RS Islam Klaten

22/06/2013

Fluke Biomedical Ansur

Test and Inspection Procedure
Copyright 2000 - 2012 Fluke Biomedical

Test record
TEST PASSED
Test performed
Date:

22/06/2013
AAMI NFPA-99 Hospital.mtr
AAMI NFPA-99 Hospital.mtt

Record:
Template:

Ansur components used

Ansur
Version 2.9.7
Plug-In: ESA612

Version 1.1.2

Plug-In: AVPI

Version 2.4.10

Test setup
Selections
Service events performed

Standards performed
AAMI/NFPA-99 (H)

Device under test

Serial number
Appliance code
Group
Status
Manufacturer

test

Type
Model
Location
Address 1
Address 2

MTI Data
Test instrument
ESA612B

Serial number
2276048

Firmware version
v2.03

Signatures

Serial number: test

Date: 22/06/2013

Page 1 of 3
AAMI NFPA-99 - Hospital.mtr

RS Islam Klaten

Fluke Biomedical AnsurTest Report

22/06/2013

Test result
Test element
AAMI/NFPA-99 (Hospital)

Test type

Fail

Auto Sequence

Procedure:

(1)
(2)
(3)
(4)
(5)

Connect the DUT to the ESA612 as indicated in the operators manual.

Ensure that DUT power is off.
Click module setup and specify the patient leads that are to be tested.
Connect patient leads as indicated.
Press Start Test to perform the AAMI safety test.

Configuration:
Polarity Switching Delay:3(s)

AAMI/NFPA-99 (Hospital) - Power Off

Auto Sequence

Mains Voltage

Mains Voltage

Value
222,9

Mains Voltage
Live to Neutral
Unit
High limit
V

Value
0,5

Mains Voltage
Neutral to Earth
Unit
High limit
V

Value
223,3

Mains Voltage
Live to Earth
Unit
High limit
V

Live to Neutral
Result:
Live to Neutral

Neutral to Earth
Result:
Neutral to Earth

Live to Earth
Result:
Live to Earth

Protective Earth Resistance (Ground wire)

Result:
PE Resistance1

Value
0,086

Enclosure Leakage Current

Low limit

Standard
AAMI/NFPA-99 (H)

Low limit

Standard
AAMI/NFPA-99 (H)

Low limit

Standard
AAMI/NFPA-99 (H)

Protective Earth Resistance (Ground wire)

Unit
High limit
Low limit
Ohm
0,5

Standard
AAMI/NFPA-99 (H)

Enclosure Leakage Current

Configuration:
Applied Parts:Open

Value
0,4

Enclosure Leakage Current

Normal Condition
Unit
High limit
Low limit
uA
300

Standard
AAMI/NFPA-99 (H)

Value
0,3

Enclosure Leakage Current

Open Neutral
Unit
High limit
Low limit
uA
500

Standard
AAMI/NFPA-99 (H)

Value
95,9

Enclosure Leakage Current

Open Earth
Unit
High limit
Low limit
uA
300

Standard
AAMI/NFPA-99 (H)

Normal Condition
Result:
Normal Condition

Open Neutral
Result:
Open Neutral

Open Earth
Result:
Open Earth

AAMI/NFPA-99 (Hospital) - Power On

Serial number: test

Date: 22/06/2013

Auto Sequence

Page 2 of 3
AAMI NFPA-99 - Hospital.mtr

RS Islam Klaten

Fluke Biomedical AnsurTest Report

Test element

Test type

Enclosure Leakage Current

Enclosure Leakage Current

22/06/2013

Fail

Configuration:
Applied Parts:Open

Value
0,3

Enclosure Leakage Current

Open Neutral
Unit
High limit
Low limit
uA
500

Standard
AAMI/NFPA-99 (H)

Value
97,5

Enclosure Leakage Current

Open Earth
Unit
High limit
Low limit
uA
300

Standard
AAMI/NFPA-99 (H)

Open Neutral
Result:
Open Neutral

Open Earth
Result:
Open Earth

Serial number: test

Date: 22/06/2013

Page 3 of 3
AAMI NFPA-99 - Hospital.mtr