ACUSON P500 Ultrasound System Release 2.0 Quick Reference Guide

SIEMENS ACUSON P500™ 36366 Ultrasound System - ACUSON P500 Release 2.0 ........................................................................... Quick Reference Guide SIEMENS SIEMENS siemens.com/ultrasound Healthineers Contents 2 Smart Cart Overview 3 System Overview 10 Control Panel 18 Touch Screen 22 JORTE Patient Exam 24 2D 28 Doppler 36 Text / Body Marker 46 Measurements 48 Review 52 SABABIS Reports 56 Export / Import 60 Smart Cart Overview 3 Smart Cart Height Adjustment Press lever and either push down or pull up to adjust the height. Smart Cart Smart Cart Overview 4 Locking and Unlocking the Wheels There are two lock positions. 1. Press large tab down to lock. 2. Lift large tab up to unlock. Lock Unlock Attaching the Transducers to the System and Multiple Transducer Module (MTM) 5 1. Ensure the lever lock is in the down, unlocked position. 2. Align the connector and press into the system port. 3. To lock, place the lever in the up position. 1 2 4. Connecting transducers to the MTM follows the 3 same process. 4 Smart Cart Smart Cart Overview 6 Cable Management 1. Transducers can be placed in the holders located at each side of the Smart Cart. 2. When transporting the cart with transducers, place the cables through the provided hook to prevent damage. Instructions for removal of the ACUSON P500 system from TIP the cart are located by the back handle of the Smart Cart. Input / Output Connections Accessory Power Connection 7 Located on the upper back of the Smart Cart. Located on the lower back of the Smart Cart. TT HDMI HDMI LAN DC Out Cart Power Peripheral Power Peripheral USB Smart Cart Smart Cart Overview 8 Cleaning the Smart Cart Cleaning the Transducer Holders Clean with a mild detergent. • First, remove the transducer holder by following the steps: 1. Press the tab located at the back of the holder. 2. Pull the holder towards the floor to remove. 3. Clean with a mild detergent. 4. Insert into transducer holder pressing upward until an audible click is heard. Use only approved disinfectants. For a complete list see the ACUSON P500 system Help menu. 9 Smart Cart System Overview 10 Attaching a Transducer ......... 1. Ensure the lever lock is in the down, unlocked position. .......................................................................................... 2. Align the connector and press into the transducer port. 3. Place the lock in the up position. CH5-2 IPX8 3 4. Once the system detects the transducer, the name displays to the right of the image. Input / Output Connector 11 1. Local area network (LAN) cable connection. 2. High-definition Multimedia Interface (HDMI) connection. 3. Universal Serial Bus (USB) ports. 4. Audio Jack (Headphones). LAN HDMI SISHEYS 1 2 3 4 System Overview System Overview 12 Control Panel Workflow Controls Control Function Brightness Mode 2D Press to enter / exit 2D mode. 2D Rotate to adjust overall 2D gain / brightness. Enters / exits color Doppler or adjusts overall color Doppler gain C Press to activate / deactivate color Doppler mode. (Color Doppler) C Rotate to increase / decrease color Doppler gain. Note: Available on live image only. Enters / exits M-mode and adjusts overall M-mode gain Press to activate / deactivate. M (M-mode) Roll the trackball to position the M-mode cursor. M Rotate to adjust overall M-mode gain. Note: Available on live image only. Enters / exits spectral Doppler or adjusts overall spectral Doppler gain. 13 Press to activate / deactivate. PW Slide Touch pad to position Doppler gate. (Pulsed Wave) Select PW or CW to activate the strip. PW Rotate to adjust overall spectral Doppler gain. Note: Available on live image only. Adjusts the scanning depth and magnifies the image. Rotate clockwise / counter-clockwise to increase / decrease depth. Depth / Zoom Press to activate zoom. Rotate to adjust the scanning depth or amount of image magnification. Depth/Zoom Press again to exit zoom. Note: Zoom available in live or frozen images. Adjusts angle correction. Angle Press to cycle through 60 / 0 / 60° angle selections. Rotate to adjust values in 1° increments. Angle Note: Available on live or frozen image. System Overview System Overview 14 Control Panel Workflow Controls Cont. Control Function Reverses the Doppler spectrum (negative values display above the