User Guide

Type 1202

Flex Focus
Ultrasound Systems

English
BB1756-R
June 2016 For Professional Users Only
 LEGAL MANUFACTURER

BK MEDICAL
Mileparken 34
2730 Herlev
Denmark
Tel.:+45 4452 8100 / Fax:+45 4452 8199
www.bkultrasound.com
Email: [email protected]

The serial number of a BK Medical product contains information about the year of manufacture. To
obtain the date of manufacture of a product, please contact your BK Medical representative or write to
us at the email address above, including the product's serial number (SN number).

BK Medical Customer Satisfaction

Input from our customers helps us improve our products and services. As part of our customer
satisfaction program, we contact a sample of our customers a few months after they receive their orders.
If you receive an email message from us asking for your feedback, we hope you will be willing to
answer some questions about your experience buying and using our products. Your opinions are
important to us. You are of course always welcome to contact us via your BK Medical representative or
by contacting us directly.
If you have comments about the user documentation, please write to us at the email address above. We
would like to hear from you.

Scanner Software
• NOT FAULT TOLERANT. THE SOFTWARE IS NOT FAULT TOLERANT. BK Medical HAS
INDEPENDENTLY DETERMINED HOW TO USE THE SOFTWARE IN THE DEVICE, AND MS HAS
RELIED UPON BK Medical TO CONDUCT SUFFICIENT TESTING TO DETERMINE THAT THE
SOFTWARE IS SUITABLE FOR USE.
• EXPORT RESTRICTIONS. You acknowledge that Windows XP Embedded is of US-origin. You agree to
comply with all applicable international and national laws that apply to Windows XP Embedded, including the
U.S. Export Administration Regulations, as well as end-user, end-use and country destination restrictions issued
by U.S. and other governments. For additional information on exporting Windows XP Embedded, see http://
www.microsoft.com/exporting/
• The Flex Focus 1202 Ultrasound System is closed. Any modification of or installation of software to the system
may compromise safety and function of the system. Any modification of or installation of software without written
permission fromBK Medical will immediately void any warranty supplied by BK Medical. Such changes will also
void any service contract and result in charges to the customer for restoration of the original Flex Focus 1202
Ultrasound System.

Trademarks:
DICOM® is the registered trademark of the National Electrical Manufacturers Association for its standards
publications relating to digital communications of medical information.
FireWire™ is a trademark of Apple Computer, Inc.
HistoScanning™ is a trademark of Advanced Medical Diagnostics SA.
Microsoft® and Windows® are registered trademarks of Microsoft Corporation in the United States and other
countries.
© 2016 BK Medical
Information in this document may be subject to change without notice.
Contents

Chapter 1 General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Essential Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Modes of Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Contraindications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Chapter 2 Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Safety Symbols and Information on the Equipment . . . . . . . . . . . . . . . . . . . . . . 11
CE Marks on Electrical Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
General Safety Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Explosion Hazards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Electrical Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
ESD Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Electrical Noise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Electromagnetic Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
RF (Radio Frequency) Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Connecting Other Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Network Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Network Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Network Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
HistoScanning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Using the System with a Lithotriptor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
EMC Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Isolation of DICOM Network. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Wireless Network (Wi-Fi) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Medical Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Non-Medical Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Battery Support System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
If the System Will Not Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Touch Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Remote Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Computer Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Service and Repair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
During an Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Checking the Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Verifying the Transducer Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
VFI – Vector Flow Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
English source version
BB1756-R

3
 Puncture and Brachytherapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Picture in Picture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Acoustic Output. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Thermal and Mechanical Indices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Acoustic Output Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Functions Affecting Acoustic Output. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Default Acoustic Output. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Clinical Measurements: Ranges and Accuracies. . . . . . . . . . . . . . . . . . . . . . . . . 40
Geometric Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Time Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Doppler Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Chapter 3 Adjusting the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Calibrating the Touch Screen Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Adjusting the Touch Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Chapter 4 Battery Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Before You Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Imaging with Battery Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Battery Pack Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Power Supply. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Plugging in the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Charging the Batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Battery Status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Information Available on the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Information Available on Battery Pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Power Save Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Changing or Replacing a Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Battery Life. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Battery Support Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Cleaning and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Battery Charger Station (UA1247) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Recharging a Battery in the Battery Charger Station . . . . . . . . . . . . . . . . . . 54
Cleaning and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Chapter 5 Remote Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
The Remote Control and Its Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Pairing the Remote Control with the System . . . . . . . . . . . . . . . . . . . . . . . . 55
Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Mouse Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Replacing Batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Cleaning and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

4
Chapter 6 Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

5
6
 Chapter 1
General Information

This user guide is for all versions of the Flex Focus 1202 Ultrasound System (scanner
unit and dock) and the optional battery charger station (UA1247) from
BK Medical.
Intended use The system is a 2D and 3D ultrasound echo and flow imaging system for diagnosis,
data processing and transfer and guidance of puncture and biopsy.
NOTE: Some of the functionality and options described in this guide may not be
available with your version of the system.
Before using the equipment, please make yourself familiar with the information in
the accompanying user information documents. Some documents are printed, and
you will find the remaining documents on the accompanying User Documentation
CD (BB1984). Make sure that you also read the transducer user guide and
specifications for each transducer that you use.

Document Information
System User Guide Introductory information, safety information, getting started.
Getting Started User interface, basic operating instructions. Note: this book is part of the
system user guide.
System Advanced User Guide Information about advanced functions, glossary.
Product Data for system Specifications for the system, including disinfection methods that can be
used. Indications for use for each transducer that can be used with the
system.
Technical Data (BZ2100) Acoustic output data, clinical measurements (ranges and accuracies),
factory default power levels and data about EMC (electromagnetic
compatibility) for all transducers. Pro Package calculation formulas.
Care and Cleaning Cleaning, disinfection, sterilization, checking, storing and disposing of
BK Medical equipment. Includes environmental limits.
Transducer User Guide Specific instructions for the transducer and puncture attachments.
Product Data for each transducer Specifications for the transducer, including disinfection methods that
can be used.

Table 1-1. User information documentation that accompanies the equipment.

Improper use Failure to follow safety instructions or use for purposes other than those described in
the user manuals constitutes improper use.

Essential Performance
The system can provide 2D and 3D ultrasound echo and flow imaging systems as an
aid in diagnosis, data processing and -transfer, and guidance of puncture and biopsy.

Flex Focus 1202 User Guide (BB1756-R) General Information 7

 The system can perform simple geometric measurements and calculations.
The system can guide biopsy- and puncture needles.
The system is free from artefacts or distortion in the image or error of a displayed
value, which can be attributed to a physiological effect and which may alter the
diagnosis.
The system displays correct numerical values associated with the diagnosis to be
performed.
The AFA (As Far As Possible) principle is used and safety related indications (MI,
TIS, TIB, etc) are displayed as worst-case values.
The system does not generate unintended or excessive ultrasound output or
transducer surface temperature.
There is no unintended or uncontrolled motion of transducer assemblies intended for
intra-corporeal use.

Intended Use
The system is intended for diagnostic ultrasound imaging or fluid flow analysis of
the human body, data processing and guidance of puncture and biopsy.
The system performs simple geometric measurements and calculations in the
following areas:
• Urology
• Vascular
• Cardiology
• OB/GYN
• Emergency Medicine
• Surgery
• Anesthesia

Modes of Operation
• B-Mode (including Tissue Harmonic imaging)
• M-Mode
• PWD Mode
• CFM Mode
• Power Doppler

8 Chapter 1 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Indications for Use
The system is intended for use by qualified physicians for ultrasound evaluation.
Specific clinical applications and exam types include:
• Abdominal
• Cardiac (not for direct use on the heart)
• Fetal
• Intraoperative
• Intraoperative Neurological
• Musculoskeletal Conventional
• Musculoskeletal Superficial
• Neonatal Cephalic
• Obstetrics
• Pediatric
• Peripheral Vascular
• Small Organ
• Transrectal
• Transurethral
• Transvaginal
Indicated uses are different for different transducers. The Product Data sheet for the
system contains a table listing the indicated uses for each transducer that can be used
with the system.

Contraindications
The Flex Focus 1202 ultrasound system is not intended for ophthalmic use or any use
causing the acoustic beam to pass through the eye.

Flex Focus 1202 User Guide (BB1756-R) General Information 9

10 Chapter 1 June 2016 Flex Focus 1202 User Guide (BB1756-R)
 Chapter 2
Safety Information

The system can be used for continuous operation, but imaging duration for individual
patients must not exceed 60 minutes. We recommend, however, that you turn off the
system at the end of each workday.

Safety Information
This user guide contains cautions, warnings and other information about what you
must do to ensure the safe and proper performance of the ultrasound system and the
optional battery charger station (UA1247). You must also follow local government
rules and guidelines at all times.

WARNING
Warnings contain information that is important for avoiding personal injury.

Caution
Cautions contain information and instructions that must be followed to avoid
damaging equipment, data, or software.

NOTE: Notes contain information that you should be aware of.

Safety Symbols and Information on the Equipment

Table 2-1 contains brief explanations of the symbols and information used to label the
equipment. (Some labels in the table may appear on the transducer.)
BK Ultrasound disclaims all responsibility for the operating safety, reliability and
performance of the equipment if these symbols and warnings are disregarded in any
way.

Symbol Name Description

Caution or Warning Consult accompanying user guides when you
encounter this sign on the instrument, to avoid
reducing its safety.
Consult instructions Consult user guide or other instructions.
for use
Pushing prohibited Do not use excessive force to push the system.
Excessive force when pushing over uneven surfaces
can cause the system to overbalance and tip.
Manufacturer Legal manufacturer.

