Invacare IRC5PO2AW Instrukcja obsługi

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Instrukcja obsługi

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Invacare® Perfecto
2
TM
Series
IRC5PO2AW, IRC5PO2VAW
en HomeFill® System Compatible Oxygen
Concentrators with SensO
2
User Manual ................................ 3
cs HomeFill® systém kompatibilní
koncentrátory kyslíku s SensO
2
Návod k obsluze ............................ 35
fr Système HomeFill® compatibles
concentrateurs d'oxygène avec SensO
2
Manuel d'utilisation .......................... 67
de HomeFill® systemfähig
Sauerstokonzentratoren mit SensO
2
Gebrauchsanweisung.........................101
it Sistema HomeFill® concentratori di
ossigeno compatibili con SensO
2
Manuale d’uso...............................135
pl Systemowe HomeFill® Kompatybilne z
SensO
2
koncentratorów tlenu
Instrukcja obsługi ............................167
This manual MUST be given to the user of the product.
BEFORE using this product, read this manual and save for future reference.
© 2017Invacare Corporation
Allrightsreserved.Republication,duplicationormodificationinwholeorinpartisprohibitedwithout
priorwrittenpermissionfromInvacare.Trademarksareidentifiedby™ and®.Alltrademarksare
ownedbyorlicensedtoInvacareCorporationoritssubsidiariesunlessotherwisenoted.
Pine-solandLestoilaretrademarksofTheCloroxCompany.
DawnisatrademarkofTheProctorandGambleCompany.
Making Life's Experiences Possible is a registered trademark in the U.S.A.
Contents
ThismanualMUSTbegiventotheuseroftheproduct.
BEFOREusingthisproduct,readthismanualandsaveforfuture
reference.
1General........................................4
1.1Symbols.....................................4
1.2IntendedUse..................................6
1.3Description...................................7
1.4Contraindications..............................7
2Safety..........................................8
2.1LabelLocations................................8
2.2GeneralGuidelines.............................9
2.3RadioFrequencyInterference......................12
3Components....................................13
3.1ComponentIdentification.........................13
4Accessories.....................................15
4.1OptionalAccessories............................15
5Setup..........................................16
5.1Unpacking....................................16
5.2Inspection....................................16
5.3Storage......................................16
6Usage..........................................17
6.1Introduction..................................17
6.2SelectaLocation...............................17
6.3SettingUptheConcentrator......................18
6.3.1SettingUptheHumidifier......................18
6.3.2TurningtheConcentratorOn...................21
6.3.3Flowrate..................................22
6.3.4SensO
2
OxygenPurityIndicator.................22
6.3.5InitialStartupoftheConcentrator................22
6.3.6ExplanationofOxygenPurityIndicatorLights........23
6.3.7ElapsedTimeMeter(HourMeter)................23
7Maintenance....................................24
7.1CleaningtheCabinet............................24
7.2CleaningtheCabinetFilter........................25
7.3HumidifierCleaningandThermicDisinfection..........26
7.4CleaningandDisinfectionBetweenPatients............26
7.5PreventiveMaintenanceChecklist...................27
8AfterUse.......................................28
8.1RecyclingInformation............................28
8.2WearandTear................................28
9Troubleshooting.................................29
9.1Troubleshooting...............................29
10Technicaldata..................................31
10.1TypicalProductParameters......................31
Invacare®Perfecto™Series
1General
1.1Symbols
Signalwordsareusedinthismanualandapplytohazardsorunsafe
practiceswhichcouldresultinpersonalinjuryorpropertydamage.
Seetheinformationbelowfordefinitionsofthesignalwords.
DANGER!
Dangerindicatesanimminentlyhazardoussituation
which,ifnotavoided,willresultindeathorserious
injury.
WARNING!
Warningindicatesapotentiallyhazardoussituation
which,ifnotavoided,couldresultindeathorserious
injury.
CAUTION!
Cautionindicatesapotentiallyhazardoussituation
which,ifnotavoided,mayresultinpropertydamage
orminorinjuryorboth.
Givesusefultips,recommendationsandinformationfor
efficient,trouble-freeuse.