baseline) Invert Select to activate / deactivate. Note: Available on live or frozen image. One-button image optimization TEQ™ Press to optimize the overall image displayed. ultrasound technology Press twice to deactivate. Note: Available on live image only. UD 1, 2 User-defined keys which may be programmed to perform a single function. Print Store 1, 2 User-defined keys for print and store functions. Measure Activates / deactivates exam specific and generic measurement packages. x ... x 15 Clip Store Activates / truncates clip capture. Adjusts the pulse repetition frequency (PRF) Scale Increase / decrease to adjust the PRF. Note: Available on live image only. Adjusts the range of flow velocities displayed above and below the baseline 4 Baseline Move up / down to adjust the baseline of the active mode. Note: Available on live image only. Freeze Freezes the clip / image frame. New New User-programmable key for ending the current study. Body Marker Activates the Body Marker menus available for the active preset. T Text Activates / deactivates the annotation menus for the active preset. System Overview System Overview 16 Cleaning the ACUSON P500 System Control Panel Turn off and unplug the system. • Moisten clean lint-free cloth with a mild detergent or an approved disinfectant. • Ensure both a Touch pad and slide controls are free of gel. • Dry surfaces with a lint-free cloth. • Monitor Moisten a clean lint-free cloth with mild detergent or water. • Wipe the monitor to clean. • Dry the surface with a lint-free cloth. • Use only approved disinfectants. For a complete list see the ACUSON P500 system Help menu. 17 System Overview Control Panel 18 1 2 1. Power On / Off A A 2. Soft keys 4 3 3. DGC 2 4. Depth / Zoom -- W 5. Measure 6. Clip Store New Alt Clear 7. Print Store 1 Ctrl Screen 8. Print Store 2 15 14 13 4 9. Freeze 10. TEQ 10 Angle th / Zoom 11. Touch pad keys 11 5 6 Invert 12. Touch pad 4 Scale Bases 9 Measure Clip Store 12 7 8 13. 2D and Gain 14. Color Doppler UD 1 UD 2 Print Freeze Store 1 15. M-mode 16. Pulsed wave Doppler 19 4 A 4 4 17. Invert 2 18. Baseline U O 19. Scale 30 G H 20. User Defined 1 21. User Defined 2 Ctrl New Alt Clear Screen T 22. Angle push / rotary 23 26 24 25 27 28 29 23. Workflow Controls 22 16 24. Arrow 17 25. Alternate keyboard Depth / Zoom 19 18 26. New Invest 27. Clear Screen X ... x Scale Baseline Measure Clip Store 20 21 28. Text / Annotation UD 1 UD 2 Print 29. Body Marker Freeze Store 30. Alphanumeric keyboard Control Panel Control Panel 20 Control Panel Workflow Controls Control Function Patient Opens the New Patient and Edit Patient Data page. Exam Opens / closes Exam Selection. Review Opens the page to review an exam, create a slide show or teaching file. Report Opens the report screen to view the results and close the study. Allows viewing of the patient studies, beginning a new exam, restarting an exam Browser and deleting studies. Config Opens menus for user customization of the system. Help Opens the user manual menu. Touch Pad 21 Action Result Activates functions assigned to the surrounding keys Tap Activates selected button on a form i.e., Reports page. Anchors caliper when measuring. Moves or changes on-screen functions such as a caliper or the color box Slide position Scrolls through a list i.e., thumbnails. Pinch and spread Changes the size of an on-screen function i.e., Doppler gate Control Panel Touch Screen 22 1 2 3 1. Mode indicators 2D PW xxxxxxxxxxx xxxx xx_xx_xxxx_xx_xx_xx x ACUSON 9 xxxx-xxxxxxxxxxxx 2. Patient banner VF13-5 Small Parts Physio Tx Power 100% 13 Settings MA 0,59 10 3. System status bar ASC 2 DTCE Low Dyn R 75 dB 4. Thumbnail panel THI 8.9 MHz 26 dB 45 tps Biopsy 5. Soft keys 4 << Steer Steer >> Touch pad 8 6. 12 7. Soft keys L/R Flip U/D Flip L U 8. Left Panel controls Trapezoid 9. Imaging parameters Dual 11 Print Clear Delete 10. Transducer orientation Update indicator Edge Focus MultiHertz Dyn R THI Gate Image Tx Power OTCE Map Presets Focus Min ... Adv: SieCl... Tint Po sitio 8.9 MHz 76 dB Po sition Po sition On 0 Gen n Parallel ... 11. Thumbnail editing tools 7 6 5 12. Doppler tracing 13. 