Table 2-1. Symbols and information on the equipment.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 11

 Symbol Name Description
UL Classification for UL requirements are met for special conditions.
3D56
Canada and US
UL Recognized UL recognizes this as part of a UL-approved apparatus.
Component for
Canada and US
Potential Terminal connected to the chassis. Should be
Equalization connected to corresponding terminals on other
equipment to eliminate potential differences.
Ground (earth) Additional protective ground (earth).
Type BF BF: Isolated from ground.
Maximum patient leakage current under
• Normal condition 100A
• Single-fault condition  500A

Type BF BF, defibrillator-proof

Type B B: Maximum patient leakage current under
• Normal condition 100A
• Single-fault condition  500A

Sealing Dust- and immersion-protected according to EN

60529 [1].
Standby Symbol on ON/Standby button on back of scanner
unit – used to turn system on and off.
Not watertight Plug may not be immersed (unless it is covered with a
special watertight plug cover).
ESD (electrostatic Do not touch pins in connectors with this symbol
discharge) unless you follow ESD precautionary procedures.
Specified Radio (On remote control UA1237.) This equipment
Equipment conforms to Japanese Radio Law regulations
concerning frequency and power.
WEEE waste Within the EU, when you discard the equipment, you
must send it to appropriate facilities for recovery and
recycling.
Battery waste (On battery UA1225.) Dispose of used batteries
properly. When you dispose of the batteries, you must
follow national rules. Within the EU, you must send
LI-ION
them to appropriate facilities for recovery and
recycling.
China ROHS 25 Years Environmentally Friendly Use Period for ROHS is 25
Lifetime years.
Battery recycle (On battery UA1225.) Recycle used batteries properly.

Table 2-1. Symbols and information on the equipment. (continued)

12 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Symbol Name Description
Internally Powered (On the battery pack.) The text “Internally powered or
100V~, 60Hz / 100V-230V~, 50 Hz” indicates that the
system can also use batteries as a power source.
Table 2-1. Symbols and information on the equipment. (continued)

CE Marks on Electrical Devices

The European Union has introduced directives requiring b marks on devices.
Non-medical devices marked with b comply with relevant directives, for example
EEC Directive 2004/108/EC concerning Electromagnetic Compatibility.
BK Ultrasound devices marked with b or c comply with EEC Council Directive
93/42/EEC of 14 June 1993 concerning Medical Devices. b applies to Class I
medical devices. c applies to Classes Im, IIa, IIb and III. BK Ultrasound defines
classes assuming imaging duration for individual patients does not exceed 60
minutes.

General Safety Precautions

The ultrasound system is designed and tested in accordance with EN/IEC 60601-1
[2] (Part 1: General requirements for safety) and EN 60601–2–37 [3] (Particular
requirements for the safety of ultrasonic medical diagnostic and monitoring
equipment). The ultrasound system and the optional battery charger station
(UA1247) comply with requirements for Class 1 (protective earth) and – for systems
that include the mobile battery keyboard dock – internally powered devices of
EN/IEC 60601-1. They also comply with UL 60601-1 [4] and CSA C22.2 No.
601.1–M90 [5]. They fulfill the requirements for dust protection (IP20) for ordinary
equipment specified in EN 60529 [1].

Caution Rx-c1
Physicians United States law restricts this device to sale to, or on the order of, a physician.
only

WARNING GS-w1
Proper To ensure safe and proper use of the equipment, before you attempt to use BK equipment,
Training you should be trained in ultrasonography or be under the supervision of someone who is
trained in ultrasonography. You should also be thoroughly familiar with the safe operation
of your ultrasound system: read all the user documentation that accompanies it.
In addition, if your system interacts with other equipment directly or indirectly, you need
to make sure the interactions are both safe and secure.
No further training is required, but BK Ultrasound offers training in how to use the system.
Consult your BK representative for information.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 13

 WARNING GS-w2a
Equipment If at any time the system malfunctions, or the image is severely distorted or degraded, or
failure you suspect in any way that the system is not functioning correctly:
• Remove all transducers from contact with the patient.
• Turn off the system. Unplug the system from the wall – and for systems that include the
mobile battery keyboard dock, remove the batteries from the battery pack – to make
sure it cannot be used until it can be checked.
• Do not try to repair the system yourself.
• Contact your BK Ultrasound representative or hospital technician.

WARNING GS-w3a
Isolating the The power supply cord connects the equipment to the line voltage. To isolate the
system equipment, you must unplug the power supply cord from the power source, and for
systems that include the mobile battery keyboard dock, remove the batteries from the
battery pack. Do this before you try to make any repairs to the system.

Caution S-c2
Spilled The keyboard panel of the ultrasound system is not watertight. Be careful not to spill any
liquids liquids, gels or moist substances on the keyboard.

Caution S-c3
Conden- Large variations in temperature or humidity may cause water to condense inside the
sation system. If this happens, the system may fail to operate properly. Always let the system
come to room temperature before you plug it in.
• Wait at least 2 hours after the system has been subjected to major changes in
temperature or humidity.
• If there is visible evidence of condensation, wait at least 8 hours.

Caution S-c4
Never unplug the system from the wall while it is running. Turn off the system and wait for
the light on the keyboard and the ON/Standby button to go out before unplugging.

Before you use the equipment, make sure that all the safety requirements described
in this chapter have been satisfied.

Mechanical Safety
Mechanical failure or unintended use of ultrasound equipment can result in physical
injury to patients or operators.

14 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 WARNING MS-w1
Mechanical Be careful to avoid the following potential sources of injury:
injury • Parts of the body can be pinched by moveable parts of the equipment, such as the
control panel.
• Tilting the system can cause it to be unstable and injure someone.
• Do not lean or sit on the control panel or any other part of the system. The control
panel or monitor can break if subjected to heavy weights or impact.

WARNING MS-w2
All parts When parts of the equipment can be mounted individually (for example, for use in an
must be operating room) each part must be securely mounted to a stable support so that it does
stable not tip, fall or come loose and injure someone.

WARNING MS-w3
Don’t drop To avoid personal injury or damage to the system, if you handle the scanner unit by itself,
the scanner make sure you have a firm grip so that you do not drop it. Note that it may be hot.
unit

WARNING MS-w4
Don’t push To avoid injury and equipment damage, do not push the system too hard, especially when
too hard you roll the system over an uneven surface. Applying excessive force near the top could
cause the system to overbalance and tilt.

Explosion Hazards
WARNING EH-w1
Explosion The equipment is not designed to be used in potentially explosive environments. It should
hazards not be operated in the presence of flammable liquids or gases, or in oxygen-enriched
atmospheres.
There is a possible explosion hazard if the equipment is used in the presence of flammable
anesthetic. The system should be placed at least 25cm (10 inches) from the patient.
The ultrasound system contains a lithium battery. Never remove or replace this battery.
The lithium battery must not be removed except by a BK Ultrasound service
representative.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 15

 Electrical Safety
WARNING ES-w1
Do not use a Do not plug the equipment into an ordinary power strip. If the ground connection fails,
power strip this is dangerous because
• the total leakage current for all the connected equipment can exceed the limits
specified in EN/IEC 60601-1 (Part 1: General requirements for safety).
• the impedance of the ground connection could exceed the limits specified in EN/IEC
60601-1.

WARNING ES-w2
Leakage When the equipment is used with 230V (and you believe the leakage current would be
current within the UL limit if you were using 120V), power to the equipment must come from an
installation or supply unit with a center-tapped, 240V single-phase circuit. This will make
sure that chassis leakage current during single fault condition fulfills the requirements
specified in UL60601-1 [4] (limit of 300μA). If power is not supplied in the way specified,
the leakage current can be as high as 500μA, the limit specified in EN/IEC 60601-1 [2] (Part
1: General requirements for safety).

WARNING ES-w3
Electrical You risk electrical shock if you try to get inside the equipment (other than opening a cover
shock to access connectors described in the user guide). Do not allow anyone but qualified
service personnel to service the equipment.

ESD Training

The ESD Symbol

Anyone using the equipment must be able to recognize the ESD symbol and
understand how to take the necessary precautionary procedures, as described in the
caution below.

Caution ESD-c1
ESD Do not touch pins in connectors that have the ESD symbol . Do not connect
anything to them unless you follow these ESD (electrostatic discharge) precautionary
procedures:
• Discharge your body to ground before you touch the pins with your hand or a tool. For
example, touch an unpainted metal part of the system cover.
• You can use a wrist strap connected to the additional protective ground or potential
equalization terminal on the system if that is more convenient.

Interference
The Flex Focus 1202 Ultrasound System and the optional battery charger station
(UA1247) are suitable for use in all establishments, other than domestic
establishments and those directly connected to the public low-voltage power supply
network that supplies buildings used for domestic purposes.

16 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Electrical Noise

WARNING EN-w1
Electrical Electrical noise from nearby devices such as electrosurgical devices – or from devices that
noise can transmit electrical noise to the AC line – may cause disturbances in ultrasound images.
This could increase the risk during diagnostic or interventional procedures.

Electromagnetic Interference
Medical electrical equipment requires special precautions regarding EMC
(electromagnetic compatibility) [6]. You must follow the instructions in this chapter
when you install the system and put it into service.
If the image is distorted, it may be necessary to position the system further from
sources of electromagnetic interference or to install magnetic shielding.

WARNING EMC-w1
Other Do not use this equipment adjacent to other equipment. If you must place it next to or
equipment stacked with other equipment, verify that it operates normally there and neither causes
nearby nor is affected by electromagnetic interference.

EMC noise can reduce the usable image depth. Therefore, to avoid having to repeat
an ultrasound examination, you must make sure beforehand that the ultrasound
system can be used for the examination. Repeating an examination can be regarded
as a potential risk that should be avoided, especially if the examination involves
transducers used intracorporeally or transducers used for puncture.

RF (Radio Frequency) Interference

Portable and mobile RF (radio frequency) communication equipment can affect the
system, but the system will remain safe and meet essential performance
requirements.
An ultrasound system intentionally receives RF electromagnetic energy for the
purpose of its operation. The transducers are very sensitive to frequencies within
their signal frequency range (0.3MHz to 80MHz). Therefore RF equipment
operating in this frequency range can affect the ultrasound image. However, if
disturbances occur, they will appear as white lines in the ultrasound picture and
cannot be confused with physiological signals.

Caution Inter-c1
Possible Other equipment may interfere with the system, even if that other equipment
interference complies with CISPR (International Special Committee on Radio Interference)
sources emission requirements.

