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Thursday, 13 October 2011

Medical Devices

Device Master Record

INTRODUCTION
     Document For Intended Employees
     Adequate Information
     Preparation and Signatures
     Location of Records
     Record Retention
DEVICE MASTER RECORD CONTENTS
     Device Specification
     Specific Documents
     Records for In Vitro Diagnostic Products
QUALITY SYSTEM RECORD DOCUMENTS
WRITTEN PROCEDURES
     Developing Procedures
     Content of Procedures
CHANGE CONTROL
EXHIBITS
     Documents That May Appear in a Device Master Record
     Device Master Record Index
     Product Specification for a Portable Defibrillator
     Zener Diode Specification
     Label Example
     Handle Assembly and Parts List
     Cable Assembly and Parts List
     Device Master Record Index for Amylase
     Product Description
     Amylase Diluent Solution
     Filling Record - Liquid, Non Freeze Dried
     Finished Product Release Form
     Production Sample Card
     Shop Order Traveler


INTRODUCTION

Device master record (DMR) is the term used in the Quality System (QS) regulation for all of the routine documentation required to manufacture devices that will consistently meet company requirements. Section 820.3(j) of the QS regulation defines device master record as a compilation of records containing the procedures and specifications for a finished device. The detailed requirements for device master records are contained in section 820.181, as well as throughout the regulation.

The definition for design output in 820.3(g) gives the basis and/or origin of the device master record for all Class II and III devices as follows:

Design output means the results of a design effort at each design phase and at the end of the total design effort. The finished design output is the basis for the device master record. The total finished design output consists of the device, its packaging and labeling, and the device master record.

For some devices, many of the design output documents are the same as the device master record documents. Other device output information is used to create a DMR drawing such as for a test or an inspection procedure. Figure 6.1 shows the close relationship between design output and the device master record.

Section 820.181, Device Master Record, lists some typical documents in a DMR as follows:

The DMR for each type of device shall include, or refer to the location of, the following information:

(a) Device specifications including appropriate drawings, composition, formulation, component specifications, and software specifications;

(b) Production process specifications including the appropriate equipment specifications, production methods, production procedures, and production environment specifications;

(c) Quality assurance procedures and specifications including acceptance criteria and the quality assurance equipment to be used;

(d) Packaging and labeling specifications, including methods and processes used; and

(e) Installation, maintenance, and servicing procedures and methods.

The definition for Design Output 820.3(g) and requirements for Design Output 820.30(d) do not apply to most Class I devices. Therefore, the requirements for the DMR for most Class I devices are in 820.181 Device Master Record. Of course, a manufacturer of Class I devices may use the design output sections of the GMP as guidance.

However, almost all sections of the QS regulation have requirements related to the device master record. The device master record contains specifications for the device, accessories, labeling, and packaging, and contains a full description of how to procure the components and manufacture the device including specifications for facilities, environment, and production equipment. In addition to the device specifications, a device master record contains documents that cover typical manufacturing activities such as:
  • procurement,
  • assembly,
  • labeling,
  • test and inspection,
  • packaging, and
  • where applicable, sterilization.
Note that the listed activities and records or documents are required to produce any product –– medical, industrial, or consumer. There is nothing special about device master records except the name!
Also, note that in common usage, the term "device master record" refers to the total record or any of its individual records. Therefore, the term is singular for the total record, singular for a single document, and plural for a group of single documents. The term also may refer to an original record or a copy of a record.
Device master records should be technically correct, contain and/or reflect the approved device and process designs, be under change control, contain the release or other control date, contain an approval signature, and be directed toward the intended user. These requirements are in the QS regulation because the device master record is the "beginning and end" of a product –– errors in the device master record will have a serious impact on the state­of­control of the manufacturing operation and may have a serious impact on the safety and performance of the device. The device master record should be accurate and complete because the essence of the QS regulation is a quality system based on designing a device to meet user needs, documenting the design and production procedures in the device master record and then producing a finished device that meets the device master record requirements. Thus, the device master record shall accurately reflect the device intended to be produced by a manufacturer.

Document For Intended Employees
The content, style, language, graphics, etc., of device master records should be directed toward the needs of the intended employees and, if the record is a specification or text for labeling, it should be directed toward users. A failure to consider the intended user leads to confusion and means that the company has not achieved the state­of­control intended by the QS regulation. Therefore, applicable records should be directed toward the needs of procurement, processing, and test/inspection personnel, rather than the needs of drafting, technical services, or product development departments. Likewise, installation instructions should be directed to installers. Labeling is often prepared by the same employees that draft device master records; and, these employees should also be aware that labeling shall meet the needs of the user as directed by 21 CFR 809.10, 801.6 and 820.30.

In any manufacturing activity such as assembly, labeling, processing, testing, etc., achieving and maintaining a state­of­control is enhanced by appropriate personnel knowing:
  • what task is to be done,
  • how to do the task,
  • who is to do the task,
  • what task is being done, and
  • what task was done and/or the results of the activity.
In order for employees to perform a job correctly, they should know exactly what is to be done and exactly how to do the work. Section 820.181 requires that what is done be documented in the device master record. The device master record also contains test and inspection procedures and data forms that are used to help determine and record what was done.

Documents that instruct people how to fabricate, assemble, mix, label, test, inspect, etc., or how to operate equipment should:
  • be directed toward the needs of the employees who will be using them and not directed toward the drafts-person or designer;
  • match the tools and equipment to be used;
  • be correct, complete, and current; and
  • depend on part numbers and basic drawings to transfer information rather than almost photographic type drawings.
If a component is changed, the representations on pictorial/photographic type drawings are no longer correct and may be very confusing to employees, particularly new employees.

The how­to­manufacture instructions should be adequate for use by the intended employees and correct for the intended operation. In the medium­to­large company, the instructions tend to be extensive technical (engineering) drawings and written procedures. In any company, particularly small manufacturers, the work instructions may take several forms as discussed below.
  • Engineering drawings may be used if employees are trained to read and use them. Some of the how­to information comes from employee training rather than from drawings.
  • Assembly drawings may contain parts list and quality acceptance criteria. A separate quality acceptance test and/or inspection procedure is not always necessary. An example of an engineering drawing for assembling a handle is exhibited at the end of this chapter. This drawing also includes some of the quality acceptance criteria for evaluating the handle in Notes 1 and 2. The parts list for the handle is on the page after the assembly drawing. Some manufacturers that manufacture simple devices use large sheets of paper for assembly drawings and include the parts list on it. The combination drawing results in instant availability of the parts list and reduces the number of drawings to be controlled. An example of an engineering drawing for assembling a cable and the associated parts list follows the handle assembly drawings.
  • Exploded­view drawings are used when employees cannot read plan­view engineering drawings. Exploded­view drawings tend to be more "how to" than plan­view drawings. Exploded­view drawings are expensive to draft ­­ in some cases it may cost less to teach employees how to read and use ordinary plan­view drawings.
  • Step­by­step written procedures may be used to detail how to perform specific tasks with check­off blanks to show that each specific task was performed. This type of procedure is commonly used for critical operations and where there is little or no visual indication of what has been done, such as for cleaning operations and for mixing chemicals.
Documentation may be supported by production aids such as labeled photographs, video tapes, slide shows, sample assemblies, or sample finished devices. All of these perform device master record functions and should be identified, and be current, correct, and approved for the intended operation.

The most commonly used aids are models or samples. There are two conditions that should be satisfied in order to use these aids. First, a written specification for the sample shall be contained in the device master record. This specification, of course, may be the same as the specification for the assembly or finished device to be manufactured. This specification shall be subject to a formal change­control procedure. Even though a model is available, the specification is needed for present and future product development, and for production control purposes. Second, the sample should:
  • adequately reflect the device master record specification;
  • be identified as an approved acceptable representative sample, which means it shall meet the company required workmanship standards; the sample need not be a working model if the nonworking condition is not misleading to employees being guided by the sample; and
  • when appropriate, contain or be tagged with a drawing number, revision level, and control number (lot, serial, batch).
A card or tag as shown in the exhibits or an equivalent card may be used to identify and help control the use of samples of assemblies or finished devices. Such tags are usually covered by a clear plastic pouch and attached to the model or sample.

Samples and other aids such as photographs are subject to normal wear and tear in a production environment. Therefore, such aids should be adequately protected by a suitable means such as being located in a protected area, or covered by a protective pouch or container. Production aids should be periodically audited to make sure they continue to be suitable for the intended use. Section 820.100 contains requirements for corrective action. Corrective action may involve the use of samples, changes to the samples, or changes in the control of the samples.

