medical Department’s proponent for managing Class VIII readiness and maintenance significant equipment on the MMDF. The USAMMA, NMP initiates MMDF addition, deletion, or change requests to LOGSA as identified by acquisition life cycle managers. The goal is to ensure that the MMDF is kept up-to-date and is managed to resolve cataloging issues before updates are processed.

d. If you have questions or comments concerning the MMDF, contact the USAMMA NMP

at the phone numbers and/or e-mail references furnished in Chapter 1, paragraph 1-3. For questions, concerns, or assistance downloading or installing the MMDF in SAMS-E, contact the 6th Medical Logistics Management Center at commercial phone number (301)-619-7970/9370 or DSN 343-7970/9370.

1-17. CENTRALIZED DIAGNOSTIC THERAPEUTIC RADIATION PRODUCING DEVICE (DTRPD) SUPPORTABILITY

a. This paragraph provides an overview of active efforts by the National Maintenance

Program (NMP) to revise TB MED 750-1, “Operating Guide for Medical Equipment Maintenance (April 1998)” and TB MED 521, “Management and Control of Diagnostic, Therapeutic, and Medical Research X-Ray Systems and Facilities (February 2002).”

b. Implementation of Technical Bulletin (TB) revisions will centralize maintenance

supportability and sustainment coverage across the Device Therapeutic Radiation Producing Device (DTRPD) life cycle; providing guidance on maintenance and user-community roles impacting the support, management, and control of TDA and TOE DTRPD.

c. TB MED 750-1, Chapter 4 entitled “Management and Maintenance of Diagnostic

Imaging and Radiation Therapy Devices” is being revised to exclusively support DTRPD maintenance personnel. This revision will integrate all cited DTRPD maintenance-related roles, responsibilities, and performance tasks formerly specified in TB MED 521. When complete, revision content upgrades will eliminate the need to reference TB MED 521 when performing DTRPD maintenance actions. TB MED 750-1 reference applicability extends to:

• Health Services Maintenance Technician (HSMT) - MOS 670A • Biomedical Equipment Specialist (BES) - MOS 68A • Qualified civilian equivalents

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d. Revised subject-matter coverage of TB MED 750-1, Chapter 4 will address the full breadth of DTRPD life cycle applicability. This generally encompasses Technology Assessment and Requirements Analysis (TARA) and annual DTRPD repair and calibration radiation- measurement practices. Coverage additionally includes submission and administration of Form FDA 2579 and associated Radiation Protection Program File (RPPF) records. Subject matter discussed in Chapter 4 includes but is not limited to:

• Acquisition Management • Records Administration and Reporting • DTRPD Inspection Program Implementation • Medical Device Quality System Management • DTRPD Disposal

e. TB MED 521 is being revised to exclusively support DTRPD users including those

personnel responsible for DRTPD survey and measurement. TB MED 521 reference applicability extends to:

• Professional hospital staff • Medical Physicists • Health Physicists • Qualified civilian equivalents

f. Revised subject-matter coverage of TB MED 521 is anticipated to eliminate all cited

DTRPD maintenance-related performance tasks while addressing modalities that include:

• Computed Radiography (CR) • Direct-to-Digital Radiography (DDR) • New and emerging imaging technologies

1-18. ABBOTT POINT OF CARE BI-ANNUAL i-STAT® UPDATE DISTRIBUTION PROVISIONING CHANGES

a. Effective immediately, Abbott Point of Care bi-annual i-STAT® Software and

Documentation update distributions will only include i-STAT® System-Manual Update Packets which can be printed and used to update existing i-STAT® System Manuals.

b. Complete i-STAT® System Manuals will no longer be furnished in upcoming bi-

annual i-STAT® Software and Documentation CD-ROM releases. These manuals are, however, available for immediate online access in Adobe PDF format, along with associated Technical Bulletins, Product Updates, User Guides, and supporting i-STAT® System Manual Configuration information.

c. All current-release documentation resources may be downloaded directly from the

Abbott Point of Care, ‘Customer Information Center,’ located at: http://www.abbottpointofcare.com/customer-info-center/user-documentation.

1-19. DRAEGER MEDICAL, 6515-01-457-1840: FAULTY INTERNAL OXYGEN REGULATOR PIPING CONFIGURATION (NARKOMED M ANESTHESIA SYSTEM)

a. Recent oxygen (O2) regulator replacement purchases for the Draeger Medical

Narkomed M Anesthesia System have been received with safety relief-valve piping ported to the wrong regulator orifice. This faulty configuration prohibits correct internal O2 regulator replacement.

b. The diagram below illustrates a ‘back view’ representation of the internal O2

regulator depicting a proper piping configuration lineup.

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Draeger Medical Oxygen Regulator

c. Draeger Medical has been advised of O2 regulator piping configuration deficiencies but a fix has not been implemented as of the date of this publication.

d. Biomedical Equipment Specialist (BES) maintainers should inspect all newly

purchased internal O2 replacement regulators received from Draeger Medical; and, if necessary, reconfigure orifice connections for proper anesthesia system installation.

e. Technical support can be obtained from the following contact sources:

• Draeger Medical Technical Support (800) 437-2437 • Draeger Medical Telford, PA (800) 543-5047, (800) 437-2437

1-20. DRAEGER MEDICAL, 6515-01-502-2117: ANESTHETIC SAMPLE FLOW-RATE CORRECTIONS (VAMOS AND VAMOS PLUS ANESTHETIC GAS MONITORS)

a. Draeger Vamos and Vamos Plus anesthetic gas monitor sample flow rates cited in

Preventive Maintenance Checks and Services (PMCS) procedure 4.7.2 are incorrectly stated. A published documentation revision correcting sample flow-rate value inaccuracies will be introduced by Draeger Medical at a later date.

b. Correct anesthetic sample flow-rate values for Draeger Vamos anesthetic gas

monitor configurations can be determined by first identifying the specific monitor type:

(1) Draeger Vamos Anesthetic Gas Monitors. These monitors are recognized by the name Vamos imprinted on the monitor’s front control panel. Vamos monitors require separate purchase of anesthetic gas detection options and come in two distinct configurations; each having different sample flow rates. Configuration sample flow rates are distinguished by a 7-digit ‘reference number’ listed on the product identification label affixed to the upper chassis of the monitor; these rates include:

Reference No.

Draeger Vamos

Sample Flow Rate

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6871990

Sample rate of 200 +/- 20 milliliters (ml)/minute (min)

6870750 Sample rate of 150 +/- 20 ml/min

(2) Draeger Vamos Plus Anesthetic Gas Monitor. This monitor is recognized by the name Vamos Plus imprinted on the monitor’s front control panel. The Vamos Plus features an automatic gas detection option along with an ability to measure multiple anesthetic gases simultaneously. The correct anesthetic sample flow-rate for the Vamos Plus anesthetic gas monitor is 200 +/- 20 ml/min.

c. Technical support can be obtained from the following contact sources:

• Draeger Medical Technical Support (800) 437-2437 • Draeger Medical Telford, PA (800) 543-5047, (800) 437-2437

1-21. DRAEGER MEDICAL, 6515-01-564-6213: CLIC ADAPTER ABSORBER ASSEMBLY, FABIUS TIRO M ANESTHESIA APPARATUS

a. This paragraph introduces essential service information for the CLIC adapter absorber assembly not otherwise documented in the Fabius Tiro M Anesthesia Apparatus service manual.

b. The CLIC adapter absorber assembly permits soda-lime chemical absorption of

carbon dioxide (CO2), using a high-capacity Dragersorb® 800-plus disposable CLIC absorber canister.

c. Physical inspection of the CLIC adapter should be performed during

scheduled services; or, at the conclusion of any unit repair. Two CLIC adapter performance tests should additionally be performed during these maintenance intervals, including:

(1) An operational test of the CLIC adapter folding mechanism.

(2) A CLIC adapter leak test (this activates the CO2 bypass function and tests

bypass integrity against leakage).

(a) CLIC adapter leak-test setup involves connecting the inspiratory and expiratory ports with a 22-milimeter (mm) hose followed by placement of a rubber plug on the ventilator connection. Connect the bag mound to the low pressure port on the VT Plus using a test connector and tubing. Set the Adjustable Pressure Limiting (APL) valve to its maximum pressure value and fold the CLIC to the open position. Open the flow control valve until a pressure of 30 mbar is present on the VT Plus low pressure port. Close the flow control valve and time the rate of leakage (as measured on the VT Plus from its low pressure port) for 15 seconds. Pressure differential must be less than 15 mbar and leakage rate must be less than 15 mbar in 15 seconds starting from a 30 mbar baseline.

