99-ROC-2002-Standard for Health Care Facilities Care Facilities Technical Correlating Committee ... (Chapter 3) Hugh O. Nash, Jr., Chair ... Peter Atkinson, Hyperbaric Technical &

Copyright 2001, NFPA

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Report of the Committee on

Health Care Facilities

Technical Correlating Committee (HEA-AAC)

John P. Swope, ChairDerwood, MD [SE]

Constance Bobik, B&E Fire Safety Equipment Inc., FL [IM]Jay Crowley, U.S. Department of Health/Human Services, MD[E]Marvin J. Fischer, Jamesburg, NJ [U]Thomas W. Gardner, Gage-Babcock & Associates, VA [U] Rep. American Health Care AssociationStanley Kahn, Tri-City Electric Company, Inc., CA [IM] Rep. National Electrical Contractors AssociationWilliam E. Koffel, Koffel Associates, Inc., MD [SE]Thomas A. Salamone, Health Care and Life Safety Concepts,NY [I] Rep. Kemper Insurance CompaniesSteven Werner, Marsh USA, Inc., WI [I]Mayer D. Zimmerman, U.S. Department of Health and HumanServices, MD [E]

Alternates

Sharon M. Stone, Koffel Associates, Inc, MD [SE] (Alt to W. E. Koffel)

Committee Scope: This Committee shall have primaryresponsibility for documents which contain criteria forsafeguarding patients and health care personnel in the delivery ofhealth care services within health care facilities: a) from fire,explosion, electrical and related hazards resulting either from theuse of anesthetic agents, medical gas equipment, electricalapparatus and high frequency electricity, or from internal orexternal incidents that disrupt normal patient care; b) from fireand explosion hazards associated with laboratory practices; c) inconnection with the use of hyperbaric and hypobaric facilities formedical purposes; d) through performance, maintenance andtesting criteria for electrical systems, both normal and essential;and e) through performance, maintenance and testing andinstallation criteria: 1) for vacuum systems for medical or surgicalpurposes, and 2) for medical gas systems.

Technical Committee on

Administration (HEA-ADM)(Chapters 1, 2, and 4)

Michael Crowley, ChairThe RJA Group, Inc., TX [SE]

James S. Davidson, Jr., Davidson Associates, DE [SE]August F. DiManno, Jr., Fireman’s Fund Insurance Company, NY[I]William C. McPeck, State of Maine Employee Health & Safety, ME[E]Thomas A. Salamone, Health Care and Life Safety Concepts, NY[I] Rep. Kemper Insurance Companies

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents on thescope, application, and intended use of documents under theHealth Care Facilities Project, as well as definitions not assigned toother committees in the Health Care Facilities Project.


Electrical Equipment (HEA-ELE)(Chapter 7 [new Chapter 8] and Chapter 9 [new Chapter 10])

Lawrence S. Sandler, ChairV. A. Medical Center, CA [U]

Saul Aronow, Waban, MA [SE]Robert A. Carlson, Hubbel Inc., CT [M] Rep. National Electrical Manufacturers AssociationYadin David, Texas Childrens Hospital, TX [U]Albert G. Garlatti, Intertek Testing Services NA Inc., MN [RT]Alan Lipschultz, Christiana Care-Health Services, DE [SE] Rep. Association for the Advancement of MedicalInstrumentationJames A. Meyer, Pettis Memorial VA Hospital, CA [C]

Rep. American Society of AnesthesiologistsJoseph P. Murnane, Underwriters Laboratories Inc., NY [RT]Mike Velvikis, High Voltage Maintenance Corporation, WI [IM] Rep. International Electrical Testing Association, Inc.Robert F. Willey, III, Siemens Medical Systems, Inc., NJ [M] Rep. Health Industry Manufacturers. Association

Alternates

Dale Woodin, American Society for Healthcare Engineering, IL [U] (Alt to T. Peglow)

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringthe maintenance, performance and testing of equipment for thepurpose of safeguarding patients and staff within patient care areasof health care facilities from the hazards of fire, explosion,electricity, nonionizing radiation, heat and electrical interference.


Electrical Systems (HEA-ELS)(Chapter 3)

Hugh O. Nash, Jr., ChairNash Lipsey Burch, LLC, TN [SE]

Robert A. Carlson, Hubbell Inc., CT [M] Rep. National Electrical Manufacturers AssociationDan Chisholm, Motor and Generator Institute, Inc., FL [IM]James H. Costley, Jr., Newcomb & Boyd Engineers, GA [SE]James L. Crawford, U.S. Department of Health & Human Service,WA [E]Herbert Daugherty, Middlesex County Utilities Authority, NJ [U] Rep. Electrical Systems AssociationAlbert G. Garlatti, Intertek Testing Services NA Inc., MN [RT]James W. Hillebrand, Byron Electric Company, KY [IM] Rep. National Electrical Contractors AssociationJames R. Iverson, Onan Corporation, MN [M]Edward A. Lobnitz, Tilden Lobnitz & Cooper Inc., FL [SE]Alfred J. Longhitano, Gage-Babcock & Associates Inc., NY [U] Rep. American Health Care AssociationJoseph P. Murnane, Underwriters Laboratories Inc., NY [RT]David K. Norton, U.S. Department of Veterans Affairs, DC [E]Ronald M. Smidt, Carolinas HealthCare System, NC [U] Rep. American Society for Healthcare EngineersHoward Stickley, U.S. Army Corps of Engineers, DC [U]Mike Velvikis, High Voltage Maintenance Corporation, WI [IM] Rep. International Electrical Testing Association Inc.Walter N. Vernon, IV, Mazzetti & Associates Inc., CA [SE]

Alternates

Lawrence A. Bey, Onan Corporation, MN [M] (Alt. to J. R. Iverson)Douglas S. Erickson, American Society for Healthcare Engineers,VI [U] (Alt. to R. M. Smidt)James Meade, US Army Corps of Engineers, MD [U] (Alt. to H. Stickley)Jeffrey L. Steplowski, U.S. Department of Veterans Affairs (183A),DC [E] (Alt. to D. K. Norton)Herbert V. Whitall, Electrical Generating Systems Association, FL[U] (Alt. to H. Daugherty) Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringperformance, maintenance and testing of electrical systems for thepurpose of safeguarding patients, staff and visitors within healthcare facilities.


Gas Delivery Equipment (HEA-GAS)(Chapter 2 [definitions] Chapter 8, 13 [moving some items to

Chapter 13] and 21)

Gerald L. Wolf, ChairSUNY/HCSB, Brooklyn, NY [C]

Rep. American Society of Anesthesiologists

M. Lee Bancroft, Beth Israel Deaconess Medical Center, MA [U]Jay Crowley, U.S. Department of Health and Human Services,MD [E]

NFPA 99 — November 2001 ROC — Copyright 2001, NFPA

179

Yadin David, Texas Childrens Hospital, TX [U]Gordon Earhart, HSB Professional Loss Control, TN [I]Richard E. Hoffman, Hoffman & Associates, Inc., KS [M] Rep. Compressed Gas AssociationAlan Lipschultz, Christiana Health Care Services, DE [SE] Rep. Association for the Advancement of MedicalInstrumentationGeorge Mills, MM EC, Limited, IL [U] Rep. American Society for Healthcare EngineeringDwight R. (DAK) Quarles, Institute of Exercise & EnvironmentalMedicine, TX [U]Jay R. Sommers, Kimberly-Clark Corporation, GA [M]

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents on theperformance, and maintenance criteria for safeguarding patientsand health care personnel from fire, explosion, electrical, andrelated hazards in anesthetizing locations involving theadministration of both flammable and nonflammable anesthetics,including equipment and facilities ancillary thereto; and theperformance, maintenance and testing of patient-related gasequipment for the purpose of safeguarding patients and staff withinhealth care facilities.


Health Care Emergency Preparedness and Disaster Planning (HEA-HCE)

(Chapters 2 and 11)

Russell Phillips, ChairRussell Phillips & Associates, Inc., NY [SE]

Pete Brewster, US Dept. of Vererans Affairs-EMSHG, IN [U]Steve Ennis, The Reciprocal Group, VA [I]Curt Fogel, Vaaler Insurance, Inc., ND [I]Joseph J. Gulinello, Integrated Security Solutions, NJ [SE]John P. Jarrett, New Paltz Nursing Home, NY [U] Rep. NFPA Health Care SectionYvonne M. Keafer, Sedgwick James of PA, Inc., PA [I]James C. Kendig, Jr. Health First, FL [U]James W. Kerr, M. R. Inc., MD [SE]David J. Kitchin, Milcare, AZ [M]William C. McPeck, State of Maine Employee Health & Safety, ME[E]Thomas A. Salamone, Health Care and Life Safety Concepts, NY[I] Rep. Kemper Insurance CompaniesW. Thomas Schipper, Kaiser Foundation Hospitals, CA [U] Rep. American Society for Healthcare EngrMichael L. Sinsigalli, Windsor Locks Fire Department, CT [E]Gregory E. Spahr, Loss Prevention Services, Inc., CA [SE]Robert J. Stone, Acordia of Cincinnati, Inc., OH [I]Clevis T. Svetlik, Marsh USA, Inc., OH [I]Steven Vargo, Raritan Bay Medical Center, NJ [U]Ronald W. Woodfin, TetraTek, Inc., TX [SE]

Alternates

A. Richard Fasano, Russell Phillips & Associates Inc., CA [SE] (Alt. to R. Phillips)Susan B. McLaughlin, SBM Consulting Limited, IL [U] (Alt. to W. T. Schipper)Richard C. Ryan, TetraTek, Inc., TN [SE] (Alt. to R. W. Woodfin)

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringthe performance of health care facilities under disaster conditions.


