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XRCISE LINE MED
Technische und optische Änderungen sowie Druckfehler vorbehalten - © 2019 by ERGO-FIT GmbH & Co. KG
131
Einlegekarte für das Medizinproduktebuch
Betreiber: __________________________________________
__________________________________________
__________________________________________
1. Bezeichnung des Medizinproduktes:
_________________________________________________________________
2. Funktionsprüfung und Einweisung:
Funktionsprüfung durchgeführt
am: ________________ von: _________________________________________
Einweisung durchgeführt
am: ________________ von: _________________________________________
Eingewiesene Personen: ____________________________________________
____________________________________________
____________________________________________
3. Messtechnische Kontrollen: spätestens alle 2 Jahre
Nächste Durchführung: ______________________________________________
Durchführende Person: ______________________________________________
4. Instandhaltungs-/Sicherheitsüberprüfung (gemäß MPBetreibV): Empfehlung alle 12 Monate
Nächste Durchführung: ______________________________________________
Durchführende Person: ______________________________________________
5. Datum, Art und Folgen von Funktionsstörungen und wiederholten gleichartigen
Bedienungsfehlern: _________________________________________________
_________________________________________________________________
_________________________________________________________________
6. Meldungen von Vorkommnissen an Behörden und Hersteller:
________________________________________________________________________
________________________________________________________________________
137


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