(b) Remove the test configuration and restore CLIC adapter to a normal

operating lineup by opening the flow control valve. Fold the CLIC to the closed position and set APL valve to a pressure value of 40 to 50 mbar. Disconnect the bag mound, test connector, and tubing from the VT Plus low pressure port. Remove rubber plug from the ventilator and disconnect all 22mm inspiratory and expiratory port hose connections.

d. CLIC adapter maintenance kits provide seals and parts necessary for annual, 2-year

(including all seals furnished in the annual kit), and 4-year servicing intervals. Maintenance kit and other associated part numbers include:

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MX00004) • Annual CLIC adapter maintenance seal kit (part number M36045) • 2-year CLIC adapter maintenance seal kit (part number M35381) • 4-year CLIC adapter replacement (part number MX50090) • Dragersorb® 800-plus disposable CLIC absorber canister (part number • Test Instructions Rev 2.0 Fabius GS/OS/GS Premium (part #9500422)

e. Technical support can be obtained from the following contact sources:

• Draeger Medical Technical Support (800) 437-2437 • Draeger Medical Telford, PA (800) 543-5047, (800) 437-2437

1-22. DRAEGER MEDICAL 6515-01-564-6213: FABIUS TIRO M ALTERNATE OXYGEN CONCENTRATION VERIFICATION SETUP PROCEDURES

a. Steps 4.20.1 and 4.21 of the Fabius Tiro M Preventive Maintenance Checks and

Services manual provide incomplete oxygen concentration verification setup procedures. b. The following alternate setup procedure extrapolated from step 4.7.2 of the Tiro civilian

model and modified for use with the Fabius Tiro M should be utilized when performing oxygen concentration verification:

(1) Remove fresh-gas line from the COZY and place it into the O2 sensor housing. (2) Set unit to Man/Spont mode. (3) Adjust O2 flow to 4 liters per minute (lpm). (4) Press the O2 flush button for 5 seconds. (5) Verify oxygen concentration within a range of 97% to 100%. (6) Set Air flow to 2 lpm. (7) Verify oxygen concentration within a range of 68% to 78%.

c. Enter the oxygen concentration ‘pass/fail’ status on the test result form. Annotate in the

test result form’s ‘Report’ section that an alternate oxygen concentration verification setup procedure was used. An example of an annotated entry would include: ‘Verified steps 4.20.1 and 4.21 using alternate oxygen concentration verification setup procedures based on Tiro civilian model service manual step 4.7.2.’

d. Technical support can be obtained from the following contact sources:

• Draeger Medical Technical Support (800) 437-2437 • Draeger Medical Telford, PA (800) 543-5047, (800) 437-2437

1-23. DRAEGER MEDICAL 6515-01-564-6213: FABIUS TIRO M BATTERY FAILURE

When technicians are servicing Tiro M Anesthesia units they are frequently receiving error messages indicating “Battery Failure”. Unbeknownst to technicians less familiar with the Tiro M, the real culprit is in many instances the 3.15A Battery Fuse.

(1) The Vaporizer must be sent to a manufacturer authorized service center for overhaul every ten years. This service can be obtained through USAMMA.

(2) The flow rate recommended for the Measured Output readings is 4 LPM of Air or Oxygen. When using a flow rate of 4 LPM you are required to wait 2 minutes between readings.

(3) The resistance test is carried out at 4 LPM through the Vaporizer. The difference between the pressure on the input to the Vaporizer at 4 LPM unconnected to the Vaporizer and the pressure on the input to the Vaporizer at 4 LPM connected to the Vaporizer is 9.4 cmH2O +/- 3.4 for an Isoflurane Vaporizer and 10 cmH2O +/- 4 for a Sevoflurane Vaporizer.

1-24. PENLON SIGMA DELTA VAPORIZER SERVICE PROCEDURES

a. Details of how to properly service the Sigma Delta Vaporizer in the operation manual found with the Magellan Anesthesia Apparatus are unclear and vague.

(1) The Vaporizer must be sent to a manufacturer authorized service center for overhaul

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every ten years. This service can be obtained through USAMMA.

(2) The flow rate recommended for the Measured Output readings is 4 LPM of Air or Oxygen. When using a flow rate of 4 LPM you are required to wait 2 minutes between readings.

(3) The resistance test is carried out at 4 LPM through the Vaporizer. The difference between the pressure on the input to the Vaporizer at 4 LPM unconnected to the Vaporizer and the pressure on the input to the Vaporizer at 4 LPM connected to the Vaporizer is 9.4 cmH2O +/- 3.4 for an Isoflurane Vaporizer and 10 cmH2O +/- 4 for a Sevoflurane Vaporizer.

See figure below for example of resistance test set up.

2-1

CHAPTER 2. TMDE UTILIZATION INFORMATION 2-1. ANALYZER, GAS, ANESTHETIC, 6630-01-487-6987

a. The accessory kit provided with the RIKEN meter initially may not have included the

hose assembly that connects between the fresh gas outlet of the Narkomed-M Anesthesia Apparatus and the inlet port of the meter itself. To make this hose assembly, use a fresh gas hose (Draeger Part Number 4108577). Glue the end that connects to the absorber assembly into the small end of the “tee” that comes with the RIKEN meter kit. Attach the white tubing that goes to the RIKEN inlet port to the barb on the “tee.”

b. The equipment manufacturer does not have a replacement part number for the

13/16-inch OD (outside diameter) tubing that goes from the high pressure regulator to the cylinder gauge inside the anesthesia unit. For repairs, this must be purchased locally and cut to fit.

2-2. AUTO SEQUENCES, FLUKE BIOMEDICAL/DNI TEST EQUIPMENT

a. There have been several instances noted in which TMDE that comes with defaulted

auto sequence options are not consistent with the medical equipment OEM’s test procedure and/or standard.

b. Repairers should print a copy of the auto sequence and verify all test procedures

(settings are appropriate and the tolerance is correct) required to properly test the item of equipment IAW the OEM standards. If you discover the auto sequence is incorrect, you may reprogram the auto sequence manually to comply with OEM standards.

c. The two most notable inconsistencies are when testing the Valleylab Force 2

Electrosurgical Unit. In this testing incident, the RF leakage tests set in the TMDE auto sequence uses an open load and should use a 200 ohm load; and the Lifepak 10 Defibrillators tolerance set in the TMDE auto sequence is 15 percent and should be 7 percent.

2-3. CALIBRATOR – ANALYZER (VT-PLUS), 6515-01-491-6615

a. The 754M Ventilator was designed to only communicate with the RT-200 Calibration

Analyzer. The Fluke Biomedical VT-Plus, with the ability to emulate the RT-200, can also be used to calibrate and service the 754M ventilator.

b. Although previous versions of firmware allowed the ability to calibrate the 754M,

repairers were often confused because the screen would request “RT-200 specific” input during the calibration procedure.

c. Recent software revisions for the VT-Plus and VT-Plus-HF are available to assist

repairers with servicing the 754M ventilator with minimal perplexity. The newer revisions provide true “Emulation” thus the software recognizes the VT-Plus as a RT-200 and goes directly into the calibration mode. The software revision number can be found on the warm- up screen, when the unit is first turned on.

(1) For the VT-Plus, Software Revision Number 1.07.03 or higher is recommended. (2) For the VT-Plus-HF, Software Revision Number 1.08.06 or higher is

recommended. (3) Contact Tracy Depot, Medical Support Division, Tracy, California, at one of the

following telephone numbers: DSN 462-4556/Commercial 209-839-4556.

2-4. UNFORS 710L, 6525-01-502-0504, METER X-RAY CALIBRATION

X-Ray reproducibility and standard deviation made easy with the Unfors 710L: (1)

Set the parameter to Dose (R or mR on display). (2) Hold the parameter button for 4 seconds to toggle on “Normalization Mode”. (3) Take an exposure as per the manufacturers procedures for “Reproducibility”. The

Unfors meter will automatically give the value of 1.000 to the first exposure. (4) The deviation value (around the initial exposure) will automatically display after each

exposure. (5) Record the values. (6) Average the decimal portion of each number to give you the Standard Deviation. (7) Hold the parameter button for 4 seconds to toggle off Normalization Mode.

Example:

10-exposure reproducibility test for an Alfa MPDX Dental X-Ray (the standard deviation spec on this unit is <0.02):

10 exposures were taken. The results were: 1.000, 1.002, 1.009, 1.003, 1.008, 1.001, 1.005, 1.000, 1.003, and 1.005.

Add the decimal portion of each exposure (.036) Divide the answer by 10 (.0036) Standard Deviation for the unit is .0036 No calculator or calculus needed.

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APPENDIX A.

EXTERNAL STANDARD OPERATING PROCEDURES MEDICAL MAINTENANCE OPERATIONS DIVISION,

HILL AIRFORCE BASE (AFB), UTAH

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SB 8-75-S6

APPENDIX A. EXTERNAL STANDARD OPERATING PROCEDURES MEDICAL MAINTENANCE OPERATIONS DIVISION HILL AFB, UT

US Army Medical Materiel Agency Medical

Medical Maintenance Management Directorate Maintenance Operations Division

Medical Maintenance Operations Division – Hill AFB Utah External Standing Operating Procedures

MCMR-MMO-MH

1. Purpose

To provide guidance to units and organizations requesting services from the US Army Medical Materiel Agency (USAMMA), Medical Maintenance Management Directorate, Maintenance Operations Division, Medical Maintenance Operations Division – Hill AFB, UT (MMOD-Hill AFB).

2. Scope

These procedures are applicable to all units and activities requesting support.

3. Mission

The USAMMA MMOD-Hill AFB provides depot-level services and functions in support of all field TOE medical equipment (except x-ray). We have the capability to refurbish and rebuild field medical equipment to like-new condition, provide repair and return services, administer a Medical Standby Equipment Program (MEDSTEP) and provide on-site support.