Caution Inter-c2
Use specified If you use accessories, transducers or cables with the system, other than those specified,
equipment increased emission or decreased immunity of the system may result.
only

Flex Focus 1202 User Guide (BB1756-R) Safety Information 17

 Installation
WARNING I-w1
Installation To ensure safe performance, a qualified electrician or hospital safety personnel must verify
safety that the equipment is correctly installed and that it complies with the following safety
requirement requirements:
• Use only the original power supply cord. In the USA, this is fitted with a hospital grade
three-prong grounded power plug. Never try to remove or change the plug on the
power supply cord.
• All equipment must only be connected to a grounded AC power supply (or wall outlet)
that meets EN/IEC/NEC requirements or applicable local regulations. The examination
room’s grounding system should be checked regularly by a qualified electrician or
hospital safety personnel.
• Never use extension cords. The increased length of the cord will increase the resistance
of the protective ground conductor and may increase the equipment’s leakage current
beyond an acceptable level.
• Keep power cords, sockets and plugs clean and dry at all times.
• Make sure that the power supply cord cannot be accidentally disconnected from the
power source or the equipment.

Original If the original power cords are missing or damaged, you must order new ones from
power cords your local BK Ultrasound representative.

Additional Protective Ground and Potential Equalization

An additional protective ground can be connected to the terminal underneath the
control panel, see Fig 2-1.
The potential equalization terminal underneath the control panel is connected to
the system chassis. It can be connected to corresponding terminals on other
equipment to eliminate potential differences. Do NOT use it for additional protective
grounding.

Figure 2-1. The terminals for potential equalization and additional protective ground
are underneath the control panel.

Connecting Other Equipment

For connection to other equipment, BK Medical systems have a communication
protocol on top of TCP/IP

18 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 WARNING C-w1
Connection Follow the guidelines in EN60601-1-1[7] (Safety requirements for medical electrical systems)
guidelines when you connect the system to other equipment.

Network Connection
BK’s range of ultrasound systems comply with the DICOM standard for handling,
storing, printing and transmitting information in medical imaging.
DICOM includes a file format definition and a network communication protocol
which facilitates the exchange of data between electronic medical systems.
For detailed information about:
• network requirements
• network configuration
• workflow between devices
• technical specifications
• safety specifications
see the DICOM conformance statement at
www.bkultrasound.com/support/bk/resources/DICOM

Network Security
It is the responsibility of the on-site personnel or technician to maintain the IT-
network and identify, analyze, evaluate and control new risks caused by a change in
the network configuration.
If the applicable network connection does not meet the required characteristics of the
IT-network, the following hazardous situations may occur:
• Corrupt patient data due to network errors, see Warning Exam-w3 on page 32
• System is unable to use the network due to faulty or overloaded network, see
Warning GS-w1 on page 13
• System overloads the network causing other equipment to fail.
Network NOTE: If your system interacts with other equipment directly or indirectly you must
guidelines ensure that your network is properly dimensioned and that critical equipment is
placed on a separate network. Otherwise you could risk overloading the network and
your equipment failing.

Network Printing
For printing on network printers, BK supports protocols PCL 5, PCL 6 and PS (Post
Script).

Flex Focus 1202 User Guide (BB1756-R) Safety Information 19

 Connectors
PC connectors for connecting the system to other equipment such as approved
printers and video equipment are located in the neck of the system. To access them,
unscrew the screw on the bottom of the neck and remove the connector cover. See
Fig 2-2.

Connector cover

Unscrew here to remove

connector cover

Figure 2-2. Flex Focus connector cover.

Some connectors are used by the system. Do not use connectors that are not labelled
in Fig 2-3. For systems with a battery pack, the external power is plugged directly
into the battery pack on the system stand. The system is then connected to the power
source through a connection from the battery pack to the 12 V plug in the neck (see
“Systems with battery pack” in Fig 2-3). Systems with a battery pack are delivered
with a power cord in the neck; this is an auxiliary power source for an approved
printer. When there is no printer on the system, the plug on the auxiliary power cord
is stored in the empty space next to the 12 V outlet in the neck.
More information about the connectors is in Table 2-2. Information about the cables
to use is in Table 2-4.

20 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 NOT USED

DVI-I

Systems without battery pack Systems with battery pack

Auxiliary power outlet - For systems without printer,
for approved printers auxiliary power cord plug
Power supply only (for approved printers only) is
placed here for future use 12 V from battery
cord goes here pack goes in
to power the
system here

Ground
connector

Push tab to release

fuses. Click new
ones in place

Figure 2-3. Connectors in the neck of the Flex Focus system.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 21

 Symbol Connector Additional Information
DVI-I DVI-I Connector for auxiliary DVI or VGA
monitor.
Composite/S-video In 7-pin S-video connector that can be
adapted to a composite video input (see
Table 2-3).
Audio In
Audio Out
4 USB 2.0 connectors, A-type 500mA current limit on each.
FireWireTM Not currently supported. For future use.
10/100/1000 Ethernet LAN: 10/100/1000 LAN connector, RJ45.

Table 2-2. Connectors in the neck of the Flex Focus system.

Video Output
Although 4 different video output signal formats are available, the image quality is
not the same for all of them.
DVI gives best To get the best image quality possible, connect your monitor or other video
image quality equipment using the output signal that gives the highest quality image. See the list
below.
Output signal types (in order of quality, with digital DVI highest)
1 DVI - digital output that gives the best image quality.
2 VGA – this analog output from the DVI connector gives slightly poorer image
quality than the digital DVI output.
If you must use a cable that does not have a DVI connector, you may need to use an
adapter. Table 2-3 shows you which adapters can be used.

22 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Cable Connectors Adapter Flex Focus Connector
(in order of preference)
DVI-D
Not needed. DVI-I

15-pin (VGA) DVI to VGA adapter (2 views)

DVI-I

BNC (Composite) 7-pin S-video to Composite +

BNC (female) to Phone (male)
+

Phono RCA (Composite) 7-pin S-video to Composite

Table 2-3. Video connectors and adapters.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 23

 HistoScanning1
The scanner units to be used with HistoScanning™ systems from AMD have an extra
connector on the back of the monitor, in the upper left corner. It is used to take raw
data, before it has been converted to an image on the monitor, out of the system.
To use the Flex Focus for HistoScanning, you must have a HistoScanning license
installed.

Pull firmly to open,

so you can attach
the connecting
cable

Figure 2-4. Connector for HistoScanning.

A cable (AO1385) is supplied to use with this connector.

Using the System with a Lithotriptor

Special considerations apply if you are using a lithotriptor with the system.
• The lithotriptor must comply with the guidelines in EN 60601–1–1 [7] (Safety
requirements for medical electrical systems).
• You must have a license installed to use a lithotriptor with the system.
• You must always follow instructions in the manufacturer’s user guide for the
lithotriptor.

WARNING LT-w1
To avoid an inaccurate location of the crosshair cursor due to misalignment of recorded
image and graphics, ensure the coordinate systems are synchronized.

Power Connections
Do NOT connect a lithotriptor to the auxiliary power outlet. Plug the system and the
lithotriptor directly into independent wall power outlets.

Connecting the System to the Lithotriptor

Connect the lithotriptor to a USB connector on the system. If necessary, use a USB
RS-232 adapter cable.

1. HistoScanning has not been market cleared by the FDA or licensed by Health Canada.

24 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Follow the connection instructions in the manufacturer’s user guide for the
lithotriptor system. The connections must follow the guidelines given in EN 60601–
1–1 [7] (Safety requirements for medical electrical systems).

EMC Requirements
To fulfill EMC requirements, cables attached to the system must be shielded and no
longer than 5 m.

Connector name Cable type Type and length

DVI-I Dual link Shielded, 5 m
S-video/composite In S-video Shielded, 5 m
Audio In Stereo, 3.5 mm jack Shielded, 5 m
Audio Out Stereo, 3.5 mm jack Shielded, 5 m
USB 1 USB, 2.0 Shielded, 5 m
USB 2 USB, 2.0 Shielded, 5 m
USB 3 USB, 2.0 Shielded, 5 m
USB 4 USB, 2.0 Shielded, 5 m
FW400 FireWire Shielded, 5 m
10/100/1000 Ethernet Network, CAT6E Shielded, 5 m
HistoScanning/Research MDR-26 Shielded, 3 m
Interface

Table 2-4. List of cables used in testing for EMC compliance

Do not attach transducers and other accessories unless the user guide for the
transducer or accessory states that it can be used with this system. Attaching other
equipment may cause an increase in electromagnetic emissions or may cause the
system to be more sensitive to electromagnetic interference.

Isolation of DICOM Network

The system must not be galvanically connected to a computer network (DICOM ) ®

that has not been isolated. If the network is not isolated, the system must be
connected via a network isolator DP0925.

Wireless Network (Wi-Fi)

The system can be connected to a wireless network for printing and archiving data.
This requires the optional wireless license for the system, and a Wi-Fi adapter that is
supplied by BK Medical when you buy this option. The Wi-Fi adapter is inserted into
one of the USB connectors located in the neck of the system (see Fig 2-3 on page 21).

Flex Focus 1202 User Guide (BB1756-R) Safety Information 25

 Caution: Wifi-c3
Do not use a USB extension cable to connect a Wi-Fi adapter to the system. If you do, the
wireless network may become unstable due to electromagnetic interference.

For information on how to install a license on the system, see Appendix C in the Flex
Focus 1202 Advanced User Guide (BB1946).

Connecting to a Wireless Network

You must establish a secure wireless network at your hospital, clinic or institution,
including a password for the network, before you can use the system’s Wi-Fi for
printing and archiving.
To use Wi-Fi on the system you need to install a license. When you have installed the
license, a Wi-Fi logo is visible on the lower right of the main screen.

Figure 2-5. Position of the Wi-Fi symbol on the screen.

To connect to a wireless network, click the Wi-Fi logo, choose the appropriate
network, and type in the password.

Figure 2-6. Wi-Fi connection window.

