In Reply:—
The completion of a preoperative checkout of anesthesia equipment is clearly supported by Datex-Ohmeda (Madison, WI). The authors state that the anesthesia system was checked in accordance with the protocol adopted by the safety subcommittee of the Singapore Society of Anaesthesiologists. However, Datex-Ohmeda believes that, if available, the anesthesia system’s specific preoperative checkout procedures should be used instead of generic guidelines. This is true both for the protocol adopted by the safety subcommittee of the Singapore Society of Anaesthesiologists and for the generic 1993 Food and Drug Administration Anesthesia Apparatus Checkout Recommendations. The Food and Drug Administration supports this position as described in their introduction to the Food and Drug Administration checkout, which states, “This is a guideline which users are encouraged to modify to accommodate differences in equipment design and variations in local clinical practice. Such local modifications should have appropriate peer review. Users should refer to the operator’s manual for the manufacturer’s specific procedures and precautions.” If the user had performed the preoperative checkout described in the Excel 210 SE Operation and Maintenance manual, the situation would have been identified before use.