3.1. Hill serves as the regional manager, and your single point of contact to address all of your TOE medical maintenance requirements. The map below depicts Hill’s Region.

A-3

SB 8-75-S6

(continued) APPENDIX A. External Standard Operating Procedures Medical Maintenance Operations Division, Hill AFB, UT

4. Hours of Operation

Our duty hours for the MMOD–Hill AFB are 0500 to 1630 (MT), Monday through Friday. If you need assistance or service for field TOE medical equipment, please contact the following personnel:

Chief 801-586-4947 DSN 586-4947 Shop Supervisor 801-586-4948 DSN 586-4948 Production Control 801-586-4949 DSN 586-4949 Parts Section 801-586-4950 DSN 586-4950 Fax 801-586-5058 DSN 586-5058 Website: http://www.usamma.army.mil/m3d.cfm

5. Services Available

5.1. All maintenance significant medical materiel except high capacity x-rays and optical equipment.

5.2. On-site technical assistance (request must be made to HQ, USAMMA)

5.3. Telephonic technical assistance – Shop Supervisor: (801) 586-4948

5.4. Medical Equipment Standby Program – Production Controller: (801) 586-4949

5.5. Repair of TO&E medical equipment – Shop Supervisor: (801) 586-4948

5.6. Parts support to AMEDD Limited Support Items (ALSI) – Parts Section: (801) 586-4950

6. Requesting Services

6.1. Prior to sending any nonstandard medical equipment, call DSN 586-4949/4947 to ensure that the items can be supported at this division.

6.2. When shipping equipment for repair or service, please use the following address:

US Army Medical Materiel Agency Medical Maintenance Operations Division Medical Support Division-Hill AFB 6149 Wardleigh Road Bldg. 1160, Bay 1 Hill AFB, UT 84056-5848 DODAAC: W81PYK

6.3. The owning or supporting unit is responsible for ensuring that the equipment is cleaned and disinfected prior to shipping the item to our Division for service. Contaminated or unsanitary equipment will be returned to the owning unit with no maintenance action taken.

A-4

SB 8-75-S6

(continued) APPENDIX A. External Standard Operating Procedures Medical Maintenance Operations Division, Hill AFB, UT

6.4. Each equipment item must be shipped and contained with the following:

♦ All accessories needed to operate, test and/or calibrate the unit ♦ Manufacturer’s service literature for non-standard equipment ♦ DA Form 2409 (for manual systems), or a work history printout (for automated systems) ♦ DA Form 2407 containing the following:

Unit name and address DODAAC and UIC Point of contact Commercial/fax telephone numbers Priority Brief description of the problem or requested service

(i.e., repair and return) Note: We request that you contact us prior to shipping non-standard equipment.

6.5. Upon receipt of your equipment, an automated work order will be generated and faxed to your point of contact. Please reference our work order number regarding all inquiries.

6.6. When services are completed, the equipment will be shipped to your return address and POC. A copy of our closed automated work order will be returned with the equipment for updating your unit’s records.

6.7. Equipment that is not economically repairable will be condition coded in accordance with applicable regulations. The owning or supporting unit will be notified for disposition instructions. Equipment items will be returned to your unit or disposed of locally, in which case your unit will be provided a copy of the closed automated work order and a signed copy of the DD Form 1348 for your records.

6.8. Repairs or services that will exceed the Maximum Expenditure Limit (MEL) will require a waiver approved by your organization commander or designee prior to the accomplishment of any repairs or services.

6.9. All units, organizations, facilities or agencies other than active army (P84 and medical P1 funds) are required to reimburse USAMMA for all services. Army National Guard and Army Reserve units are not required to submit funding citations as their respective headquarters provide funds on an annual basis to cover their medical equipment. Funding documentation from other reimbursable customers must include the following:

Document number to include owning DODAAC, UIC, and address Funding citation Authorized amount (amount authorized for service) Point of contact and telephone number Nomenclature of item National stock number, management control number, or non-standard number Model number and quantity sent with serial numbers Any accessories, maintenance manuals, or other materiel that may be required

to perform service on the equipment Identification of all accessories

6.10. On-site maintenance support for field TOE equipment is available from our Division and should be coordinated with us first to ensure availability of manpower and resources. All requests for on-site maintenance support must be through appropriate command channels to the Commander, US Army Medical Materiel Agency, ATTN: MCMR-MMO-MO, 693 Neiman Street, Fort Detrick, MD 21702-5001. Requests must include name and location of the requesting unit and work site, specific requirement to include estimated man-hours, recommendation, and priority from local command.

6.11. On-Site Sustainment Maintenance support for National Guard TO&E medical equipment is available from the MMOD–Hill AFB on an annual basis for the states of UT, ID, KS, MO, NE, IA, MN, WI, WY, CO, MT, AK, ND, SD, MI, IN, IL, and KY. Personnel from our Division will be contacting all USANG TO&E units within these states annually to arrange for specific dates and times for providing service. For this program to be successful, it is essential that our records reflect the most current information for each unit’s point of contact, phone number, e-mail address, unit name, location and UIC. If any of this information has recently changed or your unit has not been contacted by our Division, please contact us at (801) 586-4948/4947 or DSN 586-4948/4947.

7. Repair Parts for Field TOE Equipment

7.1. Repair parts to support equipment for which the manufacturer or other sources will no longer supply parts may be requested from our MMOD–Hill AFB, commercial 801-586-4950/ 4948. All requests will require your unit name, address, DODAAC, point of contact, commercial/fax telephone numbers, the NSN of the end item and the part number(s) of the items requested.

7.2. The USAMMA is in the process of establishing a Centralized Repair Parts Program at the MMOD–Hill AFB for all TO&E Medical Equipment. Depending on the availability of funding, we may be able to assist you with your repair parts requirements. Please call one of our Supply Technicians at COM 801-586-4950/5962 or DSN 586-4950/5962 and they will explain how the process works and what information you will need to provide.

8. Medical Standby Equipment Program (MEDSTEP)

8.1. MEDSTEP assets will not be used to fill equipment shortages, replace uneconomically repairable items or expand operational missions.

8.2. MEDSTEP assets will be requested through our Medical Maintenance Operations Division at commercial 801-586-4949. All requests will require your unit name, address, DODAAC, point of contact, commercial/fax telephone numbers, and a brief description of your requirement.

8.3. The requesting unit is responsible for the care and maintenance of the MEDSTEP item and to ensure the item is cleaned and properly packed prior to returning the item to our Division.

9. Cannibalization Point

The MMOD–Hill AFB maintains unserviceable assets of selected medical equipment for cannibalization. Authorized customers may request parts from cannibalization for mission critical medical equipment when parts are not available from any other source.

Chief, Medical Support Division – Hill AFB, UT USAMMA

SB 8-75-S6

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APPENDIX B.

EXTERNAL STANDARD OPERATING PROCEDURE, MEDICAL MAINTENANCE OPERATIONS DIVISION,

TOBYHANNA, PENNSYLVANIA

B-2

APPENDIX B. EXTERNAL STANDARD OPERATING PROCEDURES, MEDICAL MAINTENANCE OPERATIONS DIVISION, TOBYHANNA, PA

US Army Medical Materiel Agency Medical Maintenance Management Directorate

Maintenance Operations Division Medical Maintenance Operations Division –

Tobyhanna, Pennsylvania External Standing Operating Procedures

MRMC-MMO-MT

1. Purpose

To provide guidance to units and organizations requesting services from the US Army Medical Materiel Agency (USAMMA), Medical Maintenance Management Directorate, Maintenance Operations Division, Medical Maintenance Operations Division – Tobyhanna, PA (MMO-MT).

2. Scope

These procedures are applicable to all units and activities requesting support.

3. Mission

The USAMMA MMOD-Tobyhanna provides depot-level services and functions in support of TDA and TOE medical equipment. In addition to providing outstanding maintenance support for a wide variety of the Army’s medical equipment, we operate USAMMA’s Center of Excellence for the AMEDD’s Diagnostic Imaging Acceptance Program; the physical examination equipment refurbishment and loan program; the Army’s Dental Hand Piece Rebuild Program; the audiometric equipment calibration program; Optical Equipment maintenance; TOE Laboratory Equipment, and PACS acceptance testing and centralized monitor support.

3.1. Tobyhanna serves as the regional manager, and your single point of contact to assist you with all of your medical maintenance support requirements.

3.2. The map below depicts Tobyhanna’s Region.

SB 8-75-S6 (Continued) Appendix B. External Standard Operating Procedures,

Medical Maintenance Operations Division, Tobyhanna, PA

B-3

4. Hours of Operation Normal duty hours are 0630 to 1630 (ET) Monday through Friday. If you need assistance or service please contact the following personnel:

Chief 570 615-7744 DSN 795-7744 Shop Supervisor 570 615-7134 DSN 795-7134 Production Control 570 615-6396 DSN 795-6396 Work Order Status 570 615-7843 DSN 795-7843 Supply 570 615-7614 DSN 795-7614 Fax 570 615-7699 DSN 795-7699 Website: http://www.usamma.army.mil/m3d.cfm

5. Services Available

The MMOD-Tobyhanna has the capability to refurbish and rebuild medical equipment to like-new condition, provide repair and return services, administer a Medical Equipment Standby Equipment Program (MEDSTEP), and provide on-site support. Tobyhanna is also one of three Regional Managers for the AMEDD Maintenance Sustainment Program.

