OncoTherm EHY-2000plus User manual

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USER’S MANUAL
SAFETY, GUARANTEE
OncoTherm Kft.
July 2010
Both the hardware and software are specially developed for the
OncoTherm systems.
Copyrights belong to OncoTherm Kft.
All rights reserved.
This book is sold subject to the condition that it shall not by way of trade or otherwise, be lent, re-sold, hired out or
otherwise circulated without the OncoTherm prior consent in any form of binding or cover other than that in which it is
published and without a similar condition including this condition being imposed on the subsequent purchase.

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Contents
CONTENTS............................................................................................................................................ 2
INTRODUCTION.................................................................................................................................. 3
THE PRODUCTION IS CONTROLLED ALSO BY THE RIGOROUS PRODUCTION
STANDARDS OF EU, CERTIFIED FOR ISO-13485 AND ISO-9001, APPROVED ALSO BY
THE GERMAN TÜV PRODUCT SERVICE (MUNICH). THE PRODUCT IS
COMPLETELY MANUFACTURED IN THE EUROPEAN UNION.SAFETY AND
CAUTIONARY NOTES........................................................................................................................ 4
I NSTRUCTIONS ...................................................................................................................................... 4
E LECTRICAL CONNECTION .................................................................................................................... 5
I NSTALLATION ...................................................................................................................................... 5
Pre-installation notices................................................................................................................... 5
Installation notices.......................................................................................................................... 6
S AFETY - U NIT ...................................................................................................................................... 7
S AFETY - W ATERBED ........................................................................................................................... 8
W ARNING ............................................................................................................................................. 8
IMPORTANT MEDICAL NOTICES................................................................................................ 10
Operator’s table:.......................................................................................................................... 14
GUARANTEE ...................................................................................................................................... 15
Q UALITY REFERENCES :....................................................................................................................... 15
CONTACTS.......................................................................................................................................... 16

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Introduction
Congratulation on your excellent choice!
You are an owner of a high-tech medical product, developed and produced by
OncoTherm Kft.
on the basis of the latest bio-engineering and medical knowledge.
EHY-2000 is a German product, approved by the TÜV Product Service (Munich, Germany),
tested and approved by the German law according to the European Medical Device
Directive (called medical CE).

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The production is controlled also by the rigorous production standards of EU,
certified for ISO-13485 and ISO-9001, approved also by the German TÜV Product
Service (Munich). The product is completely manufactured in the European
Union.Safety and cautionary notes
Please read these installation- and
operating-instructions carefully
before using your device. These
instructions contain important
notes regarding installation, use
and maintenance of your
appliance.
Please keep these instructions in a safe place and, if you sell the appliance,
hand them to the new owner.
The manufacturer cannot accept liability if these instructions are not
adhered to.
Instructions
Read the instructions in this user's manual carefully since you will find all
the instructions you require to ensure safe installation, use and maintenance.
Always keep this manual close at hand since you may need to refer to it in the
future.
When the packing is removed, check that the appliance is not damaged. If
you have any doubts, do not use the appliance, call for a qualified technician. Since
the packing (plastic bags, foamed polystyrene, nails, etc.) are potential sources of
danger, never leave them within the reach of children.
The device must be installed by a qualified technician/engineer sent or
contracted by OncoTherm Kft in compliance with the instructions provided. The
manufacturer declines all responsibility for improper installation which may harm
people and damage property.
The user must not replace the supply cable of this appliance. Always call an
after-sale-service centre authorised by the manufacturer in case of cable damage or
replacement.
This device must be used for the purpose for which it was expressly
designed. Any other use is considered to be improper and consequently dangerous.
The manufacturer declines all responsibility for damage resulting from improper
and irresponsible use.