26 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 You only have to type in a password the first time you connect to a specific network.
When you turn on the system an attempt is made to reconnect to the network that the
system was connected to before it was turned off.
The bars in the Wi-Fi logo represents the signal strength. The more lit bars in the
Weak vs. logo, the stronger the signal.
strong signal
When the system is not connected to a wireless network, the Wi-Fi logo has a red ‘X’
over it.
No wireless
connection An advanced Wi-Fi setting option is available on the system using Windows
configurations. Always follow the security procedures that have been established for
your hospital, clinic or institution, as well as national guidelines. Contact your BK
Medical service representative for more information.

Additional characteristics
Frequency band 2.412~2.4835 GHz
Data throughput Max 150 Mbps
Latency Depends on network setup
Integrity Full integrity of archiving operations
Security characteristics Support for WEP, WPA and WPA2 encryption.
Enterprise encryption (802.1x) requires
assistance from an authorized BK Medical
technician.
Spectrum management None required

When you transmit data over a wireless network, some special considerations apply.
In particular, the network connections must be set up correctly. See Warning GS-w1
on page 13.
NOTE: The system only supports one network at a time.
If the system loses connection with the network while transmitting (for example,
because it is moved out of range of the network during a transmission), the pending
data is stored temporarily and re-transmitted when the connection is re-established.
For information on saving and printing using the DICOM protocol, see the DICOM
chapter in Flex Focus 1202 Advanced User Guide (BB1949).

Caution: Wifi-c1
The network must be set up correctly so that data is sent to the correct location. Otherwise
data can be lost or accessed by unauthorized people.

Caution: Wifi-c2
A safe encrypted protocol for data transmission, approved by the hospital, must be used.
This is to prevent unauthorized people from getting access to the data.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 27

 Medical Equipment

WARNING ME-w1
Power Follow the guidelines in EN 60601–1–1[7] (Safety requirements for medical electrical
source systems).
Equipment that complies with the requirements of EN/IEC 60601–1[2] (Part 1: General
requirements for safety) ANSI/AAMI ES60601-1 or CSA C22.2 No. 601.1–M90 [5] can be
connected to the system, but one of the following conditions must be fulfilled:
• Each piece of equipment is plugged directly into an independent wall power outlet.
or
• The system and other equipment are plugged into an external common isolation
transformer to control the leakage current during a ground connection fault.
If in doubt, contact your local BK Ultrasound representative.

WARNING ME-w2
Printers and An approved printer, specified in the Product Data sheet, can be connected to the internal
auxiliary auxiliary power outlet on the system. Do not use the auxiliary power outlet on this BK
power outlet Ultrasound system for any other equipment.
The auxiliary power outlet is still live even when the ON/Standby button on the system is
ON/Standby turned off. To remove voltage from this outlet, you must unplug the power supply cord
button does from the power source.
not turn off
outlet

Non-Medical Equipment

WARNING NME-w1
Follow the guidelines in EN 60601–1–1[7] (Safety requirements for medical electrical
systems).
If you connect non-medical equipment (instruments that do not comply with safety
requirements for medical equipment, such as a video monitor, video recorder, endoscopic
camera control unit or other documentation device), this equipment must be placed
outside the patient environment (1.5m from the bed, for example). The equipment must
fulfill the relevant EN standard or other applicable national or international standard.
One of the following conditions must be fulfilled:
• The system and other equipment are plugged into an external common isolation
transformer to control the leakage current during a ground connection fault.
or
• The system is grounded with an additional safety ground connection (see “Additional
Protective Ground and Potential Equalization” on page 18).
If in doubt, contact your local BK Ultrasound representative.

28 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Battery Support System
If you use a battery pack to supply power to the system, be sure to read the battery
support chapter of this user guide.
Also observe the following warnings for both the battery pack and the optional
battery charger station (UA1247):

WARNING BS-w1
To ensure proper ventilation and avoid overheating, keep both ends of the battery pack
(or optional battery charger station (UA1247)) clear.

WARNING BS-w2
To prevent damage to the equipment, use only the UA1225 battery set – check the
number on the battery set before you insert it into the battery pack or recharge in the
optional battery charger station (UA1247).

WARNING BS-w3
The batteries in the battery pack (or optional battery charger station (UA1247)) may
present a risk of fire or chemical burn if mistreated. Do not disassemble, heat above the
manufacturer’s maximum temperature limit, or incinerate. Replace battery with the
UA1225 battery set only. Use of another battery may present a risk of fire or explosion.

Battery When you dispose of the batteries, you must follow national rules. Within the EU,
disposal you must send them to appropriate facilities for recovery and recycling.

WARNING BS-w4
Dispose of used batteries properly. Keep away from children. Do not disassemble and do
not dispose of in fire.

Information Printed on the Battery (UA1225)

The following information, including Warning BS-w5a below, is printed on one side
of the battery (UA1225).

WARNING BS-w5a
Charge only with a SMBUS complaint level 2 or 3 charger. Do not heat above 80°C. Do not
open battery, dispose of in fire or short circuit – may ignite, explode, leak or get hot
causing personal injury. Replace battery with same part number only. Use of another
battery may present a risk of fire or explosion. Keep away from children.

<100Wh Lithium ion rechargeable battery. 0% Hg, 0% Cd, 0%Pb. For optimal
performance use BK Medical equipment for charging. Must be recycled or disposed
of properly. Recycle facilities may not be available in all areas. Charge before use.
To re-purchase contact your local BK representative. Can be found on
www.bkultrasound.com

Flex Focus 1202 User Guide (BB1756-R) Safety Information 29

 If the System Will Not Start
The batteries supplied for use with the system are called smart batteries, which
means they have built-in safety features to prevent overloading. If, for unknown
reasons, the batteries are overloaded and the safety feature is triggered, you may not
be able to start the system, even if it is plugged in to a power source.

To reset the batteries:

1 Unplug the system.
2 Open the door on the battery pack.
3 Pull out all 4 batteries approximately 1 cm so they are no longer connected
inside the battery pack.
4 Wait approximately 1 minute.
5 Plug in the system.
6 Make sure that the fan is started.
7 Push all batteries into place and close the battery pack door.
This procedure resets the safety feature and should resolve the issue. If the problem
persists (for example, the fan does not start), contact your BK representative.

Touch Screen
NOTE: This information applies to the Flex Focus 700 (order no. 1202-3) with touch
screen.
When using sterile covers available in some hospitals and clinics, make sure only the
area with keyboard and screen controls are covered. No cover is necessary on the
image area of the touch screen because it is not touch sensitive.

WARNING TS-w1
Touch screen To avoid misdiagnosis of an image, make sure the touch screen is clean before use.
must be
clean

Remote Control
If you use a wireless remote control UA1237 with the system, be sure to read the
remote control chapter of this user guide.
The remote control uses short wave radio waves to communicate with the system.

WARNING RC-w2
The remote control is active at a distance of at least 10 meters from the system, even if the
system is in a different room.

30 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Caution: RC-c1
The remote control can be disrupted by other equipment operating at the same
frequency of 2.5 GHz.

This device complies with Part 15 of the FCC Rules. Operation is subject to the
following two conditions:
1 This device may not cause harmful interference, and
2 This device must accept any interference received, including interference that
may cause undesired operation.

Computer Security
When the Flex Focus is connected to a hospital network, BK Ultrasound does not
take any responsibility for computer viruses from the network that may infect the
Flex Focus.

Caution CS-c1
Check You must perform a virus check on any external storage medium (USB device or DVD) to
external make sure that it is virus-free before you connect it to the system.
media

Service and Repair

WARNING SR-w1
Authorized Service and repair of BK Medical electromedical equipment must be carried out only by
personnel the manufacturer or its authorized representatives. BK Medical reserves the right to
disclaim all responsibility, including but not limited to responsibility for the operating
safety, reliability and performance of equipment serviced or repaired by other parties.
After service or repairs have been carried out, a qualified electrician or hospital technician
should verify the safety of all equipment.

Transducers
WARNING T-w1
Electrical The transducer sockets contain terminals with 3.3V. Do not touch the patient while you
shock are touching an uncovered socket.

WARNING T-w2
Type B When using Type B (non-isolated) transducers, carefully check all electrical equipment
transducers within the patient area. Also, consider using additional protective grounding.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 31

 WARNING T-w3
Electrical Do not leave transducers in contact with the patient when using HF electrosurgical
burns equipment.

BK Ultrasound transducers fulfill EMC requirements when they are outside as well
as inside the patient’s body.
¨
WARNING T-w4
Surface Do not turn the transducer on and allow it to scan into mid-air without ultrasound gel
temperature applied to the surface of the array. Doing so may cause the surface temperature on the
on array array to heat up to 27 °C above room temperature (measured according to EN 60601–2–
37 [3] (Particular requirements for the safety of ultrasonic medical diagnostic and monitoring
equipment)). To avoid this, freeze the image when the transducer is not used for imaging.

WARNING C-J-w1
Creutzfeldt- Do not use a transducer for neurosurgical applications if the patient is suspected of having
Jakob Creutzfeldt-Jakob disease. If a neurosurgical transducer has been used on a patient
disease suspected of or diagnosed as being Creutzfeldt-Jakob positive, the transducer must be
destroyed, following approved procedures for your hospital.

During an Examination

Checking the Date

Before you start imaging, verify that the date and time displayed on the monitor are
correct.

WARNING Exam-w1
Date An incorrect date or time will make documentation of the image incorrect and may also
cause some calculated values to be incorrect.

WARNING Exam-w2a
Patient ID You must enter a new patient ID before you image a new patient. Otherwise the
required documentation will not contain the correct patient identification, and you will not be able
to capture images and clips. We recommend that you enter the complete name of the
patient.

WARNING Exam-w3
Verify Verify that the patient name and ID are correct.
patient ID

32 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Verifying the Transducer Type

WARNING Exam-w4
Type Before you start to image, verify that the type number on the transducer matches the
number number displayed on the monitor. In case of any inconsistency, stop imaging, turn off the
displayed system, and contact your local BK Ultrasound representative.
must match
number on
transducer

Measurements
Pay careful attention when you position cursors to make measurements on a scanned
image or on a Doppler curve.