Adequate Information
Although a manufacturer tries to document for the intended employees, there is a need to audit periodically to see how well the goal is being met. There are various means of determining if information in the device master record, production tools, and other production elements are adequate for a given operation and associated employees. These include analyzing the:
  • assistance required by new employees;
  • assistance required when a new device is introduced into production;
  • confusion and hesitation;
  • information exchanged among employees;
  • "homemade" documentation drafted by the line employees;
  • rework;
  • products produced (productivity);
  • complaints from departments that subsequently process the device; and
  • customer complaints.
If any of these factors persist and are out of line with industry norms or with the previous production experience, then the manufacturer should take corrective action. Management shall review the quality system as directed by 820.20 and, thus, be aware of device quality problems or quality system problems such as listed above. The corrective action may include changes in supervision or documentation, adding new documentation, modifying the design, using different tools, modifying the environment, etc.

Preparation and Signatures
A separate device master record is required for each type or family of devices. Also, a separate device master record may be needed for accessories to devices when these are distributed separately for health care purposes. Such accessories are considered to be finished devices. In practice, if the device and accessories are made by the same manufacturer, the device master record for the accessory may be incorporated into the device master record for the primary device.

Within a family of devices, variations in the family may be handled by dash number extensions on drawing and procedure numbers. Usually, a top assembly or other major drawing contains a table/list of the devices in the family and lists the variable parameters for each member of the family.

Section 820.40 of the QS regulation requires that an individual(s) be designated to: review, date, and approve all documents required by the QS regulation including the device master record and authorize changes. An individual(s) with the necessary technical training and experience shall be designated to prepare and control device master records. In addition to requiring approval signatures on device master records, the QS regulation requires individual identification for a few other activities. For convenience, these activities along with the section numbers that require them are listed in Table 8.1.

Table 8.1 GMP ACTIVITIES REQUIRING INDIVIDUAL IDENTIFICATION

820.30(b) Approval of Design Plans
820.30(c) Approval of Design Input
820.30(d) Approval of Design Output
820.30(e) Results of Design Review
820.30(f) Results of Design Verification
820.30(g) Results of Design Validation
820.40 Approval of in Device Master Record or Changes
820.70(g) Equipment Maintenance and Inspection Activities Performed
820.72(b) Calibration Performed
820.75(a) Approval of Process Validation
820.75(1)(2) Performance of Validated Process
820.80(d) Release of Finished Devices
820.80(e) Acceptance of Activities Conducted
820.90(b) Authorization to Use Non-Conforming Product
820.120(b) Labeling Inspection
820.180(c) Audit Certification
820.198(b) Decisions Not to Investigate Complaints
The list is self­explanatory except for audit certification. When a manufacturer certifies in writing to FDA that quality system audits have been performed, the certification letter is signed by management having responsibility for the matters audited. Also note that the records in 820.70, 820.72, 820.80, 820.90(b), 820.120(b) and 820.160 are not part of the device master record but, instead, are part of the device history record (DHR). Records in 820.198(b) are part of the complaint files.

If a record that requires a signature is maintained on a computer, it is best if the designated individual(s) maintains an up­to­date signed printout of the record. Where it is impracticable to maintain current printouts, computer­compatible identifiers may be used in lieu of signatures as long as there are adequate controls to prevent improper use, proper employee identification, inaccurate data input, or other inappropriate activity. If identifiers such as coded badges and equipment keys are not controlled (i.e., not restricted to designated employees), then these will not meet applicable GMP "signature" requirements.

Location of Records
Device master records shall be stored at the manufacturing establishment or at other locations (820.180) that are reasonably accessible to company employees responsible for the manufacturing activities and accessible to FDA investigators. Appropriate records may be maintained in computer data banks if the records are protected, change controlled, and readily accessible for use by responsibleemployees at all relevant facilities. It is acceptable for a manufacturer to maintain records on microfilm and discard the original hard copies. Microfiche and/or microfilm reductions may be used in lieu of original record retention if the following conditions are met.
  • All reductions shall be readily available for review and copying by FDA investigators and designated company personnel at any reasonable time.
  • All necessary equipment shall be provided for viewing and copying the records.
  • Reproductions shall be true and accurate copies of the original record.
If the reproduction process results in a copy that does not reveal changes or additions to the original record, the original should be retained. In this situation, the reproduced copy and any image shown on a viewing screen should note any alteration from the original and indicate that the original record is available.

By maintaining the device master record, complaints and other records required by the QS regulation at the manufacturing establishment or other reasonably accessible location, responsible officials of a company can exercise control and accountability over the entire design, manufacturing, and postmarketing activities and, thereby, maximize the probability that the finished device conforms to its design specifications. This GMP requirement helps assure that responsible officials at the manufacturing establishment have ready access to those documents essential for producing devices and for conducting self­inspections, complaint investigations, failure analyses, audits, and corrective action.

The device master record is a single source document or file. Portions of this file may be kept in various locations. A device master record may exist as:
  • one or more files or volumes of the actual records containing the information required by the QS regulation;
  • a reference list of such documents and their location; or
  • any combination of actual documents and/or reference lists.
These documents shall contain the latest DMR revisions, be signed, and be dated to show they have been checked for adequacy and approved for use (820.30, 820.40 and 820.181).

The QS regulation allows use of reference lists as a means to reduce the duplication of records, particularly duplication of general documents such as standard operating procedures (SOP's). General SOP's (not directly related to a product or process) however should be made a part of the quality system record (QSR) (820.186).

Use of a reference list also allows filing of device master record documents at several convenient locations. If the device master record contains a list of documentation, the actual documents shall be available for employee use and FDA inspection at the manufacturing site or other reasonably accessible locations. As noted above, this is a key and important GMP requirement. Typical locations of various device master records are shown in Table 8.2.

When performing an inspection of a company, FDA investigators shall have access to actual records for review and copying during reasonable business hours. FDA investigators review these records to determine if a manufacturer is complying with the QS regulation and with the Food, Drug, and Cosmetic Act.

Records deemed confidential by a manufacturer should be marked to aid FDA in determining whether or not specific information may be disclosed under the Freedom of Information Act. However, routinely stamping every document as "Confidential" defeats the purpose of requesting extra care be taken to protect a specific document or set of documents.


Table 8.2 LOCATION OF DEVICE MASTER RECORDS

Typical Locations of Documents
TYPE OF DMR ELEMENT ORIGINALS WORKING COPIES
Reference list(s) Engr. master file  
Component drawings Engr. or Manuf. Engr. master file Manuf. or Procurement
Component acceptance procedures SOP master file Receiving department
Device Input specifications (final version) Engr. master file Marketing or Engineering
Manufacturing procedures Engr. or Manuf. Engr. master file Manufacturing
Test specifications Engr. master file Engr. or Manuf. Engr.
Test procedures Engr. or Manuf. Engr. master file Manuf., QA, QC or Final Test
Inspection procedures Manuf., QC, or SOP master file Manufacturing or QC
Label drawings Engr. master file Engr., QA, or Manuf.
Label artwork Artwork master file Engr., Procurement
Label control procedures Manuf., QC, or SOP master file Manufacturing
Specific cleaning procedures SOP master file Manufacturing
General cleaning procedures QSR master file  
System audit procedures QSR master file  
Employee training procedures QSR master file  
SOP = Standard Operating Procedure
QSR = Quality System Record
QA = Quality Assurance
QC = Quality Control

Record Retention
The QS regulation in section 820.180(b) requires that all records pertaining to a device shall be retained for a period of time equivalent to the design and expected life of the device, but in no case less than two years from the date of release for commercial distribution by the manufacturer. Manufacturers of long­life products should make prudent decisions as to how long to keep records. For example, there
may be no value in keeping records for long­life devices such as stretchers, surgical tools, containers, etc., forever if the probability is low that any post­distribution remedial activity will occur. For devices that require repair or capital equipment devices that probably will be updated, appropriate records should be retained to support these repairs or modifications.

Device master record requirements apply to devices modified in the field by the manufacturer's representatives after the devices are commercially distributed. Modification of a device is manufacturing and the QS regulation covers all manufacturing of devices where the result is placed into commercial distribution. In any case, a manufacturer should be prepared to provide a rationale for its decision to discontinue record-keeping.

DEVICE MASTER RECORD CONTENTS

As discussed above, the device master record shows and/or tells employees how to perform specific functions related to the production of a device. The QS regulation does not dictate how this information is to be arranged or filed in the device master record and quality system record except that it shall be readily accessible. Because each device master record and quality system record contain many documents, an index of each is usually needed.