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Electrical connection
1. Connect the equipment to 220-240 V A/C socket with ground only.
Ensure that the socket is properly installed.
2. Observe that a min. 16 Ampere fuse protects the socket.
3. Make sure, that the device uses the single-phase independently from
other appliances. Let an independent phase for the device and others for
the other applied electric appliances (for example: air-conditioning,
diagnostics systems, computers, sterilization equipment, etc.) in the
room.
(Our service team controls these conditions, and the preinstallation
discussions will be also taken into consideration to satisfy these requests.)
Installation
Pre-installation notices
1. Put the device into a quiet, independent room, devoted only to the
OncoTherm device and treatment procedure.
2. The room must have normal conditions (e.g. temperature humidity,
pollution, etc.) throughout its lifetime.
•temperature range: 15 – 23 °C,
•humidity range: 20 – 60 %,
•No aggressive pollution (e.g. chemicals, fibers, dust, smoke,
etc.) is allowed in the room where the device is installed.
3. Let the room have enough natural and/or artificial light for the proper
handling of the treatment.
4. Do not install the device on textile carpet. Avoid using the equipment
on soft surfaces.
5. Do not use the equipment where it may be subject to vibration.
6. Avoid using the equipment near appliances generating strong electro-
magnetic fields (e.g. motors, transformers, etc.).
7. In the room there has to be a safe place for treatment accessories.
8. On delivery, observe the device carefully and wait for the authorized
Service for the installation.
9. If your device looks damaged, do not attempt to use it, when in doubt
ask OncoTherm service team for advice.

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10. To move the device into another room and/or into any other place from
the place where it originally was installed please ask for the assistance
of the OncoTherm service. The unauthorized relocation is strictly
prohibited, avoid the mains and grounding discrepancies and the
possible electric shock.
11. Avoid using your equipment immediately after sudden changes of the
outside temperature, due to the moisture damage in the electronics.
12. Ensure that no objects or fluids pass through the ventilation openings. If
liquid is spilt into the equipment, disconnect it from the mains and
consult a qualified service technician.
13. Dangerous voltage inside. Do not open the cabinet. There are no user
serviceable parts inside. Only qualified service personnel should carry
out repairs.
Installation notices
1. This unit should be situated away from heat registers, radiators, stoves
or other appliances that produce heat. Also windy places or the near
vicinity of the windows should be avoided.
2. For best performance and safety, please place this unit in the middle of
the room, make it possible for the operator to access the device from any
direction. Any walls and/or grounded surfaces have to be minimum 1.5
meter away from the treatment bed, on the way, that the patient could
not reach any surfaces independent from the device, which could cause
an electric shock for him/her.
3. The EHY unit must be located on a suitable place, where the
emergency switch of the device can be accessible for anybody in
case of a dangerous situation. This emergency switch cut off the mains
voltage of EHY device itself, but this button does not affect on the
waterbed and PC.
4. Good air circulation around the device is essential to prevent internal
overheat of the electronic parts.
5. Choose a dust-free, well-ventilated position, do the everyday cleaning
by washing up the floor, as it is usual in medical institutions.
6. Take care of the intactness of cables and water pipes. Do not break
them, or obstruct the free flow of the cooling water.
7. Electrical safety of the appliance is only guaranteed if the grounding
system of the building is in accordance with local electricity board
regulations. The OncoTherm service team controls it at the regular
services. The proper electric conditions are the liability of the customer.

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8. Only an authorized service personnel should carry out repairs and any
other work on the device. The approval must be on written form from
OncoTherm Kft. The relocation and/or using other mains-socket than
the originally installed, must be done only by OncoTherm or its
authorized service-representative. Only the service personnel, a
qualified and authorised OncoTherm personnel should service the unit
when it does not operate normally or shows marked change in its
performance.
9. Devices, which are to be discarded, must be made unusable. Pull out the
plug, remove the cable and make the door lock and door catch unusable.
Safety - Unit
1. The device is only suitable for normal treatment use and for the
purposes and intended use stated in the operating instructions.
2. Do not use any extension- and radio-frequency-cables, only those which
are provided by the authorized service and/or by OncoTherm.
3. Before starting any cleaning work on the device it must be disconnected
from the electric supply by removing the plug from the socket. Do not
pull the cable!
4. The mains lead of the unit should be unplugged when the unit is not in
use.
5. Do not plug in or unplug the mains lead with wet hands.
6. Do not use the device barefoot.
7. Take care that objects do not fall and liquids are not spilled into the
interior of the device through openings.
8. Do not allow children to operate and/or control the equipment.
9. Do not allow people who are not experienced nor trained in operating
the equipment to use it, without supervision.
10. Never leave the device exposed to environmental effects (rain, sun
etc.).
11. Every six months the service team has to check the device according to
the ‘Periodical safety testing instruction’ (see User’s manual / Technical
part / Appendix 1).

