Midas Rex Legend Stylus

W1

It is important that the IPC system operator be familiar with the system User’s Guide, its precautions, procedures and safety issues.

W2

Do not use the IPC POWEREASE system in the presence of flammable anesthetics. Avoid potential ignition or explosion of gases.

W3

When not operating handpiece, eliminate accidental foot control activation. Control energy to and through the handpiece to prevent unintended tissue, bone, or nerve resection.

W4

Disconnect power to the IPC system before cleaning the unit to avoid electrical macro shock.

W5

Do not attach unapproved components to the IPC system to avoid electrical macro shock.
 

W6

To avoid the risk of electrical shock, achieve electrical grounding reliability with proper connections. Connect the IPC system to hospital grade receptacles only.
 

W7

This medical device complies with EN60601-1-2 safety standard for electromagnetic compatibility, requirements and test. However, if this equipment is operated in the presence of high levels of electromagnetic interference (EMI) or highly sensitive equipment, interference may be encountered and the user should take whatever steps are necessary to eliminate or reduce the source of the interference. Diminished performance may lengthen operating time for anesthetized patient.
 

W8

Medical Electrical Equipment needs special Precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in this Guide.
 

W9

Portable and mobile RF communications equipment can affect Medical Electrical Equipment.
 

W10

Do not operate the IPC POWEREASE system in the presence of Magnetic Resonance Imaging devices.
 

W11

Use of accessories and cables other than those specified and sold by Medtronic may result in increased emissions and decreased immunity of this unit.
 

W12

The IPC system should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the IPC system should be observed to verify normal operation in the configuration in which it will be used.
 

W13

Do not attempt to run the IPC POWEREASE system handpiece immediately after autoclaving. Allow an adequate “cool down” period (Typically 1 hour).
 

W14

Consult the Legend Bone Mill product insert before use with the Integrated Power Console system.
 

W15

For metal transection, observe the following safety precautions:

• W15a   Eye wear protection is essential.
• W15b   Irrigate well to cool the cutting surfaces.
• W15c   Protect the wound site from metal debris.
• W15d   Use a clamp or grasping device to control loose fragments during transection of any metal component.

W16

Do not operate the IPC POWEREASE system without eye protection.
 

W17

All service must be performed by Medtronic qualified personnel only.
 

W18

Repair and/or modification to the IPC system by anyone other than qualified service personnel may significantly compromise the unit’s ability to perform effectively and/or void the equipment warranty.

W19

Do not use any parts other than Medtronic system components as damage or substandard performance could result.
 

W20

Always inspect the components before and after use for any damage. If damage is observed, do not use damaged part until it is repaired or replaced. Damaged parts may deposit metal shavings on surgical site.
 

W21

When precise location of blade tip is required, engage the rotation lock on the handpiece, then calibrate and verify the blade tip on Image Guided Surgery (IGS) system. Always lock M4 and M5 handpieces when driving non-rotatable blades to maintain their IGS calibration.
 

W22

Employ visualization, including use of imaging techniques (e.g., fluoroscopy, image guided surgery) when using rotating powered accessories. Discontinue powered application in the event of lack of visualization of surgical site.
 

W23

Midas Rex Variable Exposure attachments. Surgeons should familiarize themselves with the performance of dissecting tools before use, and should explore the effect of various levels of tool exposure on dissection stability. If the tool exhibits excessive chatter, vibration, or movement, decrease the tool exposure.
 

W24

Motors and attachments may fail due to extended use and allow a component to detach and fall from the motor or attachment, causing patient injury.
 

W25

Electrical contacts must be dry prior to use.
 

W26

Heavy side loads and/or long operating periods may cause the device to overheat.
 

W27

Do not use an overheated device, as it may cause thermal injury to the patient or operator.
 

W28

Use adequate irrigation. The use of a tool without irrigation may cause an inordinate amount of heat buildup resulting in a thermal injury to tissue. Depending on the amount of irrigation used, the drill bits and saw blades can achieve temperatures in excess of 50°C.
 

W29

Do not attempt to change a dissecting tool, saw blade, or attachment while the motor is running, or when the motor or attachment is in an overheated state.
 

W30

Do not immerse the system components, except as noted.
 

W31

Do not place motor, attachment and tool on the patient or in an unsecured location during surgery.
 

W32

A system that is not functioning properly should not be used until all necessary repairs have been made and the unit is tested to ensure that it is functioning in accordance with Medtronic specifications.
 

W33

Match the nomenclature and color code on the tool packaging to the same nomenclature and color code on the Attachment.
 

W34

Make sure that the attachment is still in the locked position after each adjustment of the tool exposure, as attempting to increase the tool exposure too far, may result in the attachment accidentally being unlocked.
 