5.1. TO&E Equipment - All TO&E equipment, to include high capacity x-rays and imaging (All versions of Orex, Compano, and ACR 2000 CR Readers).

5.2. TDA Equipment Items – Our TDA equipment maintenance support includes Optical Equipment, Audiometric Equipment, and Dental Hand pieces. Tables 1, 2, and 3 list the respective TDA equipment items that are routinely serviced at Tobyhanna. Equipment items not listed in “services available” or on the USAMMA Maintenance Operations Divisions’ website should not be sent without prior coordination.

TABLE. 1 TDA OPTICAL EQUIPMENT

MICROSCOPES PHOROPTERS LENSOMETERS

Nikon – Labophot 1 & 2 , Eclipse 50i All Marco Marco 101 Olympus – BH series & BX 40 Leica 11625 Leica 21 65 70 All Cambridge All American Optical Nikon – EL-7S All Leica All Reichert Reichert – ML1 All AO

SLIT LAMP VISION TESTER

TOPCON – SL30, SL6E & SL-D7 AFVT 2300

TABLE 2. TDA AUDIOMETRIC EQUIPMENT All Tracor/Tremetrics NOTE: RA 400A supportability is limited. All Maico Beltone – 120 Grason Stadler ( Limited Supportability) – GSI 16, 27, 27A, 28, 33, and 38 Grason Stadler – Tympstar, GSI 61, GSI 17

SB 8-75-S6

(Continued) Appendix B. External Standard Operating Procedures,

Medical Maintenance Operations Division, Tobyhanna, PA

B-4

TABLE 3. DENTAL HANDPIECES Kavo 632, 635, 642, and 643 Lares 557-757 Mid West, XGT Mid West, Shorty-1 and 2-Speed (Slow Speed) Mid West, Tradition (High Speed)

Mid West, Shorty Nose Cone (Fits on Shorty 2-Speed) Mid West, Prophy Angle Mid West, Quiet Air Mid West, 8000 I Star, 430 Star, Titan Scaler

5.3. Assistance Visits: On-site assistance visits will be conducted annually by MMOD-Tobyhanna for National Guard supported units within our region. This will be accomplished by division maintenance teams or arranged maintenance support with other maintenance activities in the state. The Chief/Shop Supervisor, Tobyhanna, will coordinate scheduling of visits. All other assistance visits to include On-Site technical assistance, training, and X-ray acceptance inspection requests will be coordinated through HQ, USAMMA. Please contact the Chief, Medical Maintenance Operations Division, prior to submitting any request for assistance. Any unit desiring an on-site assistance visit with the exception of National Guard units will be required to submit a memorandum to:

US Army Medical Materiel Agency ATTN: MCMR-MMO-MT 693 Neiman Street Fort Detrick, MD 21702-5001

Please contact the Chief, Maintenance Operations Division at 301-619-9780 for further assistance.

5.4. Telephonic technical assistance - Technical experts are available to share their knowledge and experience. They will help diagnose and troubleshoot equipment failures.

5.5. Military Entrance Processing Station (MEPS) Direct Exchange Program - The MMOD- Tobyhanna provides an equipment-direct exchange program for the MEPS. When a piece of equipment fails, the MEPS call us for an exchange replacement. The replacement equipment is sent out immediately to the requesting unit. The unit then sends their broken equipment to us for repair and placement back into the exchange program. This process alleviates the need for any direct MEDDAC/MEDCEN involvement. Table 4 below, is a listing of equipment in the direct exchange program.

TABLE 4. MEPS EQUIPMENT

NSN NOMENCLATURE MODEL MFR

6515-01-C01-0001 Audiometer HT Wizard Tremetrics 6515-01-X18-2319 Bio-Acoustic Sim Oscar VII Quest 6640-01-C03-0017 Centrifuge 225A Fisher 6515-01-C05-0004 EKG LE11 Burdick 6515-01-C05-0005 EKG Atria 3000 Burdick 6540-01-452-8207 Color Vision Tester Optec 900 Stereo Optical

SB 8-75-S6

(Continued) Appendix B. External Standard Operating Procedures, Medical Maintenance Operations Division, Tobyhanna, PA

B-5

NSN NOMENCLATURE MODEL MFR

6530-01-429-4649 Exam Light 48600 Welch Allyn 6650-01-207-0829 Microscope Labophot Nikon 6650-01-325-3747 Microscope Various Amer Optical 6670-01-C19-0036 Digital Scale WB-100A Tanita 6670-01-C19-0032 Digital Scale BWB-627A Tanita 6640-01-375-9031 Vision Tester 2300A & 2300 Stereo Optical 6515-01-C13-0001 Vital Signs Monitor Spot 4200B Welch Allyn

Note: The MMOD-Tobyhanna provides a Direct Exchange Program for selected equipment. To qualify for a DX, the equipment must be the same make and model, and must be repairable. No direct exchange will be complete until both parties are satisfied with the equipment they received.

5.6. Medical Equipment Standby Program (MEDSTEP) - This program is available to provide temporary loaner equipment during long repairs or temporary mission support. MEDSTEP assets may only be utilized to provide temporary replacement for equipment being serviced at the MMOD-Tobyhanna. Our MEDSTEP assets include a variety of end items, components, or assemblies. A list of MEDSTEP assets available at the MMOD-Tobyhanna is published periodically in the SB 8-75 series bulletins. Contact our Supply Section to request MEDSTEP assets.

Note: MEDSTEP equipment may not be used to fill equipment shortages or expand operational missions. Exceptions require command approval. When the owner’s original equipment is received back, the MEDSTEP item, to include all accessories, must be returned to the MMOD- Tobyhanna. Reimbursable customers that use MEDSTEP must provide funds as necessary to restore the MEDSTEP item back to serviceable condition.

5.7. AMEDD Sustainment Maintenance Program - The program is an OTSG/MEDCOM initiative with the USAMMA Medical Maintenance Management Directorate as the action office. USAMMA has operational responsibility for the program and acts as the focal point for all MTOE medical equipment maintenance. This program is designed to provide technical assistance visits to supported activities without organic maintenance capability, or when repairs are beyond their capabilities, manpower limits, or technical expertise. The overall objectives of the AMEDD Maintenance Sustainment Program are to:

a. Increase readiness by ensuring MTOE medical equipment is mission capable. b. Provide visibility of medical equipment status for the Total Army. c. Increase flexibility to cross-level DS/GS sustainment maintenance workload. d. Establish sustainment training for medical equipment repairers. e. Provide a maintenance structure that will accommodate any medical maintenance

related initiative. f. Increase maintenance capability by ensuring efficient use of all maintenance

resources. g. Tobyhanna provides Sustainment Maintenance Support to the following areas:

Alabama Maine North Carolina Tennessee Connecticut Massachusetts Ohio Virginia Delaware Maryland Pennsylvania Virgin Islands District of Columbia New Hampshire Rhode Island Vermont Florida New Jersey Puerto Rico West Virginia Georgia New York South Carolina

5.8. X-ray Acceptance Procedures - Upon completion of an x-ray system installation, the contractor is required to notify the Defense Support Center, Philadelphia (DSCP) that the system is ready for an acceptance inspection. Notification by the contractor should be made

SB 8-75-S6

(Continued) Appendix B. External Standard Operating Procedures, Medical Maintenance Operations Division, Tobyhanna, PA

B-6

in writing to:

Defense Supply Center Philadelphia Medical Directorate - Capital Equipment DSCP-FSDA 700 Robbins Ave. Philadelphia PA 19111

Note: Acceptance inspections cannot be performed by this activity without the approval of the manufacturer and notification from DSCP.

a. Once notification has been received by DSCP that the unit is ready for inspection,

DSCP will in turn notify the appropriate service (U.S. Army, U.S. Air Force or Navy) representative. The U.S. Army Representative at USAMMA/Tobyhanna Army Depot will then contact the facility and notify them that the Government has received an official notice that a Radiology System has been installed and that the facility has 30 working days to complete the inspection. If the facility cannot perform the required inspection they will need to reply back to the representative (USAMMA) that they need assistance to complete the testing and indicate the reasons. If the system passes the inspection then the start date of the warranty will be the date of the original notice sent to DSCP. If the system fails the inspection then the warranty start date will be the date when it passes the re-inspection. If the inspection is not completed within this time frame, then the Government automatically accepts the system under default and the warranty start date is the date of the original notice sent to DSCP.

b. Upon completion of acceptance testing, the report must be forwarded to the address

of paragraph 5.8, above.

c. For the U.S. Army, a copy of the report, along with a completed copy of the FDA 2579 must be sent to:

Medical Maintenance Operations Division ATTN: MCMR-MMO-MT (X-ray Acceptance Testing) Tobyhanna Army Depot 11 Hap Arnold Blvd. Tobyhanna PA 18466-5063

d. Applying for a Variance - Variances to the inspection time frame cannot be

negotiated locally. Requests for variances must be made as early as possible and directed to DSCP-MX prior to the expiration of the established 30 working day inspection period. Requests must state the reason(s) for not complying within the stipulated time frame and the actions, which are desired or required, e.g., time extension.