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Safety - Waterbed
1. Never use waterbed without the mattress. Touching pure copper heating
surface can cause burn!
2. Never use the mattress without water (Only distilled water can be used.)
as the patient can compress it and can touch copper heating surface
almost directly! (Check of filling up: Push the middle of one half of the
mattress with one hand till reaching bottom. Then push with other hand
the middle of the other half - minimum ½ meter from the first point. It
must not reach the bottom.)
3. Water leakage is shown on display (sensed electronically in wastewater
tank). In case of waterloss failure, treatment can be finished, but call for
service soon. If water flows quickly, treatment must be stopped, switch
off the bed and pull out mains plug.
4. In case of noticing water in the plastic tray or on the surface of the
mattress, please check water level in mattress and presence of possible
mechanical damage. Do not use damaged mattress, avoid electric shock.
5. The patient’s surface must not be damp. After cleaning the surface the
user have to wait until it is dry.
6. Using EHY2000plus with not heated waterbed may decrease the
temperature of the body of a patient. In case of everyday use keep the
bed switched on permanently. (Heating up the water from room
temperature to treating temperature level requires about 12 -16 hours.)
7. Check the temperature settings before each treatment! Recommended
temperature setting is 32°C, because the treatment itself is heats also, so
patient will have sweaty skin which is not suitable for correct
EHY2000plus treatment.
8. Check the alarm system daily during continuous use. Switch off for a
short time. Switching on the waterbed, a self-test is implemented, and a
warning is going on, till user sets the desired temperature again.
9. Do not use other surgical or endocardial devices while patient is on the
waterbed.
Warning
A SPECIAL TRAINING IS REQUIRED TO OPERATE THE EQUIPMENT!
FOR THIS PROCEDURE ASK THE MANUFACTURER.
TO REDUCE THE RISK OF FIRE OR ELECTRIC SHOCK, DO NOT
EXPOSE THIS APPLIANCE TO RAIN OR MOISTURE. DUE TO
DANGEROUS HIGH VOLTAGE, DO NOT OPEN THE CABINET, FOR
SERVICE REFER ONLY TO THE ONCOTHERM QUALIFIED
PERSONNEL.

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This symbol is intended to inform the user about the ground independent (body
floating) construction. Do not rearrange the professional installation.
This symbol is intended to alert the user to the presence of important operating
and maintenance instructions in the literature accompanying this product.
Reads it before a usage the User’s manual.
This symbol informs the user, the device is intended to emit non-ionizing
radiation.
This symbol indicates that the waste of electrical and electronic equipment
must not be disposed as unsorted municipal waste and must be collected
separately. Please contact the authorized representative of Oncotherm Ltd. for
information concerning the decommissioning of your equipment.
CLASS
II
EQUIPMENT having a durable and substantially continuous ENCLOSURE of
insulating material
which envelops all conductive parts with the exception of small parts, such as
nameplates,
screws and rivets, which are isolated from LIVE parts by insulation at least
equivalent to REINFORCED INSULATION. The ENCLOSURE of insulation-
enclosed CLASS II EQUIPMENT
may form a part or the whole of the SUPPLEMENTARY INSULATION;

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Important medical notices
Please remember:
1. Intended user of this device is a physician and/or a trained clinical staff
under the physician’s control.
2. The treatment has to be permanently monitored by the staff.
3. The treatment needs extra care, when the patient has reduced thermal
sensitivity over the treated area.
4. Treatment is strictly prohibited when the patient is unconscious!
5. Treatment is prohibited when the patient is under deep-sedation or
anesthesia!
6. Treatment is strictly prohibited in case of children, who aren’t able to
communicate with physician!
7. If the patient has inclination to epilepsy, the physician has to take extra
attention!
8. Check the position of the electrode to keep it as smooth on the skin as
possible. The applicator (electrode) has water-bolus, a flexible surface
to have the best contact with the skin. Note that the direct-contact
placement of electrodes on the skin has to be controlled carefully,
because some temperature-increase on the skin can occur. It will not be
a sudden effect and can be indicated by the patient. Be careful because
of the touching of electrode black border to the skin. Because of the
special feature of RF field the contact the black border with the skin on
a small part of the body can cause burning.
9. Do not use the equipment improperly: it can be dangerous. Always
check the user’s manual.
10. Operating the EHY device is not suggested for a staff during pregnancy.
11. Do not use the electrodes in the vicinity of the patient′s
metallic/prothesis implantat (bone-replacement, pacemaker, joint-
support, surgery clips, etc.) Please consult the supervisor immediately
before treating such a person.
12. Check the patient, ask about her/his feelings frequently.
13. Check the good water-cooling of the electrode before positioning it.
14. After setting up treatment parameters, the door (made of glass) has to be
locked to avoid the unauthorized use or misuse.
15. At rearranging and/or positioning the applicator, please pause/stop the
treatment.
16. In case of any necessary medical aid (injection, infusion, etc.) please
pause/stop the treatment.