Hyperbaric and Hypobaric Facilities (HEA-HYP)(Chapter 19 and NFPA 99B)

Wilbur T. Workman, ChairWorkman Hyperbaric Services, Inc., TX [SE]

Peter Atkinson, Hyperbaric Technical & Nurses Associates Inc.,Australia [U]Harold D. Beeson, NASA Johnson Space Center, NM [RT]

Dave DeAngelis, U.S. Navy - Naval Facilities ESCECD, VA [E]William H. L. Dornette, Kensington, MD [SE]Christy Foreman, U.S. Department of Health & Human Service,MD [E]William C. Gearhart, University of Pennsylvania, PA [U]W. T. Gurnée, Oxy Heal Health Group, CA [M]Robert W. Hamilton, Hamilton Research Limited, NY [M]Eric P. Kindwall, Medical College of Wisconsin, WI [U]Carolyn Land, Curative Health Services, AZ [U] Rep. Baromedical Nurses AssociationMichael D. Martin, Ford Motor Company, MI [U]Barry Newton, Wandell Hull & Associates, NM [SE]Stephen D. Reimers, Reimers Systems, Inc., VA [M]Thomas A. Salamone, Health Care and Life Safety Concepts, NY[I] Rep. Kemper Insurance CompaniesRobert F. Schumacher, Nth Systems Inc., NC [M]J. Ronald Sechrist, Sechrist Industries, CA [M]Paul J. Sheffield, International ATMO, Inc., TX [U]John Steven Wood, Hyperbaric Oxygen, Inc., TX [SE]

Alternates

Greg Godfrey, Sechrist Industries, Inc., CA [M] (Alt. to J. R. Sechrist)Robert B. Sheffield, Wound Care Group, TX [U] (Alt. to P. J. Sheffield)Ellen C. Smithline, Baystate Medical Center, MA [C] (Alt. to C. Land)Joanna H. Weitershausen, U.S. Department of Health & HumanServices, MD [E] (Alt. to C. Foreman)Harry T. Whelan, Medical College of Wisconsin, WI [U] (Alt. to E. P. Kindwall)Larry L. Wischhoefer, Reimers Systems Inc., WA [M] (Alt. to S. D. Reimers)

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringthe construction, installation, testing, performance andmaintenance of hyperbaric and hypobaric facilities for safeguardingstaff and occupants of chambers.


Laboratories (HEA-LAB)(Chapters 2, 10, and 13)

Susan B. McLaughlin, ChairSBM Consulting, Limited, IL [U]

Rep. American Society for Healthcare Engineering

James F. Barth, FIREPRO, Inc., MA [SE]John Francis Capron, III, The Cleveland Clinic Foundation, OH[U]Ulrich M. Lindner, Earl Walls Associates, CA [SE]John P. McCabe, National Institutes of Health, MD [E]Thomas A. Salamone, Health Care and Life Safety Concepts, NY[I] Rep. Kemper Insurance CompaniesJosephine Simmons, U.S. The Health Care FinancingAdministration, MD [E]James O. Wear, U.S. Department of Veterans Admin. MedicalCenter, AR [U] Rep. NFPA Health Care Section

Alternates

Carol Jacobson, Ohio State Univ. Medical Center, OH [U] (Alt. to S. B. McLaughlin)Judith A. Yost, U.S. Department of Health and Human Services,MD [E] (Alt. to J. Simmons)

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringthe maintenance of equipment and environment for the purpose ofsafeguarding patients, visitors and staff within laboratories in healthcare facilities.


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Piping Systems (HEA-PIP)(Chapter 2 [definitions] and Chapter 4)

Douglas S. Erickson, ChairAmerican Society for Healthcare Engr, VI [U]

Rep. American Society for Healthcare Engr

Mark W. Allen, Beacon Medical, NC [M]M. Lee Bancroft, Beth Israel Deaconess Medical Center, MA [U]David L. Brittain, PROVAC, OH [M]Sidney L. Cavanaugh, United Association ofJourneymen/Apprentices of Plumbing/Pipe Fitters, CA, [L]James S. Davidson, Jr., Davidson Associates, DE [SE]Sharon Day, Pittsboro, NC [SE] Rep. EnviroGuardPeter Esherick, Patient Instrumentation Corporation, PA [RT]P. L. Fan, American Dental Association, IL [U]Michael Frankel, Utility Systems Consultants, NJ [SE] Rep. American Society of Plumbing EngineersRichard E. Hoffman, Hoffman & Associates, Inc., KS [M] Rep. Compressed Gas AssociationDavid Eric Lees, Georgetown University Medical Ctr., DC [C] Rep. American Society of AnesthesiologistsRichard L. Miller, Medical Gas Technology Inc., SC [RT]David B. Mohile, Medical Engr Services, Inc., VA [RT]Thomas J. Mraulak, Metropolitan Detroit Plumbing Ind. TrainingCtr., MI [L] Rep. American Society of Sanitary EngineeringFred C. Quarnstrom, Seattle, WA [U] Rep. American Dental AssociationRon Ridenour, National ITC Corporation, CA [L] Rep. Piping Industry Progress and EducationE. Daniel Shoemaker, MDS Matrix, AZ [M]Ronald M. Smidt, Carolinas HealthCare System, NC [U] Rep. NFPA Health Care SectionEdward K. Stevenson, LMG Property Engineers, MA [I] Rep. The Alliance of American InsurersJ. Richard Wagner, Poole & Kent Company, MD [IM] Rep. Mechanical Contractors Association of America, Inc.Craig B. Williams, Hill-Rom, GA [M]

Alternates

Dale J. Dumbleton, National ITC Corporation, LA [L] (Alt. to R. Ridenour)David D. Eastman, Metro Detroit Plumbing Industry TrainingCenter, MI [L] (Alt. to T. J. Mraulak)David Esherick, Patient Instrumentation Corporation, PA [RT] (Alt. to P. Esherick)Robert A. Ferdig, Nellcor/Puritan-Bennett Corporation, KS [M] (Alt. to R. E. Hoffman)Christopher R. Gossett, Squire-Cogswell Company, IL [M] (Voting Alt. to Squire-Cogswell Rep.)Michael J. Lynam, Porter Instrument Company, Inc., PA [M] (Voting Alt. to IAS Rep.)James A. Meyer, Pettis Memorial VA Hospital, CA [C] (Alt. to D. E. Lees)Sharon Stanford, American Dental Association, IL [U] (Alt. to P. L. Fan)Christopher P. Swayze, The Sherman Engineering Company, PA[M] (Alt. to M. W. Allen)Dale Woodin, American Society for Healthcare Engineering, IL[U] (Alt. to D. S. Erickson)

Committee Scope: This Committee shall have primaryresponsibility for documents or portions of documents coveringthe performance, maintenance, installation, and testing of medicaland dental related gas piping systems and medical and dentalrelated vacuum piping systems

Staff Liaison: Craig H. Kampmier

These lists represent the membership at the time each Committee wasballoted on the text of this edition. Since that time, changes in themembership may have occurred. A key to classifications is found at thefront of this book. The Report of the Committee on Health Care Facilities ispresenting two Reports for adoption, as follows:

The Reports were prepared by the:

• Technical Correlating Committee on Health Care Facilities(HEA-AAC)• Technical Committee on Administration (HEA-ADM)• Technical Committee on Electrical Equipment (HEA-ELE)• Technical Committee on Electrical Systems (HEA-ELS)• Technical Committee on Gas Delivery Equipment (HEA-GAS)• Technical Committee on Health Care EmergencyPreparedness and Disaster Planning (HEA-HCE)• Technical Committee on Hyperbaric and Hypobaric Facilities(HEA-HYP)• Technical Committee on Laboratories (HEA-LAB)• Technical Committee on Piping Systems (HEA-PIP)

Report I: This Report on Comments was prepared by theTechnical Committee on Health Care Facilities, and documents itsaction on the comments received on its Report on Proposals onNFPA 99, Standard for Health Care Facilities, 1999 edition, aspublished in the Report on Proposals for the 2001 NovemberMeeting.

This Report has been submitted to letter ballot of the individualTechnical Committees. The results of the balloting, aftercirculation of any negative votes, can be found in the report.

This Report has also been submitted to letter ballot of theTechnical Correlating Committee on Health Care Facilities , whichconsists of 10 voting members; of whom 9 voted affirmatively and 1ballot was not returned (Crowley).

Report II: This Report on Comments was prepared by theTechnical Committee on Hyperbaric and Hypobaric Facilities ,and documents its action on the comments received on its Reporton Proposals on NFPA 99B, Standard for Hypobaric Facilities ,1999 edition, as published in the Report on Proposals for the 2001November Meeting.

