RMA REQUEST Please complete the RMA form below, making sure to fill out all required items. Flat Rate repair is not inclusive of shipping charges, and does not include missing or damaged cosmetic/mechanical repair parts. Once accepted by RepairMED, an RMA packing list will be emailed within one business day. Some email filters block PDF attachments. Add biomed@repairmed.net to your contact list to ensure deliverability. Name* First Last Organization*Email* Phone*Facility Name*Return Shipping Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Return Shipping Preference*UPS GroundUPS 3 Day SelectUPS 2nd Day Air A.M.UPS 2nd Day Air P.M.UPS Next Day Air A.M.UPS Next Day Air P.M.FedEx GroundFedEx Express Saver (3 business days)FedEx 2 DayFedEx 2 Day A.M.FedEx Standard OvernightFedEx Priority OvernightFedEx First OvernightReturn Shipping Account Number*Total Number of Devices to Ship*12345678910Device #1Device 1 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 1 Serial #*Device 1 Purchase Order Number (if applicable)Device 1: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #2Device 2 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 2 Serial #*Device 2 Purchase Order Number (if applicable)Device 2: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #3Device 3 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 3 Serial #*Device 3 Purchase Order Number (if applicable)Device 3: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #4Device 4 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 4 Serial #*Device 4 Purchase Order Number (if applicable)Device 4: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #5Device 5 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 5 Serial #*Device 5 Purchase Order Number (if applicable)Device 5: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #6Device 6 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 6 Serial #*Device 6 Purchase Order Number (if applicable)Device 6: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #7Device 7 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 7 Serial #*Device 7 Purchase Order Number (if applicable)Device 7: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #8Device 8 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 8 Serial #*Device 8 Purchase Order Number (if applicable)Device 8: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #9Device 9 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 9 Serial #*Device 9 Purchase Order Number (if applicable)Device 9: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Device #10Device 10 Manufacturer/Model*Type to search.[Infusion Pumps] Baxter Sigma Spectrum[Infusion Pumps] Baxter InfusOR[Infusion Pumps] B Braun Vista Basic[Infusion Pumps] B Braun Infusomat/Perfusor/ Basic[Infusion Pumps] B Braun Perfusor Compact S[Infusion Pumps] Carefusion Ivac 7200 Series[Infusion Pumps] Carefusion Medley 8000/8015 PC[Infusion Pumps] Carefusion Medley 8100 Infusion[Infusion Pumps] Carefusion Medley 8110 Syringe[Infusion Pumps] Carefusion Medley 8120 PCA[Infusion Pumps] Carefusion Medley 8210 Nellcor SPO2[Infusion Pumps] Carefusion Medley 8220 Masimo SPO2[Infusion Pumps] Alaris/Carefusion Medley 8300 ETCO2[Infusion Pumps] Carefusion Medsystem III[Infusion Pumps] Hospira LifeCare PCA 2 4100[Infusion Pumps] Hospira LifeCare PCA 3[Infusion Pumps] Hospira LifeCare PCA MedNet[Infusion Pumps] Hospira Plum A+ / A+[Infusion Pumps] Hospira Plum A+3 / A+3[Infusion Pumps] Medex Inc 3010A[Infusion Pumps] Moog / Curlin Painsmart[Infusion Pumps] Moog / Curlin 4000 PLUS[Infusion Pumps] Moog / Curlin 4000 / 6000 CMS[Infusion Pumps] Smiths Medical Medfusion 3500[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel REPAIR[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter Single Channel EXCHANGE[Sigma Pump Battery Modules] Baxter 35162 Wireless Transmitter PURCHASE[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel REPAIR[Sigma Pump Battery Modules] Baxter 35195 Wireless Transmitter Dual Channel