MA 25 Operating Instructions May 2010

MAICO Diagnostic GmbH

Operating Instructions MA 25

MAICO Diagnostic GmbH, Salzufer 13/14, D-10587 BERLIN, Tel. +49 30-70714650, Fax +49 30-70714699

Operating Manual MA 25 / MA 25e Table of Contents

Page

1 Introduction ... 2 2. Description ... 3 2.1 Important safety note ... 4 2.2 Unpacking and checking the MA 25 ... 5 2.3 Standard accessories ... 5 2.5 Connecting the accessories ... 6 3 Function of buttons and display ... 7 3.1 Function buttons ... 7 3.2 Special functions of MA 25e ... 8 3.3 Display ... 9 4 Performing tone audiometric tests ... 10 4.1 Performing automatic tone audiometric test (MA 25e)... 10 5 Setup menu ... 11 6 Warranty and disclaimer ... 15 7 Care and maintenance ... 16 8 Safety regulations ... 17 8.2 Measurement safety ... 17 8.3 Instrument handling ... 17 8.4 Operation... 17 9 Technical data ... 18

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Operating Manual MA 25 / MA 25e 1 Introduction Thank you for selecting one of our quality products from the MAICO family range. The MA 25 is designed and manufactured to meet all quality and safety requirements, and has been certified with the CE-symbol according to Medical Directive. Particular attention has been taken during the designing phase of the MA 25 to ensure its user-friendliness, meaning that its operation is simple, easy to learn and to understand. As all the functions are software-controlled, upgrading the software and/or adding additional functions at a later date will be simple and cost-effective. By purchasing the MAICO MA 25, you have made a decision towards long-term investment. This operating manual aims to make learning and understanding the different MAICO MA 25 functions as quick and as easy as possible. Should you encounter any problems or have ideas for any further improvements, we are only a phone call away. Please do not hesitate to contact us. Your MAICO-Team

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Operating Manual MA 25 / MA 25e 2. Description The MA 25 / MA 25e screening audiometer is designed to be a device for screening for hearing loss. Output and specificity of this type of device are based on the test characteristics defined by the user, and may vary depending on environmental and operating conditions. The screening for hearing loss using this kind of audiometer depends on the interaction with the patient. “Normal hearing” result should not allow for ignoring other contra indications. A full audiologic evaluation should be administered if concerns about hearing sensitivity persist. The MA 25/MA 25e audiometer is intended to be used by an audiologist, hearing healthcare professionals, or trained technicians in a quiet environment. Extended Functions The MA 25e extends the MA 25 functionalities with the following two extra features: In addition to traditional manual testing, the MA 25e incorporates a Hughson Westlake patient controlled automatic threshold test complying with ISO 8253. When the test is completed the results are easily recalled from the internal memory of the MA 25. Talk Forward function that makes the MA 25e easy to work with particularly in sound booth installations.

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Operating Manual MA 25 / MA 25e 2.1 Important safety note The MA 25 should always be operated in a quiet room with minimal magnetic influence, to ensure that examinations are not disturbed by external noise. Electro-medical instruments that emit strong electromagnetic fields (e.g. microwaves, radiotherapy devices) can affect the operation of the MA 25. Therefore, the operation of these instruments in close proximity to the MA 25 should be avoided at all times. The examination room should have a normal temperature between 15˚C/ 59˚F and 35˚C/ 95˚F. If the instrument has cooled down during transportation, please wait for it to warm up to room temperature before operation. MAICO MA 25 is specified according to EN 60 601-1. Attention PLEASE READ THE ENTIRE MANUAL CAREFULLY BEFORE OPERATING THIS INSTRUMENT. Please only use this instrument as described in the manual. Please familiarize yourself with the instrument and its operation before using. Should defects or damages be suspected, please do not, under any circumstances, use or attempt to fix the instrument yourself. Calibration of the instrument: The audiometer and the headphone complement each other and share the same serial number (i.e. 7663252). Therefore, the instrument shall not be used with any other headphone prior to recalibration. Recalibration also needs to be conducted, when a defected headphone is replaced. Uncalibrated instruments may lead to faulty measurements and sometimes even damage the hearing of the examinee. Take note to ensure that all the accessories have been properly connected. To avoid person-to-person cross contamination of communicable diseases, parts that come in direct contact with the patient (i.e. earphone cushions) should be disinfected using commercial disinfectant after each use.

