SkyVision Hybrid II Digital Integration System powered by

SkyVision Hybrid II Digital Integration System powered by TEC-R-0008 REV5 7/12 Pre-Installation Manual

SkyVision Installation Criteria Page 1 Introduction The SKYTRON SkyVision Hybrid II Digital Integration System is open architecture design based, therefore every installation can vary according to the specific equipment needs of the OR facility. What is common in all installations is that assorted video and data input sources are routed to various outputs such as displays, video recorders or networks providing communication and video conferences. This SkyVision Pre-Installation Manual will provide an overview of typical installation considerations and specific installation requirements associated with a SKYTRON SkyVision System. Only SKYTRON technicians are authorized to install a system. SkyVision technicians are SKYTRON trained and certified and possess all the tools necessary to successfully complete an installation. SkyVision installation teams consist of two or more technicians who coordinate with the hospital staff and local subcontractors to complete an installation. Technicians follow specific installation details mandated by the customer and specified in the SkyVision Order / Production / Installation (OPI) Form. SKYTRON supports SkyVision installations with thorough documentation, classroom training, and technical support. Environmental Requirements The SKYTRON SkyVision System must be located in a clean, dust free environment. Ambient room temperatures should be maintained between 60 and 75 Fahrenheit with non-condensing humidity between 20% to 50%. The SkyVision Hybrid II Digital Integration System components will generate up to 2900 BTU's/ hr. when fully equipped and under maximum load during peak operating times. Mechanical design of the SKYTRON SORIC system Nurse Documentation Center and Third Party provided Nurse Documentation Centers must address heating, ventilation and air conditioning (HVAC); humidification and dehumidification requirements in a manner consistent with desirable temperature and humidity ranges specific to SkyVision components. When installing the integration system within custom cabinetry or Nurse Documentation Center a minimum of 5cfm via a 12" sq. opening for constant return HVAC is required. This will allow the systems to operate within the equipment temperature specification of up to 90 F and ensure optimum long term performance and product life. Power Requirements The SKYTRON SkyVision System requires two 120VAC/20A dedicated circuits connected to the hospital critical power/generator backup power grid. One circuit is dedicated to the component rack and the second circuit is dedicated to the monitor power supplies. SkyVision Hybrid II features a battery back-up system that maintains system operation until the critical power/generator back-up system restores electricity to the power grid ensuring uninterrupted performance. The component rack generates 2900 BTUs per hour. Grounding Requirements The SKYTRON SkyVision System requires isolated ground AC power outlets. Isolated ground outlets provide enhanced protection from electromagnetic and radio frequency interference for the system's sensitive electronic instruments. The instrument rack requires a 10AWG braided ground wire terminated to an earth ground rod.

Page 2 Mounting Requirements The SKYTRON SkyVision System is offered in a single 30U wall mounted rack, that does NOT stand on the floor, or as part of a nurse documentation center (NDC) in two 12U racks. For wall mount installations it is the responsibility of the local contractor to provide sufficient backing/studs in the wall to support the minimum structural required rack load of 500 pounds. The contractor is required to install a 12 x12 x4 junction box that is the conduit termination housing for the mounting rack. See installation illustrations on pages 4 thru 7. Display Power Management The SKYTRON SkyVision System offers NDS Radiance displays and GDM Z3 displays that can be mounted to boom arms. There are two methods for providing power to either boom arm mounted display: 1. Mount the low voltage power supply onto the display bracket powered by a low leakage 120VAC power line run through the boom arm. 2. Place the low voltage power supply in a hospital provided NEMA 4 enclosure located in the ceiling or at the equipment rack and run the low voltage power line through the boom arm to the display. The remote location of the Z3 display power supply is limited to 75 feet (cable length) - P/N: MON-CBL-001 required. For Integration installations where the rack is within a 75 feet (cable length) of the display, the power supply can be located in the rack. If not, a NEMA 4 encased power supply in the ceiling is recommended (Supplied by others). The remote location of the NDS Radiance display power supply is limited to 30 (cable length) P/N: 90I0017 required and must be housed in a NEMA 4 enclosure in the ceiling (Supplied by others). The minimum size NEMA 4 enclosure for each supply is 14 L x 12 W x 7 H (L-Com Global Connectivity Model: NB1207-10FS-UL or equivalent). Appropriate power supplies and cables required for displays not provided by SKYTRON must be provided by the equipment vendor to meet the specific needs of the display location. Image/Video Capture Devices Although the SKYTRON SkyVision System offers a Digital Capture Streaming System (image/video capture device), some hospitals will maintain existing capture devices and cameras. When the capture device is located close to the camera, connections can be made by a short copper cable (provided by the Minimally Invasive Surgery (MIS) vendor). Typically, the capture device is located at the nurse s station, far from the camera. The appropriate cable between the camera and the capture device must be provided by the equipment vendor. The SkyVision system will process the capture device output signal, rather than the camera output signal (to maximize functionality), and route the output signal, as limited by the technology of the capture device. If a printer is used with this capture device, the cable between the capture device and the printer is supplied by the hospital or by the MIS vendor, if the printer was part of the purchase agreement.