This Report on Comments has been submitted to letter ballot ofthe Technical Committee on Hyperbaric and Hypobaric Facilities ,which consists of 19 voting members. The results of the balloting,after circulation of any negative votes, can be found in the report.

This Report on Comments has also been submitted to letterballot of the Technical Correlating Committee on Health CareFacilities which consists of 10 voting members; of whom 8 votedaffirmatively, and 2 ballots were not returned (Crowley, Gardner).


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NFPA 99

(Log #126)Committee: HEA-PIP

99- 1 - (Entire Document): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-7RECOMMENDATION: The Technical Correlating Committeedirects that the primary units of measure be in SI units and thatconversion to english units be provided in parentheses.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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(Log #127)Committee: HEA-ADM

99- 2 - (Chapter 1): Accept in PrincipleSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: It was the action of the TechnicalCorrelating Committee to direct the Technical Committee toinclude "areas not addressed" and refer the user to a locationwhere the information can be found.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept in Principle.Revise as follows: 1.1.4.1 (c) "... fire protection signaling systems are covered inNFPA 72, National Fire Alarm Code, except..." 1.1.4.1 (d) "...fire pumps are covered in NFPA 20, Standard forthe Installation of Stationary Pumps for Fire Protection, except..." 1.1.5.1 Requirements for portable compressed gas systems arecovered in Chapter 9. The chapter does not apply to portablecompressed gas systems. 1.1.9.1* Areas Not Addressed. This chapter does not apply tospecial atmospheres, such as those encountered in hyperbaricchambers. A.1.1.9.1 See chapter 20, "Hyperbaric Facilities" (existing A-8-1.4,and ...Chapter 19.) 1.1.11.1 "Areas Not Addressed. This section is not intended tocover hazards resulting from : the misuse of: 1.1.14. "in health care facilities. Requirements for specific healthcare facilities are addressed in the following chapters: (a) Hospitals-Chapter 13 (b) Nursing Homes-Chapter 17 (c) Limited care facilities-Chapter 18 1.1.14.1 Areas Not Addressed. As defined in Chapter 3: (a) Hospitals (b) Nursing Homes (c) Limited care facilitiesCOMMITTEE STATEMENT: The Committee retains the existing"not addressed" text when there is either nothing to specificallyreference, or the sources are too numerous. The intent is to clarifythe parameters of scope. Modifications are made to subsectionsfor the purpose of clarification and in accomplishing the TechnicalCorrelating Committee's direction.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 3 - (Chapter 1): TCC NOTE: This action is put on "Hold", and will be processedas a proposal in the next revision cycle pursuant to NFPARegulations Governing Committee Projects 4-4.7.2, and 4-3.5. Thisrequirement has to be reviewed in a forum where the stakeholders,including those working in this area are involved, and all of the

NFPA 99 technical committees are involved in the review. Acorrelating committee task group will provide a preliminary reportto the Correlating Committee in Fall 2002.SUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Add after first sentence, a new sentence:This scope also applies to veterinary facilities. SUBSTANTIATION: We must also safe guard the health carepersonnel who are giving care to animals. In NFPA 99 12-4.1.1.1and in TCC scope of HEA-AAC they refer to safe guarding healthcare personnel from "...fire... and related hazards associated withthe administration of inhalation anesthetics."COMMITTEE ACTION: Accept in Principle.Add text to read as follows: 1.1.1 This scope also applies to veterinary facilities, for theprotection of staff from hazards associated with piped gas andvacuum systems. COMMITTEE STATEMENT: The Committee sees the need for aminimum level of safety for veterinary facility staff working withpiped gas and vacuum systems.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 4 - (1-1): Accept in Principle TCC NOTE: See Technical Correlating Committee Note onComment 99-3 (Log #32)SUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-10RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: We must protect the veterinarian and hisassistants from fire, explosion, electrical, and related hazardsassociated with the administration of inhalation anesthetics. Re thecommittee statement-must we have a loss before we add somethingto the standard?COMMITTEE ACTION: Accept in Principle.COMMITTEE STATEMENT: See Committee Actions in Comment99-3 (Log #32), and Committee Comments 99-7 (Log #CC300), 99-216 (Log #CC301) and 99-9 (Log #CC302).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 5 - (1-1.4.1(b)): Reject TCC NOTE: The action of the Technical Committee is accepted.It was the action of the Technical Correlating Committee to directthe Technical Committee to review and revise section 1.1.4.1pursuant to the Manual of Style, next cycle.SUBMITTER: Burton R. Klein , Burton Klein AssociatesCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Move sentence 2 ("The alternate source ofemergency power . . . essential electrical system.") to Chapter 3,Electrical Systems.SUBSTANTIATION: 1. Section 1.1 covers ‘Scopes.’ Sentence 2 isa requirement and not a scope statement. 2. Sentence 2 is a requirement that is covered in Chapter 3 ofNFPA.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Submitter was not specific on wherethe paragraph should be located, pursuant to NFPA RegulationsGoverning Committee Projects, Section 4-4.5.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 6 - (1-1.4.1(c)): Reject TCC NOTE: See Technical Correlating Committee Note onComment 99-5 (Log #2).SUBMITTER: Burton R. Klein , Burton Klein AssociatesCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: 1. Revise (c) to read: "Requirements forfire protection signaling systems. 2. Add to Chapter 3, Electrical Systems, the following: "Thealternate power source for fire protection signaling systems shall bethe essential electrical systems."SUBSTANTIATION: 1. Section 1.1.4.1 is titled ‘Areas notcovered.’ Wording includes requirements. 2. Subject of emer. power for fire protection signaling systemsbelongs in Chapter 3.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Submitter was not specific on wherethe paragraph should be located, pursuant to NFPA RegulationsGoverning Committee Projects, Section 4-4.5.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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(Log #CC300)Committee: HEA-ADM

99- 7 - (1.1.5): Accept TCC NOTE: See Technical Correlating Committee Note onComment 99-3 (Log #32).SUBMITTER: Technical Committee on AdministrationCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Add the following paragraph to 1.1.5: (e) Gas and vacuum systems used within veterinary facilities.SUBSTANTIATION: For consistency with the Committee's Actionon Comment 99-3 (Log #32).COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 8 - (1-1.11.1(c)): AcceptSUBMITTER: Burton R. Klein , Burton Klein AssociatesCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Move sentence "Although it deals with . .. of these materials." To Appendix A or Annex A in new format.SUBSTANTIATION: 1. Section 1.1.11.1(c) lists ‘Areas notcovered.’ Sentence is explanatory in nature. 2. Appendix A is location for explanatory material.COMMITTEE ACTION: Accept.Move the following sentence to the annex: 1.1.11.1(c)*Although it deals primarily with hazards related tofires andexplosions, many of the requirements to protect against fire orexplosion, such as those for hood exhaust systems, also serve toprotect persons from exposure to nonfire health hazards of thesematerials. A.1.1.11.1(c) to read as follows: A.1.1.11.1(c) Although it deals primarily with hazards related tofires andexplosions, many of the requirements to protect against fire orexplosion, such as those for hood exhaust systems, also serve toprotect persons from exposure to nonfire health hazards of thesematerials. NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 9 - (1-1.15 (New) ): Accept TCC NOTE: See Technical Correlating Committee Note onComment 99-3 (Log #32).SUBMITTER: Technical Committee on AdministrationCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Add a new 1.1.15 to read as follows: Chapter 15 Veterinary Facilities addresses the requirements forthe safe use of gas and vacuum systems for veterinary facilities.SUBSTANTIATION: The scope clarifies the committee's intent inthe acceptance of Comment 99-3 (Log #32) in protecting veterinaryfacility staff.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 10 - (2-2): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-22RECOMMENDATION: Accept in principle.SUBSTANTIATION: Since there is no printed definitions ofLevels 1-4 except 3 the submitter didn’t know correct wording touse. Can’t the committee supply wording here?COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Proposal 99-22 did not propose anylanguage, therefore the only option available to the TechnicalCommittee was to reject. Section 4-3.5.1, last sentence givesdirection on how to process the proposals with missinginformation or no recommendation.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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(Log #34)Committee: HEA-GAS