W35

Midas Rex Legend EHS Motor and Midas Rex Legend EHS Stylus Motor should only be operated when the attachment is in the locked position. Attempting to operate the Midas Rex Legend EHS Stylus Motor when the attachment is in the unlocked position may result in the motor stalling.

W36

Smoke and/or excessive heat may be generated if attachment is not in the fully locked position. This may result in thermal injury to the surgeon or staff.
 

W37

The Indigo and Legend EHS motors will not run properly unless the attachment is in the locked position.
 

W38

DO NOT change accessory with handpiece running to prevent laceration of user and cross-contamination through compromised glove.
 

W39

Remove Legend Footed Attachments cautiously and slowly as per instructions to avoid injury to the operator.
 

W40

DO NOT modify accessories used with the handpiece. Performance could be diminished with modified accessories.
 

W41

The safe use of the Endo-Scrub 2 System in procedures where surgical lasers are also employed has not been clinically demonstrated.
 

W42

In order to ensure compliance with requirements of IEC 60601-1, use a Medtronic approved power cable.
 

W43

To avoid the risk of electric shock, this equipment must only be connected to a supply main with protective earth.
 

W44

Keep NIM Muting Probe cable away from IPC system cables.
 

W45

Verify reusable device was sterilized prior to use. If not sterilized, do not use.

W46

Tools are available for resection of soft tissue and bone for surgical procedures. Use of tools depends on the intended application and patient needs. Sharp-cutting powered tools induce bleeding and removal of significant tissue and bone.
 

W47

Use methods at the operative site to control bleeding that do not compromise patient safety during at-risk surgery.
 

W48

Always keep the cutting area of the tool/saw blade away from fingers and loose clothing. Prevent laceration of user and cross-contamination through compromised glove.
 

W49

Operate the tool only after the appropriate anatomical landmarks and the intended surgical site have been confirmed.
 

W50

Use care in application of the moving cutting end to only appropriate anatomical landmarks and the intended surgical site when using powered accessories.
 

W51

Insertion of metal objects in accessory tip may cause the accessory to break leaving fragments in the wound. The fragments may be difficult to remove, causing irritation, inflammation and foreign-body response at surgical site.
 

W52

Bending or prying may break the accessory, causing harm to patient or staff.
 

W53

Do not use excessive force to pry or push bone with the attachment, tool or blade during dissection.
 

W54

A tool’s size and geometry may create excessive vibration at certain speeds. Increase or decrease speed on console. Change to a new tool to prevent unintended tissue removal from patient.
 

W55

Test for wobble at desired speed prior to use. Discontinue use of accessory if tip begins to wobble and replace accessory to prevent unintended tissue removal from patient.
 

W56

Eccentricity of the tool can cause tool vibration and may result in excess tissue and bone destruction and hearing damage.
 

W57

Excessive noise from the tool when drilling close to the cochlea or ossicular chain may cause hearing damage.
 

W58

CONSULT the cranial perforator device labeling for the recommended speed specifications.
 

W59

Tools with “L” identification are longer tools intended for light bone dissection. The increased tool head/stem configuration may affect dissection stability.
 

W60

Tool flutes and blade teeth are sharp and may perforate surgical gloves. Tools/blades may be grasped with a hemostat to aid in installation and removal.
 

W61

DO NOT attempt to resharpen used tools. Worn tools should be replaced with new ones frequently to ensure effective cutting and control.
 

W62

Carefully inspect tool both prior to and following each use for signs of excessive wear, fragmentation, eccentricities or other defects. Replace any suspicious tools with a new one prior to use.
 

W63

Excessive pressure applied to bur may cause bur fracture. Should a tool fracture in use, extreme care must be exercised to ensure that all fragments of the tool are retrieved and removed from the patient. Unremoved tool fragments may cause tissue damage to the patient.
 

W64

Do not use metal-cutting tools on bone.
 

W65

Use only rotary tools specifically designed for use with this drill system.
 

W66

When using non-rotatable tools, ensure rotation lock is engaged to prevent inadvertent rotation.
 

W67

The use of powered reciprocating instruments may result in vibration / related injury.
 

W68

Powered blades should be operated in the oscillate mode only. Operating in the forward mode may cause damage to the blade.
 

W69

Do not attempt to sterilize disposable devices. The disposables are packed sterile and are not intended for repeat use. To prevent contamination, use only once.
 

W70

Any tubing or other tip protectors used during shipping must be removed prior to cleaning and sterilization.
 

W71

Do not use accessory if package is opened or damaged. Broken seal offers no protection against cross-contamination.
 

W72

Properly dispose of single-use devices removed from sterile packages. Devices lose sterility upon removal from packaging.
 