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17. Be careful with temperature measurements and the other controlling
units. Any metallic part could be an antenna. Using any non-
OncoTherm product to control is prohibited. Do not use any system-
independent electric device during the treatment. It can cause electric
shock due to the broken safety isolation.
18. Before the treatment any metallic pieces (necklaces, rings, jeweller,
watches, pipes, coins, phones, hairpins, pens, etc.) has to be left far
away from the treatment bed. Do not treat patients who have earphones,
hearing-aid, music devices (Walkman, walk-watch, etc.) and/or any
wire-connected instruments.
19. Credit-cards and/or any other magnetically sensitive products (diskettes,
tapes, etc.) are recommended not to be kept near the treatment. No
guarantee of not loosing the information from the data-carriers
20. Do not treat near the eyes of the patient. The direct RF-radiation can
cause temporary or permanent blindness. The treatment of the head
requires special training at one of the OncoTherm reference clinics.
21. Do not clean the electrodes while the equipment is on! Do not use such
wet textile-tissue that could release water to penetrate into any parts of
the equipment!
22. The optimal placement of the applicators is to position them parallel to
each other. Such an arrangement gives the most effective heating power.
Note that in many cases only a small power is required for the treatment
(for example when treating a brain tumour) which can be regulated by
the output power control or by placing the electrodes in a non-parallel
arrangement. Patient must be between the electrode and counter
electrode placed into the waterbed.
23. Do not wrap the electrode into any textile material for the treatment.
Reduce the thickness of textile material to a minimum between the
electrode and patient’s skin. Textile quality has an effect on tuning
frequency which can lead to system error in tuning under the given
circumstances.
24. During treatment, relaxing (so called 'alpha') music is suggested for
psychological reasons (faster recovery is possible).
25. This kind of radio-frequency treatment has an effect on the
surroundings. This is why some attention should be taken on how to set
up the treatment system and how to furnish the room in which
treatments will take place. Note, do not install the machine in the
vicinity of sensitive equipments (ECG, EEG, intensive-care control-
monitor, ultra-sound, video-rectoscopy and/or other sensitive imaging
systems, etc.) without shielding. Shielding is also required to defend the
EHY-2000plus in the vicinity of large electro-magnetic sources and/or
high-power machines (power transformer, X-ray units, NMR, CT, etc. It
should be noted that microwaves could influence the OncoTherm device
in the treatment room and vice-versa. Make sure that these machines are
well shielded.

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26. It is optimal if the device is separated from the control-computer. The
central computer should be placed outside the treatment room. An
observation room has to be arranged from where the personnel can
control the patient's treatment.
27. The personnel, responsible for the treatment/equipment, should check
the cables before each treatment. At any doubt about the intact isolation,
stop the treatment and call for an immediate service check-up.
28. Clean the electrodes before each treatment. Follow the procedure
written in the maintenance part (see above). Alcohol (or its substitute)
has to be used for disinfecting.
29. Before the treatment any sharp objects (knives, scissors, needles, pens
pencils, glasses etc.) have to be left far away from the treatment bed in
case of using waterbed.
30. Using waterbed mattress without checking of its sufficient amount of
water can be dangerous, the patient can suffer a burn.
31. The EHY treatment can have a side effect (about 3% of the cases). In
cases when the treatment area is covered by a considerable adipose
tissue, subcutane fat-burn could create. Also red-skin (slight burn) could
happen.
32. The water in the mattress must be heated up before the treatment.(See in
detail the Treatment information-Preparation section)
33. Accessory equipment connected to the analog and digital interfaces
must be certified according to the respective IEC standards (e.g. IEC
60950 for data processing equipment and IEC 60601-1 for medical
equipment). Furthermore all configurations shall comply with the
system standard IEC 60601-1-1. Everybody who connects additional
equipment to the signal input part or signal output part configures a
medical system, and is therefore responsible that the system complies
with the requirements of the system standard IEC 60601-1-1. If in
doubt, consult the technical service department or your local
representative.
Resident risks:
User has to follow the instructions mentioned above otherwise burning
or overheating of the tissue can occur.
The temperature calculation (displayed temperature) is only a
calculation. Take in consideration that the temperature of some points of the
heated local area can be considerably higher than the average. This effect in
the Literature is called “hot spots”. This inaccuracy can cause overheating of
the tissue.