99- 11 - (2-2): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-15RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: In "Health Facilities Management"magazine, January 2001, Under "Codes and Standards" "SneakPreview a Look at the 2001 Edition of AIA’s Guidelines". Theymake reference to "Class B or Class C Sedation" under"Ambulatory Care Facilities" Paragraph 3. Upon investigation, Ihave learned that Class B sedation patients will have minor ormajor anesthesia but will respond to commands and that Class Csedation patient will have general anesthesia that will render themincapable of responding to commands. Since anesthetics otherthan inhalation anesthetics can render a patient to be incapable ofresponding to commands, the areas where these anesthetics areused should have the same safe guards that are afforded to patientsthat are using inhalation anesthetics.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The term is considered for itsapplication in an oxygen enriched atmosphere [OEA], and not forits mobility or response inhibiting characteristics.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 ABSTENTION: 1 NOT RETURNED: 1 CrowleyEXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 12 - (2-2): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-16RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: See statement of problem and substantiationfor comment under Proposal 99-15.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The scope of this committeepertains to gas delivery equipment, and therefore inhalation agents.Focusing on other agents would be a significant change in scope.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 ABSTENTION: 1 NOT RETURNED: 1 CrowleyEXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 13 - (2-2): TCC NOTE: The Technical Committee's action is rejectedpursuant to NFPA Regulations Governing Committee Projects 4-4.7.1, and refers to the action of 99-361 Log #129.SUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-17RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: This committee MUST address theconfusion terminology. What is a "Clinic". Different people, businesses, legal entitiesdiffer as to what is a clinic. NFPA should get a standard definitionfor each entity i.e.: hospital, clinic, out patient surgery, etc. andabide by that.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 14 - (2-2): AcceptSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-24RECOMMENDATION: Modify text as follows: <5 mg/m 3 at normal atmospheric pressure of particulate at 1micron size or greater. SUBSTANTIATION: See Committee Action on Proposal 99-23.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: Increasing the allowable level of particulate matterin a drug delivery system in order to make the particulate test easyfor the system verifier is the wrong reason to change the standard.The present standard allows an almost zero level of particulatematter. This is a safe level especially when compared to the FDA's1978 Good Manufacturing Practices Regulations (cGMP) and 1996Quality System Regulations for drug delivery systems, and FederalRegulations 21 CFR 210 & 211 and 21 CFR 820 which allows for nocontamination of the drug product in the drug delivery system.The NFPA should not be specifying particulate contaminationlevels for drug delivery systems, especially if the only reason is tomake the test easy for the verifier.

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99- 15 - (2-2): AcceptSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-29RECOMMENDATION: Revise text to read as follows: "Patient Care Area (b) Critical Care Areas. Critical care areasare those special care units, intensive care units, coronary careunits, angiography laboratories, cardiac catheterizationlaboratories, delivery rooms, operating rooms, postanesthesiarecovery rooms, emergency departments, and similar areas inwhich patients are intended to be subjected to invasive proceduresand connected to line-operated, patient-care-related electricalappliances."SUBSTANTIATION: Postanesthesia recovery rooms andemergency rooms were added in the 1999 edition. The TechnicalCorrelating Committee has directed the term emergencydepartment be used.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 16 - (2-2): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-22RECOMMENDATION: The Technical Correlating Committeedirects that the committee action be changed to Accept InPrinciple pursuant to the action on 99-20 (Log #CP710).SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Proposal 99-22 did not propose anylanguage, therefore the only option available to the TechnicalCommittee was to reject. Section 4-3.5.1, last sentence givesdirection on how to process the proposals with missinginformation or no recommendation.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 17 - (2-2): AcceptSUBMITTER: Technical Committee on AdministrationCOMMENT ON PROPOSAL NO: 99-14RECOMMENDATION: Revise text to read as follows: Health Care Facilities. Buildings or portions of buildings inwhich medical, dental, psychiatric, nursing, obstetrical, or surgicalcare are provided. Health care facilities include, but are notlimited to, hospitals, nursing homes, limited care facilities, clinics,medical and dental offices, and ambulatory health care centers,whether permanent or movable. (ADM)SUBSTANTIATION: Editorial parallelism.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 18 - (2-2, 4-4, 12-3.4, Chapter 13, 16-3.4, 17-3.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-29RECOMMENDATION: The Technical Correlating Committeedirects that the recommended text be reconsidered by theapplicable Technical Committee and consider the followingrecommendations: Paragraph 2: "...emergency rooms departments ..." to beconsistent with current nomenclature. Paragraph 3: "Note: For the purpose..." Delete Note per Manualof Style. The Technical Correlating Committee refers paragraph 3 2 to theTechnical Committee on Administration for review and comment.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 19 - (2-2 Ambulatory Health Care, Free Standing BirthingCenter, Hospital Facility, Hyperbaric, Hypobaric, Limited CareFacility ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-14RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that the Technical Committee review twodefinitions for stylistic continuity or parallelism. In the firstparagraph, "Hospital Facility" delete "facility." In the secondparagraph, "Ambulatory Health Care", insert the word "Center"after "Ambulatory Health Care."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise text to read as follows: Ambulatory Health Care Center . A building or portion thereofused toprovide services or treatment simultaneously to four or morepatients that (1) provides, on an outpatient basis, treatment forpatients that renders the patients incapable of taking action for self-preservationunder emergency conditions without the assistance ofothers; or (2) provides, on an outpatient basis, anesthesia thatrenders the patients incapable of taking action for self-preservationunder emergency conditions without the assistance of others.Free Standing Birthing Center. A facility in which low-risk birthsare expected following normal, uncomplicated pregnancies, and inwhich professional midwifery care is provided to women duringpregnancy, birth, and postpartum. Hospital Facility . A building or portion thereof used on a 24-hourbasis for the medical, psychiatric, obstetrical, or surgical care offour or more inpatients.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 20 - (2-2 Clinic): Accept TCC NOTE: The Technical Correlating Committee acknowledgesthat "clinic" is contained in "Comment 99-13 (Log #36), andrecognizes the final action of the Technical Committee onAdministration to delete clinic.SUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-17RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Administrationfor review and comment.

SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Action on Proposal99-18 (334a).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 21 - (2-2 Compressed Air System, Gas Powered System, Level 1Medical Piped Gas and Vacuum Systems, Level 2 Medical PipedGas and Vacuum Systems, Level 3 Piped Gas Systems, Level 3Vacuum System): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-20RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Administrationfor review and comment.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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(Log #132a)Committee: HEA-ADM

99- 22 - (2-2 Various Definitions, 4-4, 12-3.4, Chapter 13, 16-3.4, 17-3.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-29RECOMMENDATION: The Technical Correlating Committeedirects that the recommended text be reconsidered by theapplicable Technical Committee and consider the followingrecommendations: Paragraph 2: "...emergency rooms departments ..." to beconsistent with current nomenclature. Paragraph 3: "Note: For the purpose..." Delete Note per Manualof Style. The Technical Correlating Committee refers paragraph 3 2 to theTechnical Committee on Administration for review and comment.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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(Log #CC314)Committee: HEA-ELE

99- 23 - (Chapter 3): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-2RECOMMENDATION: Revise definitions pursuant to MOSrequirements for clarity and format: Appliances: Utilization equipment, generally other thanindustrial, normally built in standardized sizes or types , that isinstalled or connected as a unit to perform one or more functions.such as clothes washing, air conditioning, food mixing, deepfrying, etc.


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Accept the NFPA 70 preferred, but replace which with that , anddelete the examples which are misleading for medical. Critical Care Area: STET. Direct Electrical Pathway to the Heart.* An externalizedconductive pathway, insulated except at its ends, one end of whichis in direct contact with heart muscle while the other is outside thebody and is accessible for inadvertent or intentional contact withgrounded objects or energized, ground-referenced sources. (EE) Physiologically there is more than one heart muscle, and thisaccurately reflects the intent and meaning desired by the T/C. Double-Insulated Appliances.Appliances having an insulationsystem comprising both basic insulation necessary for thefunctioning of the appliance and for basic protection againstelectric shock and supplementary insulation. The supplementaryinsulation is independent insulation provided in addition to thebasic insulation to ensure protection against electric shock in caseof failure of the basic insulation. (EE) Revise to read as follows: Double-Insulated Appliances.* Appliances where the primarymeans of protection against electrical shock is not grounding. Theprimary means is by the use of combinations of insulation andseparation spacings in accordance with an approved standard. A.3.3 Double-insulated appliances can be identified by a symbolconsisting of a square within a square, or wording such as "double- insulated" marked on the appliance. Appliance packaging anddocuments may also provide identification. Although double- insulated appliances do not require a third wire or pin, somedouble insulated appliances have a third conductor or pin solelyfor purposes of electro-magnetic compatibility (EMC). Electrode. An electrically conductive connection to a patient.Some electrodes of interest are: (EE) Active Electrode. An electrode intended to generate a surgical orphysiological effect at its point of application to the patient. (EE) Bipolar Electrode. An electrode consisting of adjacent contacts(e.g., the two legs of a forceps) such that the high-frequencycurrent passes between the pair of contacts generating the surgicalintended effect. (EE) Dispersive Electrode. An electrode intended to complete theelectrical path between patient and appliance and at which nosurgical effect is intended. It is often called the "indifferentelectrode," the "return electrode," the "patient plate," or the"neutral electrode." (EE) Change as follows: Dispersive Electrode. An electrode, intended to complete theelectrical path between patient and appliance and at which nosurgical effect is intended. This electrode is often called the "thegrounding electrode" , "indifferent electrode," the "returnelectrode," the "patient ground plate," or the "neutral electrode." Equipment Grounding Bus. A grounding terminal bus in thefeeder circuit of the branch circuit distribution panel that serves aparticular area. (EE) Exposed Conductive Surfaces. Those surfaces that are capable ofcarrying electric current and that are unprotected, uninsulated,unenclosed, or unguarded, permitting personal contact. (EE) Failure.* An incident that increases the hazard to personnel orpatients or that affects the safe functioning of electric appliances ordevices. (EE) Frequency.* The number of oscillations, per unit time, of aparticular current or voltage waveform. The unit of frequency is thehertz. (EE) General Care Area. See definition of Patient Care Area. STET Impedance.* Impedance is the ratio of the voltage drop across acircuit element to the current flowing through the same circuitelement. The unit of impedance is the ohm. (EE) Isolated Patient Lead. A patient lead whose impedance to groundor to a power line is sufficiently high that connecting the lead toground, or to either conductor of the power line, results in currentflow below a hazardous limit in the lead. (EE) Leakage Current. Any current, including capacitively coupledcurrent, not intended to be applied to a patient, that is conveyedfrom exposed metal conductive parts of an appliance to groundor to other accessible parts of an appliance. (EE) Patient Care Area. Any portion of a health care facility whereinpatients are intended to be examined or treated. (a)* General Care Areas. General care areas are Patient bedrooms, examining rooms,treatment rooms, clinics, and similar areas in which it is intendedthat the patient will come in contact with ordinary appliances suchas a nurse-call system, electric beds, examining lamps, telephones,and entertainment devices. (b)* Critical Care Areas.