2D reference image 23 Touch Screen Patient Exam 24 Patient Browser Press Browser 1 2 3 4 5 1. Show Files Patient Browser Show Falles 2 weeks old Source Macia [Ot] Lecal Disk Disk Space: 0.508267.458 Source Media Patient Browser Search 2. ₾ Queve Patient Last Name Date: from C2/05/2017 Patient ID search Clear search 3. Search Criteria 11 Study List Total Studies: 304) Rastart SE Patient Name Patient D Dataffime Clips/Images MB Archived 4. Search X Clove Study 82160/7917 12:13 Parlent B, 02.05.2017_11_48.59 02/05/201/ 11:48 16.0 ND 6 Parienta, 02 05 2017_11 46 45 02/05/2017 11:46 1.4 WD 5. Clear Search 6. Study List 7. Send 8. Output Device 9. Delete 10. Export, Import Export Delete Output Device Not Active Send 10 9 8 7 11. Navigation menu Patient Data 25 New Patient TIP Use Tab to move to the next field. Select Patient • An exam may begin without the patient Select New Patient TIP first being registered. The patient • information may be added at any time Enter data prior to the end of the exam. • Patient Data Patient Demographics Last Name Patient ID 02_01_2015_01_27.34 First Name Date of Birth DO MM / YYYY Me M Pre Suf Gender Male @ female @ Other Height cm BSA m Weight kc Exam Transducer VF10-5 Accession No. Exam CV Indication Select • OK Patient Exam Patient Exam 26 Patient Data Cont. Edit Patient Data To change the patient data entry fields, TIP select short or long form on the General 2 Select Patient Configuration page. • Select i Edit Patient Data • Begin a new exam or restart a previous Edit data TIP exam from the Patient Browser page. • Select • OK 27 Patient Exam 2D 28 Real-time / Post Processing Image Controls Feature Function DTCE (Dynamic TCE™ Tissue Reduces speckle and enhances tissue contrast Contrast Enhancement Settings are Low, Medium and High. Technology) Note: Available on live or frozen images. Adjusts number of gray shades displayed Dyn R Select up for a softer / grayer image. (Dynamic Range) Select down to increase contrast. Note: Available on live or frozen images. Processing curves that assign echo amplitudes to gray shades Map Maps A – G are from low to high contrast. Note: Available on live or frozen images. Colorizes the grayscale image Tint Select up or down to access tints from 0 – 15. Note: Available on live or frozen images. Adjusts orientation on image screen 29 U/D Flip (Up / Down flip) Select to switch between orientations [up(U) or down(D) and right(R) R/L Flip (Right / Left flip) or left(L)]. Note: Available on live or frozen image. Adjusts the scanning depth and magnifies the image Rotate clockwise / counter-clockwise to increase / decrease depth. Depth / Zoom Select to activate zoom. Press again to exit zoom. Note: Zoom available in live or frozen images. Clarify VE Decreases artifacts, increases contrast resolution and boundary (Clarify™ Vascular detection in structures with flow Enhancement (VE) Press to activate / deactivate. Technology) Note: Available on live imaging only. 2D 2D 30 Real-time Image Controls Feature Function 2D Image Width Narrows or enlarges the image area. Note: Available with curvilinear and phased-array transducers. Enhances contrast resolution and boundary detection Advanced SieClear™ Spatial Increase for more compounding. Compounding Decrease for less compounding. Note: Available on live image only. Settings are transducer and mode dependent. Biopsy Activates / deactivates on-screen guidelines for use with transducers compatible with needle guide attachments. Adjusts the scanning depth and magnifies the image 31 Rotate clockwise / counter-clockwise to increase / decrease depth. Press to activate zoom. Depth / Zoom Rotate to adjust the scanning depth or amount of image magnification. Press again to exit zoom. Note: Zoom available in live or frozen images. Manually adjusts gain / brightness at depth DGC Default all slide controls in the center. Note: Available on live image only. Displays two separately acquired images side-by-side Dual Select Dual to activate and toggle between images. Select the 2D to exit. Split Displays two live images side-by-side with and without color Doppler. Note: Available on live image only. 2D 2D 32 Real-time Image Controls Cont. Feature Function Sharpens the contours of a structure Increase for more sharpness. Edge Decrease for less sharpness. To deactivate, select zero. Note: Available on live image only. Adjusts the focal point Focus Rotate to move up / down and press to activate multiple focal zones. Note: Only available with certain transducers. Focal zones Changes the number of focal zones Image optimization presets