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SOMATOM DefinitionEnvironmental Product Declaration

www.siemens.com/medical

Progress that is Impressive –Ecological Advantages ofSOMATOM Definition• Dose reduction for heart examinations up to 50%

• Energy savings of up to 30% for standard examinations

• Reduction of lead content over 80% (from 110 kg to 19 kg)

• All substances contained in the product and its packaging are documented

• Plastic parts are labeled for recycling

• Disassembly instructions for high-quality recycling are available

• Complete CT systems and their components are taken back and refurbished

• Product take-back according to strict EU directives • More than 95% of the materials used can be returned to the flow of recyclable materials

• Environmental product declaration is available for download via internet

Validated information according to EMAS is marked by a grey background andthe statement EMAS: validated information.

SOMATOM Definition:Reduction of Lead Content

Rotating components of CT-systems have to be balanced for a quiet running. The easiest way is the use of lead as counter balance. But lead is a toxic element. Therefore we abandoned the usage of lead as counter balance at SOMATOM Definition completely. But lead is also necessary for shielding and shaping of radiation. There is no technically and economically feasible alternative at present. Nevertheless it was possible to optimize this lead content.Altogether the lead content was reduced from 110 kg to19 kg, this means a reduction of more than 80% compared to SOMATOM Sensation 16.

EMAS: validated information – Environmental declaration 2006

Dual Source CT.As the first CT-system worldwide SOMATOM Definition offers two x-ray tubes and two detector systems.This allows cardiac imaging twice as fast as with the fastest singlesource CT.* Not only independent of the heart rate, but also withoutthe compromises of beta-blockers or multisegment reconstruction.

Besides, SOMATOM Definition opens the door to Spiral Dual Energy imaging, enabling material characteri-zation in a single scan.

* Competitive information provided is based on interpretation of available data and may require independent verification.

Reduction of Dose and Energy Consumption

It was a challenge to reduce energy consumption and dose in spite of two X-ray tubes. The following three actions led to success:• Modulation of X-rays to different heart phases • Patient table travelling speed adapted to pulse rate • Bowtie-filter protects surrounding tissue

Reduction of energy consumption during examina-tions leads mostly to a reduction of absorbed radia-tion dose.For heart examinations the reduction of dose amounts up to 50% compared to systems without any dose modulation.

Detectors of modern CT-systems consist of many rows. So X-rays can be utilized better and absorbed radiation doses can be reduced. Radiation dose is adapted to the density profile of respective body regions via the new CARE Dose4D™-technology. Adoption of dose modulation as well as increasing of detector rows generates energy savings of 30% during a normal thorax examination in comparison to SOMATOM Sensation 16-slice configuration.

EMAS: validated informationEnvironmental declaration 2006

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Environmental Management System

Our environmental, health and safety management system conforms to ISO 14001 and helps us put our policy into practice. Our German manufacturing facilities were among the first to be validated to EMAS (Environmental Managementand Audit Scheme).You find further information about our environmental, health and safety management system at www.siemens.com/medical-ehs.

Environmental Product Design

Material supply:From natural resources to delivery of semi-finished products

Production/delivery:From production of components to operation startup by the customer

Use/maintenance:Includes daily use by our customers as well as maintenance

End of life:From disassembly at the customer through material and energy recycling

Siemens Medical Solutions considers environmental aspectsin all phases of the product life cycle, including material supply, production/delivery, use/maintenance and end of life.

Our product design procedure fulfills the requirements of IEC60601-1-9:2007 “Environmental product design for medical electrical equipment”.

This standard supports the effort to improve the environmental performance of our products.

Identification of Product Ingredients

SOMATOM Definition is mainly buildout of metals. This ensures a high degree of recyclability.

Total weight: approx. 4850 kg

EMAS: validated informationEnvironmental declaration 2007

Other Materials 1,1 %Organic substances 1,6 %

Plastics 10%Critical substances 0,76 %Inorganic materials,

ceramics 1,7 %

Other metals andsemimetals 0,24 %

Precious metals Ferrous alloys,0,0073 % steels 61 %

Nonferrous metalsand alloys 23 %

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Reduction of Critical Substances

The consumption of material per unit area for CT detectors was reduced signifi-cantly. Today we need only 40% of Gado-liniumoxide for production of a defined surface area of CT detector ceramics in comparison to five years ago.