W73

Do not use dull, damaged or bent tools. Use of dull tools can reduce handpiece effectiveness and cause the handpiece temperature to increase.
 

W74

T&A Blades: Gently remove the inner tube from the outer tube. The inner tube may elongate upon removal from the outer tube. If this occurs, the inner tube may not lock properly into the handpiece or the blade may not work properly.
 

W75

T&A Blades: Rotate the inner tube when removing and inserting it in the outer tubes to prevent damage to the internal seal. If the seal is damaged, the blade will leak at the handpiece.
 

W76

Always ensure that the drill is securely engaged into the handpiece prior to operating the system.
 

W77

Always examine operation of each tool in a handpiece before use.
 

W78

Powered burs and drills should be operated in the forward mode only.
 

W79

This system requires insulated connectors for the StraightShot M4 and M5 Microdebriders, StraightShot Magnum II Microdebrider, StraightShot III Microdebrider, Midas Rex SC1, Visao, or Skeeter handpieces and the Multi-Function Foot Control Unit.
 

W80

Sterilize and dry reusable device before storing the system. Decrease likelihood of cross-contamination with timely sterilization.
 

W81

After each procedure, properly clean all reusable system components.
 

W82

Auxiliary Power Outlet with protective cover is for use with the Hydrodebrider or Bone Mill consoles only.
 

W83

Place Stylus Touch in safe mode while not in use.
 

W84

Do not place Stylus Touch handpiece in the proximity of magnetic field, such as magnetic drape and MRI equipment, to avoid inadvertent handpiece activation.
 

W85

Do not apply excessive side loading. Excessive side loading could cause angled attachments to unlock accidentally from motor.
 

W1

It is important that the IPC system operator be familiar with the system User’s Guide, its precautions, procedures and safety issues.

W2

Do not use the IPC POWEREASE system in the presence of flammable anesthetics. Avoid potential ignition or explosion of gases.

W3

When not operating handpiece, eliminate accidental foot control activation. Control energy to and through the handpiece to prevent unintended tissue, bone, or nerve resection.

W4

Disconnect power to the IPC system before cleaning the unit to avoid electrical macro shock.

W5

Do not attach unapproved components to the IPC system to avoid electrical macro shock.
 

W6

To avoid the risk of electrical shock, achieve electrical grounding reliability with proper connections. Connect the IPC system to hospital grade receptacles only.
 

W7

This medical device complies with EN60601-1-2 safety standard for electromagnetic compatibility, requirements and test. However, if this equipment is operated in the presence of high levels of electromagnetic interference (EMI) or highly sensitive equipment, interference may be encountered and the user should take whatever steps are necessary to eliminate or reduce the source of the interference. Diminished performance may lengthen operating time for anesthetized patient.
 

W8

Medical Electrical Equipment needs special Precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in this Guide.
 

W9

Portable and mobile RF communications equipment can affect Medical Electrical Equipment.
 

W10

Do not operate the IPC POWEREASE system in the presence of Magnetic Resonance Imaging devices.
 

W11

Use of accessories and cables other than those specified and sold by Medtronic may result in increased emissions and decreased immunity of this unit.
 

W12

The IPC system should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the IPC system should be observed to verify normal operation in the configuration in which it will be used.
 

W13

Do not attempt to run the IPC POWEREASE system handpiece immediately after autoclaving. Allow an adequate “cool down” period (Typically 1 hour).
 

W14

Consult the Legend Bone Mill product insert before use with the Integrated Power Console system.
 

W15

For metal transection, observe the following safety precautions:

• W15a   Eye wear protection is essential.
• W15b   Irrigate well to cool the cutting surfaces.
• W15c   Protect the wound site from metal debris.
• W15d   Use a clamp or grasping device to control loose fragments during transection of any metal component.

W16

Do not operate the IPC POWEREASE system without eye protection.
 

W17

All service must be performed by Medtronic qualified personnel only.
 

W18

Repair and/or modification to the IPC system by anyone other than qualified service personnel may significantly compromise the unit’s ability to perform effectively and/or void the equipment warranty.

W19

Do not use any parts other than Medtronic system components as damage or substandard performance could result.
 

W20

Always inspect the components before and after use for any damage. If damage is observed, do not use damaged part until it is repaired or replaced. Damaged parts may deposit metal shavings on surgical site.
 

W21

When precise location of blade tip is required, engage the rotation lock on the handpiece, then calibrate and verify the blade tip on Image Guided Surgery (IGS) system. Always lock M4 and M5 handpieces when driving non-rotatable blades to maintain their IGS calibration.
 

W22

Employ visualization, including use of imaging techniques (e.g., fluoroscopy, image guided surgery) when using rotating powered accessories. Discontinue powered application in the event of lack of visualization of surgical site.
 