Image Presets Select to view available image presets. Note: Available on live image only. Customizable in a user-defined exam only. LAg Feature Function 33 Balances between resolution and penetration MultiHertz (MultiHertz™ Multiple Use higher frequency to increase resolution. Frequency Imaging) Use lower frequency to increase penetration. Note: Available on live image only. Overall Gain Adjusts the overall brightness of the image. Frame averaging – determines the number of frames combined into the final image Persist Increase for more frame averaging. (Persistence) Decrease to demonstrate motion. To deactivate, select 0. Note: Available only on live imaging. 2D 2D 34 Real-time Image Controls Cont. Feature Function Balances line density (spatial resolution) and frame rate RS Increase to improve image detail. (Resolution / Speed) Decrease to improve frame rate. Note: Available on live imaging. Steers the Color ROI Allows steering of a linear image. Steer Toggle the Steer key left / right to steer. Note: Steering Angle is transducer dependent. Available only on linear transducers. THI Increases contrast and lateral resolution. Reduces noise and clutter (Tissue Harmonic Select to activate / deactivate. Imaging) Note: Available on live image only. Tx Power Allows adjustment of the power setting. L4g Feature Function 35 Displays linear or trapezoid image format Trapezoid Select to activate / deactivate. Note: Available on live image only. Available on linear transducers only. The location of the Soft keys is customizable in the Configuration menu. TIP The pathway is Config > Soft Keys. 2D Doppler 36 Color Doppler Controls Pulsed wave Doppler controls that can be adjusted during real-time imaging or on the frozen image. Feature Function Automatic trace and display of PW Doppler measurements Select to activate / deactivate. Auto Stats Select settings for data above, below or on both sides of the baseline. Note: Available on live or frozen image. The values are not entered into patient report. Adjusts the sensitivity of the Trace tool when in Auto Stats Sensitivity Increase for higher sensitivity. Choices are 1–7. Note: Available on live image only. Reverses the colors depicting forward and reverses flow in the color ROI and the color bar Invert Select to activate / deactivate. Note: Available on live or frozen image. LAg Selects a processing curve that assigns the velocity / velocity variance 37 (for Color) or flow amplitudes (for Power) to a range of colors Maps Maps choices are A – I. Note: Available on live or frozen image. Adjusts the scrolling speed of the Doppler spectrum Sweep Increase to display less cardiac cycles. Decrease to display more cardiac cycles. Note: Available on live or frozen image. Colorizes the Doppler spectrum Tint Select desired Tint from 0 – 11. Note: Available on live or frozen image. Doppler Doppler 38 Color Doppler Controls Controls shared by Color Doppler Energy (CDE), and Color Doppler Velocity (CDV) modes. Feature Function Color Display Removes the color box. Flow Optimizes flow settings for Low, Med and High flow states. MultiHertz Allows user selection of the frequency. Adjusts spatial averaging (smoothing) for color flow Increase for flow sensitivity. Smooth Decrease for color spatial resolution. Note: Available on live image only. Prioritizes the display of grayscale or color flow data Priority Increase for greater vessel color fill. Decrease to prioritize grayscale and less vessel color fill. Note: Available on live image only. Enters / exits color Doppler or adjusts overall color Doppler gain 39 C Press to activate / deactivate color Doppler mode. (Color Doppler) Rotate to increase / decrease color Doppler gain. Note: Available on live image only. CDE (Color Doppler Energy) Enters / exits color Doppler Energy (Power) Doppler mode. CDV (Color Doppler Enters / exits color Velocity (Directional) Doppler. Velocity) Enters / exits spectral Doppler or adjusts overall spectral Doppler gain CW Select to activate / deactivate. (Continuous Wave Select PW or CW to activate the strip. Doppler) Rotate or select to adjust overall spectral Doppler gain. Note: Available on live image only. Doppler Doppler 40 Spectral Doppler Controls Controls used during pulsed wave (PW) Doppler real-time imaging. Feature Function Adjusts angle correction Angle Press to cycle through 60 / 