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The calculation however is based on the so-called “equivalent
temperature” idea. This means that electro-hyperthermia heats up the tissue
by a dynamic, gradient method. The calculated temperature is such one that
has the equivalent distortion ability of the cells as the static overheating. This
temperature (due to the dynamical effects) in reality could be smaller than the
statically measurable.
Tolerated accuracy of forwarded and reflected power (±30%) is
checked at start-up but will not be checked continuously under the treatment.
This can cause overheating of the tissue.

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Operator’s table:
Treated part of the
body Proposed electrode****
Electrode-skin
distance **
[cm]
Treatment
time [min]
Proposed
power* [W]
Lungs large 0 90 140-150
Kidney standard 0 60 100-130
Liver large 0 60 120-140
Stomach standard 0 60 120-130
Pancreas standard 0 90 100-120
Lymph nodes standard 0 60 80-110
Superficial small 0 60 80-90
Cole-rectal region standard 0 90 100-130
Breast standard 0 60 80-100
Prostate*** standard 0 60 60-80
Oesophagus large 0 90 100-120
Head-neck small 0 60 80-100
* Please carefully monitor the patient, and do not exceed Her/His personal
tolerance. Patient must not feel any burning or too much hot.
** Always be sure, the electrode bolus tightly touches the skin of the patient in
a largest available surface.
*** take extra care on the testes.
**** could be variable, depending on the area of the actual tumor.
Electrode dimensions:
Small: Ø10cm
Standard: Ø20cm
Large: Ø30cm

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Guarantee
The manufacturer guarantees service for the whole instrument (hardware
and software). The guarantee is free of charge for one year. After one year service
can be guaranteed in the form of a stand-by agreement. The total upgrading of the
system, to keep pace with new developments and knowledge in the field, can be
included in the stand-by service agreement.
Guarantee covers both spare parts and labour. Service under guarantee is
only provided upon presentation of reasonable evidence (e.g. completed guarantee
card or purchase receipt) that the date of claim is within guarantee period.
Guarantee is not valid if the defect is due to accidental damage, misuse
or neglect and in case of alterations or repairs carried out by unauthorised
persons.
Any changes in the hardware and/or software without written
permission of the manufacturer is strictly prohibited.
Service (during and after guarantee period) is available in all countries
where the product is officially distributed. For further information, please
contact your local distributor.
Any suggestions and/or requests for further development of the system
are highly appreciated and very welcome.
Quality references:
EHY2000plus and WEY 2000 are marked, TÜV Product Service (Munich)
has given the EC Certificate. The device is constructed and produced to satisfy the
IEC 601-1 standard and the 93/42/EEC MDD (Medical Device Directive).
The equipment has passed an EMC (Electro-Magnetic Compatibility) check
(MIKES Product Service, Strasskirchen).
EHY2000plus has a Technical Report concerning conformity according to
MSZ 16260-86 Safety levels of high frequency electromagnetic fields. Rep. No.:
2000/19/112/2 issued by ORKI
The rights to this system are the sole property of the manufacturers. Patent
is pending.
Not-permitted-change in installed hardware and/or software makes
certificates invalid!

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Contacts
In case of any question, we are happy to serve you:
Questions in production and management:
Oncotherm
Dr. Olivér Szász
Managing director
Belgische Allee 9, D-53842 Troisdorf, Germany
Phone: [phone]
Fax: [phone]
Email: [e-mail]
and
Ibolya utca 2., H-2071 Páty, Hungary
Phone: [phone]
Fax: [phone]
E-mail: [e-mail]
Questions in research and development:
Prof. Dr. András Szász
Research director
Telefon: [phone]
Fax: [phone]
E-mail: [email protected]
Your local distributor: