Spencer 4BELL Series User manual

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User manual
4BELL – TRANSPORT CHAIR
Class I Medical De ice, compliant with the Medical de ice directi e 93/42/EEC
Warning
The information contained in this manual is subject to change without notice.
The Diagrams are inserted only for reference and may vary slightly from the actual device.
Spencer Italia S.r.l. assumes no responsibility for any errors contained herein or for damage, accidents or consequences connected with the supply,
performance or use of this manual.
First edition: 25/06/2015
Re .4 26/09/2019
SPENCER ITALIA SRL – ia Provinciale n° 12 – 43038 Sala Baganza (PR) - Italy
www.spencer.it | support.spencer.it - e-mail: [email protected] | service: [email protected] |Ph./Tel. [phone]
Quality System EN ISO 9001 – EN ISO 13485

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INDEX
1. MODELS 3
2. INTENDED USE 3
3. REFERENCE STANDARD 3
4. INTRODUCTION 3
4.1 USE OF THE MANUAL 3
4.2 LABELLING AND TRACKING CONTROL OF THE DE ICE 3
4.3 SYMBOLS 4
4.4 WARRANTY AND SUPPORT 4
5. WARNINGS 4
6. SPECIFIC WARNINGS 6
6.1 PHYSICAL REQUIREMENTS OF OPERATORS 7
7. RESIDUAL RISK 7
8. TECHNICAL DATA AND COMPONENTS 8
9. INSTALLATION AND START-UP 8
10. FUNCTIONAL CHARACTERISTICS 9
11. INSTRUCTIONS FOR USE 10
11.1 MEDICAL EHICLE REQUIREMENTS 10
11.2 OPENING THE CHAIR 10
11.3 REAR HANDLES OPENING, ARMRESTS (WHERE PRESENT) AND FOOTREST 10
11.4 OPENING AND CLOSING OF TELESCOPIC HANDLES 10
11.5 HEADREST OPENING (WHERE PRESENT) 11
11.6 FRONT PARKING BRAKES 11
11.7 REAR PARKING BRAKES 11
11.8 CLOSING THE CHAIR 11
11.9 MO ING THE CHAIR ON THE GROUND 12
11.10 LIFTING THE CHAIR 12
11.11 MO ING THE CHAIR ON STAIRS 12
12. CLEANING AND MAINTENANCE 13
12.1 CLEANING 13
12.2 PRECAUTIONARY MAINTENANCE 13
12.3 PERIODIC MAINTENANCE 15
12.4 SPECIAL SER ICING 15
12.5 LIFE SPAN 15
13. TROUBLESHOOTING 16
14. ACCESSORIES 17
14.1 STANDARD EQUIPMENT 17
15. SPARE PARTS 17
16. DEMOLITION 17
Warning
The information contained in this document could be modified without any warning and is not to be intended as a commitment on behalf of Spencer Italia S.r.l. Spencer
products are exported to many countries and the same identical regulations are not always valid. For this reason there could be differences between the description here
described and the product actually delivered. Spencer continually strives to reach the perfection of all items sold. We therefore hope you will understand if we reserve the right,
at any time, to modify the shape, equipment, lay-out or technical aspects that are herein described.
© Copyright Spencer Italia S.r.l.
All rights reserved. No part of this document can be photocopied, reproduced or translated into another language without the written approval of Spencer Italia S.r.l.

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1. MODELS
The standard following models can undergo change, re ision and implementation without any notice.
•4BELL – TRANSPORT CHAIR 4BELL A IO
•4BELL – TRANSPORT CHAIR 4BELL AIR
•4BELL – TRANSPORT CHAIR 4BELL SIL ER
•4BELL – TRANSPORT CHAIR 4BELL CLASS
•4BELL – TRANSPORT CHAIR 4BELL COMFORT
•4BELL – TRANSPORT CHAIR 4BELL STAIR
2. INTENDED USE
The transport chair 4BELL is a device for transport of patients in sitting position from the rescue place to the ambulance or to another device
intended for transport on the vehicle. It is therefore non usable as a device for transport of the patient inside the ambulance.
The device is equipped with wheels that allow easy movement on flat surfaces. If handling with wheels is difficult or considered a risk, the
device can be lifted using front and rear handles.
The medical vehicle must be equipped with a dedicated Spencer fixing system that allows storage of the device in the closed position
guaranteeing maximum safety.
The patient should not intervene on the device.
3. REFERENCE STANDARD
As a distributor or end user of products manufactured and/or marketed by Spencer Italia S.r.l. you are strictly required to ha e basic
knowledge of any legal requirements applying to the de ices contained in this supply that are in power in the goods final destination
Country (including laws and norms regarding technical specifications and/or safety requirements) and therefore you are strictly required
to ha e the necessary knowledge to guarantee all aspects regarding the total conformity of the products to the regulations in the rele ant
territory.
RIFERIMENTO TITOLO DEL DOCUMENTO
UNI EN 1865-1 (not applicable to model Stair)
Patient handling equipment used in road ambulances - Part 1: Specification for
general
stretcher systems and patient handling equipment
UNI EN 1865-4 (Only mod. Stair) Patient handling equipment used in road ambulances – Part 4: Foldable patient
transfer chair
UNI EN 1789 § 4.5.9 - § 5.4.2 - § 5.4.5 Medical vehicles and their equipment - Road ambulances
4. INTRODUCTION
4.1 USE OF THE MANUAL
This manual is intended to provide the health care operator with the all the necessary information for its safe and appropriate use as well as
adequate maintenance of the device.
Note: The manual is an integral part of the device. It must be kept for the duration of the device and must accompany the
device in case of change of ownership or destination. If the operating instructions received relate to products not received, you
must immediately contact the manufacturer before use.
The Spencer product manuals can be downloaded from the website or can be requested by http://support.spencer.it or by contacting the
manufacturer. Exceptions are items whose essentiality for reasonable and predictable use is such as to make it unnecessary to prepare
instructions in addition to the following warnings and directions on the label.
Regardless of the level of experience gained in the past with similar devices, it is recommended that you carefully read this manual before
installing, operating or using the product or any maintenance
4.2 LABELLING AND TRACKING CONTROL OF THE DEVICE
Each device has got an identification label positioned on the device itself and/or on its box, which includes identification data about the
manufacturer, the product, the CE mark, the serial number (SN) or lot number (LOT).
It must never be removed or covered.
In case of damage or loss, request a duplicate from the manufacturer. Failure to do so will interrupt the validity of the guarantee as the
device can no longer be traced.
The Directi e 93/42/EEC requires manufacturers and distributors of medical de ices to keep track of the de ice location. If the de ice was
in a different location to the address where it was sent or to where it had been sold, donated, lost, stolen, exported, or destroyed,
permanently remo ed from use, or if the de ice had not been deli ered directly from Spencer Italia S.r.l., register your de ice at
http://ser ice.spencer.it or inform the customer (see § 4.4).