Critical care areas are Those special care units in which patientsare intended to be subjected to invasive procedures and connectedto line-operated, patient-care-related electrical appliances.Acceptdeletion of hyphens. Move this to Annex A: Examples of critical care areas include intensive care units,coronary care units, angiography laboratories, cardiaccatheterization laboratories, delivery rooms, operating rooms,postanesthesia recovery rooms, and emergency rooms. (EE) Patient Care Related Electrical Appliance. An electrical appliancethat is intended to be used for diagnostic, therapeutic, ormonitoring purposes in a patient care vicinity. (EE) Accept-deletehyphens. Patient Care Vicinity. A space, within a location intended for theexamination and treatment of patients, extending 1.8 m (6 ft)beyond the normal location of the bed, chair, table, treadmill, orother device that supports the patient during examination andtreatment. A patient care vicinity and extends ing vertically to 2.3 m(7 ft 6 in.) above the floor. (EE) Patient Equipment Grounding Point. A jack or terminal thatserves as the collection point for redundant grounding of electricappliances serving a patient care vicinity or for grounding otheritems in order to eliminate electromagnetic interference problems.(EE) Patient Lead.* Any deliberate electrical connection that can carrycurrent between an appliance and a patient. It is not intended toinclude adventitious or casual contacts such as a push button, bedsurface, lamp, hand-held appliance, etc. (EE) Relocate second sentence to Annex A with the existing AppendixA note. It is not intended to include adventitious or casual contacts suchas a push button, bed surface, lamp, hand-held appliance, etc. andso forth. Plug (Attachment Plug, Cap). A device that, by insertion in areceptacle, establishes connection between the conductors of theattached flexible cord and the conductors connected permanentlyto the receptacle. (EE) Reactance. The component of impedance contributed byinductance or capacitance. The unit of reactance is the ohm. (EE) Reference Grounding Point. A terminal bus that is the equipmentgrounding bus, or an extension of the equipment grounding bus,and is a convenient collection point for installed grounding wiresor other bonding wires where used. (EE)SUBSTANTIATION: Definitions in Chapter 3 were revisedpursuant to the Manual of Style for clarity and format.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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(Log #133)Committee: HEA-ELS

99- 24 - (3-3.2.1.2(a) 5e and 12-4.1.2.10 (new)): TCC NOTE: The Technical Committee's action is rejectedpursuant to NFPA Regulations Governing Committee Projects 4-4.7.1, and refers to the action of Log #134 [99-36]. Procedureroom is well defined and the criteria for emergency lighting isnecessary for patient safety while the patient is undergoingprocedures.SUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-35RECOMMENDATION: The Technical Correlating Committeedirects the Technical Committee on Electrical Systems and theTechnical Committee on Gas Delivery Equipment to considerbattery operated automatic activating battery pack emergencylighting. The Technical Correlating Committee therefore directsthat public comments be submitted in the correlating committee’sname requesting that HEA-ELS and HEA-GAS reconsider thisproposal with the following proposed revision to the proposal asfollows: "...shall be provided in each operating room anesthetizinglocation and procedure room ." The Technical CorrelatingCommittee proposes the following definition: Procedure room.Where the proceduralist is using instrumentation that requiresconstant observation and control. Substantiation: Introduction of anew term requires a definition. (Technical Correlating Committeeexplanation: The intended application of the definition incorrelation with the new 12-4.1.2.10 is that constant observation


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means with light to see, i.e. the removal of a corn and not theretraction of an instrument from a body cavity.)SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept in Part.Revise "...shall be provided in each operating room anesthetizinglocation and procedure room. " to read as follows: "...shall be provided in each anesthetizing location."COMMITTEE STATEMENT: The term procedure room is toobroad and will potentially include rooms that are not intended tohave battery lights.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 25 - (3-3.2.1.2(a) 5e and 12-4.1.2.10 (new)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-36RECOMMENDATION: The Technical Correlating Committeedirects the Technical Committee on Electrical Systems and theTechnical Committee on Gas Delivery Equipment to considerbattery operated automatic activating battery pack emergencylighting. The Technical Correlating Committee therefore directsthat public comments be submitted in the correlating committee’sname requesting that HEA-ELS and HEA-GAS reconsider thisproposal with the following proposed revision to the proposal asfollows: "...shall be provided in each operating room anesthetizinglocation and procedure room ." The Technical CorrelatingCommittee proposes the following definition: Procedure room.Where the proceduralist is using instrumentation that requiresconstant observation and control. Substantiation: Introduction of anew term requires a definition. (Technical Correlating Committeeexplanation: The intended application of the definition incorrelation with the new 12-4.1.2.10 is that constant observationmeans with light to see, i.e. the removal of a corn and not theretraction of an instrument from a body cavity.)SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NEGATIVE: 1 ABSTENTION: 1 NOT RETURNED: 1 CrowleyEXPLANATION OF NEGATIVE: DAVID: "Proceduralist" is not a familiar term for health careworkers. "A person conducting the procedure" is familiar.EXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 26 - (3-3.2.1.2(a)5, 3-3.2.1.2(a)5f, 13-3.3.2.1(a), A-12-4.1.2.6(a)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-37RECOMMENDATION: The Technical Correlating Committeedirects that 5.e. of the recommendation be revised to read asfollows: "... shall be provided in accordance with as required in NFPA 70 ..." for continuity with 5.a. and per Manual of Style, 3-6.6.1.

SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 27 - (3-3.3.2.3, 7-5.1.3.3, 9-2.1.13.3): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-39RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee forreconsideration. The action and Committee Statement areconfusing. The Technical Committee chairs for Electrical Systemsand for Electrical Equipment are directed to collaborate indeveloping consistent requirements with specific wording, andrationale, for applicable paragraphs.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The committee was incorrect in theassumption that Proposal 99-39 was addressing line isolationmonitoring. There are two similar tests in chapter 3 and 7;however, they are mutually exclusive. The test for Chapter 3 is forthe installed electrical system and the test for Chapter 7 is forportable medical equipment.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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(Log #137)Committee: HEA-ELE