WARNING M-w1
Polygon To prevent wrongful diagnosis, you must be aware that:
measuring • When you use the polygon measuring tool, if the sides of the polygon intersect
tool (as in forming a curve like a figure eight, for example), the area calculation is
incorrect. In this case, the calculated area of the polygon is the area of the bigger
loop minus the area of the smaller loop.

WARNING M-w2
Using Drawings of Doppler curves, manual and automatic, are meant as tools for positioning
Doppler cursors so that measurements based on the curves can be calculated automatically. The
curves system has no facilities for checking whether the automatic measurements are
reasonable. Curves drawn on very noisy spectra may lead to misplacement of
measurement cursors. Make sure that measurement cursors are positioned so that the
results are reasonable. If they are not, you must adjust the position of the cursors manually.

Nuchal Translucency

Caution NT-c1
Nuchal You must be adequately trained before you attempt to make nuchal translucency
translucency measurements.

VFI – Vector Flow Imaging

WARNING VFI-w1
Artifacts Before you turn on VFI, check the B-mode image to make sure there are no artifacts visible
in the blood vessel. If there are strong artifacts in the B-mode image, the arrows in VFI may
be pulled to point in a more axial direction (toward or away from the transducer),
especially in low flow situations with correspondingly low PRF. These artifacts will not
affect the color mode (CFM) image, so it is important to check in B-mode.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 33

 WARNING VFI-w2
Arrow Check to make sure the VFI arrows are not aliasing before you activate the assisted
aliasing Doppler gate placement. Otherwise, the Doppler gate will not be positioned correctly.

WARNING VFI-w3
Diameter Check to make sure that the diameter markers correspond to the inner vessel wall and that
markers the connecting line between the markers is perpendicular to the direction of the vessel.
Otherwise, the real-time volume flow measurement may not be precise.

WARNING VFI-w4
Doppler gate Check to make sure that the Doppler gate covers the entire vessel. Otherwise, the real-
large time volume flow measurement may not be precise.
enough

WARNING VFI-w5
Doppler gate Check to make sure that the Doppler gate only covers one vessel. Otherwise, the real-time
over only volume flow measurement may not be precise.
one vessel

WARNING VFI-w6
Doppler Check to make sure that the Doppler spectrum does not alias. Otherwise, the real-time
spectrum volume flow measurement may not be precise.
aliasing

Puncture and Brachytherapy

WARNING P-w1
Verify Before you start imaging, verify that the type number or name of the transducer and the
transducer type number or description of the puncture attachment you are using match the number
type number displayed on the monitor. Also make sure that the needle guide is positioned correctly. If
the numbers do not match, or if the needle guide position is not correct, the puncture line
on the monitor may not correspond to the true puncture path in the tissue. In case of any
inconsistency, stop imaging, turn off the system, and contact your local BK Medical
representative.

WARNING P-w2
Verify Verify that the type number of the puncture guide displayed on the monitor corresponds
puncture to the puncture guide that you are actually using. If the number is incorrect, the puncture
guide type line on the monitor may not correspond to the true puncture path in the tissue.
number

34 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 WARNING P-w4
Watch the The puncture line on the image is an indication of the expected needle path. To avoid
needle tip harming the patient, the needle tip echo should be monitored at all times so any deviation
from the desired path can be corrected.

NOTE: If the image depth is set very low (to see tissue close to the transducer with
high magnification), the needle tip echo can be outside the displayed image area. To
see the needle tip in this case, zoom out so the full needle path is visible or pan the
image to the side (to keep the high magnification).

WARNING P-w3
Offset Changes you make to the offset of a programmable puncture guide or brachy matrix will
changes affect ALL programmable puncture guides and brachy matrixes. This could lead to
incorrect puncture lines or matrix positions for a different guide than the one you wanted
to change.

Brachytherapy and Prostate Transperineal Biopsy

WARNING B-w1
Verify matrix Verify that the matrix type and coordinates displayed on the monitor agree with the actual
type and matrix template you are using.
coordinates

WARNING B-w2
Verify user- If you create a user-defined matrix, it is your responsibility to verify that the matrix that
defined appears on the monitor corresponds to the physical matrix you are using.
matrix

WARNING B-w3
Verify matrix Before you use the matrix for seed implantation or biopsy, check the matrix offset value to
alignment verify that it corresponds with the chosen matrix. Then check the matrix alignment.

WARNING B-w4
To avoid harming the patient, check the needle alignment (and recalibrate if necessary)
before each use.

3D
Pay particular care to the following safety issues when operating the 3D system.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 35

 WARNING 3D-w1
3D Measurements obtained with the 3D system and used in diagnosis must be carefully and
measure- thoughtfully performed to ensure accurate quantitative assessment. Before you perform
ments a calculation, make sure that all necessary calibrations and measurements are made.
If you suspect that the 3D system’s calibration is inaccurate (that is, the measurements are
not as expected), contact your local BK service representative to check and confirm the
system’s proper operation.

WARNING 3D-w2
Untracked You cannot make accurate measurements on a 3D data set acquired using the untracked
freehand freehand method.

If you start to make a measurement on a 3D data set acquired using the untracked
freehand method, the following warning appears on the monitor:

Warning on Symbol Description

monitor
Measurement will not be accurate.

Picture in Picture

WARNING PIP-w1
PiP must not When you use Picture in Picture, do not cover critical information (such as TI or MI) on the
cover monitor. Make sure that all important information will appear if you print or save the
important ultrasound image.
information

Acoustic Output

General
Medical research has yet to prove whether or not ultrasound causes biological
effects. Therefore, prudent use considerations require you to follow certain
guidelines; see EN60601-2-37 [3] (Particular requirements for the safety of
ultrasonic medical diagnostic and monitoring equipment).

Prudent Use

WARNING AO-w1
Exposure To avoid tissue damage, always keep the exposure level (the acoustic output level and the
level exposure time) as low as possible.

36 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 • Image patients only when clinical reasons make it necessary.
• Keep exposure time as short as possible.
• Be careful to prepare the patient correctly so that you get the best possible
image.
• Start imaging at a low acoustic output level (see “Thermal and Mechanical
Indices” on page 37) and increase the level only as much as necessary to obtain
a satisfactory image.
• If you switch from an application requiring high acoustic output levels (see
“Functions Affecting Acoustic Output” on page 39), to one that requires lower
levels (fetal imaging, for example), be sure to reset the levels before you image.
(For example, start in B-mode.)
• Take into account all the types of tissue that may be affected. For example, when
imaging a breast, it may be appropriate to monitor the TI in bone rather than in
soft tissue because the ribs will be subjected to ultrasound.

WARNING AO-w2
Appropriate To avoid tissue damage, always use the transducer best suited to the examination.
transducer

Acoustic output data for transducers used with the system are given in the Technical
Data (BZ2100) that accompanies this user guide. The uncertainty level for each
parameter is also listed. For definitions of the parameters, refer to the Food and Drug
Administration (FDA) Guide [8] as well as EN 60601-2-37 [3] (Particular
requirements for the safety of ultrasonic medical diagnostic and monitoring
equipment) and AIUM/NEMA standards [9,10].
The routes (or tracks) available for clearance by the FDA are well-defined. Track 3
is for diagnostic ultrasound systems that follow the Output Display Standard [10].
Under Track 3, acoustic output will not be evaluated on an application-specific basis,
but the maximum derated Spatial Peak–Temporal Average Intensity (ISPTA) must be
720mW/cm , the maximum Mechanical Index (MI) must be  1.9, and the
2

maximum Thermal Index (TI) must be  6. All BK Ultrasound transducers for use
with the Flex Focus 1202 Ultrasound System are Track 3.

Monitor Display
The Mechanical Index (MI) and Thermal Index (TI) can be viewed in all imaging
modes.

Thermal and Mechanical Indices

The MI and TI indices are intended to allow users to implement the ALARA [11, 12]
(As Low As Reasonably Achievable) principle using an indicator related to a
potential bioeffect.
The full details of the indices are given in references EN60601-2-37 [3] and
AIUM/NEMA standard [10], but the formulas are given below.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 37

 MI Formula
P r0,3  z sp 
MI = ------------------------
fc
where the variables are defined in the table below.

Variable Definition
Pr0.3(zsp) Peak Rarefactional Pressure (MPa), derated by 0.3dB/cm·MHz, measured at zsp,
the point on the beam axis where pulse intensity integral (PII0.3) is maximum
fc measured center frequency (in MHz)

TI Formula
W0
TI = ------------
-
W deg
where the variables are defined in the table below.

Variable Definition
W0 time-averaged acoustic power of the source or other power parameter (W)
Wdeg estimated power necessary to raise the temperature of the target tissue one
degree Celsius (W/°C)

Blood As a rule of thumb, the Thermal Index (TI) indicates the highest expected
perfusion and temperature increase in degrees Celsius. It is based on an average level of blood
TI
perfusion. The displayed TI may underestimate the temperature rise in poorly
perfused tissues; you must take this into account when deciding on the maximum TI
you will allow. Conversely, in areas with a rich perfusion of blood the temperature
increase will be less than the displayed TI indicates.
Fever A temperature increase of one degree Celsius increase in a patient with fever may
cause complications in certain circumstances; it may be safer to delay the
investigation.

Acoustic Output Measurement

All values are measured in water according to the EN 60601-2-37 [3] and
AIUM/NEMA display standards [9, 10]. For some of the acoustic parameters, an
estimated in situ derated value is given. This is derived assuming a tissue attenuation
of 0.3 dB/(cm·MHz) when the estimated in situ derated value (I) is described by the
following equation:
I formula I = I w exp  – 0,069fz 

where the variables are defined in the table below.

Variable Definition
IW Intensity in water at the position where I is maximum
f transducer frequency (in MHz)
z distance (in cm) from the transducer face to the position where I is maximum

38 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 It should be stressed that the in situ values given are only applicable when there is
attenuating tissue between the transducer face and the focal point.