W23

Midas Rex Variable Exposure attachments. Surgeons should familiarize themselves with the performance of dissecting tools before use, and should explore the effect of various levels of tool exposure on dissection stability. If the tool exhibits excessive chatter, vibration, or movement, decrease the tool exposure.
 

W24

Motors and attachments may fail due to extended use and allow a component to detach and fall from the motor or attachment, causing patient injury.
 

W25

Electrical contacts must be dry prior to use.
 

W26

Heavy side loads and/or long operating periods may cause the device to overheat.
 

W27

Do not use an overheated device, as it may cause thermal injury to the patient or operator.
 

W28

Use adequate irrigation. The use of a tool without irrigation may cause an inordinate amount of heat buildup resulting in a thermal injury to tissue. Depending on the amount of irrigation used, the drill bits and saw blades can achieve temperatures in excess of 50°C.
 

W29

Do not attempt to change a dissecting tool, saw blade, or attachment while the motor is running, or when the motor or attachment is in an overheated state.
 

W30

Do not immerse the system components, except as noted.
 

W31

Do not place motor, attachment and tool on the patient or in an unsecured location during surgery.
 

W32

A system that is not functioning properly should not be used until all necessary repairs have been made and the unit is tested to ensure that it is functioning in accordance with Medtronic specifications.
 

W33

Match the nomenclature and color code on the tool packaging to the same nomenclature and color code on the Attachment.
 

W34

Make sure that the attachment is still in the locked position after each adjustment of the tool exposure, as attempting to increase the tool exposure too far, may result in the attachment accidentally being unlocked.
 

W35

Midas Rex Legend EHS Motor and Midas Rex Legend EHS Stylus Motor should only be operated when the attachment is in the locked position. Attempting to operate the Midas Rex Legend EHS Stylus Motor when the attachment is in the unlocked position may result in the motor stalling.

W36

Smoke and/or excessive heat may be generated if attachment is not in the fully locked position. This may result in thermal injury to the surgeon or staff.
 

W37

The Indigo and Legend EHS motors will not run properly unless the attachment is in the locked position.
 

W38

DO NOT change accessory with handpiece running to prevent laceration of user and cross-contamination through compromised glove.
 

W39

Remove Legend Footed Attachments cautiously and slowly as per instructions to avoid injury to the operator.
 

W40

DO NOT modify accessories used with the handpiece. Performance could be diminished with modified accessories.
 

W41

The safe use of the Endo-Scrub 2 System in procedures where surgical lasers are also employed has not been clinically demonstrated.
 

W42

In order to ensure compliance with requirements of IEC 60601-1, use a Medtronic approved power cable.
 

W43

To avoid the risk of electric shock, this equipment must only be connected to a supply main with protective earth.
 

W44

Keep NIM Muting Probe cable away from IPC system cables.
 

W45

Verify reusable device was sterilized prior to use. If not sterilized, do not use.

W46

Tools are available for resection of soft tissue and bone for surgical procedures. Use of tools depends on the intended application and patient needs. Sharp-cutting powered tools induce bleeding and removal of significant tissue and bone.
 

W47

Use methods at the operative site to control bleeding that do not compromise patient safety during at-risk surgery.
 

W48

Always keep the cutting area of the tool/saw blade away from fingers and loose clothing. Prevent laceration of user and cross-contamination through compromised glove.
 

W49

Operate the tool only after the appropriate anatomical landmarks and the intended surgical site have been confirmed.
 

W50

Use care in application of the moving cutting end to only appropriate anatomical landmarks and the intended surgical site when using powered accessories.
 

W51

Insertion of metal objects in accessory tip may cause the accessory to break leaving fragments in the wound. The fragments may be difficult to remove, causing irritation, inflammation and foreign-body response at surgical site.
 

W52

Bending or prying may break the accessory, causing harm to patient or staff.
 

W53

Do not use excessive force to pry or push bone with the attachment, tool or blade during dissection.
 

W54

A tool’s size and geometry may create excessive vibration at certain speeds. Increase or decrease speed on console. Change to a new tool to prevent unintended tissue removal from patient.
 

W55

Test for wobble at desired speed prior to use. Discontinue use of accessory if tip begins to wobble and replace accessory to prevent unintended tissue removal from patient.
 

W56

Eccentricity of the tool can cause tool vibration and may result in excess tissue and bone destruction and hearing damage.
 

W57

Excessive noise from the tool when drilling close to the cochlea or ossicular chain may cause hearing damage.
 

W58

CONSULT the cranial perforator device labeling for the recommended speed specifications.
 

W59

Tools with “L” identification are longer tools intended for light bone dissection. The increased tool head/stem configuration may affect dissection stability.
 