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4.3 SYMBOLS
Symbols Meaning
General or specific warnings
Lubricate
Caution: Federal Law restricts this device to sale by or on the order of a licensed practitioner
See instructions for use
Product code
Serial Number
The product is compliant with the requirements of Directive 93/42/EEC
4.4 WARRANTY AND SUPPORT
Spencer Italia S.r.l. guarantees that products are without defects for a period of one year from the date of purchase.
For any information regarding the correct interpretation of the instruction manual, the use, maintenance, installation and restore of the
product, contact the Spencer customer care service ph. +39.0521.541111, fax [phone], e-mail [email protected], or visit
http://it.spencer.it/contatti to find the nearest service centre for assistance.
In order to facilitate the assistance service, please always indicate the lot number (LOT) or serial number (SN) shown on the label applied on
the box or on the device.
Conditions for warranty and assistance can be iewed on http://support.spencer.it.
Note: Record and store; these instructions, lot LOT) or serial number SN) if any, date and place of purchase, date of first use, date servicing,
user names and comments.
5. WARNINGS
The warnings, notes and other important safety information are indicated in this section and are clearly visible throughout the
entire manual.
At least every 6 months, is important to verify if updated User Manuals are available or there is any change involving your
product. This information is freely available on the website http://support.spencer.it in the section “User manuals” and
“Product Updates”.
User training
Note: Laboratory testing, post production tests, instruction manuals cannot always consider every possible scenario for use.
This means that in some cases the performance of the product could be notable different from results to date obtained.
Instructions are continually being updated and are under tight surveillance of fully qualified staff with adequate technical
formation.
•Regardless of the level of experience gained previously with similar devices, it is recommended that you carefully read this manual
before installing, operating or using the product or carrying out any maintenance. If in doubt, contact Spencer Italia S.r.l. to obtain the
necessary clarifications.
•The product must be used by trained personnel only, having attended specific training for this device and not for similar products.
•The suitability of the user to use the product may be attested by the records of training, where the names of those trained, of the
trainers, dates and place are Indicated. This register which certifies the eligibility of the operators to use the Spencer de ice must be
kept for a period of 10 years after the disposal of the de ice itself. This register will be made a ailable to the competent Authorities
and/or manufacturer if requested. In the absence of such documentation, sanctions will be applied.
•Do not allow any untrained person to help during the use of the device, because they could cause damage to the patient or to
themselves.
•The product should be operated only by personnel trained in the use of this product and not in others similar.
Note: Spencer Italia S.r.l. is always at your disposal to organise product training.
Installers training
The installation of the device must be carried out only by qualified and trained staff authorized by Spencer Italia S.r.l. ates
and procedures for participating in training courses will be arranged between the customer and our Commercial offices.