Remote Trigger Image/Video Capture Page 3 Capture devices specific to endoscopic cameras allow the surgeon to capture images or video using the trigger on the camera. This method is limited to capturing only the camera source as the surgeon would need to have the camera in hand when capturing. This is not a standard option to integrate with SkyVision because of the many endoscopic vendors. Additionally, the SkyVision foot pedal option can be used to capture any source that is set as the "Capture Source" at the touch panel. The foot pedal is available as a wired or wireless model and can be found on the pricelist. If capturing endoscope images with the endoscope trigger is required, this must be specified by the sales representative as a "special" on the OPI documentation. The hospital must supply SKYTRON with the make and model number of the camera and capture device so SKYTRON can verify compatibility, proper operation, and provide the required items to quote. Keyboard/Mouse Switch One of the SKYTRON SkyVision System options available is a Keyboard/Mouse Switch (KM Switch - P/N OPC-307-KM). The KM Switch allows a single keyboard and mouse to control up to four PCs (one DCSS and three PCs) providing a simplified and neat appearing nurse station (as opposed to several keyboards and mice). When a DCSS is purchased in addition to the on-board PC, the KM Switch must be quoted. If the hospital uses their PCs instead of purchasing the SkyVision PCs, they may use their keyboard and mouse instead of the SkyVision keyboard and mouse. The hospital computer can be placed anywhere in the room with their keyboard, mouse, and monitor. If they would like to use the SkyVision keyboard and mouse, a KM Switch is required and the hospital PC must be located within ten feet of the rack. Remote Locations The stock cable length for a SKYTRON SkyVision System installation is 100 feet. If longer cable lengths are required, the length must be specified and quoted accordingly. Specific distance limitations for SkyVision components are listed in the SKYTRON H2 Maximum Distance Chart for Standard and Remote Mounting. http://skynet.skytron.us/products/skyvision2/datasheets%20%20general/h2%20maximum%20distance%20chart.pdf For installations requiring greater distances than listed, consult with the SkyVision Product Manager so the options can be specified and project details/requirements resolved.