0 / 60° angle selections. Rotate to adjust values in 1° increments. Note: Available on live or frozen image. Adjusts number of gray shades displayed Dyn R Rotate clockwise for a softer / grayer spectrum. (Dynamic Range) Rotate counterclockwise for a greater contrast spectrum. Note: Available on live or frozen image. Displays Full Screen Doppler Full D Select to activate / deactivate. Note: Available on live or frozen image. LAg Adjusts sample volume size 41 Gate Increase / decrease to adjust size. Note: Available on live image only. Simult Displays both the 2D image and spectral tracing in real-time. Adjusts the PW Doppler angle Steer Toggle left / right to reverse the steering angle. Note: Available on live image only. Available only on linear transducers. Defines the interval for refreshing the 2D-mode image Update Rate Select Off, 1 sec, 2 sec, 4 sec, 8 sec or EOS (End Of Sweep). Note: Available on live image only. Volume Increases or decreases the audio of the spectral Doppler signal. Doppler Doppler 42 Spectral Doppler Shared Image Controls Controls that can be adjusted during real-time imaging or on the frozen image on the pulsed or continuous wave tracing. Feature Function Automatic trace and display of PW Doppler measurements Select to activate / deactivate. Auto Stats Select settings for data above, below or on both sides of the baseline. Note: Available on live or frozen image. Note: These do not enter into the patient report. Reverses the Doppler spectrum (negative values display above the baseline) Invert Select to activate / deactivate. Note: Available on live or frozen image. Selects a processing curve that assigns echo amplitudes to gray shades in 43 the Doppler spectrum Maps Select desired Map from A – H. Note: Available on live or frozen image. Adjusts the scrolling speed of the Doppler spectrum Sweep Increase to display less cardiac cycles. Decrease to display more cardiac cycles. Note: Available on live or frozen image. Colorizes the Doppler spectrum Tint Select desired Tint from 0 – 11. Note: Available on live or frozen image. To bypass the Doppler Cursor Mode or select Frequency or Velocity display, TIP select the desired behavior on the Display tab of the Configuration menu. Doppler Doppler 44 Shared Doppler Controls Real-time only controls shared by PW, continuous wave, CDE, and CDV modes. Feature Function Adjusts the range of flow velocities displayed above and below the baseline Baseline Move up / down to adjust the baseline of the active mode. Note: Available on live image only. Adjusts the wall filter Filter Select to adjust rejection of low frequency signals. Note: Available on live image only. MultiHertz Allows adjustment of the frequency. Adjusts the pulse repetition frequency (PRF) Scale Increase / decrease to adjust the PRF. Note: Available on live image only. Adjusts the PW Doppler angle or the color box 45 Steer Select left / right to reverse the steering angle. Note: Available on live image only. Available only on linear transducers. Customize the ACUSON P500 system Doppler behavior TIP on the Exam tab of the Configuration menu. Doppler Text / Body Markers 46 Text Feature Function Delete Line Deletes one line of text at the cursor. Delete Word Deletes the last word. Hide / Show Text Temporarily hides text. Home Positions the cursor at the home location. Set Home Position Sets default position for text cursor. Body Marker Feature Function Change Body Marker Changes the displayed body marker. 47 Text /Body Marker Measurements 48 Doppler Auto Trace 20 C Sedel tomber : 391537 SIEMENS ------ LMAY CV TE Fewer 500% MI 0.42 1. Acquire a spectral tracing. 6.3 MME 2. Press the Auto Stats soft key on the upper left of the monitor. Boch 3. Select Above, Below, or Both. 30 - 4.14 PS - 74.7 Cmin ED . 11.1 cm/s TAmax . 33.0 cmin T.Ansean a 19.3 craie TIP Auto Stats functions on a live or frozen image. Auto Stats measurements do not enter into the exam report. General Measurements 49 Feature Function Measure Launches calipers for both general and exam-specific measurements. X ... x Touch Pad Move, anchor, and edit caliper functions. Delete Removes one measurement starting with the last one performed. Delete all Removes all calipers. Measure- ments Measurements 50 General Measurements 20 Small Parts TE Fewer 509% 1. Select the button. ASC N x ... x OTCE Lew 2. The soft keys display on the bottom of the THI ES MHE 4 40 44 Fps monitor. 