Mortara Surveyor S4 User manual

REF 9516-190-50-ENG Rev G
Surveyor
S4 Mobile Monitor
SERVICE MANUAL
Manufactured by Mortara Instrument, Inc., Milwaukee, Wisconsin U.S.A.
CAUTION: United States federal law restricts this device to sale by or on the order of a physician.

Copyright © 2019
by Mortara Instrument, Inc.
7865 N. 86th Street
Milwaukee, Wisconsin 53224
This document contains confidential information that belongs to Mortara Instrument, Inc. No part of this document
may be transmitted, reproduced, used, or disclosed outside of the receiving organization without the express written
consent of Mortara Instrument, Inc. Mortara is a registered trademark of Mortara Instrument, Inc. E-Scribe, ELI, and
VERITAS are trademarks of Mortara Instrument, Inc. Cisco® is the registered trademark of Cisco Systems, Inc.
DICOM® is the registered trademark of the National Electrical Manufacturers Association for its standards
publications relating to digital communications of medical information.
Mortara, the Mortara logo, Surveyor, and VERITAS are trademarks belonging to Mortara Instrument, Inc.
Clorox Healthcare® is a registered trademark of The Clorox Company.

i
TECHNICAL SUPPORT AND SERVICE
Headquarters
Mortara Instrument, Inc.
7865 North 86th Street
Milwaukee, WI 53224
U.S.A.
Tel: [phone]
Tel: [phone]
Fax: [phone]
Internet: http://www.mortara.com
European Union
Representative
Mortara Instrument Europe, s.r.l.
(European Headquarters)
Via Cimarosa 103/105
40033 Casalecchio di Reno (BO)
Italy
Tel: [phone]
Fax: [phone]
Service/Technical
Support Group
Mortara Instrument, Inc.
7865 North 86th Street
Milwaukee, WI 53224
U.S.A.
Tel: [phone]
Service: 888.MORTARA
(888.667.8272)
Fax: [phone]
E-mail: [email protected]m
24-hour Technical Support
Same-day Shipment of Replacement Parts
Biomedical Training Classes
Extended Warranties/Service Contracts
Sales Support/
Supplies & Accessories
Mortara Instrument, Inc.
7865 North 86th Street
Milwaukee, WI 53224
U.S.A.
Tel: [phone]
Fax: [phone]
E-mail: [email protected]m
Hospital Customers: [email protected]m
Physician Practice: [e-mail]
U.S. Distribution: [email protected]
Mortara Instrument Germany
Hofgartenstraße 16
72379 Hechingen
Germany
Tel.: [phone]
Fax: [phone]
E-Mail: info @ welchallyn.com
Mortara Instrument Netherlands
“Amerika” Gebouw– 7e verdieping
Hoogoorddreef 15
1101 BA Amsterdam
The Netherlands
Tel.: [phone]
E-mail: infonl @ welchallyn.com
Mortara Instrument Australia
Head Office
Suite 4.01, 2-4 Lyonpark Road
Macquarie Park, Sydney
NSW 2113 Australia
Tel: [phone]
Fax: [phone]
Mortara Instrument UK
Clinitron House, Excelsior Road
Ashby de la Zouch
Leicester LE65 1JG
Tel: [phone]
Fax: [phone]