Note: The local contracting officer technical representative (COTR) might not be aware of the contract requirements and inspection testing procedures. Therefore, it is to the advantage of any activity that will require an acceptance inspection to involve the local clinical engineering activity in new x-ray system installations. Unresolved local problems regarding the installation or inspection of an x-ray system should be directed to DSCP-MX, for resolution by the responsible contracting officer.

5.9. Cannibalization Point - The MMOD-Tobyhanna maintains unserviceable assets of selected medical equipment for cannibalization. Authorized customers may request parts from cannibalization for mission critical medical equipment when parts are not available from any other source.

B-7

SB 8-75-S6 (Continued) Appendix B. External Standard Operating Procedures,

Medical Maintenance Operations Division, Tobyhanna, PA

6. Requesting Services All units, organizations, facilities or agencies other than active army (P84 and medical P1 funds) are required to reimburse USAMMA for all services. Army National Guard and Army Reserve units are not required to submit funding citations as their respective headquarters provide funds on an annual basis to cover their medical equipment. Funding documentation from other reimbursable customers must include the following:

a. Document number to include owning DODAAC, UIC and address b. Funding citation. c. Authorized amount (amount authorized for service). d. Point of contact and telephone number. e. Nomenclature of item. f. National stock number, management control number, or non-standard number. g. Model number and quantity sent with serial numbers. h. Any accessories, maintenance manuals, or other materiel that may be required to

perform service on the equipment. i. Identification of all accessories.

6.1. Preparing the Equipment - Prior to sending any nonstandard medical equipment not listed in the table above, call DSN 795-6396 to ensure that the items can be supported at this division.

a. Infection Control - is primarily the responsibility of the activity requesting equipment

repair or maintenance service. Equipment must be cleaned and disinfected to the maximum extent possible prior to shipment to or receipt by this maintenance division. We retain the right to refuse equipment that has not been properly cleaned and disinfected.

b. Hazardous Waste - Equipment, which contains hazardous waste, must be disposed

of in accordance with federal and local laws. It is the responsibility of the activity requesting service to dispose of hazardous waste prior to shipment to or acceptance by this Division.

c. Packing/Transport - Equipment should be packed to prevent further damage during

shipment/transport.

Note: Each individual item of equipment excluding dental handpieces will have its own DA Form 2407 (Work Order Request).

6.2. Preparing the Paper Work - All customers may request maintenance services by submitting either a DA Form 2407 (or automated equivalent). Requests for high priority work (Priority 03) must be authenticated by the Unit Commander or a person designated by the Unit Commander. Work requests submitted without authentication for higher priority will be handled as routine.

6.3. Sending/Delivering the Equipment/Paperwork - Items can be mailed, shipped, or delivered to the address listed below. When equipment is received at the maintenance division, the following items will be checked:

a. Shipping document (if item is received via mail, UPS, or FedEx). b. Damage from shipping or handling. c. Cleanliness. d. Properly completed DA Form 2407 or equivalent. e. Equipment accessories.

Note: Accessories sent along with equipment should be annotated on the work request. Failure to complete paper work or prepare equipment properly may cause a delay in

service. When shipping or delivering equipment for repair, please ensure the manufacturer's literature (operation & service) is included. If literature is unavailable, every effort should be made to obtain it prior to shipment of the equipment.

f. When shipping equipment for servicing please use the following address:

US Army Medical Materiel Agency Maintenance Operations Division Medical Maintenance Operations Division - Tobyhanna Warehouse 4, Bay 1 Tobyhanna Army Depot Tobyhanna PA 18466-5063 DODAAC: W25AT5

6.4. Questions concerning funding or fund citations may be answered by calling the Production Controller at 570-615-6396 or DSN 795-6396.

6.5. All customers may request maintenance services by submitting either a DA Form 2407 (or automated equivalent), DD Form 1348-1 or DD Form 1149 shipping documents.

6.6. All equipment that comes in reusable containers should be shipped in those containers. All other equipment should be properly packaged so that no further damage will occur. Place a copy of the maintenance request inside the container with the equipment.

6.7. Accessories and maintenance manuals must be sent with the equipment to prevent delays in the repair or service. All accessories sent with the equipment shall be indicated in the remarks section of the shipping document.

6.8. The Maintenance Expenditures Limit (MEL) shall be included in the remarks section of the shipping form. Failure to include the MEL will result in delays.

6.9. When active army units submit equipment that belongs to a serviced unit, the owning units address and UIC will be annotated in the remarks section of the shipping document.

6.10. Equipment items not listed in services available or on the USAMMA maintenance website should not be sent without prior coordination.

6.11. The USAMMA MMOD-Tobyhanna is not responsible for billing customers. For questions concerning billing please call USAMMA’s Medical Maintenance Management Directorate at 301-619-4368 or DSN 343-4368.

Chief, Medical Maintenance Operations Division – Tobyhanna, Pennsylvania USAMMA

SB 8-75-S6

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APPENDIX C.

EXTERNAL STANDARD OPERATING PROCEDURES, MEDICAL MAINTENANCE OPERATIONS DIVISION,

TRACY, CALIFORNIA

SB 8-75-S6

C-2

Appendix C. External Standard Operating Procedures, MEDICAL MAINTENANANCE OPERATIONS DIVISION, TRACY, CA

US Army Medical Material Agency

Medical Maintenance Management Directorate Maintenance Operations Division

Medical Maintenance Operations Division – Tracy, California

External Standing Operating Procedures

MCMR-MMO-MR

1. Purpose

To provide guidance to units and organizations requesting services from the US Army Medical Materiel Agency (USAMMA), Medical Maintenance Management Directorate, Maintenance Operations Division, Medical Maintenance Operations Division-California (MMOD-California) at Defense Distribution Center, Tracy Location, Tracy, CA 95304-9150.

2. Scope

These procedures are applicable to all units and activities requesting support.

3. Mission

The USAMMA MMOD-Tracy, provides depot-level services and functions in support TOE medical equipment specializing in x-ray equipment and Special Purpose Test Measurement Diagnostic Equipment (TMDE-SP).

3.1 Tracy serves as the regional manager for all medical TOE except optical and

audiometer equipment. The map below depicts Tracy’s Region.

SB 8-75-S6

(Continued) Appendix C. External Standard Operating Procedures, Medical Maintenance Operations Division, Tracy, CA

C-3

4. Hours of Operation

Normal duty hours are 0450 to 1520 (PT) daily Monday through Friday, excluding holidays. A telephone recorder is available on DSN 462-4557 or commercial 209-839-4557 and will record messages after duty hours. When leaving messages please speak clearly so your message will be understood. If you require a response, leave your name, telephone number, and the work order number, if available. Recorded calls will be responded to on the following workday.

POSITION

COMMERCIAL

DSN

Chief 209 839-4556 462-4556

Shop Supervisor 209 839-4560 462-4560

Production Control 209 839-4557 462-4557

Fax 209 839-4563 462-4563 Website: http://www.usamma.army.mil/m3d.cfm

5. Services Provided

5.1 Assistance Visits: On-site assistance visits will be conducted annually by Tracy Division for National Guard supported units within our region. This will be accomplished by division maintenance teams or arranged maintenance support with other maintenance activities in the state. The Chief/Shop Supervisor, Tracy Division, will coordinate the scheduling of visits. All other assistance visits to include On-Site technical assistance, training and X-ray acceptance inspection requests will be coordinate through HQ, USAMMA. Please contact the Chief, Maintenance Operations Division prior to submitting any request for assistance. Any unit desiring an on-site assistance visit with the exception of National Guard units will be required to submit a memorandum to:

US Army Medical Materiel Agency ATTN: MCMR-MMO-MO 693 Neiman Street Fort Detrick, MD 21702-5001

5.2. Depot level services for all TOE except for optical and audiometer equipment.

5.3. Telephonic technical assistance.

5.4. Repair and Return services all TOE except optical and audiometer equipment.

5.5. Calibrate and repair special purpose test, measurement, and diagnostic equipment

(TMDE-SP) listed in Table 1, below.

SB 8-75-S6

(Continued) Appendix C. External Standard Operating Procedures, Medical Maintenance Operations Division, Tracy, CA

C-4

Table 1. TMDE Listing for Maintenance

Item/ Nomenclature NSN Model

T.M

.D.E

. SP (

Specia

l Purp

ose)

Meter, X-Ray Calibration Multimeter, Radiographic X-ray Calibration & Verification System

6525-01-502-0504 6525-01-387-0212 6625-01-312-0894

UNFORS 710-L PMX-III Victoreen 07/457/472/473

Gas Flow Analyzer Calibrator, Gas Flow

6515-01-491-6615 6695-01-255-2855

VT-Plus/ VT-Plus HF RT-200

Anesthetic Gas Analyzer 6630-01-487-6987 Riken 1802D

Analyzer, NIBP 6515-01-449-1423

Cufflink

IV Pump Analyzer 6515-01-449-2331 6515-01-479-2355

IPT-1 IDA-4

Defibrillator Analyzer Tester, Defibrillator

6515-01-499-1420 6625-00-433-9063

Impulse 4000 DT2000A

Densitometer, SU150/P

6525-01-161-1945

07-423

Simulator, Medical Function Calibrator Generator, ECG

6625-01-298-3830 6625-01-286-2741 6515-01-049-9449

215M 217A ECG 100

Foot Candle Meter 6695-01-303-0294 9-118 Thermometer, Dig.