EMAS: validated informationEnvironmental declaration 2007

Cumulated Energy Demand

Energy consumption is the most impor-tant environmental characteristic of med-ical devices. This is why we use cumula-tive energy demand to assess environ-mental performance. Cumulative energy demand is the total primary energy* that is necessary to produce, use and dispose of a device – including all transportation. Our medical devices can be recycled almost completely for materials or energy. With end of life treatment it is possible to return 40 MWh in form of secondary raw materials or thermal energy to the economic cycle.

* primary energy is the energy contained in natural resources prior to undergoing any human made conversions (e.g. oil, solar).

EMAS: validated informationEnvironmental declaration 2007

Con

sum

ptio

n o

f G

adol

iniu

m O

xide

(kg

/dm

2)

Prim

ary

Ene

rgy

in M

Wh

Reduction of Gadolinium Oxide

for production of CT detector ceramics

0,70

0,60

0,50

0,40

0,30

0,20

0,10

0,00FY FY FY FY FY FY00/01 01/02 02/03 03/04 04/05 05/06

1200

1000900**

800

600

400

200100

160

0-40

-200■ Material supply ■ Manufacturing/delivery■ Use/maintenance ■ End of life

** based on 60 patients per day, 20 sec scan time, 10 years usage

Product Take Back

The materials of which SOMATOM Definition is produced are mostly recyclable. 97 % (by weight) can be recycled materially and 3 % energetically.

EMAS: validated informationEnvironmental declaration 2007

The high-performance X-ray tube assemblies are designed the way that as much parts as possible may be reused. At the end of life the tube assemblies are taken back and are refurbished. Quality is guaranteed by compliance to standard IEC 62390. Under optimal conditions up to 40% of a tube assembly may consist of reused parts.

EMAS: validated informationEnvironmental declaration 2006

Our product take back program ensures we address the environmental aspects of our products – even at the end of life. As part of this program, we refurbish sy-stems and reuse components and repla-cement parts whenever possible through our Refurbished Systems business. We reuse components and subsystems for non-medical products. We also recycle for material or energy value. Disassembly instructions for disposal and recycling are available for our products.

5

Operating Data

Heat emissions of the device

– basic load1 3,6 kW– full load2 15 kW

Allowed ambient temperature3 18ºC - 28º

Allowed relative humidity 20 - 75%

Noise level

– basic load1 ≤ 57 dB(A)– full load2 ≤ 64 dB(A)

Energy consumption:

– during ramp up4 4 - 14kW– basic load1 3,3 kW– full load2 67,4 kW

Power-on time4 < 4 min

Power-off time5 < 2 min

1 device is in operation but no patient examination takes place 2

average value at examination of patients3 within examination room4 from off-mode to operating state5 from operating state to off-mode

syngo®, the ergonomic and user-friendly user interface supports the clinical workflow. The intelligent automation functions accelerate your examination and make a smooth, efficient workflow for all modalities, departments and people possible. With syngo your work-place is prepared for your mode of operation perfectly.

Technical Specifications

Interface for heat recovery ₃

Possible type of cooling Standard: water/waterOptional: water/air

Complete switch-off is possible ₃

Device is adjustable for theuser in terms of height ₃

Uniform operating symbols fordevice families ₃

Radiation

Measures/technics to minimize - Ultra Fast Ceramic (UFC ) detectorsIonizing radiation exposure - CARE Dose4D™

- Shaped Filter

Minimization compared to the limit Minimization in %value for patients head 1,3%

sinus -65,1%thorax -64,1%abdomen -37,1%pelvis -50,4%Oberbauch -39,4%spine -49,4%heart -59,0%

Measures/techniques to Not applicableminimize the exposureto electromagnetic radiation

Minimization compared to the limit Not applicablevalue for users

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Replacement Parts and Consumables

Item Life cycle*

x-ray tube 1 year warranty

UPS-battery 36 months

* recommended exchange interval

Disposal / Substance Information

End of life concept ₃

Recycling information ₃

List of hazardous substances ₃(not contained in the device)

Cleaning

Incompatible cleaning processes

– total device ₃– restrictions for particular ₃

device components

List of incompatiblesubstance classes

– total device sprays

chlorine releasing agentssubstituted phenols based agentsscouring cleaning agentsorganic solventsammonia releasing agentscontaining silicon agents

– restrictions for particular ₃

device components

Suitability of the device for ₃sterile areas

Size of the surface to be approx. 3 m2

cleaned*

* gantry-tunnel (inside), patient tabel overlay, control elements, console, keypad, intercom, mouse

Further Ecologically Relevant Information

Elements of instruction are:

– recommendations for saving energy ₃

– recommendations for efficient cleaning ₃– recommendations for appropriate use of consumables ₃

7

On account of certain regional limitations of Contact Address Germanysales rights and service availability, we cannot Siemens AG, Medical Solutions

guarantee that all products included in this Computed Tomographybrochure are available through the Siemens Siemensstr. 1, D-91301 Forchheim

sales organization worldwide. Availability and Germanypackaging may vary by country and is subject Telephone: +49 9191 18-0

to change without prior notice. Some/All of thefeatures and products described herein may notbe available in the United States.