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Product functionality
Use of the de ice in anyway other than described in this manual is forbidden.
•Before each use, the perfect operating state of the device must be thoroughly checked as specified in the instruction manual. If any
damage or abnormalities which could in any way influence the correct functioning and the safety of the device are detected, the device
must be immediately removed from service and the manufacturer must be contacted.
•If any failure or incorrect functioning of the device is detected, it must be immediately substituted with a similar item so that the rescue
procedures are guaranteed without any interruption.
•The appliance must not in any way be tampered with (modification, adjustment, addition, replacement). In such cases all responsibility
for any malfunctions or injuries caused by the appliance itself will be denied; moreover CE certification and product warranty will be
considered void.
•Those who modify or have modified, prepare or have prepared medical appliances in such a way that they no longer serve the purpose
for which they were intended, or no longer supply the intended service, must satisfy the valid conditions for the introduction onto the
market.
•During use, position and adjust the device taking care not to cause any obstruction to rescuers and or any other rescue equipment.
•Ensure that all the necessary precautions are taken in order to avoid the hazards that can arise as the result of contact with blood or
body fluids, when applicable.
•For devices intended for the transport of patients, always respect the maximum load capacity of the device, as indicated in this user's
manual. Maximum load capacity means the total weight distributed according to the human anatomy. In determining the total loading
weight of the product, the operator must consider the weight of the patient, the equipment and the accessories. Moreover, the
operator must consider that the overall dimensions of the patient do not reduce the functionality of the device.
•For devices intended for the transport of patients, make sure, before lifting, that operators have appropriate physical condition as
indicated in the manual.
•The maximum weight supported by each rescuer must comply with the requirements prescribed by the law of the land, in the field of
Health and Safety at Work.
•The warranty seals, where present, must not be remo ed; in such case, the manufacturer will no longer recognize the product warranty
and will accept no responsibility in case of incorrect operation or damage caused by the product itself.
•Avoid contact with sharp objects
•The installation of the device must be carried out only by qualified and trained staff authorized by Spencer Italia S.r.l. Timing and
procedures for conducting training courses shall be agreed between the customer and our Commercial offices.
•Operating temperature: from -10°C to + 50°C
Storage
•The device should not be exposed to or come into contact with any source of combustion or inflammable agents. Store in a cool, dry,
dark place and do not expose to direct sun.
•Do not store the device underneath any heavy objects which could cause structural damage.
• Store and transport the device in its original packaging. Failure to do so makes the warranty void.
•Storage temperature: from -20°C to +60°C
Maintenance/cleaning
Spencer Italia S.r.l. disclaims any liability for any damage, direct or indirect, which is a result of improper use of the product and
replacement parts and / or otherwise of any repairs made by an entity other than the authorized Spencer ser ice centres; this will also
in alidate the warranty.
•The operator must always wear adequate personal protection such as gloves and mask etc. during all checking, maintenance and
cleaning procedures.
•Establish a maintenance program and periodic testing, identifying an employee responsible for overseeing. The person to whom the
ordinary maintenance of the device is entrusted must ensure the basic requirements foreseen by the manufacturer in the user’s manual.
•The frequency of inspection is determined by factors such as legal requirements, the type of use, frequency of use, en ironmental
conditions during use and storage.
•Spencer Italia S.r.l. disclaims any liability for any damage, direct or indirect, that is the result of incorrect repairs or use of products made
by Spencer Italia S.r.l. Repairs must necessarily be carried out by an authorized Spencer Italia service centre, which in using original spare
parts will provide a quality repair service in strict accordance with the technical specifications given by the manufacturer. Spencer Italia
S.r.l. disclaims any liability for any damage, direct or indirect, which is a result of improper use of spare parts and/or otherwise of any
repairs made by an entity other than the Spencer service centres authorized to repair or make substitutions on this product and parts
and/or otherwise of any repairs made by an entity other than the Spencer service centres authorized to do so; the warranty will also be
invalidated.
•Use only original components, spare parts and or accessories, approved by Spencer Italia S.r.l., in order to carry out any operation
without causing any alteration or modification to the device.
•For any operations that are not carried out directly by the manufacturer but by an authorised centre, we have to underline that a report
regarding all operations carried out must be requested. This will permit both Spencer Italia S.r.l. and the end user to keep a log book
regarding the operations carried out on the device.
•All maintenance and revision must be recorded and documented with the corresponding report for technical assistance; documentation
shall be maintained for at least 10 years from the end of life and must be made available to the competent authorities and/or the
manufacturer if requested.

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•The cleaning schedule for reusable products must be performed in accordance with the directions provided by the manufacturer in the
user manual, in order to avoid the risk of cross-infection due to the presence of secretions and/or residuals.
•The device and all its components, after washing, should be allowed to dry completely before storing.
•If required, lubrication must be carried out after cleaning and complete drying.
Regulatory requirements
As a distributor or end user of products manufactured and/or marketed by Spencer Italia S.r.l., you are strictly required to ha e a basic
knowledge of any legal requirements applying to the de ices contained in this supply that are in power in the final destination Country
(including laws and norms regarding technical specifications and/or safety requirements) of the goods and therefore you are also strictly
required to ha e the necessary knowledge to guarantee all aspects regarding the total conformity of the products to the regulations in the
rele ant territory.
•Promptly notify Spencer Italia S.r.l. (already during the first product enquiry) when requesting in details regarding any revisions to be
made by manufacturer in order to guarantee the conformity of the products to the territory’s legal specifications (including those
resulting from rules and/or norms of other kind).
•Act, with all due care and diligence, and contribute to ensure conformity to general safety requirements of all devices marketed in the
territory, by providing final users with all necessary information for carrying out periodical checks on their devices, exactly as specified in
the relevant user’s manual.
•Acti ely contribute to safety checks on product sold, by communicating any relevant risk analysis information both to the manufacturer
and to any competent authorities so that the necessary action can be promptly taken.
•The distributor or final user is aware that in the event of any failure to conform to the above mentioned requirements you will be
deemed fully responsible for all damages that might occur. Therefore Spencer Italia S.r.l. expressly disclaims any responsibility and/or
liability for your non-compliance with the present regulatory provisions.
General warnings for medical devices
The user must carefully read not only these general warnings, but also those listed below.
•It is not foreseen that the use of the device is prolonged beyond the time necessary for recovery operation described in the intended use
and in this manual.
•When the device is being used, the assistance of qualified staff must be guaranteed and at least two operators must be present.
•Follow the procedures and protocols approved by the internal organization.
•The activities of disinfection and sterilization should be carried out in accordance with the parameters given in the validated cycle as
specified in the technical standards.
•With reference to the D. Lgs. 24th February 1997, n. 46 emended by D. Lgs. 25/01/2010, n. 37 – Acknowledgement of Directive
93/42/CEE and 2007/47/CE concerning Medical Devices, we remind both public and private operators, , That in the exercise of their
activity detect an accident involving a medical product are required to notify the Ministry of Health, under the terms and in the manner
established by the relative ministerial decrees and also to the manufacturer. Health care providers whether public or private are
required to communicate to the manufacturer, any other inconvenience that may allow for the adoption of measures to ensure the
protection and health of patients and users
6. SPECIFIC WARNINGS
For the use of the Transport Chair 4BELL, , the user must have read, understood and follow carefully all the instructions described in this
manual
•Follow the procedures approved by the Emergency Medical Service for the immobilization and transport of patients.
•Follow the procedures approved by the Emergency Medical Service for the positioning and transport of patients.
•Do not use if the device or its parts are pierced, torn, frayed or excessively worn out.
•The device can be used with a patient only if the belts are intact and properly fastened
•Handling of the device on the wheels, is permitted only with all four wheels resting on the floor. Is not permitted to carry the chair tilted
or resting on only two wheels.
•When the device is moved with the patient on it, is essential to have a firm grip on the handles according to the type of transport.
•The device can be lifted using front and rear handles. Before lifting, make sure that the front handles are fully extended and locked.
•Before use, ensure that all operators have a firm grip on the device.
•Avoid pulling the device on rough surfaces.
•Do not lift by crane or other mechanical lifters.
•Do not use drying machines.
•Do not use the device in combination with other equipment not expressly approved by the manufacturer.
•The device is intended to be used for patient transport as stated in the chapter Intended use and cannot be used as a parking de ice or
for the transport of patient inside the ambulance.
•Practice with an empty chair and with a simulated load in order to become familiar with the manoeuvres.
•For patient loading techniques, for particularly heavy patients, for working on uneven ground or in special and unusual circumstances,
the presence of more operators is recommended (not only 2 as required in standard conditions).
•Before each use, check the integrity of the belts and their hooks as specified in the user’s manual. In case of malfunction or damage that
may compromise the functioning and safety of the device, patient or operator, it is necessary to replace the belts.
•Make sure the belts are properly fastened to the device.