Device Specification
There may be many specifications in the device master record. One of these is the device specification. A device or product specification is a specific document in the device master record that briefly describes and gives all important details of the external characteristics of a device. The product specification may also contain some internal characteristics of the device that are important to the manufacturer and/or the users. The finished device specification is derived from the design input specifications in 820.30. For some devices, many of the external characteristics such as temperature tolerance are related to the environment in which the devices will function properly. For some in vitro products, the package insert is used by some manufacturers as the product specification for marketing purposes.

Generally a product specification will contain the device's:
  • product trade and common name(s);
  • intended use(s);
  • performance characteristics and theory of operation;
  • regulatory classification;
  • physical characteristics;
  • environmental limitations and product stability;
  • important components and formula (if applicable); and
  • user safety characteristics.
Table 8.3 contains a list of characteristics that often appear in product specifications; however, note that not all of the listed items will appear in the product specification for a given device.

In addition to defining and describing a device, a product specification is a communication tool which, if used in a timely manner, can help achieve some important results. First, it helps assure that everyone is talking about the same device and working toward the same objectives with respect to safety, effectiveness, human factors, configuration, labeling, packaging, processing, finished device acceptance, etc.

Ultimately, the device specification or a condensed version of it should be used in catalogs, or other product documentation, to aid communication between salespersons and customers. If the marketing department uses the product specifications when preparing advertisements and catalog sheets, public relations with users will be enhanced because the marketing documents are based on proven scientific safety and performance claims for the actual device. The user has an opportunity to read the technical specifications of the item actually being offered for sale.

Thus the use of device product specifications will result in:
  • improved communication between employees on a departmental and interdepartmental basis;
  • less confusion and increased morale;
  • an improved state­of­control;
  • a higher probability of meeting cost, time, safety, effectiveness, and regulatory compliance objectives; and
  • product literature that correctly describes the device for the prospective customer.
A sample product specification for a portable defibrillator is in the exhibits at the end of this chapter. This specification is long and detailed because it is a combined product and test specification, and because it is for a complex device.

Specific Documents
Specific documents are drawings, procedures, labels, data forms, etc., for a specific product or family of products. Product specific documents are almost always part of the device master record. The originals of specific documents are usually located in files in engineering or technical service departments. In most manufacturers, specific documents contain no general information; however, they often refer to general documents. (A list of specific and general documents is exhibited later in this chapter.) The number of specific documents for a given product line may range from about 10 to several hundred. If large numbers of documents are needed, an index is usually needed to help locate them, particularly forpersonnel that do not work in the drafting department or in technical services.

Records for In Vitro Diagnostic Products
The main differences between device master records for chemical­based in vitro products and for electromechanical products, such as instruments and artificial kidneys, is terminology and the relatively extensive use of written processing procedures and status reports for in vitro diagnostic products rather than a few assembly drawings and test/inspection reports. For example, device master records for chemical­based devices would contain a manufacturing section dealing with areas such as solution preparation and filling, whereas manufacturing sections for electromechanical products would cover operations such as assembly. Status records for weighing, mixing, filling, etc., are used for general control of in vitro products. Status reports are also used because it is often difficult to determine the status of in­process in vitro products by looking at them ­­ the opposite is usually true for most hardware devices. Records for in vitro devices also shall contain control data that allows components and kits to be traced [809.10(a)(9), etc.].

Table 8.3 ITEMS THAT MAY APPEAR IN A DEVICE SPECIFICATION
1. Name of Product
a. Trade name                     d. Chemical name
b. Trademark                      e. Official name
c. Generic name                  f. Common name
2. Performance Characteristics
a. Description/Intended use           e. Contraindications
b. Accessories                              f. Input/Output requirements
c. Functional parameters                g. Human interface
d. Limitations                                h. Other
3. Classification
a. Regulatory                     c. Functional
b. Commercial                   d. Other
4. Physical Characteristics
a. Weight                          e. Consistency
b. Size                              f. Packaging
c. Color                            g. Power requirements
d. Form/Shape                  h. Other
5. Environmental Limitations
a. Operating temperature range           f. Moisture protection
b. Storage temperature range              g. Pressure, altitude limits
c. Vibration and shock range               h. Electromagnetic interference
d. Voltage range                                  i. Electrical transients
e. Humidity range                                 j. Shelf life/Other
6. Important Components
a. Active ingredients                f. Service labeling
b. Major subsystems               g. Components/items supplied by user
c. Diagnostic kit materials        h. Software
d. Accessories                        i. Periodic Warranty/Other
e. Labeling
7. User Safety and Performance Considerations
a. Chemical                                       e. Personnel training
b. Electrical                                        f. Periodic testing
c. Thermal                                          g. Maintenance
d. Mechanical sharp, moving parts      h. Other

QUALITY SYSTEM RECORD DOCUMENTS

Quality system record (QSR) (820.186) or general documents are used for many activities that are essential to operating a manufacturing establishment ­­ these are not specific to any given product even if the company produces only one product. Thus, the quality system record includes general documents such as standard operating procedures (SOP's) and standard quality assurance procedures (QAP's). If the company added another product line, the basic content of these documents would undergo none or only minor changes.

In a typical manufacturing operation, general QSR, SOP, and QAP documents may include the following:
Employee training procedures Supplier assessment policy
Cleaning procedures General design control procedures
Insecticide use­removal procedures Component inspection procedures
Air conditioning/heating procedures Workmanship standards
Tool kit policy Design review policy/procedure
Safety procedures Label review policy/procedure
Procurement procedures Sterile water system maintenance
Returned goods policies Calibration policy
Drawing numbering system Complaint handling procedure
Change control procedure Recall procedure
Service policy Deviation review policy/procedure
The above list is not all inclusive. Medium­to­large companies tend to have many of these general documents to guide management in maintaining consistent operations. A very small company may have only the most essential and appropriate of these documents such as procedures for design controls, drawing numbering system, change control, employee training, use of hazardous materials, etc.

The original copy of each general procedure is filed in the department specified by management as having responsibility for maintaining that procedure, or it is filed in an automated system with access by the designated departments. The working copies of the above procedures are usually located in SOP manuals and QA manuals. The procedures are usually numbered and arranged in a logical order by topic. The QS regulation does not require manufacturers to keep quality system record documents in SOP or QA manuals; however, the experience of many industries has demonstrated that such manuals are worthwhile if they are kept current and contain only the real working procedures.

WRITTEN PROCEDURES

Many sections of the QS regulation require written procedures for instructions in performing various quality system, design product acceptance, QA, and manufacturing tasks. Certain devices such as in vitro products, because of the nature of the manufacturing operations, tend to have a relatively large number of written procedures.

Written procedures are used for quality system audits, product development, manufacturing, post­marketing activities, etc., to:
  • improve communication and guidance;
  • assure consistent and complete performance of assigned tasks; and
  • promote management of operations.
In large manufacturing facilities involving many operations and people of various skill levels, many written procedures are usually necessary. In a small manufacturer, communication lines are usually short, few people are involved, and management is readily available to provide guidance, so that the need for written procedures is usually less than for a larger manufacturer.

A manufacturer, particularly a small manufacturer, may conclude that GMP requirements for written procedures are not applicable for a particular operation. Although the number of written procedures may vary, all manufacturers are required to maintain a device master record (820.181) for each type or family of devices they produce.

Often training and work experience alone or combined with drawings, photographs, and models are valid substitutes for written procedures. For example, machinists are typically skilled personnel who fabricate components and finished devices using dimensional drawings for guidance instead of written procedures. The company and FDA investigator will evaluate each situation based on the training and knowledge of the operators and the control needed to meet device specifications. Typically, a written procedure is not necessary when:
  • the activity is very simple;
  • the activity is relatively simple and models are used as production aids;
  • straightforward quantitative rather than qualitative standards determine acceptability; and
  • the operation is performed by personnel highly skilled relative to the task being performed.
Written procedures and associated history or status records, however, are often needed for activities where there is no change, such as color, texture, or form, to indicate that the activity has been performed correctly.

Manufacturers should determine that they meet all GMP requirements and, if necessary, exceed them in order to produce finished devices that meet device master record specifications because FDA insists that manufacturers meet their quality claims [FD&C Act, section 501(c)]. Achieving this required state­of­control may require fewer or more written procedures than specifically required by the QS regulation. FDA does not insist that a manufacturer generate records that do not contribute to assuring conformance to specifications.

Developing Procedures
Developing written procedures is relatively labor intensive and time consuming, which may lead to use of "back­of­the­envelope" notes instead of formal procedures. Likewise, changing these procedures is time consuming, which may lead to delays or forgetting to make the changes. Drafting or changing written procedures is also prone to errors. Therefore, manufacturers are encouraged to use computers and low­cost printers as word processors to aid in writing and changing procedures. With the use of computers, these tasks become easier thereby increasing the probability that they will be performed correctly and when needed. Computers can also be used for generating and maintaining device master record indices and complaint files, and performing a host of other GMP related activities.

