agiliti Adapt Convertible User manual

Doc. #: IFU0000078 Rev.: 2.0 Rev. Date: 01/26/2024
Adapt Convertible™
User Manual

2
Table of Contents
Introduction ................................................. 3
Product Description ....................................... 3
Product at a Glance .......................................... 4
Symbols..................................................... 6
Labels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Safety Instructions ...........................................10
Seven Zones of Bed Rail Entrapment ........................10
Specifications................................................15
EMC Information .............................................17
Unpacking Instructions .......................................21
Set-Up Instructions.......................................... 22
Adapt Pump™ Keypad .......................................24
Operating Instructions.......................................25
Advanced Settings ..........................................28
Cleaning Instructions ........................................29
Preventive Maintenance.......................................31
Troubleshooting ............................................32
Storage, Transport and Disposal ..............................33
Frequently Ordered Parts ....................................33
Limited Product Warranty ...................................34
Rev
Title
Quality Form: QF-3191 Rev. 4.0
ECO#: W031920-1
Approved: W. Williams
FOR-0014-0320
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1 of 2
100% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Vendor
Part Number
Lisez et comprenez entièrement
le manuel avant utilisation. Le
non-respect des instructions
d’utilisation peut entraîner la
mort ou des blessures graves.
Read and fully understand
manual before operating.
Failure to follow operating
instructions could result in
death or serious injury.
27008710, Rev. 1.0
Warning/Attention
1.027008710
Read Instructions Carefully
French

3
Introduction
Product Description
The Adapt Convertible™ support surface is designed for powered or non-powered use. In a powered state,
Adapt Convertible provides Microclimate Assist™ and 1-in-2 alternating pressure, while immersion therapy
is available with or without the powered pump. Alternating pressure actively ooads pressure on the skin
surface with 5-, 10- or 15-minute cycle times. Immersion provides proper envelopment to eectively manage
pressure redistribution. Microclimate Assist helps maintain a dry, cool surface interface.
Adapt Convertible is comprised of a specialized multi-foam-filled air cell support surface and an optional
electrically powered pump. Upon setup, the firmness level is selected on the pump, which then adjusts the
support surface pressure for optimal comfort and therapy.
Intended Use
Adapt Convertible is a powered or non-powered, pressure redistributing foam support surface intended to
prevent and treat pressure injuries. The product is for use on a medical bed frame in a medical facility by
qualified personnel.
Patent Information
This product is protected by U.S. Patent No. 9,913,547, with other patents pending.
General Information
— Read and completely understand the manual before use.
— DO NOT modify this equipment without authorization from the manufacturer.
— Only use Agiliti accessories that are specific to this product.
— At certain intervals, maintenance of this product is required and must be performed by qualified personnel
only.
— Retain this manual for future use and maintenance.
— Users should be risk-assessed to ensure they are able to understand this manual and operate the product
safely without risk to themselves or others.
Symbols, definitions, and fonts are used throughout this manual to aid user readability and understanding of
content.
— Standard Text: Used for regular information.
— Bold Text: Emphasizes a word or phrase.
— NOTE: Sets apart special information or important instruction clarification.

4
Product at a Glance
Adapt Convertible™ Support Surface
1. Adapt Convertible™ Support Surface
2. Hose cluster (stowed)
3. Hose cluster straps
Adapt Convertible EX™ Support Surface
1. Adapt Convertible EX™ Support Surface
2. Side bolsters
3. Foot bolster (optional)
2
2
1
1
3
3

5
Adapt Pump™ (Optional)
1. Pump Keypad 1. Carrying handle
2. Keypad Reference label
3. Pump keypad
1. Hose cluster connection 1. Power input and fuse label 1. Carrying handle
2. Mounting hooks
3. Leakage test point label
2
2
3
1
1
1
1
1
3

6
Symbols
Symbol Description
Certification:
Indicates device has been independently tested and meets the published safety
standard(s).
Type B
Device Type:
Indicates a Type B device properly protected from electrical shock.
Follow User Manual:
Indicates mandatory action to read and fully understand these instructions prior to
use.
Accompanying Documents:
Read and fully understand all accompanying documents for product before use.
ELECTRICAL SHOCK HAZARD WARNING:
This symbol is intended to alert the user to the presence of electrical shock hazards.
It is important to follow all instructions and special procedures to avoid electrical
shock to the operator, care provider and/or patient.
WARNING:
Indicates a potentially dangerous situation, which if not avoided, could result in
injury ranging from moderate to serious severity up to and including death.
CAUTION:
Indicates a potentially dangerous situation, which if not avoided, could result in
injury ranging from minor to moderate severity.

