CADD-Prizm® Pump Cleaning and Functional Testing Checklist
The following checklist is provided as a guide only to assist in establishing documentation of cleaning and functional testing for the
Serial # _________________ Reference Number _________________________ Date _________________________
(Refer to the Technical Manual procedures.)
I. | Cleaning Completed | Yes | No |
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II. | Visual Inspection |
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| LCD | Lock |
| Data In/Out Jack |
| Occlusion Sensor Seals | Cassette Sensors (3) | Air Detector or Port Cover | |
| Valves and Expulsors | Keyboard | Pump Housing | |
| Reservoir Hinge Area | Indicator Light | Battery Door | |
| Latch | Power Jack | Battery Compartment | |
III. Mechanical Inspection |
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| Keyboard | Cassette Latch |
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| Battery Door | Cassette Lock |
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IV. Functional Inspection |
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| | RES VOL Alarm | Dose Given / Attempted | |
| Latch / Lock | Stop / Start | MG Given | |
| Cassette Sensor | Activation Timing | Air Detector | |
| LCD | Dose Key | Printer Tests | |
| Motor / Gear Train | Remote Dose Cord |
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V.Occlusion Tests (Only need to perform 1 or 2; not both) Downstream Option 1: Activations Before Alarm ___________
Downstream Option 2: High Pressure Alarm At ____________ psi
Upstream Occlusion Sensor Test
Pass ________ Fail ___________
VI. Accuracy Testing (Only need to perform 1 or 2; not both)
Volumetric Accuaracy Test
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| Inaccuracy | Accuracy |
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| Delivery |
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| Volume | Error |
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| Gravimetric Accuracy Test |
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| Amount | Intended | Inaccuracy |
| Accuracy |
| Accuracy | ||||||
| Weights | Weight |
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| Delivered | Delivery | Volume |
| Error |
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