EXCHANGE[Light Sources] Karl Storz Xenon Nova (20131520)[Light Sources] Stryker Infravision IR illuminator[Light Sources] Covidien Vital Vue 700[Light Sources] Luxtec Corp 9300XDP/LX300/9300/9300W[Light Sources] Sunoptics Medical Solar Maxx 300[Light Sources] Sunoptics Medical Titan 300/400[Light Sources] Welch Allyn 350 Proxenon[Light Sources] Carl Zeiss SuperLux 301[Light Sources] Various All Other Surgical Light Sources[Light Sources] Karl Storz Xenon 300[Light Sources] Various Surgical light pods[Electro Surgical Units (ESU)] Valley Lab FX C, FX-CS, EZ-C[Electro Surgical Units (ESU)] Covidien Force 2[Electro Surgical Units (ESU)] Covidien Force Triad[Electro Surgical Units (ESU)] Covidien FT10[Electro Surgical Units (ESU)] ValleyLab Force Argon 2[Electro Surgical Units (ESU)] Erbe Elektromedizin ICC 200 / ICC 200E INT UL[Electro Surgical Units (ESU)] Erbe Elektromedizin VIO200S / VIO-300D[Electro Surgical Units (ESU)] Ethicon Inc A J&J GEN 11[Electro Surgical Units (ESU)] Gyrus Acmi Force 40[Electro Surgical Units (ESU)] Conmed Sabre/ Conmed 500[Electro Surgical Units (ESU)] Codman & Shurtleff Inc CMC III[Electro Surgical Units (ESU)] Richard Wolf Medical ESU 2352[Electro Surgical Units (ESU)] Gyrus Group G400[Electro Surgical Units (ESU)] Olympus UES-30[Defibrillators] Philips Heartstart MRx/FRx[Defibrillators] Zoll AED & AED Plus[Defibrillators] Zoll M Series[Defibrillators] Zoll R Series (limited support)[Defibrillators] Zoll X (limited support)[Defibrillators] Zoll E Series[Defibrillators] Philips M4735A/ Heartstart XL[Defibrillators] Physio-Control Lifepak 9[Defibrillators] Physio-Control Lifepak 15[Defibrillators] Physio-Control Lifepak 12[Defibrillators] Physio-Control Lifepak 20[Defibrillators] Physio-Control Lifepak 20e[Physiological Monitors] Draeger Infinity Kappa XLT[Physiological Monitors] Draeger Infinity C700[Physiological Monitors] Draeger Infinity Delta/Delta XL[Physiological Monitors] Draeger Infinity Gamma[Physiological Monitors] Draeger Infinity Gamma XL[Physiological Monitors] Draeger Infinity Explorer[Physiological Monitors] Philips M1204A monitor[Physiological Monitors] Philips M1205A monitor[Physiological Monitors] Philips M3001A(MMS Module)[Physiological Monitors] Philips X2 M3002A[Physiological Monitors] Philips Intellivue MP2[Physiological Monitors] Philips Intellivue MP5[Physiological Monitors] Philips Intellivue MP20[Physiological Monitors] Philips Intellivue MP30[Physiological Monitors] Philips Intellivue MP50[Physiological Monitors] Philips Intellivue MP70[Physiological Monitors] Philips Intellivue MX700[Physiological Monitors] Philips M8010 module[Physiological Monitors] Datascope Passport V[Physiological Monitors] Datascope Passport, XG[Physiological Monitors] Datascope Passport 2 / 2LT / XG / EL /11/V[Physiological Monitors] Datascope Spectrum[Physiological Monitors] GE/Datex-Ohmeda Cardio Cap 5[Physiological Monitors] GE RAC 2A (Tram Rack)[Physiological Monitors] GE RAC 4A (Tram Rack)[Physiological Monitors] GE Solar 8000[Physiological Monitors] GE All DASH Models[Physiological Monitors] Welch Allyn PROPAQ LT[Physiological Monitors] Welch Allyn 202EL[Physiological Monitors] Criticare Systems Inc Vital Care 506DXN Patient Monitor[Physiological Monitors] Spacelabs 90478/90479 module[Physiological Monitors] Spacelabs 90369 Patient Monitor[Physiological Monitors] Spacelabs 91390 Qube patient monitor[Physiological Monitors] Spacelabs 91370 Monitor[Physiological Monitors] Spacelabs 91369 Monitor[Physiological Monitors] Spacelabs 90367 Monitor[Physiological Monitors] Spacelabs 91393 Patient Monitor[Physiological Monitors] Spacelabs 91518 Ultraview / Capnograph (Multi-gas analyzer)[Physiological Monitors] Spacelabs UltraView 1700SL/1050/Ultralite ABP/UCW modules[Physiological Monitors] Spacelabs UltraView Command Module[LCD Displays & Medical Computers] Various Surgical Grade Over 30''[LCD Displays & Medical Computers] Various Surgical Grade Under 30''[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors over 