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•Make sure that the tapes used to fix the seat fabric are properly secured.
•Always immobilize the patient, using the straps supplied by the manufacturer; lack of immobilization may cause serious damage. The
manufacturer is not liable for any damage caused by improper or incorrectly applied belts.
•Do not operate in case the weight has not been distributed correctly.
•Before moving the patient with the device, inform him about the manoeuvres you are going to perform
•Use only the handles or knobs to lift the chair and not any other parts of the device.
•Hold the chair firmly still when occupied by the patient.
•The Stationing brakes are aids for the operator, they do not in any way substitute his super ision.
•Great attention must be paid to any possible obstacles (water, ice, debris, etc.) on the route of the stretcher/chair, because they could
cause loss of balance of the operator and compromise the proper functioning of the device. If the path cannot be freed of
obstacles, choose an alternative route.
•To avoid injury, before lifting the chair, always check that the lifting handles are securely locked and fully extended.
•It is preferable not to use the device in the event of suspected cervical or spinal trauma, or fractures.
•To avoid any risk to the safety of the patient and rescuer, during transport on the stairs, the presence of at least two operators is
necessary.
•Condensation, water, ice and dust accumulation can affect the correct functioning of the device, making it unpredictable and causing a
sudden change in weight that operators have to sustain.
•For obstacles higher than 10mm the device must be lifted using the handles. Impact against obstacles above this height, can compromise
the integrity and security of the device.
•Do not alter or modify the device arbitrarily: the modification may cause unforeseeable functioning and damage to the patient or
operators. In any case the warranty will be void and the manufacturer relieved from any liability.
•When closing the device, make sure nothing interferes with the handling systems. Carelessness during this operation could be the cause
of crush injuries.
•Make sure that the slides, if present, are properly locked before moving the device on stairs.
•The 4BELL transport chair, is fulfils the requirements of the EN 1789 standard if used with a Spencer fastening system compliant to the
standard. Therefore, the use of fastening systems is not permitted unless approved by the manufacturer. Fastening systems that have
not been approved may alter the structural and functional characteristics of the device.
•Do not use the de ice near MRI machines
6.1 PHYSICAL REQUIREMENTS OF OPERATORS
The 4BELL transport chair is a device intended for professional use only. Each operator must be trained to transport patients
safely and efficiently. Do not allow untrained persons to help operators during use of the product, as this may cause injury to
themselves or to other people.
The operators that use the device must have the physical ability to use it and good muscle coordination, as well as presenting a strong back,
arms and legs to raise and support and be able to grasp the device firmly with both hands.
Operators must be able to pro ide the necessary assistance to the patient.
Users should be able to lift and handle safely the weight of the chair and the patient as well as any other equipment used with the de ice .
During loading procedures of extremely hea y patients, operations on rough terrain or in particular circumstances, the presence of more
operators may be needed (not only 2 as required in normal conditions)
The ability of all operators must be considered before determining their role in the use of the chair.
7. RESIDUAL RISK
The residual risks listed below have been identified exclusively in reference to the intended use of the device.
•The use by untrained personnel may result in injury to the patient, rescuer or others.
•Inadequate disinfection procedures may involve cross-infection risks.
•Failure to immobilization the patient on the device or immobilization performed using incomplete belt systems or incorrectly fixation to
the chair, can result in serious injury to the patient.
•Partial extraction of front handles could cause their sudden closing when lifting the device. Make sure the handles are fully extracted and
locked before lifting.
•Patient intervention on the device and its closing and braking mechanisms can cause unlocking of the device from open position or
unexpected movements with consequent risks for the patient. Make sure the patient does not intervene on any element of the device.
•Failure to close handles when their extraction is not required can cause obstruction during device handling. Make sure the handles are
closed when moving the device on wheels.
•Partial opening of the chair can cause its unexpected closure if lifted with consequent risks for the patient. Always verify the proper
insertion of the locking system.
•A slides locking failure, for models equipped with them, can cause their sudden closure during transport on stair with serious
consequences for the patient. Always check that all locking mechanisms are properly engaged.
•The use of fasteners not approved by the manufacturer may result in instability of the device inside the ambulance, causing the risk of
violent impact of the device against people and/or things
•Failure to comply with warnings given to operators, can cause crushing risks related to the mechanisms of the device.