ii
TECHNICAL SUPPORT AND SERVICE

iii
TABLE OF CONTENTS
TECHNICAL SUPPORT AND SERVICE ......................................................................................................................1
NOTICES................................................................................................................................................................1
MANUFACTURER’S RESPONSIBILITY...................................................................................................................................... 1
RESPONSIBILITY OF THE CUSTOMER...................................................................................................................................... 1
EQUIPMENT IDENTIFICATION............................................................................................................................................... 1
COPYRIGHT AND TRADEMARK NOTICES................................................................................................................................. 1
OTHER IMPORTANT INFORMATION ...................................................................................................................................... 1
WARRANTY INFORMATION ..................................................................................................................................3
YOUR MORTARA WARRANTY.............................................................................................................................................. 3
USER SAFETY INFORMATION ................................................................................................................................5
SAFETY REGULATIONS........................................................................................................................................................ 5
WARNINGS .................................................................................................................................................................. 5
CAUTIONS.................................................................................................................................................................. 10
EQUIPMENT SYMBOLS AND MARKINGS..............................................................................................................13
ELECTROMAGNETIC COMPATIBILITY(EMC).........................................................................................................15
GUIDANCE AND MANUFACTURER’S DECLARATION:ELECTROMAGNETIC EMISSIONS..................................................................... 16
GUIDANCE AND MANUFACTURER’S DECLARATION:ELECTROMAGNETIC IMMUNITY ..................................................................... 16
GUIDANCE AND MANUFACTURER’S DECLARATION:ELECTROMAGNETIC IMMUNITY ..................................................................... 17
RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF COMMUNICATIONS EQUIPMENT AND THE EQUIPMENT18
USA AND CANADA RADIO REGULATIONS ............................................................................................................................ 19
MAINTENANCE & CLEANING...............................................................................................................................21
PREVENTIVE MAINTENANCE SCHEDULE............................................................................................................................... 21
VISUAL INSPECTION......................................................................................................................................................... 21
CLEANING AND DISINFECTING ........................................................................................................................................... 22
DISINFECTING AGENTS ..................................................................................................................................................... 23
CLEANING AND DISINFECTING THE S4 MONITOR.................................................................................................................... 23
CLEANING AND DISINFECTING THE LI-ION BATTERY CHARGER ................................................................................................... 24
CLEANING SENSORS AND OTHER ACCESSORIES ...................................................................................................................... 24
MAINTENANCE............................................................................................................................................................... 24
UNIT DISASSEMBLY ............................................................................................................................................27
BATTERY REMOVAL......................................................................................................................................................... 28
SAM/HOUSING REMOVAL............................................................................................................................................... 30
PCBA REPLACEMENT...................................................................................................................................................... 34
CONFORMANCE TESTING ...................................................................................................................................39
REQUIRED EQUIPMENT.................................................................................................................................................... 39
UNIT VACUUM LEAK TEST (IPX4 RATING)........................................................................................................................... 40
FUNCTIONAL TESTING...................................................................................................................................................... 40
SAFETY TESTING ............................................................................................................................................................. 45
S4 MOBILE MONITOR CONFORMANCE TEST DATA RECORD ................................................................................................... 48
DEVICE SPECIFICATIONS .....................................................................................................................................51
GENERAL ...................................................................................................................................................................... 51
ENVIRONMENTAL ........................................................................................................................................................... 51
POWER REQUIREMENTS &BATTERY................................................................................................................................... 52
ECG SPECIFICATIONS ...................................................................................................................................................... 52
SPO2SPECIFICATIONS ..................................................................................................................................................... 53

TECHNICAL SUPPORT AND SERVICE
iv
WIRELESS NETWORK SPECIFICATIONS................................................................................................................................. 53
TROUBLESHOOTING ...........................................................................................................................................55
POWER AND BATTERY ..................................................................................................................................................... 55
DISPLAY AND TOUCHSCREEN............................................................................................................................................. 55
ECG TRACE................................................................................................................................................................... 55
PULSE OXIMETRY (SPO2)................................................................................................................................................. 56
NETWORK TRANSMISSION................................................................................................................................................ 57
ERROR MESSAGES .......................................................................................................................................................... 59
WIFI DIAGNOSTICS ......................................................................................................................................................... 60