There is a method for developing procedures that will result in short, clear procedures that help
solve real problems. The first two steps are:
  • identify the problems to be solved; and
  • decide if new or modified procedures are needed to help solve or reduce the problems.
Events that point to a problem are excessive rework, employee confusion, customer complaints, recalls, etc. These "pointers," however, may not be the real problem. The real problem may be inadequate design, components, equipment, maintenance, operational techniques, documentation, environment, etc. The real problem should be identified before it can be solved. A written procedure may or may not be needed to help solve the problem.

The real problem can be identified by careful analysis of:
  • the "pointers" noted above,
  • device design,
  • process design,
  • process flow and employee work habits (operational analysis),
  • test and inspection data, and
  • any other activity related to the quality of the device.
Operational analysis is aided by flow-charting which is a step­by­step chart of the minute details of the operation. Thus, a flow chart is much more detailed than a QA audit report and is very helpful in determining what is actually happening in a particular manufacturing operation. This knowledge may lead to a solution of manufacturing and quality problems. An example of a flow chart appears in the exhibit section of chapter 10.

From a company quality system, interface, and personnel management viewpoint, the problem, the reason for flow­charting the given activity, etc., should be discussed with affected personnel. Their input should be requested with respect to identifying and solving the real problem. By using the information presented by the flowchart and the experience gained while producing the chart, the QA auditor is better able to:
  • analyze the particular operation with respect to process requirements;
  • determine what needs to be added, modified, or deleted to solve any problems or improve performance; and
  • if needed, write or modify a procedure to cover the new way of performing the activity.
Content of Procedures
Written procedures are widely used and industry experience has shown that these should contain the following items:
  • company identification and a procedure title;
  • an identification or control number with a revision level code;
  • an approval signature, and date the procedure becomes effective;
  • the number of pages (e.g., sheet 1 of 4) in the procedure or another means to indicate that the employee has the complete document; and
  • step-by-step instructions for performing the required activities
The effective date may be the same as the approval date. Also, the effective date may appear on a separate document such as an engineering change order (ECO) form. The main body of the procedure should cover, as appropriate:
  • subject, scope, and objectives;
  • who is assigned to perform the task;
  • what activity or task is to be performed;
  • when and where the task is to be performed; and,
  • how to perform the task including what tools, materials, etc., to use.
Particularly for the new employee, it is important for the procedure to state the reason for performing a function and the reason it is to be performed in a certain way. Background information such as this helps the employee to understand an assignment and remember how to perform it. For example, when working on static sensitive integrated circuits that are easily damaged by electrostatic potentials, unskilled employees need to understand why they have to be grounded, work on grounded mats and, especially, why they are not allowed to wear certain fabrics while at work. Likewise, employees working in environmentally controlled, clean manufacturing areas need to be told about invisible microbes and particulates, and that humans are the major source of these unwelcome contaminates. If so informed, employees are more likely to follow the operational procedures for working in controlled areas.

The task description in each procedure should cover appropriate details such as:
  • the expected and actual results from performing the tasks, such as what data to collect and how to analyze, file, and report it;
  • what to do with the component, in­process device, or finished device if such is involved; and
  • any related activities that need to be performed in order for the overall operation to remain in a state­of­control or for the device to meet the company device master record specifications.
If the procedure being developed, for example, covers change control, the procedure should also cover related activities such as changes to labeling. Consider a change to a device where an analog meter is replaced with a digital meter ­­ obviously the instruction manual (labeling) and service manual also need to be modified. Otherwise the finished device:
  • may not meet company labeling policies;
  • is misbranded because it does not meet the labeling requirements of the FD&C Act; and,
  • is adulterated because the change does not meet the change control requirements of the QS regulation.
After the procedure is drafted, if appropriate, it should be reviewed with the affected personnel before it is approved and implemented. During the initial implementation, the use of the procedure should be monitored. Then, based on actual experience in using the procedure, if necessary, it should be modified to more exactly meet the need of the operation or process.

CHANGE CONTROL

The QS regulation in section 820.181 by reference to 820.40 requires that any changes to the
device master record be authorized by the signature of a designated individual(s). Change control requirements also appear throughout the QS regulation. The control of changes to devices, processes, and the associated device master records is one of the most important elements of a quality assurance system. The requirements for a successful change control system are so extensive that the entire next chapter of this manual is devoted to changes and associated procedures.

EXHIBITS

Reprinted on the next pages are typical documents (records) that appear in device master records. Manufacturers may use these as guides in developing their device master records.

Documents That May Appear in a Device Master Record
The first exhibit is a list of documents that might appear in device master records. Each device master record would contain only those documents that are applicable for a specific device. Some of the listed documents are general rather than product specific. General documents are usually called standard operating procedures (SOP's) and, if necessary, are referenced in the device master record rather than actually being included. The general documents are usually part of the quality system record (QSR).

Device Master Record Index
This exhibit is a policy/procedure for drafting a device master record index. An index is also known as a document plan, table of contents, etc. An example of a device master record index follows immediately after the policy/procedure. Note that this particular policy/procedure contains definitions. It is important that procedures contain definitions, in a case like a complex device master record index where employees may not be familiar with the terminology.

Product Specification for a Portable Defibrillator
Finished device or product specifications are the backbone of any device master record. The one illustrated as the third exhibit is for a complicated piece of equipment and is, therefore, extensive. For long documents it is recommended that a table of contents be incorporated as was done in this specification. Appendix A and B of this specification are not exhibited.

Zener Diode Specification
This specification for a non­complicated part contains the necessary information to describe the item in sufficient detail for the correct part to be procured per the 820.50 Purchasing Controls.

Label Example
A sample label is exhibited. Labels and labeling are components and their specifications, art work, etc., are part of the device master record. As for any component, labeling shall be specified (documented). The resulting device master record document shall be reviewed, approved, change controlled, and stored such that it may be readily accessed. Such records are used to meet requirements such as those in 820.50, 820.80(b), 820.80(d), 820.120(b), 820.120(e), etc.

Handle Assembly and Parts List
This exhibit is an engineering drawing and parts list for a handle assembly. Engineering drawings, parts lists, or formulations are a vital part of many device master records. In this case, the engineering drawing not only details how this assembly is to be made, but there is also important information in the notes on the drawing. If properly trained and with sufficient experience, employees are able to use this drawing as the instructions for assembly of this handle. A written assembly procedure is not necessary.
Cable Assembly and Parts List
This exhibit is similar to the handle assembly mentioned above. The type of drawing used and information on a drawing can aid a manufacturer in reducing paperwork needed to manufacture a specific product.

Device Master Record Index for Amylase
This document is a device master record index for an in­vitro diagnostic product. Proprietary information in this index is replaced by X's. The company that prepared this index uses purchase specifications and raw material specifications. Some manufacturers, particularly small companies, specify and purchase standard, routine items such as bottles and caps by using catalog numbers. Component specification drawings are not always used for routine items such as standard bottles.

Product Description
This exhibit is a product description for an in vitro diagnostic product. The standard operating procedures, quality control procedures, manufacturing flow sheets, and notes mentioned in this product description are not reprinted herein.

Amylase Diluent Solution
This exhibit is the procedure for making a batch of amylase solution. In this procedure, note that for each step the company requires the initials or signature of the person actually performing the operation and of the individual who checked that person's performance of the operation.

Filling Record ­ Liquid, Non Freeze Dried
This is an exhibit of a filling record used for liquid products to document the steps in a filling operation. The completed filling record becomes a part of the device history record (DHR) for the batch being filled.

Finished Product Release Form
This form is used to record that the device history record is complete for a lot of product, the product meets specifications, and the lot may be approved for release.

Production Sample Card
This exhibit shows both sides of a card or tag used to identify and help control the use of manufacturing aids such as samples of assemblies or finished devices. The use of a sample identification card is described in the main text of this chapter.

Shop Order Traveler
The last exhibit is two job travelers or job followers. These cards, forms, tags, etc., are used to identify a batch or sub­batch of in­process assemblies as they are passed from one department to another. Where needed, travelers are used to reduce mixups and confusion and, in general increase the state­of­control of an overall manufacturing operation. Travelers help meet the general requirements of 820.60, Identification, and the specific requirements of 820.86, Acceptance Status.

DOCUMENTS THAT MAY APPEAR IN A DEVICE MASTER RECORD

1.0 Device Master Record Index

The device master record Index is a table of contents which is used for convenience. It may be known as a:

Device Master Record Index
Documentation or Device Master Record Unit;
Documentation Plan;
Product Tree;
Documentation Index;
Product Structure; or
Bill of Materials (if it also lists the device master record documents).

2.0 Device Specifications

(Device specifications are described in the chapter text.)

3.0 Manufacturing Information

3.1 Index
(Optional. See 1.0 above for total table of contents.)

3.2 Formulation or top assembly drawing

3.3 List of components

1. List of ingredients (including grade or type)
2. Bill of materials (i.e., component list usually arranged by subassembly or other sub­product level or by process steps)
3. Formula

3.4 Procurement documentation

1. Specifications
2. Drawings
3. Certificate of compliance requirements
4. Supplier Assessment procedures


3.5 Device documentation

1. Fabrication drawings
2. Surface finish procedures
3. Subassembly drawings
4. Wiring and piping diagrams
5. Assembly procedures
6. Assembly drawings
7. Reference documentation
a. Wiring and piping schematics
b. Test specifications
8. Sub­batch procedures
9. Blending or mixing procedures
10. Solution procedures
11. Final formulation procedures
12. Software packages

3.6 Precautions and special notations

1. Apparel
2. Cleaning
3. Storage conditions
4. Filling, mixing conditions
5. Hazards and safety precautions

3.7 Equipment, lines, and procedures

1. Process lines
2. Assembly lines
3. Vessels
4. Mixers, tools
5. Molds
6. Machine maintenance procedures
7. Calibration procedures
8. Setup procedures
9. Operating procedures
10. Process flow charts

3.8 Sterilization procedures

1. Procedures for ethylene oxide, radiation, filtration, steam, etc.
2. Handling and flow procedures
3. Cycle parameter specifications
4. Diagrams for loading products in the chamber

3.9 Production control documentation

1. Inspection procedures
2. Test procedures
3. Blank job travelers
4. Blank inspection/test forms
5. Instrument charts
6. Reporting forms
7. Approved deviations

4.0 Labeling and Packaging

4.1 Index (Optional. see 1.0 above.)

4.2 Labeling

1. Label drawings
2. Labeling drawings
3. Label/labeling review procedures and forms
4. Production control procedures and history record forms
5. Instruction manuals
6. Service manuals
7. Customer software
8. Customer feedback forms

4.3 Packaging

1. Package drawings (usually includes labeling information)
2. Closure drawings
3. Filling and/or packaging procedures
4. Packing procedures
5. Special shipment procedures

4.4 Storage requirements

1. Temperature
2. Humidity
3. Shelf­life

5.0 Control Procedures and Activities

5.1 Index (optional. see 1.0 above.)

5.2 Inspection procedures

1. Incoming
2. In­process
3. Finished devices
4. Process control charts
5. Blank data reporting forms

5.3 Test procedures

1. Incoming
2. In­process
3. Pretest conditioning
4. Finished device
5. Process control charts
6. Blank device history record forms
7. Automated test programs and/or software

6.0 Final Release

6.1 Release document review list

6.2 Distribution procedures

6.3 Blank device history record forms


Title: DEVICE MASTER RECORD INDEX

Policy No.______________ Rev. ______________ Date _______________
Approval ___________

1.0 Purpose and Scope: To prescribe the responsibilities for preparing device master record (DMR) Indices and content of DMR Indices (lists).

2.0 Policy: A DMR Index shall be prepared and maintained for all devices being developed or manufactured.

3.0 Definition: A DMR Index is a table of contents for the device master record of a device. It also contains information on the breakdown of the device into assemblies and/or manufacturing steps. It is called a document plan during planning and early development of a new product. A DMR is:

3.1 An aid in proposing, planning, tasking, and reviewing projects;

3.2 A framework for preparing drawings, parts lists, and test equipment lists;

3.3 A means of familiarizing personnel with the device configuration;

3.4 A current record and status of the physical configuration of the device and a list of all reference documentation required; and

3.5 An index to the product­specific documentation required for procurement of components, manufacture, and evaluation of a device.

4.0 Procedure:

4.1 Preliminary document plans may be generated for the convenience of Engineering. Upon completion of the design when formal records are needed, a formal document plan will be initiated.

4.2 The configuration and structure of the document plan is set by the Engineering, Manufacturing Engineering, and Drafting Supervisors.

4.3 After agreements, the plan will be drawn, document numbers assigned, status of drawings indicated, and the plan approved by Engineering and Manufacturing. All non­product specific documents such as standard operating procedures that are used during production of the device will be listed on the plan. (Because the plan is now complete, it is a DMR Index.)

5.0 Example: Part of an index in "tree" form is on the following pages. A "tree" form allows a large amount of information to be displayed in a small area. Each column covers a major section of the documentation such as the battery charger. The index contains codes to convey additional information such as a rectangle with a dark triangle in a top corner or a mark such as "#" to indicate a parts list is included with a particular drawing.

(Sample for training purposes only. Do not use for technical parameters.)

PRODUCT SPECIFICATION PORTABLE DEFIBRILLATORS

CONTENTS

PRODUCT SPECIFICATION

1.0 Reference Documents

2.0 Overall Description

3.0 Configurations

4.0 Functional Characteristics

5.0 Performance Characteristics

APPENDIX A (not reprinted in this manual)

TEST RECOMMENDATIONS

APPENDIX B (not reprinted in this manual)

TEST POINT AND BOARD INTERCONNECT SIGNAL
DEFINITIONS

Throughout this Product Specification * indicates need for test.

NOTE: Values not in parentheses refer to Models D320 and D320W. Values in parentheses refer to Models D400 and D400W.

LTR DESCRIPTION DATE APPROVED
1 Pilot released per ER - 3556 04/23/75  
2 Revised and Retyped per ECO - 3968 01/27/76  
3 Revised and Retyped per ECO - 4225 05/28/76  
4 Revised per ECO - 4636 12/28/76  
A Released to Production per ERN - 4645 03/10/77  
       




Title: PRODUCT SPECIFICATION PORTABLE DEFIBRILLATORS


DR BY: A J Lucas

DATE: 4/15/75

DWG NO. 04300538

Sheet 1 of 14



REVISION: A

Date: 3/10/77

APP'D:

DATE:

PRODUCT SPECIFICATION PORTABLE DEFIBRILLATORS
D320, D320W, D400, & D400W

1.0 REFERENCE DOCUMENTS

1.1 Portable Defibrillators D320/400 and D320W/400W 23990081­XX

1.2 Adult Anterior Paddles 24990082­01 450 AA

1.3 Adult Anterior­Posterior Paddles 24990113­01 450 APA

1.4 Adult Anterior Paddles 24990114­03 450 AI

1.5 Pediatric Anterior Paddles 24990082­02 450 PA

1.6 Pediatric Internal Paddles 24990114­02 450 PI

1.7 Infant Internal Paddles 24990114­01 450 II

1.8 Adult Anterior Paddles with Remote Charge 24990082­03 450 AAR

1.9 Patient Cable Assay. 3 Electrode ­21 D24990118­01

1.10 Tube XXXXXX (712) 1042507001

1.11 D320/400 Shipping List

1.12 D320/400 Operators Manual

1.13 D320/400 Maintenance Manual

2.0 OVERALL DESCRIPTION

The D320/400 (Ref. 1.1) is a portable defibrillator with integral isolated input, solid trace, ECG monitor scope. The D320/400W contains in addition a 40 mm strip chart recorder. They may be used for non­synchronous ventricular defibrillation or synchronous conversion of arrhythmias. Power is derived from internal rechargeable batteries or from the AC power line whenever the unit is connected to the AC power line via the internal charger.

Standard accessories included in the D320 Shipping List (Ref. 1.11) are:

1 ­ Adult Anterior Paddle Set (Ref. 1.2)
1 ­ Patient Cable­21(Ref. 1.8)
1 ­ Tube XXXXXX Electrode Paste (Ref. 1.9)
1 ­ Operator's Manual (Ref. 1.11)
1 ­ Shipping Carton

Optional Accessories are alternate paddles described in section 4.