The information in this document containsgeneral technical descriptions of specificationsand options as well as standard and optionalfeatures which do not always have to be presentin individual cases.

Siemens reserves the right to modify the design,packaging, specifications and options describedherein without prior notice. Please contact yourlocal Siemens sales representative for the mostcurrent information.

Note: Any technical data contained in thisdocument may vary within defined tolerances.Original images always lose a certain amountof detail when reproduced.

The statements contained herein are based onthe actual experience of Siemens customers.Siemens maintains data on file to support theseclaims. However, these statements do notsuggest or constitute a warranty that all productexperience will yield similar results. Results mayvary, based on the particular circumstances ofindividual sites and users.

Please find fitting accessories:www.siemens.com/medical-accessories

© 05.2007, Siemens AGOrder No. A91CT-00443-04C1-7600Printed in GermanyCC CT 00443 WS 07070.5

Siemens AG HeadquartersWittelsbacherplatz 2 Siemens AG, Medical Solutions

D-80333 München Henkestr. 127Germany D-91052 Erlangen

GermanyTelephone: ++49 9131 84-0www.siemens.com/medical

www.siemens.com/medical

MERCADO  Dr.Popescu Sena, medic primar boli interne,competenta  ecografie  Dr.Popescu Ion, medic primar chirurg  Dr.Constantin Lucia, medic primar radiologie si imagistica  medicala,competenta in tomografie computerizata si mamografie  Dr.Ionascu Nina, medic primar radiologie si imagistica medicala,competenta tomografie computerizata si mamografie  Dr.Cucu Amalia, medic primar radiologie si imagistica medicala,competenta in tomografie computerizata  As.Sandu Alexandru, asistent principal radiolog  As.Iorga Emilia, asistent medical principal radiologie  As.Antonov Valentina, asistent medical principal radiologie As.Cicarac Corina, asistent medical principal generalist

  SENFARM Farm.Valcu Vasile Teodor, farmacist primar,diriginte de farmacie Farm.Ionescu Mina, farmacist specialist As.Veisel Ramona, asistent farmacie As.Sandu Mariana, asistent farmacie As.Vancea Laura, asistent farmacie As.Munteanu Elena, asistent farmacie

Suntem o societate cu raspundere limitata avind ca domeniu de activitate asistenta medicala ambulatorie de specialitate cu sediul social in Tulcea, str.Isaccei nr.29, bl.I7, sc.H ap1 si avind doua puncte de lucru in Tulcea:

     -str.Isaccei nr.29, bl.I7, sc.H ap 2, unde se efectueaza consultatii si tratamente in domeniul medicina interna si chirurgie, dar si ecografii 4D cu un ecograf de ultima generatie ACUSON X500 produs de firma SIEMENS

    -str.Grivitei nr. 33, care este un centru de tomografie computerizata in care este amplasat un tomograf SOMATOM BALANCE produs de firma SIEMENS. Intr-o cladire noua, la aceeasi adresa, functioneaza un centru de diagnostic imagistic       cu mamografie si radiodiagnostic classic la parter si osteodensitometrie DXA si videoendoscopie la etaj. Aparatura folosita este de ultima generatie, astfel MAMMOMAT 1000-SIEMENS, MULTIX SWING-SIEMENS, OSTEOCORE-MEDILINK       si VIDEOENDOSCOP PENTAX.

     Din 2009 societatea este certificata ISO 9001/2001 si respecta standar-dele in vigoare privind managementul calitatii.

     Punctele de lucru sunt situate in zone centrale ale orasului asigurind accesul facil al pacientilor la serviciile oferite. Contractul de colaborare cu farmacia Senfarm completeaza gama serviciilor punind la dispozitia pacientilor medicamentele necesare tratamentului recomandat    Personalul este format din cinci medici: un internist cu competenta in ecografie generala, un chirurg si trei radiologi cu competente in ecografie generala si tomografie computerizata, toti avind titlul de medic primar. Acestia sunt sistati de

trei asistenti cu grad principal, din care doi radiologi. Serviciile de secretariat sunt asigurate de o angajata specializata.