7
Labels
Manufacturer’s Label
Page 1
100% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Rev
Title
SW Master Label Form
Document number: F00014 Rev. A
FOR-0014-0322
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Part Number
2.027008641
Adapt Pump
MFG Label
27008641, Rev. 2.0
Medical Electrical Equipment
Conforms to AAMI std. ES60601-1,
IEC std. 60601-1-6
Certied to CSA std. C22.2 No. 60601-1
Model: 61600200-Adapt Pump™
MFG S/N: 135796
Manufacture Date: 231116
Electrical Rating: 120V AC, 50/60Hz, 3A
Class I
Electrical
Equipment Type B
INDOOR USE ONLY
MADE IN USA
US PATENT 9,913,547
Legal Manufacturer:
Raye’s, Inc. d/b/a Sizewise Manufacturing
206 Jeerson Street, Ellis, KS 67637
Raye’s, Inc., d/b/a Sizewise Manufacturing (f/k/a
Wheelchairs of Kansas and Sunower Medical), is a
wholly owned subsidiary of Sizewise Rentals, LLC.
Sizewise Rentals, LLC is a wholly owned subsidiary
of Agiliti Health, Inc.
Label Description
Rev
Title
Quality Form: QF-3191 Rev. 4.0
ECO#: W031920-1
Approved: W. Williams
FOR-0014-0320
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1 of 2
100% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Vendor
Part Number
Electrical Rating:
120V AC, 50/60Hz, 3A
Fuse Rating:
T 1.25A H 250V
27503886, Rev. 2.0
2.0
Platinum Electrical Info
27503886
Label indicates electrical and fuse ratings for 120V
pump.
Electrical Rating:
220-240V AC, 50/60Hz, 3A
Fuse Rating:
T 1.25A H 250V
27503887, Rev. 2.0
Label indicates electrical and fuse ratings for 230V
pump.
Rev
Title
Quality Form: QF-3191 Rev. 4.0
ECO#: W031920-1
Approved: W. Williams
FOR-0014-0320
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1 of 2
200% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Vendor
Part Number
2.027509003
LTPL
2
7
5
0
9
0
0
3
,
R
e
v
.
2
.
0
Label identifies leakage test point location on
outside of pump.
Rev
Title
Quality Form: QF-3191 Rev. 4.0
ECO#: W031920-1
Approved: W. Williams
FOR-0014-0320
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1 of 2
200% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Vendor
Part Number
2.027509002
Ground Point Label
2
7
5
0
9
0
0
2
,
R
e
v
.
2
.
0
Label identifies location of ground on pump.
Rev
Title
Price P.O. #Quantity
Approvals
Page 1
100% Scale, for Reference Only
See page 2 for Full-Size Art File
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Vendor
Part Number
1.027650015
Adapt Air System QR
SW Master Label Form
Document number: F60108
FOR-0014-0322
Master Label Form
Adapt™ Keypad Reference
Immersion Alternation Autofirm
27650015, Rev. 1.0
Alarm Mute
Cycle Time
Microclimate Digital
Resources
Label provides visual reference to pump keypad
functions. QR code provides link to online
resources.