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9
8
1
14
2
13
15
10
12
3
5
7
4
6
•Failure to respect the life span established by the manufacturer and the periodic revisions described in this manual, can result in serious
damage for patient and operators linked to the use of a product that does not comply with the safety requirements established by the
manufacturer
•Failure to read and understand the instructions of 4BELL, can ha e consequences for the patient and operators.
8. TECHNICAL DATA AND COMPONENTS
Note: Spencer Italia S.r.l. reserves the right to make changes to specifications without prior notice.
All 4BELL chairs are characterized by an aluminum frame. Armrests, headrest, rear brakes and slides are equipments for specific models
and could not be present on your device. The device is supplied with two belts attached to the seat and to the backrest.
The technical specifications of the main models are as follow:
Feature Avio/Air Silver/Class Comfort Stair
Length opened w/handles closed 750 ± 5 mm 750 ± 5 mm 750 ± 5 mm 750 ± 5 mm
Length opened w/handles opened 1170 ± 5 mm 1170 ± 5 mm 1170 ± 5 mm 1170 ± 5 mm
Width 440 ± 5 mm 485 ± 5 mm 510 ± 5 mm 510 ± 5 mm
Height opened 910 ± 5 mm 910 ± 5 mm 910 ± 5 mm 910 ± 5 mm
Height w/headrest rised / / 1360 ± 5 mm 1360 ± 5 mm
Dimensions folded 310x440x915 ± 5 mm 310x485x915 ± 5 mm 930x510x310 ± 5 mm 930x510x310 ± 5 mm
Rear wheels ø150 mm ø150 mm ø150 mm ø150 mm
Front wheels ø100 mm ø100 mm ø100 mm ø100 mm
Weight 9,3 ± 0,2 kg 9,4 ± 0,2 kg 12 ± 0,2 kg 14,5 ± 0,2 kg
Loading capacity
1
180 kg 180 kg 180 kg 180 kg
1
Maximum load capacity means the total weight distributed according to the human anatomy. In determining the total load of the weight on the product, the operator must consider the weight of the
patient, the equipment and the accessories.
9. INSTALLATION AND START-UP
Before the first use verify that:
•The packaging is intact and has protected the device during transport
•Check that are present all the components included in the accompanying list.
•Functionality of the device according to the user manual
•The ambulance is equipped with a dedicated Spencer fastener and its installation will not hinder access to any other devices.
•Sheets and belts are properly fastened. It is important to make sure that the buckles under the seat are properly inserted and the strap
bands fully adhere to each other.
•Upper belts are properly fixed to the backrest.
Do not modify for any reason any part or component of the chair as this may cause injury to the patient and/or rescuers.
If conditions mentioned abo e are not satisfied, the de ice cannot be considered secure, safe use is compromised and it is a possible
cause of injury for patient and operators and can cause damage to the de ice.
Practice with a chair without patient before the regular start-up.
For instructions on use after start-up, follow the operations described on paragraph 12.
If the above conditions are met, the device may be considered ready for use; otherwise you must immediately remove the device from
service and contact the manufacturer.
Do not alter or modify in any way the appliance; any such interference could cause malfunctions and injury to the patient and/or rescuer.
Moreover the manufacturer will no longer recognize the product warranty and will accept no responsibility.
N° Description Material
1 Transport handle Alluminium
2 Backrest P C/PE exp
3 Armrests (if present) Al/Rubber
4 Closure system unlock lever Al
5 Telescopic handles Al/Rubber
6 Footrest Steel
7 Front wheels Rubber/PP/PA
8 Rear wheels PU
9 Rear wheels brake (if present) Nylon
10 Crossbar to unlock closure
system Steel
11 Slides (if present) Al/Steel/Nylon
12 Seat P C/Nylon
13 Rear handles Al/Rubber
14 Headrest lock Nylon
15 Headrest Al/P C/PE exp

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10. FUNCTIONAL CHARACTERISTICS
Element Description Function
A Transport handle Used to safely push the chair
B Backrest P C coated, removable and washable,increases patient comfort during transport by
giving extra support to patient’s back.
C Armrests Installed only on the model COMFORT or optionally installed in other models, they
improve lateral containment of the patient and allow resting of arms
D Closure system unlock lever Lifting it with one hand in the direction of the seat frame, it unlocks chair’s locking
system.
E Telescopic handles
They can be used to lift the chair with patient. They are equipped with an automatic
locking system and a manual unlocking mechanism which is activated by pushing
downwards
F Footrest Foldable support for patient’s feet
G Front wheels
Allows easy handling of the chair. In models AIR/A IO/SIL ER/CLASS, they are equipped
with brakes for rotation and axis, minimizing the rescuer’s effort during short stationing
and that may be needed during recovery operations.
H Rear wheels Characterized by large diameter, allow optimal handling on most common surfaces. In
models COMFORT and STAIR, on each wheel there is an independent stationary brake.
I Slides Installed only on model Stair, they allow to move the chair downstairs, always under the
strict control of operators
L Seat Essential support for the patient, it is equipped with integrated removable belts fixed on
the lower side by straps.
M Rear handles
They can be used by the operator placed on the rear side of the chair in order to lift the
chair. The operator on the front side, will simultaneously lift the front of the chair using
the telescopic handles.
N Headrest
Installed only on COMFORT/STAIR models, provides more support to the patient.
Particularly useful with taller patients and indispensable during transport on stair, it is
equipped with a head fixing belt and can be folded allowing to maintain the same overall
dimensions of chairs not equipped with such accessory. The headrest can be locked in
open position thanks to the dedicated handle placed on the transport handle.
I
H
A
B
M
N
L
C
E
G
D
F