1
NOTICES
Manufacturer’s Responsibility
Mortara Instrument, Inc. (Mortara) is responsible for the effects on safety and performance of the Surveyor™ S4
mobile monitor, as indicated by the label, onlyif article 2 of 93/42/EEC directive is applied, in particular:
WARNING: Only Mortara authorized service providers should perform servicing of the S4 to ensure
that the correct maintenance and calibration procedures are followed and that the S4 is returns to proper
operation.
 The mobile monitor is used in accordance with the instructions for use.
 The mobile monitor is correctly maintained according to the standards authorized by Mortara using original
spare parts.
 The mobile monitor is used with original accessories and supplies that are in compliance with the standard
specifications described in this manual.
 The electrical installation of the relevant room complies with the requirements of appropriateregulations.
Responsibility of the Customer
The user of this mobile monitor is responsible for ensuring the implementation of a satisfactory maintenance
schedule. Failure to do so may cause undue failure and possible health hazards. This manual must be kept in a safe
place to prevent its deterioration and/or alteration. The user and Mortara authorized personnel must have access to
this manual at any time. The user of this mobile monitor must periodically check the accessories, their functionality
and integrity.
Equipment Identification
Mortara equipment is identified by a serial and reference number on the back of the mobile monitor. Care should be
taken so that these numbers are not defaced.
Copyright and Trademark Notices
This document contains information that is protected by copyright. All rights are reserved. No part of this
document may be photocopied, reproduced, or translated into another language without prior written consent of
Mortara.
Other Important Information
The information in this document is subject to change without notice.
Mortara makes no warranty of any kind with regard to this material including, but not limited to, implied warranties
of merchantability and fitness for a particular purpose. Mortara assumes no responsibility for any errors or
omissions that may appear in this document. Mortara makes no commitment to update or to keep current the
information contained in this document.

NOTICES
2

3
WARRANTY INFORMATION
Your Mortara Warranty
MORTARA INSTRUMENT, INC. (hereafter referred to as “Mortara”) warrants that components within Mortara
products (hereafter referred to as “Product/s”) will be free from defects in workmanship and materials for the
number of years specified on documentation accompanying the product, or previously agreed to by the purchaser
and Mortara, or if not otherwise noted, for a period of twelve (12) months from the date of shipment.
Consumable, disposable or single use products such are warranted to be free from defects in workmanship and
materials for a period of 90 days from the date of shipment or the date of first use, whichever is sooner.
Reusable product such as, but not limited to, BATTERIES, PATIENT CABLES, LEAD WIRES, MAGNETIC
STORAGE MEDIUMS, CARRY CASES or MOUNTS, are warranted to be free from defects in workmanship and
materials for a period of 90 days. This warranty does not apply to damage to the Product/s caused by any or all of
the following circumstances or conditions:
a) Freight damage;
b) Supplies, accessories and internal parts NOT approved by Mortara;
c) Misapplication, misuse, abuse, and/or failure to follow the Product/s instruction sheets and/or information
guides;
d) Accident;
e) A disaster affecting the Product/s;
f) Alterations and/or modifications to the Product/s not authorized by Mortara;
g) Other events outside of Mortara’s reasonable control or not arising under normal operating conditions.
THE REMEDY UNDER THIS WARRANTY IS LIMITED TO THE REPAIR OR REPLACEMENT WITHOUT
CHARGE FOR LABOR OR MATERIALS, OR ANY PRODUCT/S FOUND UPON EXAMINATION BY
MORTARA TO HAVE BEEN DEFECTIVE. This remedy shall be conditioned upon receipt of notice by Mortara of
any alleged defects promptly after discovery thereof within the warranty period. Mortara’s obligations under the
foregoing warranty will further be conditioned upon the assumption by the purchaser of the Product/s (i) of all carrier
charges with respect to any Product/s returned to Mortara’s principal place or any other place as specifically designated
by Mortara or an authorized distributor or representative of Mortara, and (ii) all risk of loss in transit. It is expressly
agreed that the liability of Mortara is limited and that Mortara does not function as an insurer. A purchaser of a
Product/s, by its acceptance and purchase thereof, acknowledges and agrees that Mortara is not liable for loss, harm,
or damage due directly or indirectly to an occurrence or consequence there from relating to the Product/s. If Mortara
should be found liable to anyone under any theory (except the expressed warranty set forth herein) for loss, harm, or
damage, the liability of Mortara shall be limited to the lesser of the actual loss, harm, or damage, or the original
purchase price of the Product/s when sold.
EXCEPT AS SET FORTH HEREIN WITH RESPECT TO REIMBURSEMENT OF LABOR CHARGES, A
PURCHASER’S SOLE EXCLUSIVE REMEDY AGAINST MORTARA FOR CLAIMS RELATING TO THE
PRODUCT/S FOR ANY AND ALL LOSSES AND DAMAGES RESULTING FROM ANY CAUSE SHALL BE
THE REPAIR OR REPLACEMENT OF DEFECTIVE PRODUCT/S TO THE EXTENT THAT THE DEFECT IS
NOTICED AND MORTARA IS NOTIFIED WITHIN THE WARRANTY PERIOD. IN NO EVENT, INCLUDING
THE CLAIM FOR NEGLIGENCE, SHALL MORTARA BE LIABLE FOR INCIDENTAL, SPECIAL, OR
CONSEQUENTIAL DAMAGES, OR FOR ANY OTHER LOSS, DAMAGE, OR EXPENSE OF ANY KIND,
INCLUDING LOSS OF PROFITS, WHETHER UNDER TORT, NEGLIGENCE OR STRICT LIABILITY
THEORIES OF LAW, OR OTHERWISE. THIS WARRANTY IS EXPRESSLY IN LIEU OF ANY OTHER
WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTY
OF MERCHANTABILITY AND THE WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE.

WARRANTY INFORMATION
4

5
USER SAFETY INFORMATION
WARNING:
Means there is the possibility of personal injury to you or others.
CAUTION:
Means there is the possibility of damage to the mobile monitor.
Note:
Provides information to further assist in the use of the mobile monitor.
NOTE: This manual may contain screen shots and pictures. Any screen shots and pictures are provided
for reference only and are not intended to convey actual operating techniques. Consult the actual screen in
the host language for specific wording.
Safety Regulations
 The Surveyor S4 (henceforth referred to as either Surveyor S4 or S4) is a medical mobile monitor.
 The S4 and its accessories are labeled, according to applicable standards.
 The S4 with all accessories that have a physical or logical connection with it, forms part of a Medical Electrical
System.
 The S4 complies with various safety and performance regulations as mentioned in this manual (Applied
Standards).
WARNINGS
 This manual gives important information about the use and safety of this mobile monitor. Deviating from
operating procedures, misuse or misapplication of the mobile monitor, or ignoring specifications and
recommendations could result in increased risk of harm to users, patients and bystanders, or damage to the
mobile monitor.
 Users are expected to be licensed clinical professionals knowledgeable about medical procedures and patient
care, and adequately trained in the use of this mobile monitor. The S4 mobile monitor captures and presents
data reflecting a patient’s physiological condition that when reviewed by a trained physician or clinician can be
useful in determining a diagnosis; however, the data should not be used as a sole means for determining a
patient’s diagnosis.
 Before attempting to use this device for clinical applications, the operator must read and understand the
contents of the user manual and other accompanying documents. Inadequate knowledge or training could result
in increased risk of harm to users, patients and bystanders, or damage to the mobile monitor. Contact Mortara
for additional training options.
 Operation of the equipment beyond its specified ranges, or beyond normal physiological conditions of human
subjects, may cause inaccurate results.
 A possible explosion hazard exists. Do not use the device in the presence of a flammable anesthetic mixture.
Do not mount any part of the device closer than 25 cm from outlets of flammable gases, including oxygen.
 For proper operation and the safety of users or patients and bystanders, equipment and accessories must be
connected only as described in the user manual.
 Repairs and modification must be made by authorized and trained technical personnel. Unauthorized
modifications and repairs will void the S4 warranty and may pose a danger to patients andusers.