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Operating Manual MA 25 / MA 25e In accordance with the Electronic Equipment Act for disposal of electronic equipment, the customer is obliged to dispose of the used consumables, according to appropriate regulation at own cost.

To observe the CE-mark with an external power supply, the power supply must be CE-medical approved according to EN 60601-1. 2.2 Unpacking and checking the MA 25 Checking for packaging and content damage Thoroughly inspect the exterior of the shipping box for any sign of damage or tempering. Should any damage be noted, please notify the carrier immediately. If the content box has been damaged during transportation, the instrument should be checked for any electrical or mechanical defects. Should any defects be identified, please contact the responsible dealer. Keep all original packaging to facilitate any insurance claims against the damages. PLEASE KEEP ALL ORIGINAL PACKAGING FOR FUTURE USE! The MA 25 is packaged in a specially-designed box. Please keep the box as it will be useful for sending the instrument for the annual instrument check-up, as required by law. Please contact your nearest responsible dealer should the annual instrument check-up be needed. 2.3 Accessories Audiometer MA 25 DD 45 Audiometric Headset. 1 Pad with 50 audiogram charts 3 batteries inside the device MA 25 e - same like MA 25 Patient response switch Optional

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Operating Manual MA 25 / MA 25e 2.5 Connecting the accessories All the connection jacks can be found on the rear side of the MA 25. All the cables and accessories have to be connected before the instrument is switched on.

Figure 1 Rear and bottom of the MA 25

Position:

Symbol:

Function:

1 2 3 4 5

Battery Power / USB Patient Resp. Right Left

Compartment for three batteries AA/LR6 Socket for external power supply Socket for patient response switch Socket for right headphone DD 45 Socket for left headphone DD 45

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Operating Manual MA 25 / MA 25e 3 Function of buttons and display

Power On and Power Off Attention: Power on is only possible if headphones are plugged-in! To turn on the audiometer press the Tone Switch button. To power off the audiometer press the level dialer and frequency dialer for a few seconds. The audiometer will also automatically power off after 3, 4, 5 minutes (or not) depending on the settings. Pure Tone Presentation Frequency: Turn the Frequency Hz dialer to select another frequency Level: Rotate the Hearing Level dB dialer to increase or decrease the level Present tone: Touch the Tone Switch 3.1 Function buttons F1 - MA 25 - Select the Right ear. MA 25e: Toggle between Right and Left. F2 - MA 25 - Select the Left ear. MA 25e: Store threshold. F3 – Pulse – Pulse Off: Manual tone presentation; Pulse On: Pulsing Tone will be presented. F4 – Warble - Warble off: Pure tones will be presented. Warble on: Warble tones will be presented.

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Operating Manual MA 25 / MA 25e 3.2 Special functions of MA 25e Talk Forward: Talk Forward is Hearing Level db dialer.

activated

by

holding

down

the

While holding down the Tone Switch the talk forward level can be adjusted. The following MA 25e F-key functionalities can be accessed by pressing the frequency dialer.

F1 - Delete all thresholds stored in the internal memory of the MA 25e. F2 - Store a Not Heard threshold point. F3 - Display the L/R thresholds stored in the internal memory of the MA 25e.

F4 - Start the Hughson Westlake (HW) automatic test procedure. Please refer to the chapter 5 for instructions about how to setup the HW test.

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Operating Manual MA 25 / MA 25e 3.3 Display Tone: A tone presentation indicator is provided in the top left corner of the display header.

Response: When using the patient response switch, a response is indicated in the middle of display header.

Power On or Battery status: The power status of the MA 25/MA 25e is indicated in the top right corner of the display header.

The icon will change depending on whether the instrument is powered via an external source (power supply or USB connection to computer) or batteries. When powered by batteries, the battery icon will change depending on the battery power level. When batteries are running low the display will read Low Battery and flash. The Power Off settings of the instrument can be adjusted at different time intervals or set to never power off – please see Setup section for details.