Page 4 Wall Mounted (DWR 30-26) Overall Width 22⅝" (574mm) Overall Height 59⅜" (1513mm) Overall Depth 27½" (698mm) Weight Capacity Minimum Structural Requirements Mounting Hole Spacing 400 lbs. 500 lbs. 16" (406mm) Left-Hand Swing Cabinet Mounting Dimensions 22 5/8" 2 5/8" 6" MIN. CLEARANCE 6" MIN. CLEARANCE 22" MIN. CLEARANCE 22" MIN. 4 9/16" CLEARANCE 5 3/8" 5 3/8" 22 5/8" 2 5/8" 29 11/16 29 11/16 27 1/2" 4 9/16" 27 1/2" 90 90 90 20 7/16" 20 7/16" (5) Mounting Hole Locations 12 1/2 (5) Mounting Hole Locations 12 1/2 12 1/2 12 1/2 1 3/8" 29 11/16 29 11/16 59 3/8 59 3/8 90 1 3/8" 4" 4" Minimum Clearance: 6" from non-hinged side, 22" from hinged side, and 4" on top and bottom. Right-Hand Swing Cabinet Mounting Dimensions 22 5/8" 22" MIN. CLEARANCE 6" MIN. CLEARANCE 2 5/8" 2 5/8" 5 3/8" 22 5/8" 5 3/8" 4 9/16" 29 11/16 27 1/2" 29 11/16 12 1/2 90 20 7/16" (5) Mounting Hole Locations 12 1/2 12 1/2 59 3/8 29 11/16 12 1/2 90 29 11/16 1 3/8" 4" 1 3/8" 4"

Page 5 Left-Hand Swing Cabinet Mounting and Junction Box Location Right-Hand Swing Cabinet Mounting and Junction Box Location STUDS 16 ON CENTER STUDS 16 ON CENTER ¾ MOUNTING HOLES 16 ON CENTER MOUNTING HOLES 16 ON CENTER ¾ 27 1 /16 27 1 /16 12¼ 12¼ 59 3 /8 59 3 /8 33 11 /16 27 1 /16 27 1 /16 33 11 /16 12 x 12 ACCESS CUTOUT FLOOR 4 4

Page 6 Left-Hand Swing Installation with Junction Box Termination 12"x12"x4" Junction Box To Be Roughed-In By the Contractor. Mount the Power Outlets In Box As Shown. 10 AWG Green Stranded Ground Wire

Nurse Documentation Center Installation Page 7 Mount Power Outlets as Shown. Center of 12" x 12" x 4" Junction Box is Located 12" In From the Side and 15" Up From the Floor. Rear Cabinet to Cabinet Connections Require 15 Foot Long Cables. NOTE: If The Junction Box Must Be Located On This Side, The Contents of Each Must Be Switched. The Conduit Must Exit At the Digital Matrix Switch.

Page 8 Connection Requirements The SKYTRON SkyVision System connects multiple types of sources (VGA, DVI, SDI, HD-SDI or S-Video/ Composite) to the control rack through conduit runways exclusively over single strand multi-mode optical fibers via Conversion Boxes located near the source. The Conversion Boxes are installed in the boom arm equipment carriers or in double-gang electrical wall boxes depending on the location of the source. The Conversion Boxes convert a copper wire signal (digital or analog) to a fiber-optic digital signal and vice-versa. Low voltage power lines are the only other type of connection utilized to and from the SkyVision system. Copper wiring is only employed between components at the rear of the SkyVision control rack. The system can route any source up to six monitors within the operating room and up to two dedicated tracking monitors, based upon selections at the touch screen monitor located at the nurse documentation station. See Conversion Box / Electrical Box illustrations on page 10 and Conduit Drawings on page 11 and 12. Network Requirements Up to ten Static IP network drops are required for the following components and options (if installed), to enable full system funtion, configuration and diagnostics. One analog phone line is required for the audio conference option. Network Drops and Required Ports Required or w/option Device Lan Drop Location TCP Ports Required UDP Ports Required Notes Required AV2 Control System 80, 41794, 41795 Required DVPHD- Dual 80, 41794, 41795 Required GDMS1616 Digital Switch 80 w/option AUD-207 Biamp Nexia TC 12001 12000 w/option IMC-702 (tcp 80 only) IMC-703(the rest) w/option OPC-702-HD w/option OPC-702-HD w/option OPC-702-HD w/hospital provided HP Network Printer w/option POD-701 w/option PC-VC-008-S DCSS PC1 PC2 PC3 unless hospital provided PC and not at rack unless hospital provided PC and not at rack unless hospital provided PC and not at rack 80, 554, 7070, 10000, 11000 standard standard standard Network Printer Printer location standard ipod Control Station HD Video Conference Codec ipod Docking Station Location 41794 1503, 1720, 3230 to 3235, 3236 to 3253 6970 through 6999 160 min. 65 min. 1503, 3230 to 3235 The network must pass multicast addresses in the range of 239.192.0.0 to 239.193.0.0