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11. INSTRUCTIONS FOR USE
Before transferring, lifting or transporting the patient, primary medical evaluations have to be performed. Once the diagnosis has been
assured, it is preferable (if possible) to suggest to the patient that he actively collaborates during transfer onto the chair, and to make sure
the patient is fully aware of all risks. Before loading the patient, place the device near the patient; always maintain the safety belts fastened
during the manoeuvres.
11.1 Medical ehicle requirements
When placed inside the ambulance, the chair 4BELL must be properly anchored in order to limit risks for occupants of the vehicle linked to
violent movements resulting from rapid acceleration or deceleration of the vehicle. For this purpose, it is essential to use a dedicated
fastener. For its installation , it is necessary that the emergency vehicle is equipped with suitable surfaces to hold safely the assembly
consisting of fastener and chair.
The user manual of the fastener contains more details about requirements of support surfaces and installation.
Failure to use the dedicated fastener or its improper installation can seriously affect the patient’s and operator’s safety.
11.2 Opening the chair
The 4BELL transport chair is maintained in closed position
thanks to the belts on the backrest (par 11.8). Before opening
the chair, release the quick release buckle of the upper belts.
Firmly hold the transport handle, press on the frame of the seat
as shown by the arrow, until all the wheels rest on the floor.
Firmly press down the seat frame until the locking system is
activated.
Check visually that the terminal part of the cross bar has
reached the end of the slot placed on the sliding profile of the
telescopic handles.
11.3 Rear handles opening, armrests (where present) and
footrest
Rear handles and armrests (if present), can be opened by
turning them as shown by the arrows. When no longer needed
or when the chair is no longer in use, they can be closed by
rotating in the opposite direction.
Similarly, open the footrest by rotating it outwards until it is
completely opened.
After use, close the footrest by rotating in the opposite
direction until it is completely closed.
11.4 Opening and closing of telescopic handles
The telescopic handles have been made to facilitate lifting of
the chair. They are kept in position by a mechanism that is
inserted automatically when reaching the excursion limit both
during opening and closing.
To unlock the mechanism allowing handle movement, press
downwards and move simultaneously.
Pull the handles until they are fully open. It Is essential to verify
that the locking system has been properly inserted.
To do this, try to slide repeatedly the handles without applying
pressure downwards. There must be no movement.
DO NOT LIFT THE CHAIR IF THE HANDLES ARE NOT COMPLETELY
EXTRACTED AND LOCKED.
Similarly it is possible to close the telescopic handles verifying
that they are locked in closed position.

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A
B
11.5 Headrest opening (where present)
To open the headrest, grasp it from the terminal part and rotate until it comes in contact with the top handlebar of the chair. Keep it pressed
against the transport handle and turn the red locking handle clockwise or counterclockwise until it is in vertical position. To close the
headrest, bring back the red handle in the horizontal position and accompany down the headrest until it is fully closed.
11.6 Front parking brakes
Chairs 4BELL AIR,A IO, SIL ER and CLASS, are equipped with
brakes on front wheels that lock both rotation and pivoting.
The brake can be operated by pressing with one foot on the lever
at the top of the wheel assembly.
Always insert both brakes
Lift the levers to release the brakes.
During any handling or working operation with the patient on the
chair, the operator must have a firm grip on the device,
regardless to the brakes being activated or not.
11.7 Rear parking brakes
Chairs model COMFORT and STAIR, are equipped with parking
brakes that lock rear wheels. To lock the rear wheels, press on
the brakes from the operator side (indicated also by a red sticker
placed on each brake).
To unlock the wheels, push on the brake from the patient side
(direction indicated by a green sticker placed on each brake)
Always insert both brakes
During any handling or working operation with the patient on the
chair, the operator must have a firm grip on the device,
regardless to the brakes being activated or not
11.8 Closing the chair
Place all the handles, headrest, armrests and slides in closed
position.
Using one hand, raise in the direction shown by the arrow, until
the part A of the frame is almost in contact with the part B of the
seat frame. This movement will disengage the locking system of
the chair.
Then lift the seat until it touches the backrest.
The front wheels will be positioned automatically.

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Before placing the chair on the fixing system, it is recommended to secure it in
closed position using the integrated belts anchored to the chair backrest.
The belts must pass through free space between the handles and the frame of
the backrest and must be attached at the level of the grips of the telescopic
handles.
11.9 Mo ing the chair on the ground
All the chairs 4Bell, can be easily moved on the ground thanks to the wheels fitted in each model.
Use the transport handle to move the chair and, once on the rescue place, with or without the patient on the device, always activate the
parking brakes.
For ground movements of all models, it is necessary to close rear and front telescopic handles as they would hinder device’s handling, being
unused items during this type of transport. During patient transport, it is essential to fasten all the belts and, for models equipped with
headrest, it should be placed in raised position. For models equipped with slides, keep them closed until reaching any stairs, as they would
unnecessary interfere with operators movements. If you are not carrying a patient on the device, it is suggested to carry the chair in closed
position to limit overall dimensions and for a more practical handling.
11.10 Lifting the chair
To carry the chair on stairs or on surfaces where the use by wheels could be
difficult, it is possible to lift the device using the telescopic handles and rear
handles. For this method of transport the presence of more operators is
required with at least one at the front side and at least one on the back side of
the chair.
Before lifting it is fundamental to erify that telescopic handles are fully
extended and locked as described in par. 11.4. Failure to control could cause
serious injury to patient and operators due to the sudden closure of the
telescopic handles.
Once on a surface allowing transport on wheels, is recommended to place the
chair on the ground in order to avoid unnecessary load on operators.
11.11 Mo ing the chair on stairs
The chair can be moved on stairs lifting it like described in the previous paragraph, or thanks to the slides fitted on model Stair.
To move the chair on stairs with model Stair, proceed as
follows:
•Lift the headrest and lock it in opened position
•Lift the slide release tab, placed on the side of the slide
itself
•Pull the slide toward you until it reaches the fully opened
position
Make sure that the angle between the frame which
constrains the mo ement of the slide and the slide itself,
is smaller than 90°. If this condition is not met, it could
cause a sudden closure of the slide itself when the chair
is mo ed on stairs.
•Load the patient on the device and secure him using all
the belts.