W60

Tool flutes and blade teeth are sharp and may perforate surgical gloves. Tools/blades may be grasped with a hemostat to aid in installation and removal.
 

W61

DO NOT attempt to resharpen used tools. Worn tools should be replaced with new ones frequently to ensure effective cutting and control.
 

W62

Carefully inspect tool both prior to and following each use for signs of excessive wear, fragmentation, eccentricities or other defects. Replace any suspicious tools with a new one prior to use.
 

W63

Excessive pressure applied to bur may cause bur fracture. Should a tool fracture in use, extreme care must be exercised to ensure that all fragments of the tool are retrieved and removed from the patient. Unremoved tool fragments may cause tissue damage to the patient.
 

W64

Do not use metal-cutting tools on bone.
 

W65

Use only rotary tools specifically designed for use with this drill system.
 

W66

When using non-rotatable tools, ensure rotation lock is engaged to prevent inadvertent rotation.
 

W67

The use of powered reciprocating instruments may result in vibration / related injury.
 

W68

Powered blades should be operated in the oscillate mode only. Operating in the forward mode may cause damage to the blade.
 

W69

Do not attempt to sterilize disposable devices. The disposables are packed sterile and are not intended for repeat use. To prevent contamination, use only once.
 

W70

Any tubing or other tip protectors used during shipping must be removed prior to cleaning and sterilization.
 

W71

Do not use accessory if package is opened or damaged. Broken seal offers no protection against cross-contamination.
 

W72

Properly dispose of single-use devices removed from sterile packages. Devices lose sterility upon removal from packaging.
 

W73

Do not use dull, damaged or bent tools. Use of dull tools can reduce handpiece effectiveness and cause the handpiece temperature to increase.
 

W74

T&A Blades: Gently remove the inner tube from the outer tube. The inner tube may elongate upon removal from the outer tube. If this occurs, the inner tube may not lock properly into the handpiece or the blade may not work properly.
 

W75

T&A Blades: Rotate the inner tube when removing and inserting it in the outer tubes to prevent damage to the internal seal. If the seal is damaged, the blade will leak at the handpiece.
 

W76

Always ensure that the drill is securely engaged into the handpiece prior to operating the system.
 

W77

Always examine operation of each tool in a handpiece before use.
 

W78

Powered burs and drills should be operated in the forward mode only.
 

W79

This system requires insulated connectors for the StraightShot M4 and M5 Microdebriders, StraightShot Magnum II Microdebrider, StraightShot III Microdebrider, Midas Rex SC1, Visao, or Skeeter handpieces and the Multi-Function Foot Control Unit.
 

W80

Sterilize and dry reusable device before storing the system. Decrease likelihood of cross-contamination with timely sterilization.
 

W81

After each procedure, properly clean all reusable system components.
 

W82

Auxiliary Power Outlet with protective cover is for use with the Hydrodebrider or Bone Mill consoles only.
 

W83

Place Stylus Touch in safe mode while not in use.
 

W84

Do not place Stylus Touch handpiece in the proximity of magnetic field, such as magnetic drape and MRI equipment, to avoid inadvertent handpiece activation.
 

W85

Do not apply excessive side loading. Excessive side loading could cause angled attachments to unlock accidentally from motor.
 

W1

It is important that the IPC system operator be familiar with the system User’s Guide, its precautions, procedures and safety issues.

W2

Do not use the IPC POWEREASE system in the presence of flammable anesthetics. Avoid potential ignition or explosion of gases.

W3

When not operating handpiece, eliminate accidental foot control activation. Control energy to and through the handpiece to prevent unintended tissue, bone, or nerve resection.

W4

Disconnect power to the IPC system before cleaning the unit to avoid electrical macro shock.

W5

Do not attach unapproved components to the IPC system to avoid electrical macro shock.
 

W6

To avoid the risk of electrical shock, achieve electrical grounding reliability with proper connections. Connect the IPC system to hospital grade receptacles only.
 

W7

This medical device complies with EN60601-1-2 safety standard for electromagnetic compatibility, requirements and test. However, if this equipment is operated in the presence of high levels of electromagnetic interference (EMI) or highly sensitive equipment, interference may be encountered and the user should take whatever steps are necessary to eliminate or reduce the source of the interference. Diminished performance may lengthen operating time for anesthetized patient.
 

W8

Medical Electrical Equipment needs special Precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in this Guide.
 

W9

Portable and mobile RF communications equipment can affect Medical Electrical Equipment.
 

W10

Do not operate the IPC POWEREASE system in the presence of Magnetic Resonance Imaging devices.
 

W11

Use of accessories and cables other than those specified and sold by Medtronic may result in increased emissions and decreased immunity of this unit.
 

W12

The IPC system should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the IPC system should be observed to verify normal operation in the configuration in which it will be used.
 