  1. CONFIGURATIONS
23990081­01 Battery Operated Defibrillator ­ D320 (120V)
23990081­02 Battery Operated Defibrillator ­ D320 (220V)
23990081­03 Battery Operated Defibrillator with Writer ­ D320W (120V)
23990081­04 Battery Operated Defibrillator with Writer ­ D320W (220V)
2399 Battery Operated Defibrillator ­ D400 (120V)
2399 Battery Operated Defibrillator ­ D400 (220V)
2399 Battery Operated Defibrillator with Writer ­ D400 (120V)
2399 Battery Operated Defibrillator with Writer ­ D400W (220V)

4.0 FUNCTIONAL CHARACTERISTICS

4.1 DEFIBRILLATOR FUNCTIONAL CHARACTERISTICS

The defibrillator becomes operational in the non­synchronous mode when the power switch is turned ON and the paddle connector is attached. A charge cycle is initiated by depressing and holding the MANUAL CHARGE button until the desired charge is reached. Automatic charge to 160 (200) or 320 (400) joules is accomplished by depressing the AUTO CHARGE 160 (200) or AUTO CHARGE 320 (400) buttons respectively. An audible tone and a DELIVERED ENERGY bar display on the scope indicate when a charge is in process. When the charge cycle is complete, the audible tone stops and the DELIVERED ENERGY meter indicates the amount of energy to be delivered. The stored energy is delivered in the form of an Edmark waveform by pressing the buttons located on the anterior paddles or, if interior paddles are used, pressing the INTERNAL PADDLE switch located on the control panel.

For safety and equipment protection, a charge cycle is followed by an automatic time out that dumps the stored energy (disarms) after 45 seconds if energy is not delivered or the charge button pressed again within the time out period. The stored energy is also automatically dumped when the power switch is turned OFF. The operator may disarm the unit by depressing the DISARM button.

4.1.1 Delivered Energy Indicator

The DELIVERED ENERGY INDICATOR displays the energy to be delivered into a 50 ohm load as a horizontal line at the top of the CRT screen. When a charge is initiated, the end of a solid bar will follow the amount of energy to be delivered.

4.1.2 Paddle and Accessory Storage

A molded paddle holder is in the defibrillator front panel cover for one set of anterior­anterior adult defibrillator paddles. One (D320W/400W) or two (D320/400) accessory holders are located below the front panel to hold cables, electrodes, and paste. Under normal usage, the defibrillator is stored or transported with defibrillator cables connected. This approach minimizes the number of steps needed to bring the defibrillator from an idle state to the emergency non­synchronous mode.

4.1.3 Anterior­Anterior paddles

Anterior­anterior paddle assemblies are available with two electrode sizes: adult 8.5 cm (Ref. 1.2) and pediatric 5.0 cm (Ref. 1.7). Each assembly consists of a connector, two paddles with discharge buttons, and a dual coiled cord extendable to 10 feet.

Ethylene oxide sterilization is the only permissible sterilization technique for all of these paddles.

4.1.4 Anterior­Anterior Paddles with Remote Charge (Optional)

Same as 4.1.3 except one paddle will have a charge button that functions identically to MANUAL CHARGE button on the front panel (Ref. 1.8).

4.1.5 Anterior­Posterior Paddles

An anterior­posterior paddle assembly (Ref. 1.4) is available for use only on adults. It consists of an anterior paddle identical to the 8.5 cm paddle in a 4.1.3, a posterior 12 cm paddle, a dual 10ft. coiled cord, and connector.

4.1.6 Internal Paddles

Internal paddle assemblies are available with three electrode sizes: adult 8.5 cm (Ref. 1.4), pediatric 5.0 cm (Ref. 1.5), and infant 2.5 cm (Ref. 1.6). Each assembly consists of a connector, 2 paddles, and a dual coiled cord extendable to 10 ft.

4.2 ECG AMPLIFIER AND SOLID TRACE SCOPE FUNCTIONAL CHARACTERISTICS

4.2.1 ECG Amplifier

The ECG amplifier is an isolated, variable gain amplifier which feeds the display, QRS detector, and output jack. Input to the amplifier is through the defibrillator paddle connector or through the patient cable. A lead selector switch selects the paddles, or leads I, II, or III for input. The amplifier incorporates the following features:

1. Slew Rate Limit ­ Limits the slew rate and, therefore, the amplitude of the pacer pulses so that they can be seen on the display and will not trigger the QRS detector in most lead configurations.

2. Fast Recovery Circuit ­ Returns the signal to on screen limits within 0.5 seconds after defibrillation or other overload.

4.2.2 Solid Trace Display

The solid trace display shows the last 4 seconds of ECG waveform on the screen. The waveform appears as if a strip chart recorder were writing the ECG at the right hand edge of the screen and the paper was being pulled from right to left. Current information is displayed at the right of the screen with information becoming increasingly older towards the left. When operating the defibrillator in the synchronous mode, sync pulses appear showing where the energy would have been delivered had the discharge buttons been pushed. The waveform may be stopped or "frozen" for review by pushing the latching FREEZE button.

4.3 HEART RATE METER FUNCTIONAL CHARACTERISTICS

The heart rate meter displays heart rate as a bar at the screen bottom. The heart rate is also compared to alarm limits that are displayed on the same bar. When a limit is exceeded for longer than three seconds, the red alarm led blinks, an audible alarm sounds, and the hard copy writer runs (D320W/400W only). Alarms are disabled or reset by putting the LOW LIMIT knob fully counter­clockwise and the HIGH LIMIT fully clockwise. In this position the limit indications are not displayed on the screen.

The threshold for QRS detection is automatically adjusted depending on the amplitude of the QRS complex. The minimum threshold is equivalent to 0.6 cm on the scope display. At maximum gain, a 0.3 mv QRS complex will be detected. Detection of a complex will cause an audible beep if the BEEP push-button is depressed. Proper adjustment of the gain control will result in an R­wave amplitude on the screen of one to two cm.

*4.4 SYNCHRONIZED CARDIOVERTER FUNCTIONAL CHARACTERISTICS

The synchronizer detects the peak of the R wave and, after the discharge buttons on both defibrillator paddles have been pushed, delivers the stored energy. The QRS amplitude must be set to at least 0.6 cm on the scope display using the SIZE control. QRS detection is verified by an audible QRS beep and by a SYNC pulse displayed on the scope at the time relative to each QRS complex that the energy would have been delivered.

4.5 WRITER FUNCTIONAL CHARACTERISTICS ( D320W/400W only)

The D320/400W is equipped with a 40 mm direct hard copy writer. The writer is started manually by the RECORD push-button on the front panel or automatically on alarm. No other controls are provided. Gain of the writer is equal to the gain of the scope. Therefore, setting the QRS size control to a convenient point for the scope will produce a reasonable gain for the writer. Centering of the writer is automatic to within approximately .25 cm. An internal stylus heat adjustment is provided. An external control is not needed due to the regulation of the stylus power supply.


4.6 MODES OF OPERATION

The defibrillator has two modes of operation: non­synchronous defibrillation and synchronous defibrillation. The defibrillator is always in the non­synchronous defibrillation mode when power is turned on. It can be switched from the non­synchronous mode to the synchronous mode by pressing the SYNC ON push-button. It can be returned to the non­synchronous mode by pressing the SYNC OFF push-button. Synchronous mode is indicated by a SYNC light on the front panel and by sync pulses appearing on the scope coincident with QRS detection.

*4.7 OPERATOR CONTROLS

4.7.1 ON/OFF
A two push-button switch turns on the ECG amplifier and Solid TraceScope and puts the unit in the non­synchronous mode when ON is depressed.

When OFF is depressed it dumps (disarms) the defibrillator capacitor and switches off all power to the unit. Closing the front cover automatically depresses OFF.

4.7.2 MANUAL CHARGE

A momentary push-button that causes the capacitor to be charged while depressed.

4.7.3 AUTO CHARGE 160 (AUTO CHARGE 200)

A momentary push-button which initiates an automatic charge to 160 joules delivered.

4.7.4 AUTO CHARGE 320 (AUTO CHARGE 400)

A momentary push-button which initiates an automatic charge to 320 joules delivered.

4.7.5 PADDLE CHARGE (Optional)

A momentary push-button located on the right paddle which functions identically to the MANUAL CHARGE push-button.

4.7.6 SYNC ON/SYNC OFF (Labeled SYNC/DEFIB ON D400/400W)

Two momentary push-buttons used to select synchronous or non­synchronous mode of operation. Pressing SYNC ON after the power is turned on puts the unit in the synchronous mode and illuminates the SYNC light. The unit is put in the non­synchronous mode when power is turned on or by pressing SYNC OFF when operating in the synchronous mode.

4.7.7 DISARM

A momentary push-button that is used to dump the internal stored charge. It is used if a lower energy than the one already selected is desired, or if no more countershocks are to be delivered.

4.7.8 QRS SIZE

A potentiometer used for setting the gain of the ECG amplifier. Gain may be varied from X300 at fully CCW to X3000 at fully CW. At center position, the gain is X1000.

4.7.9 FREEZE

A latching push-button that causes the scope to cease updating.

4.7.10 1MV

A momentary push-button that injects a 1 mv +/­ 2.5% signal.