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•To move the chair downstairs, approach the first step of the stairs, tilt
the chair by holding the headrest, keeping it balanced accompanying it
during the descent until the slides are lying on at least two steps. The
operator on the rear side of the chair, must always maintain a firm grip
on the headrest, accompanying the device regulating the descent speed.
The second operator should never be in front of the device , but should
be placed at the side of the device and a few steps lower, and has to
guide the descent optimally and must be ready to intervene in the event
of need, without compromising its safety.
•Once the flat floor is reached, bring the chair back to the vertical
position, so that the front wheels adhere to the ground, continuing the
transport with standard ground handling procedures.
It is recommended to close the slides when they are no longer needed
•To carry the chair upstairs, do not use the slides, but lift the chair like
described in paragraph 11.10.
•When lifting the chair and going upstairs, the first operator should be
placed behind the device grabbing the rear handles and facing the back
to the patient. The second operator should be placed in front of the chair
facing the patient and grabbing the telescopic handles of the chair
making sure they are properly locked in open position.
•Using the proper lifting technique, the operators should lift
simultaneously the device and start the transport.
For this type of transport is recommended the presence of a supporting
operator which will guide the maneu ers of other operators optimally.
12. CLEANING AND MAINTENANCE
12.1 CLEANING
Failure to carry out the correct cleaning routine could increase the risk of cross infection, due to presence of body fluids and/or residuals.
The operator must always wear adequate personal protection such as gloves and mask, etc. during all checking and cleaning procedures.
The exposed metal parts are usually treated and/or painted in order to increase their resistance to external agents. Clean the exposed parts
with water and a delicate soap; ne er use sol ents or stain remo ers.
Rinse thoroughly with warm water making sure that you have removed all traces of detergent, which could ruin or compromise the integrity
and durability of the device. The use of high pressure water should be a oided because water penetrates in the joints removing the
lubricant and creating the risk of corrosion of components. Allow the device to dry thoroughly before storing. Drying after washing or after
use in wet environments must be natural and not forced; do not use flames or other sources of direct heat.
If the device needs to be disinfected, use products that do not have corrosive or solvent action on the materials of which the device is made.
Be sure to take every precaution to ensure that there is no risk of cross-infection or contamination for patients and / or operators.
To maintain the polished appearance of the frame parts we recommend the use of Spencer STX 99 polish cleaner or in alternative creme or
wax normally used for polishing car bodywork.
12.2 PRECAUTIONARY MAINTENANCE
Establish a maintenance programme and periodic testing routine and identify an employee responsible for this. The person to whom the
ordinary maintenance of the device is entrusted must ensure that the basic requirements foreseen by the manufacturer in following
paragraphs are inspected.
All maintenance and periodic servicing activities must be registered and kept together with the servicing reports. These documents have to
be kept for a period of 10 years after the disposal of the device itself. This register will be made available to the competent authorities and/or
manufacturer if requested.
Routine maintenance of the device must be carried out by operators in possession of specific qualifications, trained and experienced in the
use and maintenance of the device. Such training must be recorded and maintained for at least 10 years from the end of life of the product
and shall be made available to the competent authorities and / or the Manufacturer upon request.
The operator must always wear adequate personal protection such as gloves and mask, etc. during all checking and cleaning procedures.
Checks to be carried out before and after each use and at deadline indicated above, are as follows:
•General functionality of the device
•Cleanliness of the device (remember that the failure to clean could be the cause of cross infections)
•Correct fixation of all nuts, bolts and screws
•Absence of cuts, holes, tears on the structure, including the straps
•None of the tubes or metal sheets present bends or cracks
•The seat or the backrest has no structural damage or cracks
•The seat belts, sheets, moving parts, wheels and handles are intact and functioning properly.
•Lubrication of moving parts

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•Wearing on wheels and breaking system
•Wear of slides and their proper locking in the open position. erify the correct functionality of the locking spring.
•The belts of the slides have a good sliding action
•The wheels are correctly fixed, they are stable and turn properly
•The wheels are free from debris.
•The device opens and locks properly
•The device unlocks and closes properly
•Functioning of springs
•The patient’s immobilization belts are present and they are intact and functioning.
•Telescopic handles can be positioned, folded and locked properly in all positions as described in this manual.
•Headrest (if present) works and locks properly
•erify the functionality of the system which locks the chair in open position. If you try to close the chair without actioning the unlocking
system, the chair must not close.
•The emergency vehicle is equipped with a Spencer fastening system intended for the chair
•The connection of the two devices is always correctly inserted and safe.
The inspection frequency is determined by factors such as local legal requirements, the type of use, frequency of use, en ironmental
conditions during use and storage.
The only part that needs to be lubricated and must be lubricated at
least once a month, is the guides of the locking system of the chair.
Lubrication of other components or parts is not required.
Before lubricating any part, be sure to remove any dust or dirt in the
area.
Please note that you must do the cleaning as described in this manual
and verify functionality before and after each use. Spencer Italia S.r.l.
declines any responsibility for the improper functioning or injury
caused to the patient or user by the use of devices that have not been
subjected to a routine maintenance programme which will void the
warranty and the compliance to the Medical Device Directive
93/42/CEE.
E ery 2 years the seat and backrest P C sheets and patient belts must
be substituted.
12.2.1 Seat belts and sheet replacement
The seat belt is fixed to the sheet by means of straps.
Tear off the belt from the seat.
Open up elcro closure on the side of the protection sheet that covers
the quick release buckles on the lower side of the seat sheet.
Unclip the quick release buckles
Pull the sheet from the front of the chair.
Install the new sheet and belts following the above steps in reverse
order. Pay attention that all buckles are correctly engaged and all the
straps adhere properly.