6685-01-292-7873

51-II

Oscilloscope, Digital 6525-01-448-9577 THS720P

Wattmeter, Ultrasound Therapy 6625-01-504-2654 6625-01-141-7357 6625-01-487-6986

UW-4 UMR3-C UMR 3-D

Simulator, Pulse Oximeter 6515-01-504-8537 6515-01-499-1422

INDEX 2 Cardiosat

Tachometer, Stroboscopic 6680-01-307-6190 6680-00-243-9977

1893A 1726

Test Set, Electro-surgical 6515-01-438-2409 6625-01-042-8213

454A RF302

Tester, Current Leakage 6625-01-142-8233 6625-01-207-8270

232M 232D

Tester, Ventilator 6515-01-449-1421 Pneuview 3600i

C-5

SB 8-75-S6

(Continued) Appendix C. External Standard Operating Procedures, Medical Maintenance Operations Division, Tracy, CA

5.5.1 TMDE-SP Calibrated or Verified at Tracy

If listed as Verify/Original Equipment Manufacturer (OEM), Tracy will verify and if within calibration, will complete. If item is out of calibration and needs adjustment, the item will be sent to OEM for repair and calibration. If listed as Calibrate/OEM Tracy will make adjustments to bring item within calibration. If unable to bring within tolerance, Tracy will send to OEM for repair and calibration.

Item/ Nomenclature Model Service

Meter X-Ray Calibration UNFORS 710-L Verify/OEM Multimeter Radiographic PMX-III Verify/OEM X-Ray Calibration & Verification System Victoreen 07/459/472/473 Calibrate Gas Flow Analyzer VT-Plus Verify/OEM Calibrator Gas Flow RT-200 Calibrate/OEM

Anesthetic Gas Analyzer Riken 1802D Verify/OEM Analyzer NIBP Cufflink Calibrate IV Pump Analyzer IPT-1 and IDA-4 Calibrate Defibrillator Analyzer TPA Impulse 4000 Calibrate Tester Defibrillator DT2000A Calibrate

Densitometer, SU150/P 07-423 Calibrate Simulator, Medical Function 215M, 217A Calibrate Calibrator Generator, ECG ECG 100 Calibrate Computer, Laptop Various Load Software Foot Candle Meter 9-118 Calibrate

Thermometer, Digital 51 II Calibrate

Oscilloscope, Digital THS720P Send out to TSC Or OEM 100%

Wattmeter, Ultrasound Therapy UW-4 Calibrate Wattmeter, Ultrasound Therapy UMR 3-C Calibrate Wattmeter, Ultrasound Therapy UMR 4-D Calibrate

Simulator, Pulse Oximetry INDEX 2M FE Calibrate Simulator, Pulse Oximetry Cardiosat EF Calibrate Tachometer, Stroboscopic 1893A, Calibrate Tachometer, Stroboscopic 1726 Calibrate Test Cassette, X-Ray 07-467 Calibrate

Test set, Electrosurgical 454A and RF302 Calibrate Tester Current Leakage 232M and 232D Calibrate Tester, Ventilator Pneuview 36000I Calibrate

5.5.2 Test Measurement, and Diagnostic Equipment (TMDE)

All field medical unit special purpose TMDE-SP such as defibrillator testers, patient simulators, electro surgical test sets, and x-ray calibration sets are supported with repair and calibration services. To maintain capability when TMDE-SP is turned in for repair or calibration a like item may be borrowed, if available.

5.6 Direct Exchange of X-ray Tube Heads

An exchange for x-ray tubes may be requested by calling customer assistance at DSN 462-4560/ 4556 or commercial 209-839-4560/4556. A questionnaire will be faxed to your activity to

SB 8-75-S6

(Continued) Appendix C. External Standard Operating Procedures, Medical Maintenance Operations Division, Tracy, CA

C-6

determine the appropriate information for the exchange. Tracy division rebuilds or provides a direct exchange for the following types of x-ray tube heads:

National Stock Number (NSN)

Tube Type

6525-00-C95-9590 Picker PX1300 Series

6525-00-C95-9600 Picker PX1400 Series

6525-00-C95-9560 Eureka Emerald 125 Series

6525-00-C95-9550 Eureka Sapphire 150th Series

6525-00-C95-9570 Eureka Diamond 150th Series

6525-00-C95-9785 Philips ROT 350-10

6525-00-C95-9630 G.E. Maxiray 75

6525-00-C95-9640 G.E. Maxiray 100

6525-00-C95-9640 G.E. Maxiray 100 Flouro

6525-01-328-3430 Dynarad/Port-A-Ray 1200

6. Requesting Services

6.1. Prior to sending any nonstandard medical equipment, call DSN 462-4557 to ensure that the items can be supported at this division.

6.2 When shipping equipment for repair or service, please use the following address:

US Army Medical Materiel Agency Medical Support Division - California Building T-255 25600 South Chrisman Road Tracy, CA 95304-9150 DODAAC: W62SEV

6.3. All units, organizations, facilities or agencies other than Active Army (P84 and medical P1 funded) are required to reimburse USAMMA for all services. Army National Guard and US Army Reserve units are not required to submit fund citations as their respective headquarters provide funds on an annual basis to cover their medical equipment. Funding documentation from other reimbursable customers must include the following:

* Document number to include owning DODAAC or UIC, and address

* Funding citation

* Authorized funding (amount authorized for service)

* Point of contact and telephone number * Nomenclature of item * National stock number, management control number, or non-standard number

* Quantity of items to include serial numbers

* Any accessories, maintenance manuals, or other materiel which may be required to perform services on the equipment

* Identification of all accessories

6.4 Questions concerning funding or fund citations may be answered by calling DSN

462-4557 or commercial 209 839-4557.

6.5. All customers may request maintenance services on their medical equipment by submitting either a DA Form 2407 (or the automated equivalent) or DD Form 1348-1, Shipping Document. TMDE-SP equipment must include DA7372, POC and a return address.

6.6. All equipment that has reusable containers will be shipped in those containers. If

equipment does not have reusable container equipment will be packed so that no further damage can occur.

6.7. Place a copy of the document being used as the maintenance request inside the

shipping container with the equipment. The transportation personnel or the commercial carrier often removes documents placed on the outside of the container.

6.8. Accessories and maintenance manuals must be sent with the equipment to prevent

delays in the repair or service. All accessories or materials sent with the equipment shall be indicated in the remarks section of the DA Form 2407 and DD Form 1348-1 or by other documentation.

6.9. The Maintenance Expenditure Limit (MEL) shall be included in the remarks section of

either the DA Form 2407 or DD Form 1348-1. Failure to include the MEL will result in delay of repairs.

6.10. When Active Army units submit equipment to the MMOD-Tracy that belongs to

another unit, the owning unit, address, UIC, and DODAAC will be given in the remarks section of either the DA Form 2407 or DD Form 1348-1. Unless otherwise specified, after repairs are completed the equipment will be returned to the owning unit.

6.11. Equipment items not listed in paragraph 5 entitled, “Services” of this SOP or on

the USAMMA Maintenance website should not be sent without prior coordination.

6.12. The USAMMA MMOD-Tracy is not responsible for billing reimbursable customers. For questions concerning billing call USAMMA's Resources Management Division at DSN 343-2111 or commercial 301-619-2111.

6.13. Any questions regarding MMOD-Tracy's services, work order status, complaints,

technical assistance or general information may be answered by calling DSN 462-4557/4556/4560 or commercial 209 839-4557/4556/4560. Please have the serial number of equipment item and work order number available when you call.

7. Direct Exchange of X-ray Tube Heads

An exchange for x-ray tubes may be requested by calling customer assistance at DSN 462- 4560/4556 or commercial (209) 839-4560/4556. A questionnaire will be faxed to your activity to determine the appropriate information for the exchange.

8. Medical Standby Equipment Program

The USAMMA MMOD-Tracy provides a Medical Standby Equipment Program (MEDSTEP) for selected x-ray equipment. A list of the MEDSTEP assets available at the MMOD-Tracy is published periodically in the SB 8-75 Series Supply Bulletins. MEDSTEP assets may only be utilized to provide serviceable temporary replacement for equipment being serviced at the MMOD-Tracy. The USAMMA Maintenance Operations Division must approve exceptions. Exceptions may be requested telephonically by calling DSN 343-9780 or commercial 301-619-9780. Once the owner’s original equipment is received back, the MEDSTEP item, to include all

SB 8-75-S6

C-4

accessories, must be returned to the MMOD-Tracy. Reimbursable customers that use MEDSTEP must provide funds as necessary to restore the MEDSTEP item back to serviceable condition.

9. Cannibalization Point

The USAMMA MMOD-Tracy maintains unserviceable assets of selected medical equipment for cannibalization. Authorized customers may request parts from Cannibalization for mission critical medical equipment when parts are not available from any other source.

10. Training

Training for the repair and calibration of various x-ray equipment is available. Training is tailored to meet your requirements. Training can be provided either in your facility or in the Division facilities. On-site training costs are based upon travel, per diem, the labor rate and training hours. Contact us about your needs at DSN 462-4556 or commercial 209- 839-4556.

Chief, Medical Support Division - Tracy USAMMA

SB 8-75-S6

D-1

APPENDIX D.