4.7.11 BEEP

A latching push-button that activates the QRS beep when depressed.

4.7.12 HIGH LIMIT

A potentiometer used for setting the alarm high rate limit over a range of at least 100 to 250 BPM. It is set to 120 BPM with knob pointer is straight up.

4.7.13 LOW LIMIT

A potentiometer used for setting the alarm low rate limit over a range of at least 0 to 150 BPM. It is set to 60 BPM with knob pointer is straight up.

4.7.14 RECORD

A latching push-button that starts the writer when depressed. The writer is always started on alarm.

4.7.15 LEAD SELECT

Four interlocking push-buttons labeled PADDLES, I, II, III that select paddles or standard leads I, II, III respectively as input to the ECG amplifier. A three­lead cable with RA, LA, and LL (which may be labeled R) can be used.


*4.8 INDICATORS

4.8.1 BATTERY LOW

A red lamp that begins flashing when the battery has a minimum of ½ hour of continuous monitoring capacity left or 2 charges to 320 joules (1 charge to 400 joules). The lamp flashes to indicate circuit operation when power is turned on.

4.8.2 SYNC

An amber LED that illuminates when the unit is operating in the synchronous mode.

4.8.3 DELIVERED ENERGY, JOULES

An illuminated bar that indicates the energy in joules to be delivered into a 50 ohm load.

4.8.4 TEST

A light located on the defibrillator paddle holder that illuminates when a counter shock of at least 300 joules is discharged into the paddle holders.

4.8.5 ALARM

A red light that flashes during an alarm.

4.8.6 LINE

Two red lights that illuminate when AC power is being received by the unit.

4.8.7 QRS Beep

An audible tone that is produced every time a QRS complex is detected when the BEEP push-button is depressed.

4.8.8 Charging

A audible tone that increases in pitch as the capacitor charges.

4.8.9 Sync Pulse

A negative pulse displayed on the ECG trace with its center within 20 ms of where the energy should have been delivered if the DISCHARGE BUTTON(S) had been pushed.

4.8.10 Heart Rate Bar

An illuminated bar graph showing Heart Rate and alarm limit settings.

*4.9 CONNECTORS

4.9.1 Defibrillator Paddle Connector

G pin High Voltage Connector

Pin D ­High Voltage Paddle Lead
Pin A +High Voltage Paddle Lead
Pin F Ground
Pin C INTPDL ­ (Internal Paddle Jumper)
Pin B FDLSW ­ (Paddle Switch)
Pin E RMTCHG ­ (Remote Charge Switch)

4.9.2 Isolated Input Connector

5 pins MS series Connector ­ Located on front panel.

Pin A Right Arm
Pin B Left Arm
Pin C Left Leg
Pin D Left Leg
Pin E Left Leg

4.9.3 ECG/Output Connector

3­wire phone jack on front panel
Tip ­ ECG Output
Ring ­ Signal Ground
Sleeve ­ Chassis Ground



Sheet 1 of 1
TITLE: IN4278 ZENER DIODE SPECIFICATION NUMBER

Drafted by App. Date
REV. ECN History Notes Date


1. SCOPE: This specification describes a one­watt zener diode used for voltage reference in the XYZ Stimulator.

2. ELECTRONIC CHARACTERISTICS

2.1 Zener Voltage: 3.1 vdc @ 76 madc

2.2 Maximum Zener Impedance: 10 ohms @ 76 madc

2.3 Reverse Leakage Current: (25%) 100 microamps (max) @ l vdc

3. TESTING: All diodes shall meet the requirements of JANTX IN4278 as specified in MIL­S­19500/127G.

4. PHYSICAL CHARACTERISTICS

4.1 Diodes shall be packaged in a void­free silicone case.

4.2 Leads shall be readily solderable.

5. MARKING

5.1 The cathode shall be identified by a color band.

5.2 An identification number and lot number or date code shall represent a specific manufacturing period.

5.3 All markings shall be permanent such that cleaning solutions will not remove the markings.

6. CERTIFICATION

6.1 A certification of compliance with this specification and a test data sheet must accompany each lot shipped.

6.2 Certification must include a statement that no changes have been made in materials or physical or electrical characteristics.

7. APPROVED SUPPLIERS

7.1 XXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXX


OPEN HERE






HAND-SWITCHING PENCIL
STERILE REUSABLE
Catalog No. E2502B

STERILITY GUARANTEED UNLESS PACKAGE HAS BEEN DAMAGED OR OPENED:

CONTENTS:
One sterile reusable Hand-switching Pencil with 10 follt cord and plug and disposable blade electrode. Accepts all standard 3/32" shaft electrodes.


DIRECTIONS:
1) Open package by peeling apart at arrow.
2) Remove LectroSwitch®Pencil from sterile package using aseptic technique. Do not
perrmit LectroSwitch®Pencil to contact unsterile end of package or any object outside the sterile field.
3) Check blade electrode connection for secure fit prior to use
4) Insert plug connection into active hand-switching receptacle on generator. An adapter
may be required for generators not manufactured by Valleylab, Inc.
5) Remove protective sleeve from blade electrode.

CAUTION:AFTER USE THE LECTROSWITCH®PENCIL MUST BE STERILIZED. DISCARD THE DISPOSABLE BLADE ELECTRODE BEFORE REPROCESSING. RECOMMENDED STERILIZATION TECHNIQUE IS SHOWN ON PACKAGE INSERT IN BOX CONTAINING LECTROSWITCH®PENCILS.

NOTE:GOOD OPEATING ROOM PRACTICE SUGGESTS THAT ACTIVE ACCESSORIES BE PLACED AWAY FROM THE PATIENT WHEN NOT IN USE.



COMPANY LOGO
PARTS LIST
PL
24990672
REV C
USED ON 29330080 TITLE Handle Assemby SHEET
1 OF 1
DRAWN DATE CHECKED DATE APPROVED DATE
ITEM NO.
SIZE
PART NO.
DESCRIPTION
REF.DES.
QTY.PER.TAB NO.
         
.01
.02
1
           
2
           
3
           
4
           
5
           
6
           
7
           
8
           
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10
           
11
           
12
           
NOTES:







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20500681
REV B
USED ON Port Scope TITLE Cable Interconnecting &
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SHEET
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DRAWN DATE CHECKED DATE APPROVED DATE
ITEM
NO.
SIZE
PART NO.
DESCRIPTION
REF.DES.
QTY.PER.TAB NO.
         
.01
.02
1
           
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Notes:


Device Master Record For Amaylase Dwg No Sheet 2 Of 2
Sheet 1 of 3
1. PRODUCT SPECIFICATION FOR AMYLASE, CATALOG NO. 3200

1.1 Product name: Amylase Set

1.2 Description of product

This Amylase Set is used for the quantitative determination of amylase in biological fluids.

The principle of the procedure is as follows:

Starch + H20 amylase > colorless starch fragments

Unhydrolyzed Starch + I2 ­­­­> colored starch­iodine complex

The color produced by the starch­iodine complex after 7.5 minutes incubation of substrate with specimen and 15 minutes color development is compared with a reagent blank. The decrease in absorbanceoptical density (OD) at 660 nm is proportional to amylase activity in the specimen because the enzyme hydrolyzes starch to fragments that do not react with the iodine reagent.

1.3 Product availability

Catalog No.: 3200­01
Catalog No.: 3200­10

1.4 Components of product

Catalog No. 3200­01
15 Tubes of lyophilized substrate
1 Bottle (10 ml) Iodine (.OIN)
1 Instruction sheet

Catalog No. 3200­10
100 tubes lyophilized substrate
2 Bottles (30 ml ea.) Iodine (.OIN)
1 Instruction sheet

1.5 Storage of reagent

Store at room temperature. Do not refrigerate.
Minimum shelf life is one year.
Do not use any substrate tube in which moisture is observed.

1.6 Stability of specimen

Amylase activity in serum is stable up to one week at room temperature and for one to two months if refrigerated at 2 to 8°C.




Caution: Some urine specimens may contain reducing substances which could exhaust the iodine reagent.

1.8 Units

One amylase unit is defined as that amount of enzyme activity which, under the conditions of this procedure, will hydrolyze 10 mg of starch in 30 minutes to a stage at which no color is generated with iodine.

1.9 Normal Range

Normal range for serum is 50 to 200 units at 37°C. Infants below two months have no measurable serum amylase. Adult level is reached by the age of one year. The above normal range includes an average serum blank of 25 amylase units. Normal values for urine is less than 375 units per hour at 37°C.




Amylase Description

DWG NO: XX-3200

Sheet 3 of 3
1.10 Precision

Coefficient of variation of 5 to 6 percent at a level of 120 units and 3 to 5 percent at a level of 250 units are obtained with good laboratory technique.