30"[LCD Displays & Medical Computers] Various ELO/Planar/LCD Monitors under 30"[LCD Displays & Medical Computers] Stryker VisionPro SYNK - Wireless LED Display[LCD Displays & Medical Computers] Stryker Vision Elect[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal under 30"[LCD Displays & Medical Computers] VTS Medical Displays VTS-24-HD003, Monitor, Terminal above 30"[Video Recorders/Printers] Sony UP-51MDS[Video Recorders/Printers] Sony UP-55MD[Video Recorders/Printers] Spacelabs All Models[Video Recorders/Printers] Stryker Printer SDP 1000[Vital Sign Monitors] GE Dinamap[Vital Sign Monitors] Datascope Accutorr Series[Vital Sign Monitors] Philips SureSigns Series[Vital Sign Monitors] Welch Allyn Welch Allyn Vital Sign Monitors 42 Series, 53 Series[Vital Sign Monitors] Welch Allyn VSM 6000 SERIES/ CONNEX[Vital Sign Monitors] Welch Allyn SpotVitalSigns LXI/42NOB Series / 53S Series[Patient Data Module ] GE PDM[Fetal Monitors] GE Corometrics 170 Series[Fetal Monitors] GE Corometrics 250 Series[Fetal Monitors] GE/Corometrics 115/116/118/120 Series[Cardiac Output Monitor] Edwards Vigilance II[Telemetry Transmitters] GE Apex Pro/CH[Telemetry Transmitters] GE Mini Telemetry transmitter[Telemetry Transmitters] Spacelabs 90478Q/T module[Telemetry Transmitters] Spacelabs 903 Series transmitters (90340-90347 )[Telemetry Transmitters] Spacelabs 913 Series Transmitters[Telemetry Transmitters] Philips MX40[Telemetry Transmitters] Colin Medical Instrument Prodigy II (2240) Vital Sign Monitor[Anesthesia Gas Benches ] Philips M1026A Repair[Anesthesia Gas Benches ] Philips M1026B Repair[Anesthesia Gas Benches ] Philips M1019A / G5 Repair[Anesthesia Gas Benches ] Datex Ohmeda E-CAIO-00[Anesthesia Gas Benches ] GE/Marquette SAM Module Repair[Anesthesia Gas Benches ] Covidien BIS Monitor AG BIS Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor Vista[Anesthesia Gas Benches ] Aspect Medical BIS Monitor A-2000[EKG Carts] GE MAC 5000[EKG Carts] GE MAC 5500[EKG Carts] Burdick 8500[EKG Carts] Burdick 3100 Atria[EKG Carts] Burdick Eclipse 850[EKG Carts] Welch Allyn CP100 / 200 / 300[EKG Carts] Welch Allyn Schiller AG 242 EKG Cart[EKG Carts] Mortara ELI 280[EKG Carts] Mortara ELI 250/ ELI 350[Pulse Oximeters] Masimo Radical 7[Pulse Oximeters] Masimo Radical 8[Pulse Oximeters] Nellcor NellCor N Series (except N85)[Respiratory] Medtronic External Model 5392[Respiratory] Oridion Medical Microstream/Microcap[Respiratory] Oridion Medical Capnostream 20/ Capnograph[Respiratory] Nellcor N-85[Respiratory] Smiths Medical Capnocheck II 8400D[Respiratory] Covidien / Oridion NPB-70 Capnograph[Respiratory] Fisher/Paykel MR850JHU[Respiratory] Fisher/Paykel MR730/MR840 Humidifier[OR Equipment] Zimmer ATS 1000/2000/1200/3000/ 4000[OR Equipment] Stryker Smart Pump Tourniquet[OR Equipment] Arizant Ranger Fluid Warmers[OR Equipment] Conmed LS7500 (Linavatec)[OR Equipment] Isolux America 1300XSB[OR Equipment] Integra Lifesciences MLX[OR Equipment] Smith and Nephew 300 XL / 500 XL[R-Wave Trigger Monitors] IVY Medical 3000 / 3150[Miscellaneous] GE Achilles Insight[Miscellaneous] Kendall SCD 700[Miscellaneous] Kendall SCD ExpressDevice 10 Serial #*Device 10 Purchase Order Number (if applicable)Device 10: Please enter comments regarding the report complaint/failure with device.*Does this device require cosmetic repair?*YesNoIf yes, describe the repair* needed.*Please note, cosmetic replacement is not included in the the flat-rate repair price.Payment InfoIf you have a Purchase Order #, please list it by the appropriate item above. If you prefer to pay using a credit card, please call 855.813.8100 or email biomed@repairmed.net to arrange credit card payment or for any additional questions about your RMA Request.Please note: when you print your PDF, only pages with device information need to be printed/included in your package.CommentsThis field is for validation purposes and should be left unchanged. RPMFL-016 Rev. C 01/30/2020 w HAVE A QUESTION? WE ARE READY TO HELP CONTACT US