Possibility of Adverse Effects

Although it is believed that diagnostic ultrasound causes no significant biological
effects in mammalian tissue [3, 10], the user should be aware of the hypothetical
possibilities of adverse effects [11, 13, 14].
Fetal imaging Current scientific and clinical concern over possible adverse effects is particularly
focused on fetal ultrasound imaging. It is due to the increased sensitivity of
mammalian cells and organs at this phase of their development and the fact that such
a risk could have profound implications on public health. If you use high acoustic
output levels for some reason (see “Functions Affecting Acoustic Output”, below),
be sure to return to B-mode alone and turn down the power level before you do any
fetal imaging.

Functions Affecting Acoustic Output

The system has a control function that ensures that neither the ISPTA nor MI nor TI
value exceeds the maximum allowable value. When necessary, the system will
reduce the output voltage and/or PRF (pulse repetition frequency) to the transducer
to comply with requirements.
Some of the system functions can affect the acoustic output, as listed here.
(Instructions for using these functions are given in the relevant sections of this user
guide.)
• Sizing functions such as ROI (region of interest) – in general, smaller size
results in higher acoustic intensity because the pulse repetition frequency (PRF)
is higher or the ultrasound beam is more strongly focused.
• Focus – in general, strongly focusing the beam makes the acoustic intensity
higher.
• Frame rate – higher frame rate results in higher acoustic intensity.
• Range – increasing the Doppler range increases the acoustic intensity by
increasing the PRF.
• CFM Resolution – higher resolution increases the acoustic output.
• Color box size – narrowing the color box generally increases the acoustic output
within it.
The user can set a Thermal Index limit. This will provide an upper limit for acoustic
output.

Default Acoustic Output

After the system has been turned off, the transducers will start in the default setup
when the system is turned on again. The default setup may be factory-defined or
defined by the user.
The factory-defined default setup values of acoustic output for each transducer are
listed in the Technical Data (BZ2100).

Flex Focus 1202 User Guide (BB1756-R) Safety Information 39

 These setups have been optimized to give the best compromise between low acoustic
output and enough power to obtain the image features as quickly as possible. This is
part of the ALARA principle. The factory default setup for all transducers is B-Mode
to ensure the lowest acoustic output when you start imaging.
When you enter a new patient ID, by default the transducer setup will be reset to the
factory setup.
Fetal imaging When you use transducers intended for fetal imaging, it is important to make sure
that the default settings are appropriate and to reset to the default setting before
imaging a new patient.

Clinical Measurements: Ranges and Accuracies

This section states the accuracies for measurements made using the BK Ultrasound
range of ultrasound systems. A table containing accuracies for specific transducers
can be found in the Technical Data (BZ2100) that accompanies this user guide.
The measurement accuracies are based on the assumption of “ideal” tissue, that is, a
tissue characterized by a sound velocity of 1540 m/s. When making clinical
measurements with ultrasound, errors may arise which are not taken into account in
this section. For example,
• The sound velocity may vary from approximately 1450 m/s in fatty tissue to
1585 m/s in muscle. This can, in simple cases, give rise to errors of up to 6% for
linear measurements. This inaccuracy may be further increased by refraction
occurring at tissue boundaries.
• The user can introduce errors when using approximate formulas, when
positioning the system’s calipers with respect to the ultrasound image and when
outlining structures in the image.
• The ellipsoid volume approximation, described in this user guide, is only
applicable when the cross section of the structure being studied approximates an
ellipse (the circle being a special ellipse), and when the structure is roughly
symmetrical about the selected axis of rotation
NOTE: The choice of the axis of rotation is important for the calculation of the
volume. A vertical axis gives a different volume than a horizontal axis.
The minimum requirement is that the cross section outlined by the user should be
convex. If the user draws a non-convex outline, an inaccuracy is introduced which is
not taken into account in this section. In this case, the system calculates and displays
the convex hull of the figure, that is, the smallest convex figure containing the non-
convex figure outlined by the user (see Fig 2-7). The system bases the calculation of
the ellipsoid volume on the convex hull.

40 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Figure 2-7. The dotted line indicates the convex hull of the non-convex figure.

Measuring volume using a stepping method produces an approximation caused by

the finite number of steps in the measurement. The user must always try to assess
how large an inaccuracy is introduced by the selected step size, that is, the distance
between organ cross sections.

Geometric Measurements

2D Measurements
The geometric measurements performed by BK Ultrasound ultrasound systems are
distance, perimeter, area and ellipsoid volume. The accuracy of these measurements
is influenced by the following factors:
• Transducer geometry
• Rounding of results
• Resolution of digital image memory

3D Measurements
The 3D volume is found by summing the marked area in the individual slices and
multiplying by a factor that includes the distance between the slices and their relative
orientation.
To obtain the accuracies listed in the table in the Technical Data (BZ2100), you must
ensure that the calculation is based on contributions from at least 10 slices for very
regular shapes and more for irregular shapes. It must also be possible to discriminate
the boundary of the object from the surrounding tissue.
Volume The volume accuracy in the table is given as a percentage of the captured 3D volume
accuracy starting with the first slice and ending with the last slice that intersects the object of
interest.
If the 2D ROI (region of interest) is set to be much larger than the object, the accuracy
as a percentage of the object volume can be much worse (higher percent).
NOTE: To ensure that the accuracy of your volume measurement is as high as
possible, make sure that the object you are interested in fills the region of interest as
much as possible.
Distance and The accuracy of a distance measurement on a 3D image will never be better than 6%;
area accuracy the accuracy of an area measurement on a 3D image will never be better than 6%.

Flex Focus 1202 User Guide (BB1756-R) Safety Information 41

 In the table in the Technical Data (BZ2100), the overall measurement accuracy for a
full range measurement is given in the right-hand column for each measurement. The
footnote below the table states the digital image resolution.

Time Measurements
In M-mode and spectral Doppler mode, data is displayed along a time axis. It is
possible to measure time differences. The accuracy for a time difference
measurement is
• Rounded to the nearest: 0.01s
• Accuracy: 0.01 x t
where t is the full time scale of the image field.

Doppler Measurements
In measuring blood flow velocity it is assumed that the measured power spectral
distribution of the Doppler signal equals the blood cell velocity distribution.
The measurement accuracy of blood flow velocity is heavily dependent on the angle
 between the ultrasound beam and the velocity vector of the blood cells. The
velocity accuracies given in the Technical Data (BZ2100) are valid for  = 55. To
find the percentage accuracy for other angles, multiply the stated accuracy by
cos  – cos   + 1,8  
 ------------------------------------------------  100 + 0,5
 cos  

If the blood velocity exceeds the selected velocity range, aliasing occurs,
corresponding to an overload condition of the measurement system.

References
[1] EN 60529:1991+A1:2000. Specification for degrees of protection provided by enclosures
(IP code).
[2] EN/IEC 60601-1:1990+A1:1993+A2:1995+A13:1996 Medical electrical equipment. Part
1: General requirements for safety.
EN/IEC 60601-1:2006 3rd Ed. Medical electrical equipment. Part 1: General requirements
for basic safety and essential performance.
[3] EN 60601-2-37:2001+A1:2005+A2:2005 Medical electrical equipment – Part 2-37: Par-
ticular requirements for the safety of ultrasonic medical diagnostic and monitoring equip-
ment.
EN 60601-2-37:2008 Medical electrical equipment – Part 2-37: Particular requirements
for the basic safety and essential performance of ultrasonic medical diagnostic and moni-
toring equipment.
[4] UL 60601-1:2003 Medical Electrical Equipment – Part 1. General Requirements for Safety.
[5] CSA C22.2 No. 601.1–M90 Medical Electrical Equipment – Part 1. General Requirements
for safety.
[6] EN 60601-1-2:2001 + A1:2006 Medical electrical equipment - Part 1-2: General require-
ments for safety. Collateral standard: Electromagnetic Compatibility-Requirements and
tests.
EN 60601-1-2:2007 Medical electrical equipment - Part 1-2: General requirements for
basic safety and essential performance. Collateral standard: Electromagnetic Compatibil-
ity-Requirements and tests.

42 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 [7] EN 60601–1–1:2001 Medical electrical equipment –Part 1-1: General requirements for
safety. Collateral standard: Safety requirements for medical electrical systems.
[8] Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Sys-
tems and Transducers. FDA Center for Devices and Radiological Health. September 2008.
[9] Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment.
AIUM/NEMA. 2004.
[10] Standard for Real-Time Display of Thermal and Mechanical Acoustic Output Indices on
Diagnostic Ultrasound Equipment. AIUM/NEMA. 2004.
[11] Medical Ultrasound Safety. Second edition. AIUM. 2009.
[12] ALARA Training Program. Ultrasound III Training. BK Ultrasound. 1993.
[13] Bioeffects considerations for the safety of diagnostic ultrasound. Journal of Ultrasound in
Medicine, Vol. 7, No. 9 (supplement). September 1988.
[14] The safety of diagnostic ultrasound. The British Institute of Radiology. 1987.
AIUM: American Institute of Ultrasound in Medicine
CSA: Canadian Standards Association
EN: European Standards
FDA: Food and Drug Administration (USA)
IEC: International Electrotechnical Commission
NEC: National Electrical Code
NEMA: National Electrical Manufacturers Association
UL: Underwriters Laboratories Inc., USA

Flex Focus 1202 User Guide (BB1756-R) Safety Information 43

44 Chapter 2 June 2016 Flex Focus 1202 User Guide (BB1756-R)
 Chapter 3
Adjusting the System

Calibrating the Touch Screen Alignment

If you have trouble activating the correct screen control when you tap it, you may
need to recalibrate the alignment. This is simple to do.

To align the touch screen:

1 Click the Keyboard tab.
2 Click Alt, then C.
3 Follow the directions on the screen. (You will have to tap each cross that appears
and then confirm the process at the end.)
NOTE: The tap is registered when you remove your finger from the screen, so don’t
hold your finger down and try to press hard if you think nothing is happening.
The touch screen is recalibrated.

Adjusting the Touch Screen

Viewing the image and other information on the monitor can be affected by lighting
in the room. To avoid glare, you can tilt the monitor from its upright position (see
Getting Started with Flex Focus).
Hold the top of the monitor and the bottom of the monitor and push backward or
forward for easy adjustment. The range for tilting the monitor is approximately 15°.
If you adjust the angle of the screen, you should check the calibration of the touch
screen to ensure accuracy.