SymbolsinDocumentation
Readmanual
NoSmoking
NoOpenFlame
ClassII,DoubleInsulated
AlternatingCurrent
TypeBFequipment
Recycle
DONOTdisposeofinhouseholdwaste
ElectricalHazard
Keepdry
ECRepresentative
Manufacturer
4 1195656-A
General
Callsupplier
ThisproductcomplieswithDirective
93/42/EECconcerningmedicaldevices.
Thelaunchdateofthisproductisstatedinthe
CEdeclarationofconformity.
FormoredetailsaboutCEmarks,refertoTypicalProduct
Parameters.
SymbolsonProduct
Unitrunning
Unitnotrunning
O
2
Indicators
SymbolO
2
PurityIndicatorLights(LED)
O
2
SYSTEMOKAY
O
2
over85%
GREENIndicatorLight
O
2
between73%to
85%
YELLOWIndicatorLight
A.YELLOWSolid
B.YELLOWFlashing
Sensor
Failure
Callaqualifiedtechnician
SYSTEMFAILURE
O
2
Below73%
REDIndicatorLight
ContinuousAudible
AlarmSieveGARD™
CompressorShutdown
1195656-A 5
Invacare®Perfecto™Series
1.2IntendedUse
Youroxygenconcentratorisintendedforindividualusebypatients
withrespiratorydisorderswhorequiresupplementaloxygen.The
deviceisnotintendedtosustainorsupportlife.Theconcentratoris
intendedforusewithinahomeorinstitutionalenvironment.
DANGER!
RiskofInjuryorDeath
Thisproductistobeusedasanoxygensupplementand
isnotintendedtobelife-supportingorlife-sustaining.
ONLYusethisproductifthepatientiscapableof
spontaneousbreath,abletoinhaleandexhalewithout
theuseofamachine.
DONOTuseinparallelorserieswithotheroxygen
concentratorsoroxygentherapydevices.
DANGER!
RiskofInjuryorDeath
Dependingontheirmedicalcondition,patientsonflow
ratesgreaterthan5l/mmaybeatanincreasedriskfor
seriousinjuryordeathintheeventoffailure.
ALWAYSdiscussthisincreasedriskwithyourhealth
careproviderBEFOREusingthisproductifyouare
prescribedaflowrategreaterthan5l/m.
DANGER!
RiskofInjuryorDeath
WhileInvacarestrivestoproducethebestoxygen
concentratorinthemarkettoday,thisoxygen
concentratorcanfailtoproduceoxygenduetopower
failureordevicemalfunction.
ALWAYShaveabackupsourceofoxygenreadily
available.
Intheeventtheconcentratorfailstoproduceoxygen,
theconcentratorwillbrieflyalarmsignalingthepatient
toswitchtotheirbackupsourceofoxygen.Referto
Troubleshootingformoredetail.
WARNING!
RiskofInjuryorDamage
Useofthisproductoutsideoftheintendeduseand
productparametershasnotbeentestedandmayleadto
productdamage,lossofproductfunction,orpersonal
injury.
DONOTusethisproductinanywayotherthan
describedintheproductparametersandintendeduse
sectionsofthismanual.
6 1195656-A
General
1.3Description
TheInvacarePerfecto
2
concentratorisusedbypatientswith
respiratorydisorderswhorequiresupplementaloxygen.Thedevice
isnotintendedtosustainorsupportlife.
Theoxygenconcentrationleveloftheoutputgasrangesfrom87%
to95.6%.Theoxygenisdeliveredtothepatientthroughtheuse
ofanasalcannula.
TheInvacarePerfecto
2
concentratorusesamolecularsieveand
pressureswingadsorptionmethodologytoproducetheoxygen
gasoutput.Ambientairentersthedevice,isfilteredandthen
compressed.Thiscompressedairisthendirectedtowardoneof
twonitrogenadsorbingsievebeds.
Concentratedoxygenexitstheoppositeendoftheactivesievebed
andisdirectedintoanoxygenreservoirwhereitisdeliveredtothe
patient.
TheInvacarePerfecto
2
concentratoriscapableofoperationbythe
patientinahomeenvironmentorinaninstitutionalenvironment.
Deviceoperatesatanominal230VAC/50Hertzsupply.
Bothconcentratormodels(IRC5PO2AWand
IRC5PO2VAW)haveidenticaloperatingparameterswiththe
exceptionoftheproductweightandpowerconsumption.
Refertotypicalproductparameters.
Serviceinformationwillbeavailableuponrequesttoqualified
technicalpersonnelonly.
1.4Contraindications
InvacareisnotawareofanycontraindicationsfortheInvacare
Perfecto
2
ConcentratorSeries.
1195656-A 7
Invacare®Perfecto™Series
2Safety
2.1LabelLocations
A
Serialnumberlabelislocatedontheresonator
intakeassembly.
B
SpecificationLabelislocatedonthebackofthe
concentratoratthebase.
C
EURepresentativelabelislocatedonthebase.
D
Phthalatelabelislocatedonthebase.
E
8 1195656-A
Safety
2.2GeneralGuidelines
Inordertoensurethesafeinstallation,assemblyandoperationofthe
concentratortheseinstructionsMUSTbefollowed.
DANGER!
RiskOfDeath,Injury,OrDamage
Improperuseoftheproductmaycausedeath,injuryor
damage.Thissectioncontainsimportantinformationfor
thesafeoperationanduseofthisproduct.
DONOTusethisproductoranyavailableoptional
equipmentwithoutfirstcompletelyreadingand
understandingtheseinstructionsandanyadditional
instructionalmaterialsuchasusermanuals,service
manualsorinstructionsheetssuppliedwiththis
productoroptionalequipment.
Ifyouareunabletounderstandthewarnings,cautions
orinstructions,contactahealthcareprofessional,
dealerortechnicalpersonnelbeforeattemptingto
usethisequipment.
CheckALLexternalcomponentsandcartonfor
damage.Incaseofdamage,oriftheproductisnot
workingcorrectly,contactatechnicianorInvacare
forrepair.
THEINFORMATIONINTHISDOCUMENTIS
SUBJECTTOCHANGEWITHOUTNOTICE.
DANGER!
RiskOfDeath,Injury,OrDamageFromFire
Textiles,oilorpetroleumsubstances,grease,greasy
substancesandothercombustiblesareeasilyignited
andburnwithgreatintensityinoxygenenrichedairand
whenincontactwithoxygenunderpressure.Toavoid
fire,death,injuryordamage:
DONOTSMOKEwhileusingthisdevice.
DONOTnearOPENFLAMEorIGNITION
SOURCES.
DONOTuseanylubricantsonconcentratorunless
recommendedbyInvacare.
NOSMOKINGsignsshouldbeprominentlydisplayed.
Avoidcreationofanysparknearoxygenequipment.
Thisincludessparksfromstaticelectricitycreatedby
anytypeoffriction.
Keepallmatches,lightedcigarettesorothersources
ofignitionoutoftheroominwhichthisconcentrator
islocatedandawayfromwhereoxygenisbeing
delivered.
Keeptheoxygentubing,cord,andconcentratorout
fromundersuchitemsasblankets,bedcoverings,
chaircushions,clothing,andawayfromheatedorhot
surfacesincludingspaceheaters,stoves,andsimilar
electricalappliances.
CAUTION!
Federal(statutory)lawrestrictsthisdevicesaletoor
ontheorderofamedicalpractitionerlicensedbya
governmentalagencywherehe/shepractices.
ONLYalicensedmedicalpractitionermayorderthe
purchaseoruseofthisdevice.
1195656-A 9
Invacare®Perfecto™Series
DANGER!
RiskofDeath,Injury,fromElectricShock
Toreducetheriskofburns,electrocution,deathor
injurytopersons:
DONOTdisassemble.Referservicingtoqualified
servicepersonnel.Therearenouserserviceable
parts.
Avoidusingwhilebathing.Ifcontinuoususage
isrequiredbythephysician'sprescription,the
concentratormustbelocatedinanotherroomat
least7ft(2.5m)fromthebath.
DONOTcomeincontactwiththeconcentrator
whilewet.
DONOTplaceorstoreconcentratorwhereitcan
dropintowaterorotherliquid.
DONOTreachforconcentratorthathasfalleninto
water.UnplugIMMEDIATELY.
DONOTusefrayedordamagedACadaptercords.
WARNING!
RiskOfInjuryOrDamage
Invacareproductsarespecificallydesignedand
manufacturedforuseinconjunctionwithInvacare
accessories.Accessoriesdesignedbyother
manufacturershavenotbeentestedbyInvacareand
arenotrecommendedforusewithInvacareproducts.