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12.2.2 Backrest sheet replacement
The sheet of the backrest is secured only by velcro bands. Detach the end of the sheet on the rear side of the backrest and replace it with the
new one.
12.2.3 Upper belts replacement
This operation requires the use of a 8mm socket wrench and a 4mm Allen key.
Unscrew the nut and screw as shown in the picture.
Assemble the new belts paying attention to the position of the plastic component where the nut is housed. This component must be
inserted in the metal buttonhole of the belt and in the rear handle support.
Use only accessories/original spare parts approved by Spencer Italia S.r.l. Failing to do so, we will accept no responsibility for the incorrect
functioning and/or damage caused by the use of any device which has not been repaired, or certified on expiry date by the manufacturer or
by one of the manufacturer's authorised service centres. Warranty will be considered void in compliance with the Medical Device Directive
93/42/EEC.
12.3 PERIODIC MAINTENANCE
The de ice must be ser iced by the manufacturer or by an authorised centre, e ery year.
If the correct revision is not carried out, the device MUST BE PUT OUT OF SERVICE, because the CE branding will no longer be considered
valid and consequently it is no longer compliant with the safety standards declared by the manufacturer at time of purchase.
Spencer Italia S.r.l. will take no responsibility for the incorrect functioning or any damage caused by a device that has not undergone regular
revision.
The belts, seat and backrest sheets must be necessarily replaced e ery 2 years.
For any operations that are not carried out directly by the manufacturer but by an authorised centre, we have to underline that a report
regarding all operations carried out must be requested. This will permit both Spencer Italia S.r.l. and the end user to keep a log book
regarding the operations carried out on the device.
12.4 SPECIAL SERVICING
Only the manufacturer or centres with written authorisation are authorised to complete any special ser icing operations.
For any operations that are not carried out directly by the manufacturer but by an authorised centre, we have to underline that a report
regarding all operations carried out must be requested. This will permit both Spencer Italia S.r.l. and the end user to keep a log book
regarding the operations carried out on the device.
The end user is authorised to replace only the spare parts indicated in the paragraph 15.
12.5 LIFE SPAN
The de ice, if used as indicated in the following instruction manual, has a life span of 5 years starting from the purchase
date. The life span can be extended following the annual re ision.
PVC sheets, seat belts and backrest ha e to be replaced e ery 2 years from the purchase date
General revisions must be carried out by the manufacturer or by a centre authorised by the manufacture. If such annual re isions are not
carried out, the de ice MUST BE DISPOSED ACCORDING TO THE PROCEDURES SPECIFIED IN PARAGRAPH 16 AND THIS EVENT MUST BE
NOTIFIED TO THE MANUFACTURER.
The life span can be extended, by unquestionable judgment of Spencer or authorized service center, if the safety requirements of the device
are still guaranteed.
Spencer Italia S.r.l. will accept no responsibility for the incorrect functioning and/or damage caused by the use of any device which has not
been serviced by the manufacturer or authorised centre, or of any device for which the life span is expired.

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13. TROUBLESHOOTING
PROBLEM CAUSE SOLUTION
The seat sheet doesn’t support the patient’s
weight
The quick release buckles are not
properly engaged
erify the proper closure of the buckles placed on
the lower side of the sheet
Worn cloth Replace the sheet as described in the manual
The telescopic handles don’t lock in closed or
opened position
The telescopic handles have not
been completely extracted or
inserted.
Extract or insert the telescopic handles until the
end position is reached
The locking system is damaged. Put the chair immediately out of service and
contact the service centre
The headrest doesn’t lock in open position The locking system has not been
correctly inserted
Make sure that the locking handle is properly
turned. Check also that no element of the locking
lever is damaged. If anomalies are present, put the
device immediately out of service and contact the
service centre
Front wheels are not automatically positioned The self-positioning spring has
been lost or is damaged
Contact the service centre. The problem does not
require to put the device out of service
The brakes do not work Worn wheels or damaged
mechanism
Put the chair immediately out of service and
contact the service centre
The rear handles are unstable or deform under
loading Handle assembly damaged Put the chair immediately out of service and contact the service centre
The device is difficult to
move on wheels or is not
stable
One or more wheels are
damaged
Put the chair immediately out of service and
contact the service centre
When placed on the fastener, the chair is not
stable or doesn’t remain closed
The coupling between the chair
and the fastener was not done
properly.
Consult the users manual of the fastener
The fixing system in use is
inappropriate for the chair.
Put the device out of service and replace the fixing
system with an appropriate one
The spare sheets haven’t enough tension or can’t
be installed because are too tight
The purchased sheets are for the
narrower or the wider models Contact your dealer to obtain the correct item
Slides do not lock properly
The slides are not completely
opened
erify that the slides are completely opened like
described in this manual
The slides or their locking
systems are damaged
Put the chair immediately out of service and
contact the service centre

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14. ACCESSORIES
14.1 Standard equipment
ST10432B 4BELL FIXATION SYSTEM MAX 10G TESTED
15. SPARE PARTS
RIST006A SEAT SPARE SHEET FOR 4BELL
RIST035A BACKREST SPARE SHEET FOR 4BELL
RIST007A SPARE BELTS SET FOR 4BELL CHAIR
16. DEMOLITION
When the device is no longer suitable for use, if they haven’t been contaminated by any particular agents, they can be disposed of as normal
solid waste. Otherwise follow the current regulations for demolition.