W13

Do not attempt to run the IPC POWEREASE system handpiece immediately after autoclaving. Allow an adequate “cool down” period (Typically 1 hour).
 

W14

Consult the Legend Bone Mill product insert before use with the Integrated Power Console system.
 

W15

For metal transection, observe the following safety precautions:

• W15a   Eye wear protection is essential.
• W15b   Irrigate well to cool the cutting surfaces.
• W15c   Protect the wound site from metal debris.
• W15d   Use a clamp or grasping device to control loose fragments during transection of any metal component.

W16

Do not operate the IPC POWEREASE system without eye protection.
 

W17

All service must be performed by Medtronic qualified personnel only.
 

W18

Repair and/or modification to the IPC system by anyone other than qualified service personnel may significantly compromise the unit’s ability to perform effectively and/or void the equipment warranty.

W19

Do not use any parts other than Medtronic system components as damage or substandard performance could result.
 

W20

Always inspect the components before and after use for any damage. If damage is observed, do not use damaged part until it is repaired or replaced. Damaged parts may deposit metal shavings on surgical site.
 

W21

When precise location of blade tip is required, engage the rotation lock on the handpiece, then calibrate and verify the blade tip on Image Guided Surgery (IGS) system. Always lock M4 and M5 handpieces when driving non-rotatable blades to maintain their IGS calibration.
 

W22

Employ visualization, including use of imaging techniques (e.g., fluoroscopy, image guided surgery) when using rotating powered accessories. Discontinue powered application in the event of lack of visualization of surgical site.
 

W23

Midas Rex Variable Exposure attachments. Surgeons should familiarize themselves with the performance of dissecting tools before use, and should explore the effect of various levels of tool exposure on dissection stability. If the tool exhibits excessive chatter, vibration, or movement, decrease the tool exposure.
 

W24

Motors and attachments may fail due to extended use and allow a component to detach and fall from the motor or attachment, causing patient injury.
 

W25

Electrical contacts must be dry prior to use.
 

W26

Heavy side loads and/or long operating periods may cause the device to overheat.
 

W27

Do not use an overheated device, as it may cause thermal injury to the patient or operator.
 

W28

Use adequate irrigation. The use of a tool without irrigation may cause an inordinate amount of heat buildup resulting in a thermal injury to tissue. Depending on the amount of irrigation used, the drill bits and saw blades can achieve temperatures in excess of 50°C.
 

W29

Do not attempt to change a dissecting tool, saw blade, or attachment while the motor is running, or when the motor or attachment is in an overheated state.
 

W30

Do not immerse the system components, except as noted.
 

W31

Do not place motor, attachment and tool on the patient or in an unsecured location during surgery.
 

W32

A system that is not functioning properly should not be used until all necessary repairs have been made and the unit is tested to ensure that it is functioning in accordance with Medtronic specifications.
 

W33

Match the nomenclature and color code on the tool packaging to the same nomenclature and color code on the Attachment.
 

W34

Make sure that the attachment is still in the locked position after each adjustment of the tool exposure, as attempting to increase the tool exposure too far, may result in the attachment accidentally being unlocked.
 

W35

Midas Rex Legend EHS Motor and Midas Rex Legend EHS Stylus Motor should only be operated when the attachment is in the locked position. Attempting to operate the Midas Rex Legend EHS Stylus Motor when the attachment is in the unlocked position may result in the motor stalling.
 

W36

Smoke and/or excessive heat may be generated if attachment is not in the fully locked position. This may result in thermal injury to the surgeon or staff.
 

W37

The Indigo and Legend EHS motors will not run properly unless the attachment is in the locked position.
 

W38

DO NOT change accessory with handpiece running to prevent laceration of user and cross-contamination through compromised glove.
 

W39

Remove Legend Footed Attachments cautiously and slowly as per instructions to avoid injury to the operator.
 

W40

DO NOT modify accessories used with the handpiece. Performance could be diminished with modified accessories.
 

W41

The safe use of the Endo-Scrub 2 System in procedures where surgical lasers are also employed has not been clinically demonstrated.
 

W42

In order to ensure compliance with requirements of IEC 60601-1, use a Medtronic approved power cable.
 

W43

To avoid the risk of electric shock, this equipment must only be connected to a supply main with protective earth.
 

W44

Keep NIM Muting Probe cable away from IPC system cables.
 

W45

Verify reusable device was sterilized prior to use. If not sterilized, do not use.

W46

Tools are available for resection of soft tissue and bone for surgical procedures. Use of tools depends on the intended application and patient needs. Sharp-cutting powered tools induce bleeding and removal of significant tissue and bone.
 

W47

Use methods at the operative site to control bleeding that do not compromise patient safety during at-risk surgery.
 

W48

Always keep the cutting area of the tool/saw blade away from fingers and loose clothing. Prevent laceration of user and cross-contamination through compromised glove.
 

W49

Operate the tool only after the appropriate anatomical landmarks and the intended surgical site have been confirmed.
 

W50

Use care in application of the moving cutting end to only appropriate anatomical landmarks and the intended surgical site when using powered accessories.
 

W51

Insertion of metal objects in accessory tip may cause the accessory to break leaving fragments in the wound. The fragments may be difficult to remove, causing irritation, inflammation and foreign-body response at surgical site.
 

W52

Bending or prying may break the accessory, causing harm to patient or staff.
 

W53

Do not use excessive force to pry or push bone with the attachment, tool or blade during dissection.
 

W54

A tool’s size and geometry may create excessive vibration at certain speeds. Increase or decrease speed on console. Change to a new tool to prevent unintended tissue removal from patient.
 

W55

Test for wobble at desired speed prior to use. Discontinue use of accessory if tip begins to wobble and replace accessory to prevent unintended tissue removal from patient.
 

W56

Eccentricity of the tool can cause tool vibration and may result in excess tissue and bone destruction and hearing damage.
 

W57

Excessive noise from the tool when drilling close to the cochlea or ossicular chain may cause hearing damage.
 

W58

CONSULT the cranial perforator device labeling for the recommended speed specifications.
 

W59

Tools with “L” identification are longer tools intended for light bone dissection. The increased tool head/stem configuration may affect dissection stability.
 

W60

Tool flutes and blade teeth are sharp and may perforate surgical gloves. Tools/blades may be grasped with a hemostat to aid in installation and removal.
 

W61

DO NOT attempt to resharpen used tools. Worn tools should be replaced with new ones frequently to ensure effective cutting and control.
 

W62

Carefully inspect tool both prior to and following each use for signs of excessive wear, fragmentation, eccentricities or other defects. Replace any suspicious tools with a new one prior to use.
 

W63

Excessive pressure applied to bur may cause bur fracture. Should a tool fracture in use, extreme care must be exercised to ensure that all fragments of the tool are retrieved and removed from the patient. Unremoved tool fragments may cause tissue damage to the patient.
 

W64

Do not use metal-cutting tools on bone.
 

W65

Use only rotary tools specifically designed for use with this drill system.
 

W66

When using non-rotatable tools, ensure rotation lock is engaged to prevent inadvertent rotation.
 

W67

The use of powered reciprocating instruments may result in vibration / related injury.
 

W68

Powered blades should be operated in the oscillate mode only. Operating in the forward mode may cause damage to the blade.
 

W69

Do not attempt to sterilize disposable devices. The disposables are packed sterile and are not intended for repeat use. To prevent contamination, use only once.
 

W70

Any tubing or other tip protectors used during shipping must be removed prior to cleaning and sterilization.
 

W71

Do not use accessory if package is opened or damaged. Broken seal offers no protection against cross-contamination.
 

W72

Properly dispose of single-use devices removed from sterile packages. Devices lose sterility upon removal from packaging.
 

W73

Do not use dull, damaged or bent tools. Use of dull tools can reduce handpiece effectiveness and cause the handpiece temperature to increase.
 

W74

T&A Blades: Gently remove the inner tube from the outer tube. The inner tube may elongate upon removal from the outer tube. If this occurs, the inner tube may not lock properly into the handpiece or the blade may not work properly.
 

W75

T&A Blades: Rotate the inner tube when removing and inserting it in the outer tubes to prevent damage to the internal seal. If the seal is damaged, the blade will leak at the handpiece.
 

W76

Always ensure that the drill is securely engaged into the handpiece prior to operating the system.
 

W77

Always examine operation of each tool in a handpiece before use.
 

W78

Powered burs and drills should be operated in the forward mode only.
 

W79

This system requires insulated connectors for the StraightShot M4 and M5 Microdebriders, StraightShot Magnum II Microdebrider, StraightShot III Microdebrider, Midas Rex SC1, Visao, or Skeeter handpieces and the Multi-Function Foot Control Unit.
 

W80

Sterilize and dry reusable device before storing the system. Decrease likelihood of cross-contamination with timely sterilization.
 

W81

After each procedure, properly clean all reusable system components.
 

W82

Auxiliary Power Outlet with protective cover is for use with the Hydrodebrider or Bone Mill consoles only.
 

W83

Place Stylus Touch in safe mode while not in use.
 

W84

Do not place Stylus Touch handpiece in the proximity of magnetic field, such as magnetic drape and MRI equipment, to avoid inadvertent handpiece activation.
 

W85

Do not apply excessive side loading. Excessive side loading could cause angled attachments to unlock accidentally from motor.
 