USER SAFETY INFORMATION
6
 If additional devices beyond the S4 are connected to the patient, leakage currents could add up and should be
accounted for.
 The S4, as all medical equipment or systems, requires special precautions regarding EMC, and should be
installed and put into service according to the EMC information provided in the installation procedure to obtain
a sufficient degree of immunity as well as not to create disturbance to other equipment. Refer to the specific
EMC instructions in the user manual.
 The quality of the signal produced by the device may be adversely affected by the use of other medical
equipment, including but not limited to electrosurgery and ultrasound machines. Do not use the S4 system in
the presence of imaging equipment such as magnetic resonance imaging (MRI) and tomography systems.
Simultaneous operation may damage the device or lead to erroneous results.
 There is no known safety hazard if other equipment, such as pacemakers or other stimulators, is used
simultaneously with the device; however, disturbance to the signal may occur.
 Portable and mobile RF communications equipment may affect medical electrical equipment or systems as well
as the S4 and its accessories. Do not operate the S4 near sources of high frequency emissions (e.g.
microwaves). Unauthorized wireless devices, such as personal access points and WiFi hotspots including those
available on personal smartphones, may also interfere with the operation of the system.
 A mobile monitor is not intended to replace clinical assessments. It is important that a qualified individual
regularly supervise the patient.
 The S4 is restricted to use on one patient at a time.
Power Supply Warnings
 Only use the recommended batteries. Use of alternate batteries may damage the device or cause other hazards.
 Only charge Mortara Rechargeable Battery (Mortara Re-Order Number 4800-018) in the Mortara Li-Ion
Battery Charger. Attempting to charge unauthorized batteries may result in damage to the unauthorized battery
and/or the Li-Ion Battery Charger.
 The S4 is a battery operated device that transmits data reflecting a patient’s physiological condition to a
receiving device. During operation failure, data transmission and LCD information will cease to occur. In the
case of battery depletion, replace the batteries on the device to resume monitoring. In mission critical
conditions, it is advisable to have a backup device available.
 Only use the Mortara-provided external battery charger and adapter with the S4. Ensure that the electrical
installation also complies with local safety requirements for the environment where it is used.
 Regularly check all cables for damage and proper connection. Do not use equipment with a damaged cable.
 The S4 contains an internal battery. The following precautions should be taken regarding the internalbattery:
o Do not immerse in water.
o Do not heat or throw in fire.
o Do not leave in conditions over 60 ºC.
o Do not crush or drop.
o Only use the approved batteries.
o Follow the instructions in the disposal section of this manual when taken out of service.