Flex Focus 1202 User Guide (BB1756-R) Adjusting the System 45

46 Chapter 3 June 2016 Flex Focus 1202 User Guide (BB1756-R)
 Chapter 4
Battery Support

This chapter is only relevant if your system has battery support.

The battery pack enables you to operate the system while it is not connected to an
external electrical supply.

Before You Start

Be sure to read the battery support warnings (warnings with BS numbers) in “Battery
Support System” on page 29. Also note the following:
Plug imaging NOTE: To ensure that batteries charge properly, you MUST connect the power supply
system into cord to the line voltage BEFORE you insert any batteries in the battery pack.
wall before
inserting Be sure to read the rest of this chapter before you use the battery support system.
batteries
To configure and customize the battery pack’s operation, see Flex Focus Advanced
User Guide.

Imaging with Battery Support

This is an overview of the steps for using the battery support system to power the
imaging system.
1 Make sure the batteries are charged.
(If not, plug in the imaging system to use it or to change the batteries.)
2 Turn on the system.
3 When the batteries run down, you do not have to turn off the imaging system.
Either
• plug it into the wall to recharge the batteries while you run on power from the
normal power supply
or
• plug it into the wall, change the batteries (see “Changing or Replacing a Battery”
on page 52), unplug from the wall and run on battery power again.
If you have an extra set of batteries that you charge with a battery charger station
(UA1247), you can always have charged batteries ready to insert when needed.

Battery Pack Location

The battery pack is located in the bottom drawer of the backpack on the mobile
battery keyboard dock.

Flex Focus 1202 User Guide (BB1756-R) Battery Support 47

 Battery pack

Figure 4-1. System with battery support in the backpack.

Power Supply

Plugging in the System

NOTE: Always plug in the system before inserting any batteries.
On systems with a battery pack, the power supply cord plugs into the battery pack
(instead of the neck of the system). The auxiliary power outlet (to be used only for
approved printers) is in the neck of the system.

Display
Power supply

Push tab to release

fuses. Click new
ones in place.

Figure 4-2. The back of the battery pack.

48 Chapter 4 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Charging the Batteries
Batteries automatically begin charging when the system is plugged into the power
outlet.
Charger Batteries can also be charged in the battery charger station where it takes
station approximately 2 hours and 45 minutes to recharge 4 batteries. See “Battery Charger
Station (UA1247)” on page 53. The battery charger station is optional (see
Accessories in the Flex FocusProduct Data sheet).
Charging New batteries are typically at a 50% charge. There is a built-in battery check on
new batteries batteries for the battery pack. Always check before using for the first time. When
using new batteries in the system, BK Medical recommends that you plug in the
system for approximately 1.5 hours to charge the batteries fully.

NOTE: A minimum of 2 batteries is required to run the system on battery power. The
system can only run on either 2 batteries or 4 batteries. This is true at all times.

May need to If the Batteries Appear Not to Charge to 100%

discharge
and recharge After repeated use, the batteries may require a full discharge, full charge, and full
fully discharge in order to recalibrate the electronic fuel gauge so that the indication of
how much charge is left in the battery is accurate.

Battery Status
While the system is operating, battery status is visible both on the monitor (in the
bottom right-hand corner) and on the display on the back of the battery pack (see Fig
4-2).
• When the system is plugged into a power outlet, battery status is shown as
percent (%) of capacity remaining.
• When the system is running on the battery, battery status is shown as time
remaining in “hours:minutes”.

Information Available on the Monitor

The battery status indicator appears in the bottom right-hand corner of the monitor.

Figure 4-3. Battery level shown as % or as time available.

A message appears on the monitor (Fig 4-8) when a battery reaches the end of its
lifespan and needs replacing. For information about the disposal of depleted
batteries, see page 29.

Flex Focus 1202 User Guide (BB1756-R) Battery Support 49

 Information Available on Battery Pack
Battery pack The display on the back of the battery pack shows % of battery capacity or time left.
display A display of :::: indicates there are no batteries in the battery pack.
NOTE: The time displayed is an estimate based on typical use; for continuous
imaging, the actual time available will be less than indicated on the display.
Battery When the door to the battery pack is open, you can see LED indicator lights showing
indicators the status of each individual battery (see Fig 4-4). The battery numbers refer to the
position of the battery in the pack and are relevant for system messages about battery
status.

Batteries

Door latch 3

Pull tabs

AC power Battery indicator light

indicator light

Figure 4-4. Front of a battery pack containing 4 batteries.

LED Indicator Light Battery Status

Green light Charged
Red light Battery level is below 33%
Off No battery in slot or battery is flat

Low Battery
When battery capacity is very low,
• The system beeps
• A message appears on the monitor
• The on-screen battery indicator turns red
• The display on the battery box blinks regularly

50 Chapter 4 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Figure 4-5. Low battery message.

The low-battery message informs you that the battery level is low and that the system
will shut down when the system monitor clock matches the time stamp in the
message (shown here as 13:18:58).
The display on the battery box begins to blink regularly when the low battery
threshold is met, and it continues to blink even after the critical low battery threshold
is met and the system has shut down.
To set the level for the low battery message, see Flex Focus Advanced User Guide.

Critical Low Battery

The setting for critical low battery is set to 3 minutes by default. When the battery
reaches the critical level, the system shuts down immediately.
To set the level for the critical low battery message, see Flex Focus Advanced User
Guide.
AC power When the system is plugged in, the display on the battery box is lit and the AC Power
LED indicator light (normally hidden by the door on the battery pack) is lit. See Fig 4-4.

Power Save Mode

Power save With power save mode, you can conserve battery power and reduce energy
mode consumption when the system is not in active use. A message appears on the monitor
to notify you when the system is about to go into power save mode.

Figure 4-6. Power save message.

To exit power save mode and restore the system to normal power, you can do one of
the following:
• Press a key on the keyboard
• Press the transducer button
• Move the trackball
To enable and configure power save mode, see Flex Focus Advanced User Guide.

Flex Focus 1202 User Guide (BB1756-R) Battery Support 51

 Changing or Replacing a Battery
Whether you are changing a battery that is low on charge or replacing a dead battery,
you follow the same steps for removing and inserting batteries in the battery pack.
A message on the monitor will alert you to the need to change batteries.
NOTE: You must always replace 2 or 4 batteries at a time.

To change batteries:
1 Plug in the power cord.
2 Press the latch on the back side of the battery pack to open the cover.
3 To disengage a battery, pull its tab and slide it completely out of the frame.
4 Slide charged batteries into the free slots.
5 Unplug the power cord.
NOTE: See the battery disposal warning (BS-4) in “Battery Support System” on
page 29.

Battery Life
The battery (UA1225) has a built-in check to indicate how much charge is available
in the battery. Light-diodes mark when there is 25%, 50%, 75% or 100% charge on
the battery.

To check the charge on a battery (UA1225):

1 Press the round circle next to the word “Push” on the battery.
2 The light diodes indicate the charge level:
• 25% charge: 25 is lit.
• 50% charge: 25 and 50 are lit.
• 75% charge: 25, 50 and 75 are lit.
• 100%: 25, 50, 75 and 100 are lit.
• No diodes are lit when the battery is flat.

Figure 4-7. The built-in check button and diodes on the battery (UA1225).

Typical vs. With typical use (which includes imaging and freezing), a fully charged battery pack
continuous containing 4 batteries provides approximately 4 hours of operation. With a fully
use
charged battery pack, you can scan continuously for approximately 3 hours.

52 Chapter 4 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Battery When a battery reaches the end of its lifespan, the replace battery message appears
lifespan on the monitor at start-up, informing you which of the 4 batteries must be replaced.
Note that the batteries are referred to by number in the message, with 1 being the top
battery and 4 being the bottom battery.
Replace When it is time to replace a battery, a message appears on the monitor telling you
battery which batteries should be replaced. The battery numbers in the message refer to the
message
numbering used in Fig 4-4.

Figure 4-8. Message when a battery reaches the end of its lifespan.

Battery On average, a battery will need to be replaced after approximately 300 recharge and
lifespan discharge cycles – the battery lifespan.
For information about the disposal of depleted batteries, see page 29.

Battery Support Setup

To customize the operation of the battery pack, see Flex Focus Advanced User
Guide.

Connectors
PC connectors for connecting the system to other equipment such as approved
printers and video equipment are located in the neck of the system. For information
about the connectors to use, see “Connecting Other Equipment” on page 18.

Cleaning and Disinfection

The cleaning and disinfection instructions for the system in Care, Cleaning & Safety
apply to the battery pack.

Battery Charger Station (UA1247)

NOTE: This section is only relevant if you have purchased the optional battery
charger station (UA1247). See the Flex Focus Product Data sheet for ordering
information.
The battery charger station is a stand-alone device with the sole purpose of
recharging batteries used by the system battery support that uses UA1225 batteries.
Powering the The battery charger station is powered when plugged into the power outlet. There is
battery no power switch on the battery charger station for turning it on or off.
charger
station
Charge time It takes approximately 2 hours and 45 minutes hours to recharge 4 batteries in the
station.

Flex Focus 1202 User Guide (BB1756-R) Battery Support 53

 The display on the back of the battery charger station shows % of battery capacity
(see Fig 4-2). A display of :::: indicates there are no batteries in the battery charger
station.
Battery When the door to the battery charger station is open, you can see LED indicator lights
indicators showing the status of each individual battery (see Fig 4-4).

LED Indicator Light Battery Status

Green light Charged
Red light Battery level is below 33%
Off No battery in slot or battery is flat

Recharging a Battery in the Battery Charger Station

To insert or remove batteries:
1 Press the latch on the back side of the battery charger station to open the cover.
2 Slide drained (or new) batteries into the empty slots.
3 When a battery is fully charged, pull its tab and slide it completely out of the
frame.
NOTE: See the battery disposal warning (BS-4) in “Battery Support System” on
page 29.
NOTE: See the warning about using only authorized UA1225 batteries (BS-2) in
“Battery Support System” on page 29.