8
Label Description
Rev
Page 1
100% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Part Number
Title
27503970 1.0
Adapt Air Connector Mylar
CPR
DateVendor
Price P.O. #Quantity
Approvals
Marketing
Plant Engineering
Product Development
Purchasing
Quality
SW Master Label Form
Document number: F00014 Rev. A
FOR-0014-0322
Master Label Form
Labels identify CPR Release on hose cluster/pump
connection.
Screen printing on mattress identifies support
surface name/version.
Labels to identify support surface top cover/
bottom cover part and lot numbers.
Label provides the Unique Device Identification
(UDI) number of support surface.
Page 1
100% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Rev
Title
Part Number
27503972 1.0
Adapt Air Connector Mylar
(Press to Release)
DateVendor
Price P.O. #Quantity
Approvals
Marketing
Plant Engineering
Product Development
Purchasing
Quality
SW Master Label Form
Document number: F00014 Rev. A
FOR-0014-0322
Master Label Form
PRESS TO RELEASE
27503972, Rev. 1.0
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
Rev
Title
SW Master Label Form
Document number: F60108
FOR-0014-0322
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1
25% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Part Number
1.000000000
Top Cover Screen:
Adapt Convertible EX
Adapt Convertible EX™
POWERED OR NON-POWERED
SUPPORT SURFACE
FOR USE WITH OR WITHOUT ADAPT PUMP™
SEE USER MANUAL FOR CLEANING INSTRUCTIONS
Rev
Title
SW Master Label Form
Document number: F60108
FOR-0014-0322
Master Label Form
Price P.O. #
Vendor Date
Quantity
Approvals
Page 1
25% Scale, for Reference Only
See page 2 for Full-Size Art File and Material Specs
Marketing
Plant Engineering
Product Development
Purchasing
Quality
Part Number
1.000000000
Top Cover Screen:
Adapt Convertible
Adapt Convertible™
POWERED OR NON-POWERED
SUPPORT SURFACE
FOR USE WITH OR WITHOUT ADAPT PUMP™
SEE USER MANUAL FOR CLEANING INSTRUCTIONS

9
Label Description
Label provides support surface cleaning
instructions.
Label identifies legal details of support surface
manufacturing.
Label identifies support surface compliance with
Technical Bulletin 117-2013.
Label identifies support surface compliance with
16 CFR Part 1633.
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover withneutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1
General cleaning of this mattress cover can
be accomplished by wiping down the surface
with a mild solution of soap and water.
Always rinse thoroughly with water.
DO NOT AUTOCLAVE. If this cover needs to
be disinfected, use a standard hospital
approved quaternary disinfectant, a
germicide, or disinfecting soap and water.
Do not use a phenolic based cleaning agent.
Use all products in dilutions as specified on
the manufacturer's label and follow the
appropriate dwell time.
Do not use bleach in stronger concentration
than 1:10 dilution of the household bleach.
For soils and stains, clean cover with neutral
suds and lukewarm water. For hard to clean
spots, use a standard liquid household vinyl
cleaner with a soft bristle brush.
LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
TOP COVER
0010ADC13582
Manufactured By:
Sizewise Manufacturing
252 Mariah Circle
Corona, CA 92879-1751
Date of Manufacture:
MM/YYYY
Model :
Prototype ID :
This mattress meets the requirements of
16 CFR Part 1633 (federal flammability
(open flame) standard for mattress sets)
when used without a foundation
THIS MATTRESS IS
INTENDED TO BE USED
WITHOUT A FOUNDATION
NOTICE
THIS ARTICLE MEETS THE FLAMMABILITY
REQUIREMENTS OF CALIFORNIA
BUREAU OF HOUSEHOLD GOODS AND
SERVICES TECHNICAL BULLETIN
117-2013. CARE SHOULD BE EXERCISED
NEAR OPEN FLAME OR WITH BURNING
CIGARETTES.
THE UPHOLSTERY MATERIALS
IN THIS PRODUCT:
THE STATE OF CALIFORNIA HAS
UPDATED THE FLAMMABILITY STANDARD
AND DETERMINED THAT THE FIRE
SAFETY REQUIREMENTS FOR THIS
PRODUCT CAN BE MET WITHOUT
ADDING FLAME RETARDANT CHEMICALS.
THE STATE HAS IDENTIFIED MANY
FLAME RETARDANT CHEMICALS AS
BEING KNOWN TO, OR STRONGLY
SUSPECTED OF, ADVERSELY IMPACTING
HUMAN HEALTH OR DEVELOPMENT
CONTAIN ADDED FLAME
RETARDANT CHEMICALS
CONTAIN NO ADDED FLAME
RETARDANT CHEMICALS
TB117-2013
X
UNDER PENALTY OF LAW THIS TAG IS
NOT TO BE REMOVED EXCEPT BY THE
CONSUMER
ALL NEW MATERIAL
CONSISTING OF
POLYURETHANE FOAM 100%
REG. NO. CA 46736
Agiliti Health, Inc.
MADE FOR
in. x in.
Net of Matl: lbs. oz.
Mattress
MADE IN THE USA
MANUFACTURED IN:
MONTH __________ YEAR __________
MMM YYYY
11095 Viking Dr., Ste 300
Eden Prairie, MN 55344
35 82
XX X
ADAPT-CONVERTIBLE LOT #XXXXXXX
ADAPT CONVERTIBLE 35"x82"
BOTTOM COVER
0010ADC23582
REVISION TABLE
REV # DESCRIPTION ECO# DRAWN BY APR DATE
X06 INITIAL DESIGN N/A AL
LOCATION:
PROPRIETARY NOTICE
Y:\AUTOCAD\ALL CUSTOMER INFO\MEDICAL\SIZEWISE MANUFACTURING\AGILITI\PRODUCT DRAWINGS\0010ADC03582 -- ADAPT CONVERTIBLE 35X82\0010ADC03582 -- ADAPT CONVERTIBLE 35X82 -- REV X06.DWG { ASSEM }
PAGE OFSCALE:
CHECKED BY:
DRAWN BY:
PROD MAN:
DESCRIPTION:
SHEET DRAWING NUMBER REVISION
Signature Date
Signature Date
BX06
CUSTOM
CHECKED
CRAIG MILLER JR.
4
9/13/2023 8:05 AM
LAST UPDATED:
CUSTOMER APPROVAL:
CUSTOMER:
UNLESS OTHERWISE SPECIFIED:
ALL DIMENSIONS ARE IN INCHES
TOLERANCES ARE 1/4"
THE DATA CONTAINED HEREIN CONSTITUTES PROPRIETARY
INFORMATION OF SIZEWISE MANUFACTURING, AND SHALL
NOT BE USED, DUPLICATED OR DISCLOSED IN WHOLE OR IN
PART WITHOUT THE PRIOR WRITTEN CONSENT OF SIZEWISE
MANUFACTURING.
SIZEWISE MANUFACTURING.
252 MARIAH CIRCLE
CORONA, CA 92879
®
®
4
0010ADC03582
N/A
ANDREW LU
ADAPT CONVERTIBLE
35" x 82"
LABELS
ENGINEERING NOTE:
1 LABELS ARE REPRESENTATIVE AND MAY NOT BE
AN EXACT MATCH TO PRINTED LABELS
1
1