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Operating Manual MA 25 / MA 25e 4 Performing tone audiometric tests Hearing threshold levels can be determined by presenting test signals to the test subject with the included earphones (air conduction – AC). The purpose of AC audiometry is to establish the hearing sensitivity at various frequencies. The test can specify the AC loss but cannot distinguish between abnormality in the conductive mechanism and sensor neural mechanism. The patient should sit at a distance of at least 1 m from the device. Eliminate any obstructions which will interfere with the placement of the earphone cushions on the ear (i.e. hair, eyeglasses). Ensure that the headphones are positioned correctly: Red side on the right, blue side on the left. Adjust the headband of the headphones so that the earphones are positioned at the correct height (i.e. the sound output grid exactly facing the ear canal). Prior to hearing threshold level measurements, the following instructions should be given. "You will now hear a variety of pitches with various loudness levels. Please push the response switch when you hear a tone and release the button when you no longer hear it. If not using the response switch, ask the patient to “raise their left or right hand when you hear the tone in the left or right ear". Threshold Determination: The test normally starts at 1000 Hz on the patient's better ear with the L/R switch adjusted accordingly. Attention: Background noise can produce false test results, especially at lower frequencies. For hygienic reasons, it is important to clean the headphone ear cushions after testing. 4.1 Performing automatic tone audiometric test (MA 25e) Another form of threshold search is using the Hughson Westlake automatic tests procedure, also known as the “10 down, 5 up” method. Prepare and instruct the test person as described above. Press the Frequency Hz dialer and F4 to start the automatic Hughson Westlake test. If Familiarization is activated the HW tests starts with 1000 Hz at 40 dB and proceeds in 10 dB steps in a familiarization phase before the Hughson Westlake test itself starts. If the hearing level is confirmed the value will be stored and the next frequency is selected automatically. The level decreases for 10 dB.

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Operating Manual MA 25 / MA 25e 5 Setup menu To access the MA 25/MA 25e setup menu press F1 and F4 simultaneously for 2-3 seconds. F1 F2 F3 F4

Change setting Browse up in the setup menu Browse down in the setup menu Save settings and Back to previous screen display – see below for details

Power Up Tone

Press Change to toggle between Manual and Reverse. Man: Tone is presented as long as the Tone Switch is activated. Rev: Tone will be interrupted if Tone Switch is activated. Power Up Ear

Press Change to toggle between Right and Left ear as the default ear for Power Up Default Intensity

The default intensity when changing ear side is 20 dB. Choose between: Off, -10dB, -5dB, 0dB, 5dB, 10dB, 15dB, 20dB, 25dB, 30dB, 35dB, 40dB, 45dB and 50dB. GEBA_MA25_E_10a.docx

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Operating Manual MA 25 / MA 25e Intensity Steps

Choose between 1 dB and 5 dB. Power Off Settings

Press Change to toggle between Never, 1, 2, 3, 4 or 5 minutes. Pulse Length

Press change to toggle between 250 msec and 500 msec. Language

Press Change to toggle between English, German, Spanish and French. LCD Contrast

Press Change to toggle between settings ranging from 0 (very bright) to 6 (very dark).

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Operating Manual MA 25 / MA 25e HW Test (only MA 25e)

Press Change to go to the Hughson Westlake (HW) automatic test procedure setup.

Press Change to toggle between Familiarization On/Off. Familiarization is used to train the patient.

Press Change to toggle between “2 correct out of 3 answers” and “3 correct out of 5 answers”. The conditions used before saving the hearing threshold and going to the next frequency.

Select the frequencies to include in the HW test. Press Change to toggle between frequencies On/Off. Press Save to return to the main HW setup menu.

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Operating Manual MA 25 / MA 25e Frequencies

Press Change to access the default frequency range from 125 Hz to 8 kHz for daily operation.

10 frequencies are available to change: 125; 250; 500; 750; 1,500; 2,000; 3,000; 4,000; 6,000 and 8,000. Press Change to toggle between On or Off. Press Save to return to the main setup menu License

Press Change to access the license key of the MA 25/MA 25e.