TABLES OF SPECIAL PURPOSE, TEST, MEASUREMENT, AND DIAGNOSTIC EQUIPMENT (TMDE-SP)

SB 8-75-S6

APPENDIX D. TABLES OF SPECIAL PURPOSE TEST, MEASUREMENT, AND DIAGNOSTIC EQUIPMENT (TMDE-SP)

D-2

TABLE 1. COMBAT SUPPORT HOSPITAL, MEDICAL COMPANY FSC Component Material Description SLIN Comp unit Quantity

6515 01-449-1421 TESTER VENTILATOR PTB T05633 EA 1

6515 01-449-1423 ANALYZER NONINVAS BLD A27104 EA 1

6515 01-535-2790 SIMULATOR SENSOR N/A EA 1

6515 01-536-2122 ANALYZ IV INFU PUMP J24245 EA 1

6515 01-541-0432 TESTER PULSE OXIMETER S57953 EA 1

6515 01-541-2864 ANALYZER GAS FLOW C61523 EA 1

6515 01-546-0561 KIT CALIBRATION ANE N/A KT 1

6515 01-564-8554 ANALYZER ELECTROSURG T90883 EA 1

6515 01-575-2825 ANALYZER DEFIB EKG A83433 EA 1

6525 01-502-0504 METER X-RAY CALIBRA C05856 EA 1

6530 01-546-1369 KIT CALIBRATION VEN N/A KT 1

6625 01-513-7811 OSCILLOSCOPE N/A EA 1

6625 01-548-3352 SIMULATOR CARDIAC S56720 EA 1

6625 01-550-3339 TACHOM DIGITAL T07421 EA 1

6625 01-577-6744 TESTER SAFETY ELECT N/A EA 1

6630 01-530-7959 ANALYZER GAS PRTBLE A00098 EA 1

6685 01-292-7873 THERMOMETER SELF-INDI N/A EA 1

6695 01-574-8935 METER ILLUMINATION N/A EA 1

6695 01-575-6270 METER ULTRASOUND R95994 EA 1

8145 01-535-7927 SHIPPING AND STORAG N/A EA 2

8145 01-535-8067 SHIPPING AND STORAG N/A EA 2

8145 01-535-8237 SHIPPING AND STORAG N/A EA 1

TABLE 2. MEDICAL COMPANY W/68A AUTHORIZATION

FSC 6515

Component

01-449-1421

Material Description

TESTER VENTILATOR PTB

SLIN

T05633

Comp Unit

EA

Quantity

1

6515 01-449-1423 ANALYZER NONINVAS BLD A27104 EA 1

6515 01-535-2790 SIMULATOR SENSOR N/A EA 1

6515 01-536-2122 ANALYZ IV INFU PUMP J24245 EA 1

6515 01-541-0432 TESTER PULSE OXIMETER S57953 EA 1

6515 01-541-2864 ANALYZER GAS FLOW C61523 EA 1

6515 01-575-2825 ANALYZER DEFIB EKG A83433 EA 1

6525 01-502-0504 METER X-RAY CALIBRA C05856 EA 1

6530 01-546-1369 KIT CALIBRATION VEN N/A KT 1

6625 01-513-7811 OSCILLOSCOPE N/A EA 1

(Continued) TABLE 2. MEDICAL COMPANY W/68A AUTHORIZATION

FSC 6625

Component

01-548-3352

Material Description

SIMULATOR CARDIAC

SLIN

S56720

Comp unit

EA

Quantity

1

6625 01-550-3339 TACHOM DIGITAL T07421 EA 1

6625 01-577-6744 TESTER SAFETY ELECT N/A EA 1

6685 01-292-7873 THERMOMETER SELF-INDI N/A EA 1

6695 01-574-8935 METER ILLUMINATION N/A EA 1

8145 01-535-7927 SHIPPING AND STORAG N/A EA 2

8145 01-535-8067 SHIPPING AND STORAG N/A EA 2

8145 01-535-8237 SHIPPING AND STORAG N/A EA 1

TABLE 3. MEDLOG BN (FORWARD)

FSC 6515

Component

01-449-1421

Material Description

TESTER VENTILATOR PTB

SLIN

T05633

Comp unit

EA

Quantity

4

6515 01-449-1423 ANALYZER NONINVAS BLD A27104 EA 4

6515 01-535-2790 SIMULATOR SENSOR N/A EA 4

6515 01-536-2122 ANALYZ IV INFU PUMP J24245 EA 2

6515 01-541-0432 TESTER PULSE OXIMETER S57953 EA 4

6515 01-541-2864 ANALYZER GAS FLOW C61523 EA 4

6515 01-546-0561 KIT CALIBRATION ANE N/A KT 2

6515 01-564-8554 ANALYZER ELECTROSURG T90883 EA 4

6515 01-575-2825 ANALYZER DEFIB EKG A83433 EA 4

6525 01-502-0504 METER X-RAY CALIBRA C05856 EA 4

6530 01-546-1369 KIT CALIBRATION VEN N/A KT 2

6625 01-513-7811 OSCILLOSCOPE N/A EA 11

6625 01-548-3352 SIMULATOR CARDIAC S56720 EA 4

6625 01-550-3339 TACHOM DIGITAL T07421 EA 1

6625 01-577-6744 TESTER SAFETY ELECT N/A EA 4

6630 01-530-7959 ANALYZER GAS PRTBLE A00098 EA 2

6685 01-292-7873 THERMOMETER SELF-INDI N/A EA 4

6695 01-574-8935 METER ILLUMINATION N/A EA 4

6695 01-575-6270 METER ULTRASOUND R95994 EA 4

8145 01-535-7927 SHIPPING AND STORAG N/A EA 8

8145 01-535-8067 SHIPPING AND STORAG N/A EA 8

8145 01-535-8237 SHIPPING AND STORAG N/A EA 4

SB 8-75-S6

APPENDIX D. TABLES OF SPECIAL PURPOSE TEST, MEASUREMENT, AND DIAGNOSTIC EQUIPMENT (TMDE-SP)

D-2

FSC

Component

TABLE 4. MEDLOG BN (REAR)

Material Description

SLIN

Comp Unit

Quantity

6515 01-449-1421 TESTER VENTILATOR PTB T05633 EA 4

6515 01-449-1423 ANALYZER NONINVAS BLD A27104 EA 4

6515 01-535-2790 SIMULATOR SENSOR N/A EA 4

6515 01-536-2122 ANALYZ IV INFU PUMP J24245 EA 2

6515 01-541-0432 TESTER PULSE OXIMETER S57953 EA 4

6515 01-541-2864 ANALYZER GAS FLOW C61523 EA 4

6515 01-546-0561 KIT CALIBRATION ANE N/A KT 2

6515 01-564-8554 ANALYZER ELECTROSURG T90883 EA 4

6515 01-575-2825 ANALYZER DEFIB EKG A83433 EA 4

6525 01-502-0504 METER X-RAY CALIBRA C05856 EA 4

6530 01-546-1369 KIT CALIBRATION VEN N/A KT 2

6625 01-513-7811 OSCILLOSCOPE N/A EA 11

6625 01-548-3352 SIMULATOR CARDIAC S56720 EA 4

6625 01-550-3339 TACHOM DIGITAL T07421 EA 1

6625 01-577-6744 TESTER SAFETY ELECT N/A EA 4

6630 01-530-7959 ANALYZER GAS PRTBLE A00098 EA 2

6685 01-292-7873 THERMOMETER SELF-INDI N/A EA 4

6695 01-574-8935 METER ILLUMINATION N/A EA 4

6695 01-575-6270 METER ULTRASOUND R95994 EA 4

8145 01-535-7927 SHIPPING AND STORAG N/A EA 8

8145 01-535-8067 SHIPPING AND STORAG N/A EA 8

8145 01-535-8237 SHIPPING AND STORAG N/A EA 4

TABLE 5. DENTAL COMPANY w/68A AUTHORIZATION

FSC

Component

Material Description

SLIN Comp unit Quantity

6525

01-502-0504

METER X-RAY CALIBRA

C05856 EA 1

6625 01-513-7811 OSCILLOSCOPE N/A EA 1

6625 01-577-6744 TESTER SAFETY ELECT N/A EA 1

6685 01-292-7873 THERMOMETER SELF-INDI N/A EA 1

8145 01-535-7927 SHIPPING AND STORAG N/A EA 2

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E-1

APPENDIX E.

Battery Failure for Draeger Fabius Tiro/Tiro M

‘Battery Failure’ for Draeger Fabius Tiro/Tiro M’s in Storage Author: Electronics Technician, CBET

Scenario: A Tiro M is pulled out of storage for scheduled maintenance by a technician who is unfamiliar with the unit. The Tiro is plugged in, turned on and runs its power on self-tests (POSTs). The last test indicates a ‘Battery Failure’. The unit is charged overnight and the ‘Battery Failure’ is still indicated. A call to the manufacturer, Draeger, results in new batteries being ordered, charged overnight and yet the battery failure persists. Culprit: The 3.15A Battery Fuse. Battery backup power for the Fabius Tiro and Tiro M is provided by two series-connected 12V rechargeable batteries. These batteries remain on charge as long as the machine is plugged into an active AC outlet AND the battery fuse is in place. The 3.15A battery fuse is located on the power entry panel on the back of the machine. Background: Per the manufacturer’s literature, when Tiros go into storage the fuse is to be removed in order to maximize battery life. When the unit is unplugged and the fuse removed, a long (approx. 60 seconds) audible buzz is emitted. Some techs remember to do it and some don't. While removed, the fuse is supposed to be stored in a fuse holder located on the rear, removable dust cover. The fuse is for the battery charging/monitoring circuit and if it is missing the unit will still work on AC but will fail the battery self-test and will not operate on battery backup power (a potential patient safety issue).

