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Medical Equipment Inspection Checklist
Equipment ID: EIT0LS6B
Model: Mayer and Sons UHPS
Department: Radiology
Inspection Date: 2025-02-13
Inspector: Charlie Schulist Sr.
Physical Condition
| Checkpoint | Functional | Needs Service | Defective | Not Applicable | Notes |
|---|---|---|---|---|---|
| Equipment housing intact | ✓ | ||||
| Display screen clear | ✓ | ||||
| Control buttons functional | ✓ | ||||
| Power cord undamaged | ✓ | ||||
| Mounting brackets secure | ✓ | ||||
| Wheels/casters condition | ✓ | ||||
| Labels and markings legible | ✓ | ||||
| Accessories complete | ✓ |
Electrical Safety
| Checkpoint | Functional | Needs Service | Defective | Not Applicable | Notes |
|---|---|---|---|---|---|
| Ground connection | ✓ | ||||
| Insulation resistance | ✓ | ||||
| Leakage current | ✓ | ||||
| Power supply stable | ✓ | ||||
| Battery backup functional | ✓ | ||||
| Circuit breaker operation | ✓ | ||||
| Surge protection | ✓ | ||||
| Cable connections secure | ✓ |
Performance Tests
| Checkpoint | Functional | Needs Service | Defective | Not Applicable | Notes |
|---|---|---|---|---|---|
| Self-test passed | ✓ | Power supply unstable, needs replacement. Last checked on 2/12/2025 | |||
| Calibration check | |||||
| Alarm systems | ✓ | ||||
| Backup systems | ✓ | ||||
| Output accuracy | ✓ | Minor wear observed, schedule maintenance. Reference ID: QTPIHA | |||
| Response time | ✓ | ||||
| Data storage/retrieval | ✓ | ||||
| Network connectivity | ✓ | ||||
| Sensor accuracy | ✓ |
Overall Status
Inspection Result:
X
Next Inspection Due: 2026-01-14