10
ZONE 6
ZONE 7
ZONE 1
ZONE 3
ZONE 5
ZONE 4
ZONE 2
Zone 1:
Within the Rail
Zone 2:
Under the Rail, Between the Rail Supports,
or Next to a Single Rail Support
Zone 5:
Between Split Bed Rails
Zone 3:
Between the Rail and the Mattress
Zone 6:
Between the End of the Rail and the Side
Edge of the Head or Footboard
Zone 4:
Under the Rail, at the Ends of the Rail
Zone 7:
Between the Head or Footboard and the
Mattress End
Safety Instructions
WARNING: Bed rail entrapment is a serious health risk that can result in serious injury
or even death. Agiliti recommends the care provider be mindful of the FDA guidelines
relevant to bed rail entrapment, as serious injury can result. These guidelines can be found
on the FDA website. When using an Air Therapy system the care provider is responsible
for ensuring the support surface properly fits the bed frame. It is also the care provider’s
ultimate decision whether or not to use bed rails with the patient.
Seven Zones of Bed Rail Entrapment
If the patient would have any clinical conditions that could result in risk of falling or improperly lying in bed,
the bed should be left at its lowest setting and in flat position when not attended. Agiliti recommends the use
of bed rails if they are available. There are seven zones of bed rail entrapment.
Reference: Hospital Bed System Dimensional and Assessment Guidance to Reduce
Entrapment. (2006, Mar. 10). U.S. Health and Human Services Food and Drug Administration
Center for Devices and Radiological Health. Retrieved from https://www.fda.gov/downloads/
medicaldevices/deviceregulationandguidance/guidancedocuments/ucm072729.pdf