Therearemanydifferenttypesofhumidifiers,oxygen
tubing,cannulasandmasksthatcanbeusedwiththis
device.Youshouldcontactyourlocalhomecare
providerforrecommendationsonwhichofthese
deviceswillbebestforyou.Theyshouldalsogiveyou
adviceontheproperusage,maintenance,andcleaning.
DANGER!
RiskofInjuryorDeath
Toavoidchokingoringestionofchemicalsfromairway
contamination:
DONOTusetheconcentratorinthepresenceof
pollutants,smoke,fumes,flammableanesthetics,
cleaningagents,orchemicalvapors.
WARNING!
RiskofInjuryorDeath
Topreventinjuryordeathfromproductmisuse:
Closelysupervisewhenthisconcentratorisusedby
ornearchildrenorphysically-challengedindividuals.
Monitorpatientsusingthisdevicewhoareunableto
hearorseealarmsorcommunicatediscomfort.
WARNING!
RiskofInjuryorDeath
Toavoidchokingand/orstrangulationfromtubing
entanglement:
Keepchildrenandpetsawayfromnasalcannulaand
tubing.
Closesupervisionisnecessarywhenthenasalcannula
isusedbyornearchildrenand/ordisabledpersons.
WARNING!
RiskofInjuryorDeath
Toreducetheriskofinjuryordeathfromillness:
Replacethenasalcannulaonaregularbasis.Check
withyourequipmentproviderorphysicianto
determinehowoftenthecannulashouldbereplaced.
DONOTsharecannulasbetweenpatients.
10 1195656-A
Safety
WARNING!
RiskofInjury
Achangeinaltitudemayaffecttotaloxygenavailableto
you.Topreventoxygendeprivation:
Consultyourphysicianbeforetravelingtohigheror
loweraltitudestodetermineifyourflowsettings
shouldbechanged.
WARNING!
RiskofInjuryorDamage
Topreventinjuryordamagefromcordmisuse:
DONOTmoveorrelocateconcentratorbypulling
onthecord.
DONOTuseextensioncordswithACpower
adaptersprovided.
Properlystoreandpositionelectricalcordsand/or
tubingtopreventatrippinghazard.
WARNING!
RiskofInjuryorDamage
Topreventinjuryordamagefrommisuse:
NEVERleaveconcentratorunattendedwhenplugged
in.
Makesureconcentratorisoffwhennotinuse.
WARNING!
RiskofInjuryorDamage
Invacareoxygenconcentratorsarespecificallydesigned
tominimizeroutinepreventivemaintenance.Toprevent
injuryordamage:
Onlyprofessionalsofthehealthcarefieldor
personsfullyconversantwiththisprocesssuchas
factorytrainedpersonnelshouldperformpreventive
maintenanceorperformanceadjustmentsonthe
oxygenconcentrator,exceptfortasksdescribedin
thismanual.
UsersshouldcontactyourdealerorInvacarefor
service.
CAUTION!
RiskofDamage
Topreventdamagefromliquidingress:
Iftheconcentratorisnotworkingproperly,ifit
hasbeendroppedordamaged,ordroppedinto
water,callequipmentprovider/qualifiedtechnicianfor
examinationandrepair.
NEVERdroporinsertanyobjectorliquidintoany
opening.
Invacarerecommendstheconcentratornotbeused
intherain.
1195656-A 11
Invacare®Perfecto™Series
2.3RadioFrequencyInterference
WARNING!
RiskofInjuryorDamage
Toreducetheriskofinjuryorproductdamagefrom
interferencewithwirelessequipment:
Keepconcentratoratleast9.8ft(3.0m)awayfrom
wirelesscommunicationequipmentsuchaswireless
homenetworkdevices,mobilephones,cordless
phonesandbasestations,walkie-talkies,etc.
ThisequipmenthasbeentestedandfoundtocomplywithEMClimits
specifiedbyIEC/EN60601-1-2.Theselimitsaredesignedtoprovide
areasonableprotectionagainstelectromagneticinterferenceina
typicalmedicalinstallation.
Otherdevicesmayexperienceinterferencefromeventhelowlevels
ofelectromagneticemissionspermittedbytheabovestandards.