Even a call to the manufacturer has been known to result in overlooking the missing battery fuse. Conclusion: Widespread training for maintenance technicians on the proper storage of the Draeger Fabius Tiro and Tiro M’s will alleviate much frustration as well as save a lot of time and, ultimately, money.

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APPENDIX F.

MEDICAL EQUIPMENT MMQC MESSAGES CONTENT AND BIOMEDICAL EQUIPMENT REPAIRER

RESPONSIBILITY FOR ACTION

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APPENDIX F. Medical Equipment MMQC Message Content and Biomedical Equipment Repairer Responsibility for Action

F-2

The following is an example of a MMQC message:

DOD Medical Materiel Quality Control Messages (MMQC)/Medical Materiel Information Messages (MMI) & Images

Medical Material Quality Control Message

MMQC-13-1362

Message Number: MMQC-13-1362

Released On: 23-APR-13

Message Class: Class III

Material Type: Equipment

Message Reference:

Subject:

Olympus SurgMaster UES-40 Electrosurgical Unit / Olympus America Inc., / Shirakawa Olympus Co., / DLA 13-166

Reason / Information:

Olympus issued a recall on the following materiel on 10 November 2009. Reason: Due to complaints of overheating, smoke vapors and failure to operate associated with the Olympus SurgMaster electrosurgical unit, mode UES-40 ("UES-40") when used in conjunction with the Olympus WA22557C electrode. The complaint investigations revealed that some users were exceeding the maximum output time beyond the timeframes specified in the labeling. Exceeding the maximum output time can cause the UES-40 to overheat thereby causing the unit to stop working and produce smoke vapors.

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APPENDIX F. Medical Equipment MMQC Message Content and Biomedical Equipment Repairer Responsibility for Action

F-3

Disposition / Instructions:

Olympus initiated their field corrective action on 10 November 2009 by sending a letter to consignees. Consignees were directed to contact Gyrus at 888-524-7266 to schedule return of the UES-40 generator for the software upgrade. The letter also directed consignees to contact OAI Customer Service at 800-848-9024 if they needed a new copy of the UES-40 Instruction Manual. Complete Field Corrective Action form and fax to 484-896-7128 (See Image on Message under Additional Documentation/Attachments). Questions, call 484-896-5688. Note: Materiel distributed from 01 April 2004 to 30 August 2009.

Item Information:

NSN (FSC-NIIN): 6515 - NS1

Nomenclature: OLYMPUS SURGMASTER UES-40 ELECTROSURGICAL UNIT; MODEL #UES-40

UI: EA

Manufacturer: SHIRAKAWA OLYMPUS CO

Distributor: LOT / SN: ALL

Service/Additional Instructions:

ARMY: Army activities in possession of subject equipment are required to report the status of their work to the USAMMA NMP NLT 23 MAY 2013. This can be accomplished by visiting the Army MMQC Equipment Status Reporting website. Complete and Submit the on-line form. For Questions or Comments, contact: USAMMA NMP

Email: USARMY.DETRICK.MEDCOM-USAMMA.MBX.NMP-MMQC@MAIL.MIL

Phone (COMM): 301-619-6648/4464/3170

Phone (DSN): 343-6648/4464/3170

POC Contact Information:

ARMY:

Email: QUADSERVICEMMQC@AMEDD.ARMY.MIL

Phone (COMM): 301-619-4300

Phone (DSN): 343-4300

Fax: 301-619-4468

AIR FORCE:

Email: AFMOA.SGALC@DETRICK.AF.MIL

Phone (COMM): 301-619-4170

Phone (DSN): 343-4170

Fax: 301-619-2557

NAVY:

Email: MMQC2@MED.NAVY.MIL

Phone (COMM): 301-619-3085

Phone (DSN): 343-3085

Fax: 301-619-2473

USAMMC-E:

Email: USAMMCE_QA@AMEDD.ARMY.MIL

Phone (COMM): 011-49-6331-86-7118/7181

Phone (DSN): 495-7118

Fax: 6218

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APPENDIX F. Medical Equipment MMQC Message Content and Biomedical Equipment Repairer Responsibility for Action

F-3

Additional Message Recipients:

Please ensure dissemination of this information to the following:

Command Channels Medical Log Officers Medical Maintenance Supply Officers Supported Activities/Centers

Message Dissemination Authorization

DOD: DODD 5105.22 and DODD 6025.13 ARMY: See Army Regulation (Ar) 40-61, 28 January 2005, Chapter 4, And The Department Of The Army Supply Bulletin (Sb 8-75-11) For Applicable Policies And Procedures. AIR FORCE: AF Activities Will Take Action As Prescribed In Afi 41-209, Medical Logistics Support, Chapters 3 And 9. For Majcoms & Ngb--This Msg Has Been Transmitted To All Designated Subordinate Medical Activities.

Additional Documentation / Attachments

MMQC-13-1362_1.pdf

*** END OF MESSAGE ***

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2014 INDEX FOR DA SB 8-75-S6

IN-1

Subject SB 8-75- Page

Abbott Point of Care Bi-Annual i-STAT Update Distribution Provisioning Changes ............................................................................................ S6 1-12 Addresses of Maintenance Divisions ............................................................... S6 1-3 AMEDD Two-Level Maintenance (TLM) ............................................................ S6 1-9 Analyzer, Gas, Anesthetic, 6630-01-487-6987 ................................................ S6 2-1 Auto Sequences, Fluke Biomedical/DNI Test Equipment ................................... S6 2-1 Availability of Maintenance Publications .......................................................... S6 1-4

Battery Failure for Draeger Fabius Tiro/Tiro M’s in Storage ............................... S6 E-1 Calibrator – Analyzer (VT-Plus), 6515-01-491-6615 ........................................ S6 2-1 Centralized Diagnostic Therapeutic Radiation Producing Device (DTRPD) Supportability ........................................................................................... S6 1-11

Defense Reutilization Management Office (DRMO) .......................................... S6 1-8 Draeger Medical, 6515-01-457-1840: Faulty Internal Oxygen Regulator Piping Configuration ................................................................................... S6 1-12 Draeger Medical, 6515-01-502-2117: Anesthetic Sample Flow-Rate Corrections ........................................................................................................... S6 1-13 Draeger Medical, 6515-01-564-6213: Fabius Tiro M Anesthesia Apparatus, CLIC Adapter Absorber Assembly ................................................................. S6 1-14 Fabius Tiro M Alternate Oxygen Concentration Verification Setup Procedures ... S6 1-15 Battery Failure .......................................................................................... S6 1-15 External Standard Operating Procedures, Medical Maintenance Operations Division, Hill AFB, UT ................................................................. S6 A-1 External Standard Operating Procedures, Medical Maintenance Operations Division, Tobyhanna, PA ............................................................. S6 B-1 External Standard Operating Procedures, Medical Maintenance Operations Division, Tracy, CA .................................................................... S6 C-1

Inscribing Equipment ................................................................................... S6 1-4

Line-Voltage and Line-Loss Problems ............................................................. S6 1-5

Maintenance Master Data File ....................................................................... S6 1-10 Maintenance Operations Division (MOD) Contact Information ........................... S6 1-1 Medical Equipment Service Literature Support ............................................... S6 1-8 Medical Equipment Maintenance Support ....................................................... S6 1-2 Medical Maintenance Support Information ...................................................... S6 1-1 Medical Materiel Quality Control (MMQC) Program .......................................... S6 1-8 MMQC Message Example .............................................................................. S6 F-1

National Maintenance Program (NMP) Contact Information ............................... S6 1-1

Penlon Sigma Delta Vaporizer Service Procedures ............................................ S6 1-16

Storage and Shipping Containers .................................................................. S6 1-4

Subject SB 8-75- Page Tables of Special Purpose Test, Measurement, and Diagnostic Equipment (TMDE-SP) ................................................................................................ S6 D-1 Test, Measurement, And Diagnostic Equipment (TMDE) Authorizations .............. S6 1-9 The USAMMA Medical Maintenance Management Directorate Contact Information............................................................................................... S6 1-1 TMDE Utilization Information ........................................................................ S6 2-1

UNFORS 710L, 6525-01-502-0504, Meter, X-Ray Calibration ............................ S6 2-2

What is “Mains Resistance”? ......................................................................... S6 1-7

SB 8-75-S6

Distribution:

This publication is available through Electronic Media Only (EMO) by accessing the Army Knowledge Online (AKO) website and is intended for the use of command levels C, D, and E for the Active Army, the Army National Guard/Army National Guard of the United States, and the US Army Reserve.

By Order of the Secretary of the Army:

RAYMOND T. ODIERNO General, United States Army

Chief of Staff Official:

GERALD B. OKEEFE Acting Administrative Assistant

to the Secretary of the Army 1417002

PIN: 064520-000