USER SAFETY INFORMATION
7
 The S4 rechargeable battery must be initially fully charged prior to use.
 When the S4 initially powers on, the screen will illuminate if the batteries are installed properly and charged.
Remove the S4 from service and contact Mortara if the screen does not activate when new or fully charged
batteries are initially installed.
 AA batteries are known to leak their contents when stored for an extended period of time in unused equipment.
Always remove the batteries after completing operating the mobile monitor. Always place rechargeable
batteries in the battery charger when not in use. This ensures that the batteries are recharged for the next time
the mobile monitor is operated.
 There is a potential pinch hazard when applying the battery compartment cover to the device that could result in
minor injury. Care should be taken to avoid entrapment of fingers when performing this operation.
Accessories, Cables, and External Connections Warnings
 The S4 is designed to meet applicable specifications when using Mortara-approved patient cables and
accessories. Use of non-approved cables and accessories may result in reduced performance or electromagnetic
interference, and may pose possible patient and user safety concerns.
 Do not use excessive force on any of the connection cables and handle all accessories with care.
 Conductive parts of the ECG patient cables, electrodes, and associated connections of type CF applied parts,
including the neutral conductor of the patient cable and electrode should not come into contact with other
conductive parts including earth ground.
 To avoid the possibility of serious injury or death during patient defibrillation, do not come into contact with
mobile monitor or patient cables.
 Accessories may be provided with separate user manuals. Read these manuals thoroughly and refer to them for
specific functions. It is recommended to keep all manuals together.
 To avoid potential for spread of disease or infection, single-use components and accessories (e.g., electrodes,
disposable SpO2sensors, pouches, etc.) must not be reused. To maintain safety and effectiveness, ECG
electrodes and sensors must not be used beyond their expiration date or useful life.
 All accessories including cables, connectors and other patient-applied parts supplied with the S4 do NOT
contain any Latex. If the patient develops an allergic reaction or rash, immediately remove the accessory and
inform Mortara.
Defibrillation and Electro Surgery Warnings
 The S4 has not been designed for use together with Electro Surgery Units.
 The S4 is defibrillator protected in compliance with IEC 60601-2-25 and IEC 60601-2-27 standards if used with
Mortara-approved patient cables. Defibrillation while using non-approved patient cables may damage the
device beyond repair and cause a safety hazard to the patient.

USER SAFETY INFORMATION
8
ECG Warnings
 Excessive patient movement could interfere with the operation of the system.
 Proper clinical procedure must be employed to prep the electrode and sensor sites, and to monitor the patient for
excessive skin irritation, inflammation, or other adverse reactions. Electrodes and other sensors that are
intended for short-term use should be removed from the patient promptly following use.
 12-lead ECGs acquired through the S4 will normally use a modified lead system with the limb electrodes
positioned on the torso. Although this is a generally accepted practice (e.g., in stress testing), the different
electrode positions can cause morphology changes on the ECG, thus influencing their interpretation. Most
frequently seen differences are a vertical and rightward axis shift, minor changes of evidence of old inferior
infarction and changes in the T-wave in the limb leads. It is recommended that you place the electrodes as close
as possible to the normal limb positions avoiding the possibility of causing artifact. The right arm and left arm
electrodes should be placed on the clavicles as close as possible to the arms. The left leg electrode should be
placed as close as possible to the left leg without subjecting it to the possibility of motionartifact.
 During periods of lead fail and when a reduced lead set is used for the S4, 12-lead ECG interpretation cannot be
reliably used in determining a diagnosis.
 When using the 5-wire ECG cable, it is not possible to acquire a 12-lead ECG with the S4.
The following warnings concern the pacemaker pulses management performed by Surveyor Central:
 Rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some
arrhythmias. Do not rely entirely upon heart rate meter ALARM SIGNALS. Keep pacemaker PATIENTS under
close surveillance. See this manual for disclosure of the pacemaker pulse rejection capability of this instrument.
 With the Surveyor S4 when used with the 4-wire, 5-wire or 10-wire ECG cable, all pacemaker spikes are
rejected per the IEC 60601-2-27 standard (0.1 - 2 ms duration, 2 - 700 mV amplitude). Signals are recognized
as pacemaker spikes when they have a slew rate over 4 V/s, as measured according to the IEC 60601-2-27
standard. Abnormally high or wide pacemaker spikes might be recognized as QRS if their amplitude and pulse
width exceed these values.
 With the Surveyor S4 when used with the 3-wire ECG cable, pacemaker spikes are not rejected consistently.
For this reason, do not rely upon heart rate meter ALARM SIGNALS, when using a 3-wire cable.
 Mortara Instrument does not claim, verify, or validate support for all available pacemakers.
SpO2Warnings
 Use only pulse oximetry sensors, cables, and accessories specifically intended for this patient monitor.
Unapproved components may result in injury, degraded performance and/or device malfunction. Refer to
Chapter 17 of the User Manual, for a list of compatible oximetry sensors, cables, andaccessories.
 Use only pulse oximetry sensors specified for the correct patient mode and for the correct application
position.
 Check the application site of the pulse oximetry sensor no less frequently than every 4 hours to evaluate the
condition of the patient’s skin, moving the sensor to an alternate site as necessary.
 Reposition the sensor at least once every 24 hours to allow the patient’s skin to breathe.
 Apply pulse oximetry sensors as directed in the Instructions for Use provided with the sensor to avoid
possible tissue damage or inaccurate measurement due to errors such as use of an inappropriate sensor for
the application, incorrect placement, wrapping too tightly, or other.