Cleaning and Disinfection

The cleaning and disinfection instructions for the system in Care, Cleaning & Safety
apply to the battery charger station.

54 Chapter 4 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Chapter 5
Remote Control

A wireless remote control is available for use with some versions of the Flex Focus
system. It uses short wave radio waves to communicate with the system and control
many of its functions.

The Remote Control and Its Functions

Blue diode. Blinks to show Battery level. Blinks to warn that

remote control is awake batteries must be replaced soon
Change exam type (list Capture an image to the
will appear on monitor) system hard disk or print it.
(User-definable)

Select Start/Stop imaging

Adjust value or size of zoom

box, etc. Holding down the
key repeats the action
In B-mode, adjust Depth. If Adjust gain for one mode only,
Doppler is on, adjust Doppler the first in this list that is active:
PRF. If Color is on but not Doppler, Color, Power, B-mode
Doppler, adjust Color PRF

Toggle imaging modes:

Start a default measurement B > Color > Doppler > B ...
(User-definable) (User-definable)
User-defined Optimize image and Doppler
settings

Hold down P and AUTO for

three seconds when pairing
with the system

Figure 5-1. The remote control, with the location of its various controls.

Pairing the Remote Control with the System

1 Plug the Mini Bluetooth Adapter into a USB connector on the system. (Use the
adapter that came with the remote control.)
2 Press any key on the remote control to wake it up.
3 Hold down the P and AUTO keys on the remote control for three seconds.
The remote control emits two beeps.
4 Release the keys after the second beep.

Flex Focus 1202 User Guide (BB1756-R) Remote Control 55

 The blue diode starts blinking fast.
A dialog box appears on the monitor. This may take up to two minutes.
5 Click Accept to pair the system with the remote control (indicated by its serial
no.).
The pairing process takes up to one minute.
When pairing is done, the remote control emits a beep and the blue diode blinks
to show the remote control is awake.
NOTE: The pairing process may time out. Try again if this happens.
NOTE: If the cursor starts drifting on the monitor, place the remote control in its
holder and leave it for 30 seconds to recalibrate.
If you have more than one remote control, be sure you know which system each is
paired with; the system and remote control remain paired even if the remote control
is taken away to be disinfected. Pairing lasts until you pair the remote control with
another system or pair another remote control with the system. Therefore, it is
important to keep track of which remote control is paired with which system.
Before each use, verify that the remote control is working correctly.

Sleep
If the remote control is not used or moved for 5 minutes, it goes to sleep to save
battery power. To wake it up, press any key.

Mouse Function
You can use the remote control as an air-tracking mouse to operate controls on the
system monitor.
To move the cursor, tilt the remote control; that is, move the front end up, down, or
side-to-side. The mouse will not respond if you keep it level.
NOTE: You do not need to point it at the monitor. The cursor responds to changes in
the position of the remote control, not to the position itself.
To select an object on the monitor, move the remote control so that the cursor is on
the object, then press Select.

Replacing Batteries
1 Remove the battery cap.
2 Insert 2 batteries LR6 size AA 1.5 volt.
3 Screw the battery cap on tight until the arrow points to the area
of the battery cap with a large gap between the ridges.
When the battery cap is screwed on tight, the remote control is
watertight and can be immersed.

56 Chapter 5 June 2016 Flex Focus 1202 User Guide (BB1756-R)

 Cleaning and Disinfection
For details of cleaning and disinfecting the remote control, see Care, Cleaning &
Safety.

WARNING RC-w1
Remote The remote control requires surface disinfection or sterilization as a minimum. The inside
Control battery compartment cannot be classified as disinfected or sterile. Follow procedures
established for your hospital, clinic or institution to avoid cross-contamination when
inserting or removing batteries.

Flex Focus 1202 User Guide (BB1756-R) Remote Control 57

58 Chapter 5 June 2016 Flex Focus 1202 User Guide (BB1756-R)
 Chapter 6
Getting Started

Getting Started with Flex Focus forms part of this user guide.

Flex Focus 1202 User Guide (BB1756-R) Getting Started 59

60 Chapter 6 June 2016 Flex Focus 1202 User Guide (BB1756-R)
Index
Numerics brachytherapy
3D warning about checking matrix 35
measurements warning 36 warning about user-defined matrixes 35
warning about untracked freehand and measure- warning to verify matrix type and coordinates 35
ments 36 brightness, adjusting monitor. See Getting Started.

A C
accuracy caution or warning, symbol 11
2D geometric measurements 41 Cautions
3D distance 41 about 11
3D measurements 41 CE marks 13
3D volume 41 center frequency 38
clinical measurements explained 40 connectors for other equipment
Doppler measurements 42 accessing 20
time difference measurements 42 location 20, 53
acoustic output picture 21
default 39 table 22
factors affecting 39 consult instructions for use (symbol) 11
measurement 38–39 Creutzfeldt-Jakob warning 32
ALARA principle 37, 40
auxiliary power outlet 28
D
DICOM
B conformance statement 19
batteries and battery pack connection if network is not isolated 25
battery disposal 29 network isolator 25
battery life 52 standard 19
changing a battery 52 disposing of the system 12
charge time for batteries 53 distorted image 17
charging batteries 49, 54 Doppler measurements
charging new batteries 49 accuracies 42
checking the charge on a battery 52 warnings 33
recycle symbol 12 Doppler mode
recycling 12, 29 fetal imaging 40
replacing a battery 52 dust protection 13
troubleshooting 30
use of authorized UA1225 battery set 29
E
warnings 29 earth. See ground.
waste symbol 12 electrical noise 17
batteries and remote control electrical safety 18
battery level 55 electrical shock 16
replacing 56 electromagnetic compatibility. See EMC.
battery charger station electromagnetic interference 17
cleaning and disinfection 54, 57 EMC
warnings 29 attaching cables 25
battery pack data in BZ2100 7
battery status 49 noise, checking for 17
cleaning and disinfection 53 precautions 17
configuring and customizing. See Advanced User equipment failure 13, 14
Guide. 47 ESD
connectors 53 precautions 16
internally powered 13 symbol 12, 16
must use 2 or 4 batteries 49 training 16
power save mode 51 examination, performing basic. See Getting Started.
replacing fuses 48 examination, viewing. See Getting Started.
biopsy. See puncture. explosion hazards 15

61
exposure level 36 responsibility for 19
extension cord, do not use 18 noise
electrical 17
F EMC 17
fetal imaging, acoustic output settings for 40 non-medical equipment, connecting to system 28
fuses not watertight (symbol) 12
replacing 21
replacing (battery pack) 48 O
on and off, turning system. See Getting Started.
G ON/Standby button
ground (earth), additional protective symbol on 12
adding 18 warning 28
symbol 12 overbalance and tipping
warning 15
H warning symbol 11
height, adjusting. See Getting Started.
HF electrosurgical equipment, warning 32 P
HistoScanning, connector for 24 pairing remote control 55
patient ID
I importance of entering 32
image distortion 13, 14, 17 verifying 32
indications for use 9 Peak Rarefactional Pressure 38
installation 18 potential equalization
intended use 8 symbol 12
Internally Powered (battery pack) 13 terminal 18
isolation from line voltage 14 power cord
keep clean and dry 18
K original 18
keys (basic), overview. See Getting Started. power plug 18
power strip, do not use 16
L power supply cord
leakage current 16, 28 accidental disconnection 18
liquids, do not spill on system 14 use original 18
lithotriptor prostate transperineal biopsy
connecting system to 24 warning about checking matrix 35
power connections 24 warning about user-defined matrixes 35
special considerations 24 warning to verify matrix type and coordinates 35
using system with 24 prudent use 36
puncture
M warning about changing offset of programmable
magnetic shielding 17 puncture guides or brachy matrixes 35
manufacturer (symbol) 11 warning to verify puncture guide number 34
measurements, Doppler warnings 33 pushing prohibited, symbol 11
medical equipment
connecting to system 28 R
MI (Mechanical Index) radio frequency interference. See RF interference.
and ALARA 37 remote control
formula 38 keys and indicators 55
Mini Bluetooth Adapter 55 mouse function 56
modes of operation 8 pairing 55
monitor brightness, adjusting. See Getting Started. replacing batteries 56
sleep and waking up 56
N RF interference 17
network
guidelines 19 S
isolator 25 safety
printing, protocols for 19 electrical 16, 18
network security transducer 31
guidelines 19 saving to USB. See Getting Started.

62
screen controls, basic, overview. See Getting Started. Type B (symbol) 12
sealing (symbol) 12 Type BF (symbol) 12
security, network. See network security. Type BF, defibrillator-proof (symbol) 12
service and repair 31
Specified Radio Equipment, symbol (Japan) 12 U
standby (symbol) 12 UA1225. See battery.
standby button. See Getting Started. UA1247. See battery charger station.
system UL (symbol) 12
isolation from line voltage 14 USB, saving to. See Getting Started.
malfunction 13, 14 User Documentation CD 7

T V
Technical Data (BZ2100) 7, 37, 40, 41, 42 VFI (Vector Flow Imaging), warnings about 33
Thermal Index limit viewing an examination. See Getting Started.
setting 39 virus
Thermal Index limit, setting 39 checking external storage media 31
TI (Thermal Index) from network 31
and ALARA 37
blood perfusion and 38 W
time measurements 42 Warnings
tipping and overbalance about 11
warning 15 waste disposal symbol 12
warning symbol 11 WEEE waste (symbol) 12
touch screen, adjusting 45 Wi-Fi
training before using equipment 13 adapter 25
transducer sockets, warning about covering 31 connecting to 26
transducer, electrical safety 31 correct setup and safe protocol required (cautions)
transperineal biopsy 27, 31
warning about checking matrix 35 network characteristics 27
warning about user-defined matrixes 35 password 26
warning to verify matrix type and coordinates 35 signal strength 27
turning system off and on, See Getting Started. using 25
Type B (non-isolated) transducers, warning about 31 wireless network. See Wi-Fi.

63
64
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