Todetermineiftheemissionsfromtheconcentratorarecausing
theinterference,turntheconcentratorOff.Iftheinterference
withtheotherdevice(s)stops,thentheconcentratoriscausingthe
interference.Insuchrarecases,interferencemaybereducedor
correctedbyoneofthefollowingmeasures:
Reposition,relocate,orincreasetheseparationbetweenthe
equipment.
Connecttheequipmentintoanoutletonacircuitdifferentfrom
thattowhichtheotherdevice(s)isconnected.
12 1195656-A
Components
3Components
3.1ComponentIdentification
A
OxygenOutlet
B
Flowmeter
C
ElapsedTimeMeter
D
OxygenPurityIndicator
Lights/FaultandPowerIndicator
Lights
E
CircuitBreaker
F
PowerSwitch
1195656-A 13
Invacare®Perfecto™Series
RearView
G
PowerCord
H
HomeFillOutletFitting
I
CabinetFilter
TheHomeFilloutletfittingHistobeusedonlyfor
fillingoxygencylinderswiththeHomeFillhomeoxygen
compressor.Theoutletfittingdoesnotaffectconcentrator
performance.RefertotheHomeFillusermanual
forconnectionandoperatinginstructions.
Whennotinuse,theplugprovidedwiththeconcentrator
shouldbeinsertedintotheoutletfitting.Formore
informationabouttheHomeFill,contactyourInvacare
dealer.
14 1195656-A
Accessories
4Accessories
4.1OptionalAccessories
Therearemanydifferenttypesofhumidifiers,oxygentubing,cannulas
andmasksthatcanbeusedwiththisdevice.Youshouldcontactyour
localhomecareproviderforrecommendationsonwhichofthese
deviceswillbebestforyou.Theyshouldalsogiveyouadviceonthe
properusage,maintenance,andcleaning.
Thesupplyaccessories(nasalcannula,mask,tubing,humidifier,etc.)
usedtodeliveroxygentothepatientneedtoincludeameansto
reducethepropagationoffireintheaccessoriesforthesafetyofthe
patientandothers.Ifacommerciallyavailable,fire-activatedflow
stopdeviceisusedintheaccessoriessetup,itshouldbeplacedas
closetothepatientaspracticable.
Thefollowingoptionalaccessoriesandreplacementparts(listed
below)arealsoavailable:
StandardAdultNasalCannula,2.1m(7feet)-M3120
StandardHumidifier-InvacarePart#1155719
PreciseRX™PediatricHumidifier/FlowmeterAccessory-
IRCPF16AW
HomeFillhomeoxygencompressor-IOH200AW
HumidifierBottleHolder-M1521
OxygenSupplyTubing2.1m(7feet)-MS4107
OxygenSupplyTubing6.3m(21feet)-MS4121
OxygenTubingConnector-MS4301
1195656-A 15
Invacare®Perfecto™Series
5Setup
5.1Unpacking
1.Checkforanyobviousdamagetothecartonoritscontents.If
damageisevident,notifythecarrier,oryourlocaldealer.
2.Removeallloosepackingfromthecarton.
3.Carefullyremoveallthecomponentsfromthecarton.
Unlesstheoxygenconcentratoristobeused
IMMEDIATELY,leaveconcentratorinitspackagingfor
storageuntiluseisrequired.
5.2Inspection
1.Inspect/examineexterioroftheconcentratorfornicks,dents,
cracks,scratchesorotherdamage.
2.Inspectallcomponents.
5.3Storage
1.Storetherepackagedoxygenconcentratorinadryarea.Referto
TypicalProductParametersforstoragetemperatureparameters.
2.DONOTplaceobjectsontopofrepackagedconcentrator.
16 1195656-A
Usage
6Usage
6.1Introduction
Youroxygenconcentratorisintendedforindividualuseindoors.
Itisanelectronicallyoperateddevicethatseparatesoxygenfrom
roomair.Itprovideshighconcentrationofoxygendirectlytoyou
throughanasalcannula.Clinicalstudieshavedocumentedthat
oxygenconcentratorsaretherapeuticallyequivalenttoothertypesof
oxygendeliverysystems.
Yourproviderwillshowyouhowtouseyouroxygenconcentrator.
He/Sheshouldbecontactedwithanyquestionsorproblems
regardingyouroxygenconcentrator.Thisusermanualwilltellyou
aboutyourconcentratorandwillserveasareferenceasyouuse
yourconcentrator.
6.2SelectaLocation
WARNING!