Page 9 Required or w/option Analog Phone Line Drop Device Drop Location w/option AUD-207 Biamp Nexia TC Network Bandwidth Minimum Requirements (DCSS) Use the chart below to determine the minimum required bit-rate needed for the resolution and frame-rate desired. The bit-rate in kilo bits-per-second, defines the maximum bit-rate that the encoders may utilize in creating the media stream. The following table lists the minimum recommended bit-rates for high quality video. Capture Resolution 640 x 480 VGA Minimum Bit Rate Required Frame Rate Recording GB/Hr. DVD Capacity DVD Burn Time (Per/hour of video) 768 Kb/sec. 30 fps 0.33 720 min. 1 min. 46 sec. 800 x 600 SVGA 1024 x 768 XGA 1500 Kb/sec. 30 fps 0.66 415 min. 2 min. 10 sec. 3000 Kb/sec. 30 fps 1.32 215 min. 3 min. 9 sec. 720p 3500 Kb/sec. 30 fps 1.53 188 min. 3 min. 25 sec. 1280 x 1024 SXGA 4000 Kb/sec. 30 fps 1.75 160 min. 3 min. 42 sec. 1080p 10000 Kb/sec. 30 fps 4.4 65 min. 7 min. 3 sec. Remote Diagnostics Requirements The SKYTRON SkyVision System includes remote diagnostics which enables off-site system troubleshooting, system management and critical software updates to occur. It is the customers responsibility to provide virtual private network (VPN) access to accommodate system remote diagnostics.

Page 10 4" x 4" x 3½" Deep Double-Gang Electrical Wall Box RACO Model 256 or Equivalent Garvin 52181-S RACO 256 Single-Gang Mud Ring Conversion Box Installation

Page 11 5085 Corporate Exchange Blvd. S.E., Grand Rapids, MI 49512 20" CEILING COVER 9 NOTES: SKYVISION RACK REQUIRES A 12" SQ. x 4" DEEP BOX PER GDM SPEC. SUPPLIED CONTRACTOR. NETWORK CONNECTIONS INSTALLED TO RACK BY OTHERS. STRUCTURAL SUPPORT FOR SKYVISION RACK DESIGNED BY ENGINEER OF RECORDS TO SUPPORT 400LBS. LOAD. MOUNTING HARDWARE SUPPLIED BY OTHERS TO MEET SUPPORT REQUIREMENTS. 20" CEILING COVER 4 5 1 1 SAMPLE B A 20" CEILING COVER 20" CEILING COVER 9 SkyVision Powered By GDM ACME HOSPITAL CONDUIT DRAWING DESIGN BY: JON SELLECK DATE: 11-12-2009 REV.: A DRAWN BY: MIKE FRANKLIN SHEET #: 1 OF 1