USER SAFETY INFORMATION
9
 Do not sterilize or immerse pulse oximetry sensors in liquid.
 Always clean and/or disinfect reusable sensors between patients.
 Shield the sensor application site from excessive ambient light as necessary when used in the presence of
strong light sources such as surgical lights, xenon light sources, ambient photodynamic therapy
(e.g. Bilirubin lamps), fluorescent lights, infrared heating lamps, and direct sunlight, to avoid potential
interference that may affect the operation of the SpO2function.
 Factors that may cause inaccurate readings and alarms, decreased perfusion, and or low signal strength
include:
Interfering substances:
o Carboxyhemoglobin may erroneously increase SpO2reading.
o
Methemoglobin (MetHb), which usually represents less than 1% of the total Hgb, but in the case
of methemoglobinemia that can be congenital or induced by some IV dyes, antibiotics (such as
sulphas) inhaled gases etc., this level increases sharply and thus can confound the SpO2reading.
o
Intravascular dyes (e.g. methylene blue, indocyanine green, indigo, carmine, fluorescein, etc…)
introduced into the bloodstream.
Physiological conditions:
o
Cardiac arrest
o
Hypotension
o
Shock
o
Severe vasoconstriction
o
Severe anemia
o
Hypothermia
o
Venous pulsations
o
Ventricular septal defects (VSDs)
o
Extremes in systemic vascularresistance
Sensor placement:
o
Incorrect sensor placement
o
Co-placement of the sensor on a limb where a blood pressure cuff and/or supplemental tape is
used
o
Poor sensor fit
 Certain conditions such as physical movement (patient and imposed motion), diagnostic testing, low
perfusion, electromagnetic interference, electrosurgical patient monitors, dysfunctional hemoglobin, and
inappropriate positioning of the pulse oximeter sensor may result in pulse oximetry readings that are
unreliable.
 If the accuracy of a measurement seems incorrect, first check the patient’s vital signs, and then check for
conditions that may cause inaccurate SpO2readings. If the problem is still not resolved, check the monitor,
cable, and/or sensor for proper functioning.
 A pulse oximeter is not an apnea monitor. A pulse oximeter should be considered an early warning device.
As a trend toward patient deoxygenation is indicated, blood samples should be analyzed by a laboratory
CO-oximeter to completely understand the patient’s condition. Check that the pulse oximetry waveform is
physiological in shape.
 Do not use sensors and/or cables showing signs of physical damage, as these may produce erroneous
measurements.
 Pulse oximetry performance may be compromised by excessive motion including tremors or shivering.
 Nail polish and/or artificial fingernails can affect the accuracy of pulse oximetry and should beremoved.

USER SAFETY INFORMATION
10
 Pulse rate measurement is based on the optical detection of a peripheral flow pulse. While a pulse rate does
assist with the detection or absence of a peripheral pulse, the pulse oximeter should not be used as a
replacement or substitute for ECG-based arrhythmia analysis.
 In certain situations such as low perfusion or weak signal strength, such as with patients who have
pigmented or thick skin, inaccurate SpO2measurements may be reported. Verification of oxygenation
should be made through other means, particularly in patients with chronic lung disease, prior to instituting
any therapy or intervention.