RiskofInjuryorDamage
Toavoidinjuryordamagefromairbornepollutants
and/orfumesandforoptimalperformance:
Locateandpositiontheconcentratorinawell
ventilatedspacesothattheairintakeandtheair
exhaustsarenotobstructed.
NEVERblocktheairopeningsoftheconcentrator
orplaceitonasoftsurface,suchasabedorcouch,
wheretheairopeningmaybeblocked.
Keeptheopeningsfreefromlint,hairandsimilar
foreignitems.
Keepconcentratoratleast12inches(30,5cm)away
fromwalls,draperiesandfurniture.
Avoiduseinpresenceofpollutants,smokeorfumes,
flammableanesthetics,cleaningagentsorchemical
vapors.
Placeconcentratorinawellventilatedareatoavoid
airbornepollutantsand/orfumes.
DONOTuseinacloset.
WARNING!
RiskofInjury
Toavoidinjuryduringtherapy:
TheoxygenconcentratorMUSTbeplacedonalevel
surfaceforuse.
DONOTrelocatetheoxygenconcentratorwhilein
use.
1195656-A 17
Invacare®Perfecto™Series
Youmayselectaroominyourhousewhereusingyouroxygen
concentratorwouldbemostconvenient.Yourconcentratorcanbe
easilyrolledfromroomtoroomonitscasters.
Youroxygenconcentratorwillperformbestwhenoperatedunder
theconditionsoutlinedintypicalproductparameters.
Usageinenvironmentsotherthanthosedescribedmayresultinthe
needforincreasedequipmentmaintenance.Theairintakeofthe
unitshouldbelocatedinawellventilatedareatoavoidairborne
pollutantsand/orfumes.
6.3SettingUptheConcentrator
1.Pluginpowercordtoanelectricaloutlet.
2.ConnectHumidifier(ifsoprescribed).
6.3.1SettingUptheHumidifier
WARNING!
RiskofInjuryorDamage
Toavoidburnsfromsteamorhotwater,inhalationof
waterand/orwaterdamagetotheconcentrator:
DONOTfillhumidifierbottlewithhotwater.Allow
boiledwatertocooltoroomtemperaturebefore
filling.
DONOToverfillhumidifier.
Replacethehumidifiercapandsecurelytighten.
Confirmthatthecapisnotcross-threadedonthe
humidifierbottle.
DONOTreversetheoxygeninputandoutput
connections.Waterfromthehumidifierbottlewill
travelthroughthecannulabacktothepatientifinput
andoutputconnectionsarereversed.
Whenusingtubingconnectionslongerthan2.1m
(7feet)inlength,positionthehumidifierasclose
tothepatientaspossibletoallowformaximum
humidificationoutput.
18 1195656-A
Usage
WARNING!
RiskofInjuryorDamage
Failuretoproperlyinstallthehumidifierbottleorother
accessoriestotheconcentratorwillimpacttheflowof
oxygen.
Tocheckforproperoperationoftheoxygen
concentratorandaccessories,placetheendofthe
nasalcannulaunderthesurfaceofahalf-fullcupof
waterandlookforthebubbles.
Iftherearenobubbles,checkallconnections
(includinghumidifierbottleandotheraccessories,if
applicable)andrepeat.Contactyourdealerorservice
providerimmediatelyifbubblesstilldonotappear.
HumidifierBottlewithCap
HumidifierBottlewithoutCap
1195656-A 19
Invacare®Perfecto™Series
1.Removecapfrombottle.
2.Fillhumidifierwithboiledtapwaterorbottledwatertothelevel
indicatedbythemanufacturer.Boiltapwaterforapproximately
10minutesandcooltoroomtemperaturepriortouse.
3.Insertaflatheadscrewdriverintheplategrooveonthetopedge
ofthefilteraccessdoorCandgentlyprythefilteraccessdoor
off.
4.PullupandremovethehumidifierbottleadapterB.
5.ReplacethefilteraccessdoorandinstalltheairscoopFonto
thefilteraccessdoorbyinsertingthesixtabsGontheairscoop
intothesixslotsDonthesidesofthefilteraccessdoor.
6.AttachthehumidifierbottleadaptertothehumidifierbottleHby
turningthewingnutonthehumidifierbottlecounterclockwise
untilitissecurelyfastened.
20 1195656-A
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