1.11 Performance characteristics

This assay measures amylase levels up to 500 units per 100ml specimen in a linear manner. Specimens with higher activity must be diluted by the procedure given in Note 2 [not reprinted in this manual]. The calculated value includes a serum blank, which averages about 25 units in human sera. Control sera may have larger serum blanks, often up to 100 units. Values obtained on patient sera when corrected for the serum blank activity of approximately 25 units are very close to the values obtained by the Somogyi Saccharogenic method.

1.12 Cautions

This product must be protected from contamination by amylase. Saliva is a very potent source of amylase. Perspiration contains some amylase as do other body fluids. Insensible droplets of saliva are projected during speech, sneezing, etc.

Face masks and hair covering must be worn during solution and diluent preparation, solution filling, tube racking and capping, and when handling any raw material defined for use with this diagnostic test.

Equipment used in the procedure should be designed "For Amylase Only". Glassware and other equipment suspected of amylase contamination must be rinsed with XXXXXXX. Avoid contamination with detergents or soap. (See SOP #G021). Observe safety precautions when handling acids (SOP #G022).

1.13 Manufacturing Flow Sheet.

See Form No. 9926. [Not reprinted in this Manual].




Page 1 of 2

FOR USE IN CATALOG Numbers: XXXX­01 15 tests and XXXX­10 100 tests
Batch No. __________________ Code No. ___________________ Date _____________________

Prepared by ___________________________Checked by __________________________________

>
MASKS MUST BE WORN THROUGHOUT THIS PROCEDURE TO PREVENT SALIVA CONTAMINATION.

FOR 50 LITERS OF AMYLASE DILUENT SOLUTION:

1. Weigh the following chemicals and place them in 43 liters of deionized water in a calibrated clean container.


DEIONIZED WATER: Source _______ Vol. _______ ml Done By _______________________
Conductivity Light: On ________ Off ________ Checked By _____________________________

VENDER LOT AMOUNT WEIGHED
CODE NO. REQ'D WEIGHT BY BY
RM. NO. CHEMICAL
__________________________________________________________________________________

01­0004 Sodium Chloride _____ _____ 425.0 g G ____ _____ _____
±0.1 T ____
N ____

01­000X XXXXXX _____ _____ 523.25 G ____ _____ _____
Basic _____ _____ ±0.1 T ____ _____ _____
N ____

01­000X XXXXXX _____ _____ 1275.0 g G ____ _____ _____
Basic _____ _____ ±0.1 T ____ _____ _____
N ____


Note: Slowly add the sodium XXXXXXXX to prevent caking.


__________________________________________________________________________________
Procedure Amylase Diluent Solution No. __________________ Rev. __________________
Completed by _____________________ Date __________________ Date Eff. _______________
Checked by _______________________ Date __________________ App'd _________________


Batch no._________________ Page 2 of 2

2. Stir the diluent until all of the salts go into solution.

Done by ____________________

3. Check the pH of the solution against 7.00 pH reference buffer.

Initial pH ____________________ Checked by ____________________

4. Adjust the solution to a pH of 7.00 + 0.05 @ 25°C using 2N NaOH
mls of _____ --_ used. Lot No. _______ pH ______ @ 25°C

Checked by ____________________

5. Add 125 mls of 1% XXXXXX solution & mix well. Done by ____________________

No. of mls added _______________ Supplier____________________ Lot No. _________________

6. Bring the volume to 50 liters with deionized water and mix well. Re­check the pH. It should still be 7.00 + 0.05 @ 25°. Adjust, if necessary, with 2N NaOH or 6N HCl.

DEIONIZED WATER:

Source ____________________ Final Vol. _________ mls. Done by __________________

Conductivity Light: On ________ Off ______________ Checked by ____________________

mls of ______ used to adjust. Lot No. ______ Done by ____________________

Final pH @ 25°C ____________________ Checked by ____________________

7. Solution must be approved by the Solutions Supervisor(s) or their designee before it can be used. Approved by: __________________ Date ____________________

8. The Solution is now ready to be used in the preparation of Amylase.
It will be filtered as it is during that preparation.

9. Label the Diluent Solution with the Product Name, Batch Number, and Date of Manufacturing.


__________________________________________________________________________________

PROCEDURE Amylase Diluent Solution No. _________________ Rev. __________________

Form No. 1084 Sheet 1 of 1
FILLING RECORD ­ Liquid, Non Freeze Dried
Product Name ____________________________________ Kit Cat. # _______________________
Distributor ____________________________________ Kit Lot # _______________________
Theoretical Tube & Vial Yield _______________________ Kit Exp. Date ____________________

SPECIAL INFORMATION _________________________________________________________
__________________________________________________________________________________

IODINE
Batch # __________________________ Date Manuf. ______________________________
Date Received _______________ Time Received _______________________________

TUBE AND VIAL Code # ________________________ # Racked
INFORMATION # Lost _________________________ Total # Used

FILLING DATA
Machine(s) Before Filling ­ Signed __________________ Date _________________
Cleaned:
After Filling ­ Signed ____________________ Date _________________
Fill Vol. ________ ml Limits ± _____ ml Filling ___________________________
Batch Vol. ______ ml Leftover ________ ml Method __________________________
# Tubes or Vials Filled _______ #Bad Fills _______ [ ] Refilled
[ ] Not Refilled
APU _______________ ml TPU ml _______________ TPR ml _______________

Filling Operators 1) _____________ 2) _____________ 3) _____________ 4) _____________
Volumetric Fill Checks: 1) _____________ 2) _____________ 3) _____________
4) _____________ 5) _____________ 6) _____________ 7) _____________ 8) _____________

Checks done by _______________________________________ Date ____________________
CAP AND LABEL INFORMATION

1. Cap Code # ___________ # Used ___________ # Lost ___________
2. Cap Code # ___________ # Used ___________ # Lost ___________
Label Code # ___________ # Used ___________ # Lost ___________

Signed _______________________________________ Date _____________________

Checked by ___________________________________________________ Date _________________
ATTACH SAMPLES OF LABELS


FINISHED PRODUCT RELEASE Form No. Rev. Sheet 1 of 1      
Form Approved by: Date      
ECN notes:      
       
       
Title: AMYLASE SET      
Packaging lot number Circle one CATALOG Number ® AM-389-01
AM-389-02
     
       
The device history documents below were reviewed by ®
Circle one form number in 2, 5 & 7 below.
MFG
ü
QC
ü
     
1. Form # 9926 Product flow sheet          
2. Form # 1077 or 1078 Iodine solution          
3. Form # 1082 Substrate solution          
4. Form # 1083 Substrate tube filling sheet          
5. Form # 1084 or 1085 Iodine filling sheet          
6. Form # 1086 Packaging record          
7. Form # QC-PP-07 or QC-PP-01 Finished device specification          
             
Comments      
       
       
Sign. MFG Designee APP. Yes or No®   xxxxxxxxx      
Comments      
       
Signature QC Designee Approved Yes or No        
Production Workmanship and Configuration Sample Tag
PRODUCTION SAMPLE NAME
INSTRUMENT/PART NUMBER REV OPTION CODES
SAMPLE NUMBER   ECN HISTORY ON BACK
NOTES:
 
 
 
APPROVED FOR USE BY: Form Number 6-53
PROJECT ENGINEER
Signature Master Sample Only
DATE
LEAD ASSEMBLER
Signature all samples
DATE
LEAD TECHNICIAN
signature all samples
DATE
PRODUCTION MANAGER
signature master sample only
DATE
Back of Sample Control Tag (the above tag)

SAMPLE MODIFICATION HISTORY
Modification Number ENG (MASTER ONLY) LEAD ASSEMBLER LEAD TECHNICIAN
  SIGNATURE DATE SIGNATURE DATE SIGNATURE DATE
             
             
             
             
             
             
             
             
             
SHOP ORDER TRAVELER

Form 058-SOT
S.O.T. NUMBER
  DATE
Description Part No.
FROM Department TO Department
Quantity Delivered Quantity Accepted
Supervisor Supervisor
Remarks Lot No. Complete Thru OPN
FOLLOWER TAG Form 092-FT
Instrument Name S/N
Line Voltage Model No.
Record discrepancies & nature of rework on back
PROCESS BY EMPLOYEE DATE
Assembled    
In-process Check    
Chassis Check    
Test & Calibration    
Burn-in    
Audio Calibration    
Final In-process Inspect.    
Seal Card Cage    
Pre-Cover Inspection    
Final Assembly    
Final Test    
Final Inspection    
Packing/Shiping Inspect.