Always monitor ECG for arrhythmia detection purposes. Pulse rate calculated from pulsatile SpO2
waveform may differ significantly from heart rate measured by the ECG.
CAUTIONS
 This device must be installed as part of a system in conjunction with the Surveyor Central Station and in
accordance to guidance and minimum characteristics per requirements provided by Mortara for deployment of
the system on the hospital/clinic’s IT network. Refer to those requirements as well as Manufacturer Disclosure
Statement for Medical Device Security (MDS2) statements provided by Mortara before deploying and using the
system.
 The device and patient cable should be cleaned between each use. Cleaning must be performed with the system
turned off and battery removed. Let all parts dry well before turning the power back on.
 Prevent liquids from penetrating the system, components, or the monitor. Do not spray the system with liquid
cleaning agents. Do not allow the system, components or accessories to become in contact with unknown
substances which may compromise its mechanical or electrical integrity. If liquids have penetrated the system,
open by authorized personnel for inspection and let dry completely.
 Do not attempt to clean the mobile monitor or patient cables by submersing into a liquid, autoclaving, or steam
cleaning as this may damage equipment or reduce its usable life. Wipe the exterior surfaces with a warm water
and mild detergent solution and then dry with a clean cloth. Use of unspecified cleaning/disinfecting agents,
failure to follow recommended procedures, or contact with unspecified materials could result in increased risk
of harm to users, patients and bystanders, or damage to the mobile monitor.
 No user-serviceable parts inside. Screw removal by authorized service personnel only. Damaged or suspected
inoperative equipment must be immediately removed from use and must be checked/repaired by authorized
service personnel prior to continued use.

USER SAFETY INFORMATION
11
 The S4 accommodates single-use or rechargeable internal batteries. If the rechargeable battery appears to
become defective, refer to Mortara Technical Support.
 Do not pull or stretch patient cables as this could result in mechanical and/or electrical failures. Patient cables
should be stored off of the floor away from bedrails and wheels to avoid cable damage. Roll the patient cables
into a loose loop prior to storage.
 When necessary, dispose of the mobile monitor, its components and accessories (e.g., batteries, cables,
electrodes), and/or packing materials in accordance with local regulations.
 Check that all operating and environment conditions such as ambient temperature meet the device’s
specifications. Allow the device to stabilize within its intended operating environment for a minimum of two
hours prior to use.
 Do not exert excessive pressure on the touchscreen LCD or use a sharp or hard object with it. Excessive
pressure may permanently damage the display.
 This device is not recommended for use in the presence of imaging equipment such as Magnetic Resonance
Imaging (MRI) and Computed Tomography (CT) devices, etc.
 The device is UL classified:
UL-classified device in the USA and Canada.

USER SAFETY INFORMATION
12

13
EQUIPMENT SYMBOLS AND MARKINGS
Indicates compliance to applicable
European Union directives
Do not dispose as unsorted municipal waste.
Per European Union Directive 2002/96,
requires separate handling for waste disposal
according to national requirements
IPX4
Indicates the device has been tested
for safety and shall have no harmful
effect from water splashing against
the enclosure from any direction
Defibrillator-proof type CF applied part
CAUTION The caution statements in
this manual identify conditions or
practices that could result in damage
to the equipment or other property, or
loss of data.
Consult accompanying documents
Mains power input
Consult instructions for use
Catalog number for relevant Mortara
part
SN
Serial number
This end up
Keep away from sunlight
Fragile, handle with care
Keep dry
Temperature limitation
Nurse Call/Control Button
The illuminated LED below this icon
indicates the Power On/Off status
The illuminated LED below this icon indicates
the status of the WiFi connection
Speaker
(RESERVED FOR FUTURE USE)
Patient Cable Input
WARNING The warning statements in this manual identify conditions or practices that could lead to
illness, injury, or death. In addition, when used on a patient applied part, this symbol indicates
defibrillation protection is in the cables. Warning symbols will appear with a grey background in a black
and white document.

EQUIPMENT SYMBOLS AND MARKINGS
14