W1

After each procedure, properly clean and disinfect all reusable system components.
 

W2

To avoid the risk of fire or explosion, do not use the NIM® System in the presence of flammable anesthetics and/or oxygen rich environment.
 

W3

Disconnect power to the NIM-Neuro®/Response® 3.0 Console before cleaning the unit to avoid electrical macro shock.
 

W4

Achieve electrical grounding reliability with proper connections. Connect the NIM-Neuro/Response 3.0 Console to hospital grade receptacles only.
 

W5

DO NOT use any parts other than Medtronic Xomed, Inc. components as damage or substandard performance could result.
 

W6

This medical device complies with EN60601-1-2 safety standard for electromagnetic compatibility, requirements and test. However, if this equipment is operated in the presence of high levels of electromagnetic interference (EMI) or highly sensitive equipment, interference may be encountered and the user should take whatever steps are necessary to eliminate or reduce the source of the interference. Diminished performance may lengthen operating time for anesthetized patient.
 

W7

It is important that the NIM-Neuro®/Response® 3.0 operator be familiar with this manual, its precautions, procedures and safety issues.
 

W8

To avoid electrical shock, do not attach unapproved components or accessories to the NIM System.
 

W9

All service must be performed by Medtronic qualified personnel only.
 

W10

To avoid patient burns:

1. Do not activate the electrosurgical instruments while stimulator is in contact with tissue.
2. Do not leave stimulating electrodes or probes in surgical field.
3. Do not store stimulating electrodes or probes in electrosurgical instrument holder.
4. Do not allow a second surgeon to use electrosurgical instruments while stimulator is in use.

W11

Direct stimulator contact may disrupt the operation of active implanted devices. Consult medical specialist before use.
 

W12

Electrocardiogram monitoring artifacts may be caused by NIM stimulus current delivery or EMG electrode impedance monitoring.
 

W13

Use of unapproved stimulators, stimulus probes, stimulus dissection instruments or electrodes may result in compromised NIM operation, such as, but not limited to decreased accuracy.
 

W14

Repair and/or modification to the NIM or any accessory by anyone other than qualified service personnel may significantly compromise the unit’s ability to monitor nerve activity and/or void the equipment warranty.
 

W15

The NIM does not prevent the surgical severing of nerves. If monitoring is compromised, the surgical practitioner must rely on alternate methods, or surgical skills, experience, and anatomical knowledge to prevent damage to nerves.
 

W16

If paralyzing anesthetic agents have been used, patient must regain muscle activity prior to use of the NIM-Neuro/Response 3.0 EMG Monitor.
 

W17

To avoid the risk of infection while using the NIM Stylus, the user must maintain good sterility practices.
 

W18

False negative responses (failure to locate nerve) may result from:

1. Shorted EMG electrode or cabling (conductive parts of applied needle electrodes or cables contacting each other).
2. Patient Interface fuse blown (32 mA, 250V. Xomed Part No.: 8250615).
3. Patient Interface defective.
4. Inadequate stimulus current.
5. Inadequate current for stimulation of nerve through hardware, such as stimulus dissection instruments, may vary based on the physical size, shape characteristics, and design of the hardware and proximity to the nerve.
6. Inadvertent simultaneous current delivery from both Stimulator (Patient Interface) probe outputs. This may result in current shunting, division between the stimulator probes.
7. Shorted internal amplifier (characterized by baseline activity of < 3 μV p-p).

W19

Stimulator current may cause involuntary patient movement resulting in patient injury.

W20

Anesthetic agents used may have an effect on the EMG amplitude.
 

W21

Be careful not to damage vascular structures when preparing the nerve for the installation of the APS™ Electrode
 

W22

EMG amplitude may be affected by anesthesia regimen used. Consult anesthesiologist if EMG changes are observed.
 

W23

Electrode integrity should be checked after electrode insertion and before electrode removal to give additional assurance that electrode continuity was maintained throughout the entire procedure. If electrode impedance is very high, discontinue use and replace.
 

W24

Remove APS electrode from patient prior to using external defibrillator to prevent thermal injury to patient at APS electrode site.
 

W25

Avoid trans-thoracic stimulation; when possible, maintain anode and cathode stimulating sites in close proximity.
 

W26

Operation in close proximity to a shortwave or microwave therapy equipment may produce instability in the electrical stimulator output.
 

W27

Safe stimulus levels are dependent on various conditions including but not limited to: type of excitable tissue, Charge Per Pulse, and Charge Per Unit Area. Waveform morphology, repetition rate, and stimulator effective surface area must be considered. Special operator attention is required for stimulus levels which exceed default settings or conditions resulting in levels higher than 2 mA RMS/cm2.