Page 12 S YTRON HII S Y ISION REFERENCE CONDUIT SCHEDULE FINAL PLACEMENT IS DETERMINED BY THE ARCHITECT AND LOCATIONS IN THE DRAWING AND IN THE SCHEDULE ARE FOR REFERENCE ONLY Item ID Item Conduit Diameter Description Termination Location To *1 SkyVision Enclosure N / A SKYVISION ROUGH-IN 12" SQ. X 4" DEEP JUNCTION BOX SEE ROUGH-IN DETAIL n/a NETWORK CONNECTIONS ROUTE TO NETWORK PER HOSPITAL Hospital Network *2 *3 4 *5 *6 *7 8 *9 10 11 Touch Panel Skytron Light Camera Control Wall Source External Computer Wall Camera IP Camera Ceiling Mounted Equipment Wall Display Audio Package Microphone Shared 1.25" SHARED 2" 3/8" FLEX 3/8" FLEX Touch Panel, Keyboard, Mouse Light Cam Video to Light Cam Video from Camera Source Description PC Video PC Keyboard/Mouse Wall Camera Wall Cameral Control IP Camera Description of Mount Wall Display Ceiling Speakers 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING PER EQUIPMENT MANUFACTURER SAMPLE 4" SQ, x 3.5" DEEP BOX w/ 1 GANG P-RING Terminates to speakers per instructions Mic Stub out 12" BELOW FINISHED CEILING 12" BELOW FINISHED CEILING 12" BELOW FINISHED CEILING MOUNT ID 60" ABOVE FINISHED FLOOR FINISHED CEILING per Hospital FINISHED CEILING per Hospital Light Cam Mount Shares with vid to Shares with vid to Network *12 HP Network Printer HP Network Printer 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING Hospital Network *13 I POD dock I POD Control 4" SQ, x 2" DEEP BOX w/ 1 GANG P-RING Hospital Network Audio Shared 14 Other NOTE: * = power source required HII S Y ISION ELECTRICAL RE UIREMENTS Item ID A B C Item Device Power SkyVision Power Ground Lead Conduit Diameter Description Termination Location To N/A 120V, 20A Duplex PER ENGINEER Electrical N/A (2)120V,20A Dedicated Circuits PER ENGINEER SkyVision Junction Box Electrical N/A Network Connections PER ENGINEER Facility Ground

Installation Responsibility Overview Page 13 SKYTRON RESPONSIBILITIES 1. SKYTRON requires a minimum of 60 days delivery time from receipt of signed drawings and Order Production-Install (OPI) document for manufacturing of the proposed SkyVision System. 2. SKYTRON will provide customer with the appropriate signal cable and wiring for the system described in this proposal. 3. SKYTRON will provide customer with a suggested conduit layout drawing, as well as signal cable and wiring specifications for the system described in the proposal. 4. SKYTRON will provide the appropriate number of specialized technical staff to complete the cable terminations, equipment rack assembly, and testing of the completed SkyVision System. 5. 6. Installation per unit includes two (2) full days of clear access to each room for cable pulling and terminations, plus at least two (2) days for fitting of connectors, final system configuring, system power up, and complete system testing. Installation should take place on consecutive days and must be coordinated by customer representative. 7. Installation will include mounting the SkyVision rack if necessary. CUSTOMER RESPONSIBILITIES 1. Customer will provide SKYTRON with the appropriate room drawings to include Plan, Electrical, and Mechanical Drawings. 2. 3. 4. Customer will be responsible for supply and installation of all conduit and electrical junction boxes. Customer will be responsible for supply and installation of drywall and ceiling backing for installation of wall or ceiling equipment respectively. Customer will be responsible for supply and installation of appropriate Nurses Documentation Station. 5. Customer will provide SKYTRON with all customer provided equipment source signal specifications including signal output type, power requirements, and cable connector types. 6. Customer will provide SKYTRON with the dates for cable installation, boom and light installation, and agree on specific dates for SkyVision system installation. Notices for cable installation and system installation must be given no less than 21 days prior to start of work. 7. 8. At time of installation, all Customer provided systems & equipment must be in place and working in order for SKYTRON to complete system installation and testing. If customer provided systems are not in place and working during the SKYTRON installation, delays in the SkyVision installation may occur and result in additional daily charges of $1900.00 per day, per technician, to be added to the final invoice. If return trips are necessary due to lack of customer suppled equipment, additional charges may occur. Customer will assign a designated representative to coordinate installation schedules and approve the SkyVision installation within ten days of completion of work. Customer representatives from BioMed, IT, and the OR Director will sign off on completion, which will signal approval of final SKYTRON invoice.

5085 Corporate Exchange Blvd. S.E. Grand Rapids, MI 49512 1.616.656.2900 FAX 1.616.656.2906