Press Change to enter and modify the license key. Use the Hearing Level dB dialer to change the letter and Frequency Hz dialer to move the cursor. Press Save to return to the main setup menu. About

Press Change to access the information in the About section. GEBA_MA25_E_10a.docx

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Operating Manual MA 25 / MA 25e 6 Warranty and disclaimer Warranty, Maintenance and After-Sales Service Hardware The MA 25 audiometer is guaranteed for 1 year. This warranty is extended to the original purchaser of the instrument by MAICO through the Distributor from whom it was purchased and covers defects in material and workmanship for a period of one year from date of delivery of the instrument to the original purchaser. The audiometer may be repaired only by your dealer or by a service center recommended by your dealer. We urgently advise you against attempting to rectify any faults yourself or commissioning non-experts to do so. In the event of repair during the guarantee period, please enclose evidence of purchase with the instrument. In order to ensure that your instrument works properly, the audiometer should be checked and calibrated at least once a year. This check-up needs to be conducted by your dealer. When returning the instrument for repairs it is essential to also send the headphone and other accessories. Send the device to your dealer or to a service center authorized by your dealer. Please also include a detailed description of the faults. In order to prevent damage in transit, if possible please use the original packing when returning the instrument.

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Operating Manual MA 25 / MA 25e 7 Care and maintenance Disconnect the power plug before cleaning! If the surface of the instrument or parts of it is contaminated, it can be cleaned using a soft cloth moistened with a mild solution of water and dish washing cleaner or similar. The use of organic solvents and aromatic oils must be avoided. After each examination of a patient, it should be ensured that there is no contamination on the parts in connection with the patient. General precautions must be observed in order to avoid that disease from one patient is conducted to others. If ear cushions are contaminated, it is strongly recommended to remove them from the transducer before they are cleaned. By frequent cleaning water should be used, but by severe contamination it may be necessary to use a disinfectant. The use of organic solvents and aromatic oils must be avoided. Always disconnect the mains conductor during the cleaning process, and be careful that no fluid is entering the inside of the instrument or the accessories; no alcohol or spirits should be used.

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Operating Manual MA 25 / MA 25e 8 Safety regulations 8.1 Electrical safety: The MA 25 / MA 25e is in compliance with Class B of EN 60601-1. The instrument is not to be used in environments dealing with explosive material or equipment. 8.2 Measurement safety: In order to ensure safety and quality of the measurement, an annual inspection and calibration should be performed. The annual check-ups can be performed by one of MAICO’s authorized service centers. MAICO will not be liable for any failure to comply with the specified inspection date, according to the Medical Product Law. The use of uncalibrated and uninspected audiometer is strictly prohibited. 8.3 Instrument handling: The instrument should be checked once a week. 8.4 Operation:

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The instrument should only be handled and operated by trained personnel (audiologists, ENT doctors or personnel with similar qualifications).

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Operating Manual MA 25 / MA 25e 9 Technical data Standards Audiometer : Safety : EMC :

EN 60645-1/ANSI S3.6, Type 4 EN 60601-1 EN 60601-1-2

0124

Frequencies and Maximum Intensities: Freq. Hz. AC (Air Condition) dB HL 125 250 500 750 1000 1500 2000 3000 4000 6000 8000

70 90 100 100 100 100 100 100 100 100 90

Inputs:

Patient response switch, USB-Power-Supply

Outputs:

Left AC, Right AC

Attenuator:

-10 to 100 dB HL in 5 dB steps.

Tone Presentation:

Manual or reverse (chosen in Setup Menu); Multiple pulses 250 or 500 msec (chosen in Setup Menu); On/Off; pure tone or warble tone

Talk Forward (MA 25e):

Built in talk forward microphone 0-100 dBSPL adjustable.

Auto Threshold (MA 25e):

Patient controlled Hughson Westlake procedure according to ISO 8253-1.

Store Function (MA 25e):

Soft key (F2-key) store button and internal memory for AC L/R. Stored measurements can be viewed on the build in display.

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