3. Swipe the touch pad to position the caliper and select Set or tap the touch pad to anchor. 4. Position the first caliper and select Set. DI # 8.3mm D - 4.6mm 5. Use the Edit button to toggle between calipers. 6. Select Set to anchor the second caliper. - - - TIP The calipers and active measurements display green. Exam-Specific Measurements 51 1. Press the button. x ... x 2. Select the desired measurement from the menu. 3. Place the caliper at the desired start location. 4. Select Set. 5. Select the Edit button to toggle between calipers. 6. Select Set to anchor the second caliper. 7. Select Print Store to enter the measurement into the patient report. Measure and enter information into the patient report from an TIP image in Review. This function only works with an open exam. Measure- ments Review 52 Feature Function Review Opens review on an exam in progress. Browser Opens a menu that allows selection of a saved exam. Return to Imaging Returns to real-time imaging. Select|Deselect Review Touch pad functions. Cine Touch pad functions. Play | Pause CINE Review 53 Cine review functions available during the exam and in Review. 1 2 11 1 60 Reset Set Start Rate 1 II 8 Set End Marker « » Marker 42 / 60 Save 3 4 5 6 7 9 10 12 1. Reset 7. Fast forward 2. First frame 8. Current frame 3. Set Start Marker 9. Set End Marker 4. Rate 10. Frame / Frame total 5. Rewind 11. Last frame 6. Stop / Start 12. Save Review Review 54 Creating a Slide Show = 1. From an active exam select Review 2. From a saved exam select Browser 3. Tap images for the slide show 4. Tap Slide Show 5. Stop or Start the slide show 6. Tap Exit to return to imaging Creating a Teaching File Adding Images to a Teaching File 55 1. From an active exam select Review 1. From an active exam select Review 2. From a saved exam select Browser 2. From a saved exam select Browser 3. Tap images for the teaching file 3. Select the teaching file 4. Tap Teaching File 4. Click on Append 5. Enter a name 5. Add images to the teaching file 6. Click on New Review Reports 56 Only entered, exam-specific measurements appear in the report. Feature Function Report Enters / exits Report page. Scrolling Touch pad allows scrolling through reports sections. Drawing on a Report Diagram To Delete Diagram 57 1. Select Report 1. Select Delete to erase the last area 2. Select xyz Description 2. Select Delete All to erase all drawn areas 3. Select Draw 4. Select Set 5. Use the pointer to draw TIP Drawing function is only available in the CV exam. Reports Reports 58 Edit a Report Deleting an Image in the Report 1. Select Results 1. Select image 2. Select either 2D or 3D measurements 2. Select Set 3. Select the value for editing 4. Enter new value Add an Image to the Report 1. Select Summary 2. Add comments in the text box 3. Select Load Comments to add preconfigured comments 59 Reports Export / Import 60 Send a Study 1. Select Browser 2. Select the exam 3. Select the Output Device 4. Click Send 5. The study appears in the (L Queue Import a Study 1. Select Browser 2. Select the Source Media Import a study only in DICOM format. 3. Select exams for import 4. Exams appear at [D:] Local Disk Image Export 61 1. Select Browser or Review Check the De-identify box to export TIP images and studies without patient 2. Select patient exam information. 3. Select images 4. Click Export 5. Select the format type 6. Select export destination 7. Click Export Export / Import The products / features mentioned in this document Images used in this guide are for educational purposes may not be commercially available in all countries. only. They have been modified or compressed and may Due to regulatory reasons their future availability not reflect the actual image quality of the system. cannot be guaranteed. Please contact your local Siemens organization for further details. ACUSON P500 Clarify, MultiHertz, SieClear, TCE and TEQ are trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Headquarters Legal Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen 22010 S.E. 51st Street Germany Issaquah, WA 98029, USA Phone: +49 9131 84-0 Phone: 1-888-826-9702 siemens.com/healthineers siemens-healthineers.com/ultrasound Order No. A91US-356-1C-4A00 | Printed in Germany | PS 4755 0617.X | © Siemens Medical Solutions USA, Inc., 2017