99- 28 - (3-3.3.2.3, 7-5.1.3.3, 9-2.1.13.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-40RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee forreconsideration. The action and committee statement areconfusing. The Technical Committee chairs for Electrical Systemsand for Electrical Equipment are directed to collaborate indeveloping consistent requirements with specific wording, andrationale, for applicable paragraphs.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The committee reviewed andreconsidered. The test circuit is designed as just one typical circuitused to simulate the frequency characteristics of human electricalleakage current susceptibility. It is designed for testing of deviceswith a high output impedance. Due to human variability there isno single exact circuit. We recommend that the Electrical SystemsCommittee adopt the circuit used in the annex to (the new)Chapter 8. The publishing of two different circuits apparentlycreates confusion.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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99- 29 - (3-3.3.3(d)): RejectSUBMITTER: Steve Campolo , Leviton Manufacturing Co., Inc.COMMENT ON PROPOSAL NO: 99-41RECOMMENDATION: Accept Proposal 99-41.SUBSTANTIATION: The proposal is directed at a requirementthat affects the impedance of the grounding path in electricalequipment. Chapter 3 of NFPA 99 goes to great lengths in itsefforts to make the impedance of the grounding path as low aspossible. Clause 3-3.3.3(d) requires that receptacle groundcontacts exhibit a minimum 4-ounce retention force. There is notest method nor equipment specified to accomplish this. My proposal suggested using a Listed Receptacle Tension Tester.Underwriter’s Laboratories has written a Standard, UL-1436, whichcontains requirements for such a tester. Any NationallyRecognized Testing Laboratory could list a product to thisstandard. It is my understanding that health care facilities utilize a variety ofmethods to conduct this test, with the majority having nocalibration or accuracy assurance on the retention measurement.Using a Listed tester (of any manufacturer) would assure thataccurate and repeatable measurements are made. I have submittedan article that I wrote which was published in the IAEI News,which details some of the more stringent requirements of UL-1436.One of the most important being the accuracy requirement of 2.5percent. Presently, NFPA 99 has no such accuracy requirement.By accepting my proposal you will ensure that an accurate tool isused for this important measurement. NFPA 99 has a rich history of requiring listed products. Also,there are numerous examples where measurement devices arerequired to be listed. For example: • Clause 9-2.1.2.1(a) requires listed attachment plugs for cordconnected appliances. • Clause A-9-2.1.3.6 requires listed overcurrent protective devicesto protect appliances. • The exception to the above allows listed terminal blocks, strips,connecting devices and RFI filters to precede the overcurrentdevice. • Clause 8-3.1.5 requires listed pressure gages and regulators. • Clause 4-5.5.2.3. requires a listed pressure regulator. • Clause 4-5.1.1.3(h) requires an oil sensor to have an accuracyof 0.03 PPM. • Clause 4-3.1.2.2(e) requires a pressure gage to have a 1%accuracy and be in compliance with ASME B-40.1. • Clause 3-3.3.2.3 requires voltage measurements to be made witha 20% accuracy. • Clause 3-3.3.2.4 requires that impedance measurements bemade with a 20% accuracy. Therefore, changing NFPA 99 to require a listed tester to be usedwhen making the tension measurement will be in agreement withthe reasoning that required the listed devices mentioned above.That is, there is nothing prohibiting requiring a listed product. Simply, by requiring a listed tension tester, the accuracy as well asthe periodic calibration is taken care of by the requirements of thestandard. As an alternative, and similar to other areas within NFPA 99, thepanel could extract the pertinent requirements of UL-1436, andsimply require the instrument used to make the measurement,exhibit those characteristics. Note: Supporting Material is available for review at NFPAHeadquarters.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Due to the variability caused by theposition of the receptacles to be tested and the operator of the testdevice, the committee can find no advantage which would assurethat accurate and repeatable measurements are made by using alisted test device. There is no substantiation that existing methodsof compliance are any less accurate. There is no substantiation thata need exists for listed test devices; hence the committee isconsidering eliminating the testing requirement for the next cycleof this document.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 10 NEGATIVE: 1 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, VernonEXPLANATION OF NEGATIVE: MURNANE: This is response to Comments 99-29 (Log #1) and99-30 (Log #115) which address the same issue (i.e. receptacleground tension requirement, Proposal 99-41). Proposal 99-41should be accepted.

As long as there is a requirement in NFPA 99 to perform a testthere is a presumption that there is a need for such test. The usersof NFPA 99 read that they need to perform this test and, ifacceptable, continue to rely on the integrity of the receptaclegrounding connection. The most reliable test equipment availableshould be used in view of the consequences of not having anadequate ground. When the test requirement was put into NFPA99 the Standard UL1436 did not exist nor did test equipment suchas the Leviton unit. All meeting attendees agreed that this testerwas preferable to the spring based one that was present forcomparison purposes which was considered representative of thesetypes. It was also agreed that accurate and repeatablemeasurements were desirable. The objection raised was thatmeasurements would vary if the tester probe was removed atdifferent angles. While this is true it is the same as any incorrectuse of a piece of test equipment. That is any test equipment needsto be used properly to reduce the risk of incorrect and/or variableresults The Listed testers come with directions for use which, iffollowed, would reduce these risks. Also these units can becalibrated and records kept. Although the committee isconsidering eliminating the testing requirement, for the time beingthere is still a test requirement that users of the standard will relyupon as the means to determine receptacle grounding reliability.

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99- 30 - (3-3.3.3(d)): AcceptSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-41RECOMMENDATION: Agree with the committee action to rejectthis proposal.SUBSTANTIATION: The submitter wants the committee torequire a listed receptacle tester. The TCC has directed thecommittee to provide more information on why it rejected theproposal. The submitter has not provided adequate evidence thatlisting of a tester will provide superior or more reliable results thanan unlisted tester. Based on my experience at CarolinasHealthCare System with over 5-million ft2 of healthcare facilitiesthe results we currently receive with our current test equipment areaccurate and repeatable. The submitter’s request would only serveto require my organization and all healthcare facilities to replaceequipment that they have relied upon for many years to purchase"listed" equipment that will not provide superior results or helpassure receptacle integrity.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 10 NEGATIVE: 1 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, VernonEXPLANATION OF NEGATIVE: MURNANE: See my Explanation of Negative Vote on Comment99-29 (Log #1).

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99- 31 - (3-3.3.3(d)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-41RECOMMENDATION: The Technical Correlating Committeedirects the Committee to provide more information in theCommittee Statement.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-29 (Log #1).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 32 - (3-4.1.1.1(i)): Accept in PartSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-44RECOMMENDATION: The Technical Correlating Committeedirects the following revised sentence be inserted under CommitteeAction: " ... vacuum pumps, pressure maintenance (jockey or make-up)pump(s) for water based fire protection systems, generator fuelpumps, jockey pumps, or other generator accessories." Substantiation: Wording was inadvertently omitted in thecommittee actions on the proposal.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept in Part.Delete "or make-up" in the Technical Correlating Committeerecommendation. " ... vacuum pumps, pressure maintenance (jockey ) pump(s) forwater based fire protection systems, generator fuel pumps, jockeypumps, or other generator accessories."COMMITTEE STATEMENT: The term "make-up" is redundantand confusing.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 33 - (3-4.1.1.5(b)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-47RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee for revision.The Technical Correlating Committee does not understand theintended actions.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Current 99-47 (Log #118): (b) Optional Any loads shall be permitted to be served by theessential electrical system generating equipment. not permitted in3-4.2 to be on the essential electrical system, Optional loads shallbe served by their own transfer switch(es) such that these loads (1)shall not be transferred onto the generating equipment if thetransfer will overload the generating equipment, and (2) shall beshed upon a generating equipment overload. Use of the generatingequipment to serve optional loads. It shall not constitute "otherpurposes" as described in 3-4.1.1.5(a). Revise Proposal 99-47 (Log #118) to read as follows: (b) Optional Any loads shall be permitted to be served by theessential electrical system generating equipment. not permitted in3-4.2 to be on the essential electrical system, Optional loads shallbe served by their own transfer switch(es) means such that theseloads (1) shall not be transferred onto the generating equipment ifthe transfer will overload the generating equipment, and (2) shallbe shed upon a generating equipment overload. Use of thegenerating equipment to serve optional loads .It shall not constitute"other purposes" as described in 4.4.1.1.8.1 3-4.1.1.5(a) andtherefore shall not require multiple generator sets . Add a new Annex A to read as follows: A.4.4.2.2.8.3 The intent of this section is: (a) Contiguous or same site non-hospital buildings may beserved by the generating equipment. However, such loads mustnot compromise the integrity of the system serving the hospital.Thus, any such contiguous or same site non-hospital buildings maybe served by the generating equipment only if the transfer meansoperates in accordance with this Section

(b) Within a hospital building, Section 4.4.2.2.2.3(i) allows"additional" loads on the critical branch and Section 4.4.2.2.3.5(j)allows "other equipment" on the equipment system in order toprovide limited flexibility to a facility to add one or two loads nototherwise listed in Sections 4.4.2.2.2.3(a)-(h), or 4.4.2.2.3.4, or4.4.2.2.3.5(a)-(i) to a critical branch panel or an equipment systempanel. This allowance is to prevent the need for an additionalpanel to serve a small number of selected circuits in a particulararea. These sections are not intended to allow large blocks of loadsnot listed in these sections to be on the Critical Branch orEquipment System. The intent of the Division of the EssentialSystem loads into Systems and Branches is to ensure maximumreliability of service to loads considered essential. Every additionalload placed onto a system somewhat increases the probability of afailure on the system that threatens the integrity of service to thebalance of loads served by the system. Therefore, while "additional"loads and "other equipment" may be placed onto the criticalbranch and equipment system in very limited situations, where afacility wants to put large blocks or loads not listed in4.4.2.2.2.3(a)-(h), or 4.4.2.2.3.4, or 4.4.2.2.3.5(a)-(i) onto thegenerating equipment, the facility may do so, but only bydesignating these large blocks of load as "optional loads" and bycomplying with Section 4.4.1.1.8.3. NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 34 - (3-4.1.1.5(b)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-48RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to Committee for revision.The Technical Correlating Committee does not understand theintended actions.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-33 (Log #140).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 35 - (3-4.1.1.5(b)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-50RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee for revision; thechanges are not explicit.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-33 (Log #140).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 36 - (3-4.2.2.2(c)8a.): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-57RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee to clarify theiraction and rationale.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Proposal 99-57 (Log #305) has been revised as follows: We have Accepted in Principle 99-57. Committee action under 4-4-2.2.2.3(h) item 1: General care beds shall have at least one duplex receptacle perpatient bedroom, and task ilumination as required by thegoverning body of the health care facility. COMMITTEE STATEMENT: The revised text accomplishes thesubmittor's original intent.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 37 - (3-4.2.2.3(e)1c.): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-59RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to committee. Inconsideration of Log #203, the Committee Statement for Log #304needs clarification.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.The committee accepts the direction from the TechnicalCorrelating Committee. The committee reconsidered their action,and retains their action of "reject."COMMITTEE STATEMENT: The committee rejects Proposal 99-59 (Log #304 ) because the exception for facilities with two servicesis needed, especially for facilities with electric heat. In addition, 3-3.2.1.1 (referring to two services) still exists, but now appears as 3-4.1.1.1 The erroneous reference was corrected by the Committee'sAction on Proposal 99-61 (Log #CP203 ).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 17VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 11 NOT RETURNED: 6 Carlson, Crawford, Lobnitz, Longhitano,Stickley, Vernon

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99- 38 - (Chapter 4): RejectSUBMITTER: Stinson Batchelor, Batchelor & Kimball Inc.COMMENT ON PROPOSAL NO: 99-413RECOMMENDATION: Expand and include data in Appendix C(Relating to Chapter 4) directly into Chapter 4 text. Clearly staterecommended delivery quantities of each gas on a per outlet/inletbasis, along with a minimum and maximum recommendedpressure at outlets/inlets and in the distribution piping system.SUBSTANTIATION: Without above proposed information, muchof which is now in the appendices, designing piping systems inaccordance with "currently accepted practices" has no realreference. At the very minimum the appendices must bemaintained in NFPA 99.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).

NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ALLEN: I continue to disagree that removal of this material isdesirable. It represents a unique body of work on therequirements for vacuum sizing and source selection, and it'sabsence leaves the industry without any guidance in any standard.The 99 is not intended as a design standard, and having thesematerials in the non-mandatory annex offers assistance but doesnot require anything.

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99- 39 - (4-1.1): Accept in Principle TCC NOTE: See Technical Correlating Committee Note onComment 99-3 (Log #32).SUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-69RECOMMENDATION: This proposal was to add veterinaryfacilities under the scope of HCA-PIP. The rejection by the ADMand TCC continues along long established lines that veterinaryfacilities are outside the scope of the Health Care Facilities scope.SUBSTANTIATION: Support in favor of this log comes not onlyfrom the verifiers of medical gas systems, but also from themanufacturers of the medical gas equipment used in veterinaryfacilities. A comment was recently made that no problems havebeen reported. Is it going to be necessary to have a death or serious injuryreported from improperly installed nonflammable gas systemsbefore action is taken? Can we not be proactive for a change?Many of the changes in NFPA are promulgated to prevent deathsand/or injuries. If HCA-PIP is not the place for this coverage, would the TCCconsider making recommendations up the line to have veterinaryfacilities covered under portion of NFPA, perhaps outside ofHealth Care facilities requirements?COMMITTEE ACTION: Accept in Principle.See the Committee Action on 99-201 (Log #9).COMMITTEE STATEMENT: This comment should be forwardedto the Technical Committee on Administration and the TechnicalCorrelating Committee. The Techanical Committee on Piping unanimously voted tosupport the substantiation of Proposal 99-69 and Comment 99-79(Log#71).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The safety and health of veterinary facility employeeis regulated by OSHA and the building, mechanical, plumbing andelectrical codes of the jurisdictions the facilities are located in.Additionally the gas flows and vacuum requirements for thesefacilities are much greater than required for humans, dependingon the type of animals and procedures performed at each facility.It is not NFPA's role to determine the gas flows and vacuumdemands, pipe sizing and equipment requirements for thesefacilities.

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99- 40 - (4-3.1.1): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: The Technical Correlating Committeedirects the committee to review the intent of diagrams. If thediagrams are directive, incorporate them in the text. If thediagrams are informational, incorporate them in the annex andreference them within the text.


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SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The figures were revised and movedto the Annex.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 41 - (4-3.1.1.2): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-77RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement andrecommends revising it to "submitter did not submit text."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 42 - (4-3.1.1.2(a)11g): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-80RECOMMENDATION: The Technical Correlating Committeedirects the Committee to substantiate the Committee Statement.Supporting data is necessary, i.e., temperature and heat absorption.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.See Substantiation on 99-44 (Log #59).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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(Log #CC1)Committee: HEA-PIP

99- 43 - (4-3.1.1.2(a)6): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: Revise 4-3.1.1.2(a)6 to read as follows: "Cylinders in use or in storage shall be prevented from reachingtemperatures in excess of 54°C (130°F)."SUBSTANTIATION: This comment clariffies that the cylindersare for in use or storage.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 44 - (4-3.1.1.2(a)11g): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-80RECOMMENDATION: Insert the wording: " In outdoor locations, cylinders shall be protected from directsun and accumulations of ice or snow. "SUBSTANTIATION: This is supported by the existing wording in4-3.5.2.2(b)3 for cylinders in storage. Including it here will protectcylinders connected to the manifold as well. This paragraph islocated at 4-3.1.1.2(e)1f in the committee response to Proposal 99-71.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The existing guidance (see 4-3.1.1.2(a)6 and 99-48 (Log #17)) to maintain cylinder temperaturesabove -7°C (20°F) and below 54.4°C (130°F) is consideredadequate for the user to determine whether additional protection(e.g. of the nature described in this proposal) is necessary. It isunnecessarily restrictive to require all users, whatever their localclimate or circumstance, to protect cylinders in this manner.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 45 - (4-3.1.1.2(a)11): AcceptSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-85RECOMMENDATION: Reconsider the rejection of this signage.SUBSTANTIATION: The action taken in Log 148 leaves thelabeling of these doors substantially unchanged from currentwording. This means that the additional hazard of asphyxiationremains unaddressed. I submit (courtesy of BOC Gases), a safetyvideo which vividly depicts this problem and substantiates theconcern. NOTE: Supporting Material is available for review at NFPAHeadquarters.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 46 - (4-3.1.1.2(a)11): AcceptSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-85RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: The submitter raises a valid issue here. Ifeel as if his proposed wording would make the rooms that containmedical gas supply systems safer for the employees maintaining thesystem.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 47 - (4-3.1.1.2(a)11): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-85RECOMMENDATION: The Technical Correlating Committeedirects the Committee Action be changed to Accept In Principle.The Committee Statement must provide justification for its actions.


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SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 48 - (4-3.1.1.2(b)): Accept in PrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-89RECOMMENDATION: Revise text as follows: 4.3.1.1.2(a)7. Central supply systems for nitrous oxide andcarbon dioxide shall be prevented from reaching temperatureslower than the manufacturer’s recommendations, but should neverbe lower than -7°C(20°F) -18°C (0°F).SUBSTANTIATION: Carbon dioxide is only at a pressure of 250psig at 0°F and nitrous oxide is only at 300 psig at 0°F. Thesepressures may be inadequate to ensure proper manifold function.The specification should limit the temperature, to the values set bythe manufacturer. Since each system is different, themanufacturer’s limits should supersede the limits listed in thisspecification. By changing the temperature limit to -7°C(20°F) theCO2 cylinder pressure will be about 420 psig and N2O will beabout 390 psig. This temperature limit allows the cylinder pressureto be about half of what it is at 70°F, which should allow sufficientpressure to the various manifold systems. The vaporization rate of the cylinders is reduced as the ambienttemperature drops, thereby reducing the available flow out eachcylinder. To help limit the effects of the drop in available flow, thetemperature limit on carbon dioxide and nitrous oxide should belimited to -7°C (20°F). Note: Supporting material is available for review at NFPAHeadquarters.COMMITTEE ACTION: Accept in Principle.Revise to read as follows: 4.3.1.1.2(a)7. Central supply systems for nitrous oxide andcarbon dioxide shall be prevented from reaching temperatureslower than the manifold manufacturer’s recommendations, butshall never be lower than -7°C(20°F) -18°C (0°F). or greater than54°C (130°F) COMMITTEE STATEMENT: The word manifold was added todistinguish between the manifold, cylinder, or gas manufacturer. The 54°C was added to ensure the central supply system did notexceed temperatures already mandated by the standard.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 49 - (4-3.1.1.2(b)1): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-90RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement forrejection. The Committee’s rationale should be more specificregarding the requirements of NFPA 50.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Proposal 99-90 will be refered to the Technical Committeeresponsible for NFPA 50. 20,000 ft3 is from Section 1-3,Definitions, of NFPA 50.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 50 - (4-3.1.1.3 (New) ): HoldSUBMITTER: Robert Sutter, BOC GasesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: Add new text to read as follows: Vaporizers. Vaporizers which are provided to convert cryogenicliquid to the gaseous state shall be ambient heat transfer units sothat the flow from the vaporizer is unaffected by the loss of power.Exception: use of powered vaporizers is permitted provided that: a. Reserve ambient vaporizers are provided are piped to thesource of supply in such a manner as to be unaffected by a freezeup or flow stoppage from the powered vaporizer. The reservevaporizer shall be capable of vaporizing at least one day’s averagesupply. b. Medical gas is available from a non-cryogenic source capableof providing at least one day’s average supply. SUBSTANTIATION: At the present time there is no requirementfor back up vaporization when powered vaporizers such as hotwater, steam or electric is being used. A loss of the source heat,water, steam or electric would allow cryogenic fluids to entermedical piping system. This requirement would allow the use ofpowered vaporizer system while insuring a continuous supply ofgaseous product to the medical facility.COMMITTEE ACTION: Hold.COMMITTEE STATEMENT: The submitter is adding newmaterial that has not had public review and would need furtherstudy. Section 4-4.6.2.2 of the Regulations Governing CommitteeProjects would allow the committee to hold. This comment willalso be submitted to the Technical Committee responsible forNFPA 50 for feedback and to see whether it applies to bulk oxygensites or not.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 51 - (4-3.1.1.3 (New) ): HoldSUBMITTER: Robert Sutter, BOC GasesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: New text to read as follows: Vaporizers. Vaporizers shall be sized to provide adequatecapacity under all conditions. Winter temperature extremes,structures that obstruct air circulation and sunlight shall beconsidered by the agency rating and selecting the vaporizers. SUBSTANTIATION: At the present time there is no requirementfor the proper sizing of vaporizers. An ambient air vaporizer has tobe properly sized for the application and environment in which it isbeing used. Improperly sized vaporizers will accumulate largequantities of low temperature ice, which has lead to equipmentdamage and equipment failure. Improperly sized vaporizers willalso allow low temperature gas to enter the medical gas piping.Vaporizers which have air circulation and sunlight restrictions willnot perform as well as the same identical vaporizers that do nothave these restrictions.COMMITTEE ACTION: Hold.COMMITTEE STATEMENT: See Committee Statement onComment 99-50 (Log #117).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 52 - (4-3.1.1.3 (New) ): HoldSUBMITTER: Robert Sutter, BOC GasesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: Add text to read as follows: Vaporizers. Vaporizers shall be installed in such a manner whichpermits the switching of units to allow deicing. Switching valvesshall:


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a. Not be a solenoid if the valve is so located as to stop the flowof gas to the facility. b. If powered, have the ability to be manually operated. c. Not stop the flow of gas to the facility during switching. SUBSTANTIATION: Vaporizers that convert cryogenic medicalproduct into gaseous medical product operate in the -250OF to -280OF range. Under these conditions moisture in the air willcondense and freeze on the piping. This ice will continue to growuntil the outer layer of the ice reaches the dew point. This growthof ice has lead to equipment and pad failures. Due to thecontinuous use of medical gases at medical facilities a typicalvaporizer will never be able to shed all of its ice. The installationof a switching system will allow a vaporizer to shed its ice load a. Solenoids should never be installed in a switching system ifthey can stop the flow of medical gas into the facility. Even failopen solenoids have failed in the closed position and these cannotbe detected until the system switches and product fails to flow in tothe medical facility. b. A switching system can be manual or automatic. Anautomatic system is better for larger medical facilities. When anautomatic system is used the timing of the vaporizer system can beset to minimize the growth of mature or hard ice. The best valvefor a switching system is a three-way divertor ball valve. Thesevalves have actuators placed on the top which can easily beremoved or made to operate in a manual mode. c. No switching system should be configured so that the flow ofmedical gas can be stopped. Some common installation designsplace globe valves in front and back of vaporizers. In order toswitch this type of system a valve must be opened and a valve mustbe closed. Doing this procedure improperly could lead to thesystem being shut down.COMMITTEE ACTION: Hold.COMMITTEE STATEMENT: See Committee Statement onComment 99-50 (Log #117).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 53 - (4-3.1.1.3 (New) ): HoldSUBMITTER: Robert Sutter, BOC GasesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: Add text to read as follows: Vaporizers. It shall be the responsibility of the facility to informthe owner or agency performing maintenance on the supply systemof changes in the site or use pattern which would affect theperformance of the vaporizers. SUBSTANTIATION: Vaporizers that convert cryogenic medicalproduct into gaseous medical product are sized to perform withinset parameters. Changes in use patterns or loads can lead to anundersized vaporizer. It is not uncommon for a medical facility tocontinue to grow adding beds, operating suites and hyperbaricchamberswithout reviewing their vaporization system.COMMITTEE ACTION: Hold.COMMITTEE STATEMENT: See Committee Statement onComment 99-50 (Log #117).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 54 - (4-3.1.1.3, 4-3.1.1.3 (a). 5): Accept in PrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-94RECOMMENDATION: Revise text as follows: 4-3.1.1.3(a)5. "...labeled for the service and condition beingmonitored. Indicators or housings shall be installed per themanufacturer’s requirements. The manufacturer’s recommendedtemperature limits may prohibit outdoor installation. Note: Whenindicators or housings are located outdoors and exposed to theelements (Not protected from direct contact with rain, sleet, snow,

sunlight etc.) they shall be listed and approved for outdoor useshall be provided for outdoor locations."SUBSTANTIATION: It appears that the intent of proposal 99-94is to provide adequate protection for the equipment. Therequirements for each product will vary and the manufacturer’sinstructions should take precedence. The proposal also includedconcerns about temperature, which were not addressed by thechange as written. The term outdoors is not defined, and this proposed changeclarifies that ‘outdoors’ means unprotected and exposed to theelements. It is possible to protect equipment located outdoors,provided the protection meets the requirements of themanufacturer. Since there are several grades of outdoorenclosures, the actual protection of the equipment should be perthe manufacturer’s requirements.COMMITTEE ACTION: Accept in Principle.Revise text as follows: 4-3.1.1.3(a)5. "...labeled for the service and condition beingmonitored. Indicators or housings shall be installed per themanufacturer’s requirements. "COMMITTEE STATEMENT: The manufacturer will specify theinstallation requirements whether these devices are placed indoorsor outdoors.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 55 - (4-3.1.1.3, 403.1.1.3 (a) 2.d): Accept in PrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-94RECOMMENDATION: Revise text as follows: (d) Components intended for outdoor installation shall beinstalled per the manufacturer’s requirements. The manufacturer’srecommended temperature limits may prohibit outdoorinstallation. Note: When components are located outdoors andexposed to the elements (Not protected from direct contact withrain, sleet, snow, sunlight etc.) they shall be listed and approvedfor outdoor use.SUBSTANTIATION: It appears that the intent of the proposal isto provide adequate protection for the components. Therequirements for each product will vary and the manufacturer’sinstructions should take precedence. The proposal also includedconcerns about temperature, which were not addressed by thechange as written. The term outdoors is not defined, and this proposed changeclarifies that ‘outdoors’ means unprotected and exposed to theelements. It is possible to protect equipment located outdoors,provided the protection meets the requirements of themanufacturer. Since there are several grades of outdoorenclosures, the actual protection of the equipment should be perthe manufacturer’s requirements.COMMITTEE ACTION: Accept in Principle.Revise text as follows: (d) Components intended for outdoor installation shall beinstalled per the manufacturer’s requirements.COMMITTEE STATEMENT: See Committee Statement onComment 99-54 (Log #15).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 56 - (4-3.1.1.3(a)): RejectSUBMITTER: Dick Langford, Victor Equipment CompanyCOMMENT ON PROPOSAL NO: 99-96RECOMMENDATION: The recommendation is to add new text,which would read as follows: "Portions of systems intended tohandle oxygen at high pressure >300 psig (2,070 kPa) shall containno polymeric materials. All components shall be made ofmaterials having a resistance to combustion not lower than that ofRed Brass in ASTM STP 1197-1993."


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I would like to propose that the wording for this paragraph be asfollows: "1. It is imperative that the information contained in references,such as those listed below, be taken into account by qualifiedtechnical personnel when designing, fabricating, and assemblinghigh-pressure oxygen systems. Many factors are involved whenevaluating the overall suitability of materials and components foroxygen service. Consultation with the gas supplier or otherqualified professionals can be helpful to understand thecircumstances that cause oxygen to react with its surroundings. 2. Nonmetallic materials have successfully demonstrated asuperior capability of maintaining leak-free systems and, as a result,enhancing safety. However, the use of plastics, elastomers, andlubricants should be avoided, where practicable, or else minimizedin high-pressure systems. 3. Where it is not practicable to avoid the use of plastics,elastomers, or lubricants (in high pressure breathing oxygensystems), the following is strongly recommended: - Minimize surface area exposed to the gas and make sure thenonmetallic material is well encased by ignition-resisting metal(heat sink) to help dissipate heat generated by adiabaticcompression or other phenomenon and to quench, contain, orotherwise avoid burning propagation. Avoid placement ofnonmetallics in the direct path of the oxygen flow. - Minimize heat of compression by design. Avoid rapidpressurization, dead ending obstructions, and constrictions. - Review assemblies where rapid pressurization is possibly in use.Where the behavior of the components under consideration isunproven or not well known, an appropriate adiabaticcompression test can be used to evaluate their suitability for such acondition. - Avoid the use of materials that can generate particulate by agingor abrasion. The system should be free of thin-walledcomponents, sharp feathered edges, leaks, incompatible materials,and contamination."SUBSTANTIATION: This information is taken from CGA TB-12-1999, Recommendations. The CGA Publication also referencesASTM G 63-92, Standard Guide for Evaluating NonmetallicMaterials for Oxygen Service, and ASTM G 88-90, Standard Guidefor Designing Systems for Oxygen Service, as well as other ASTMpublications. I would like to talk briefly about the problems we see with theproposed 4-3.1.1.3(a), as written in the November 2001 ROP. Thesubstantiation states that "a substantial problem has been reportedwith 1. Flexible cylinder pigtails lined with Teflon." I take issuewith the statement "a substantial problem". Our experience doesnot show this. However, we realize that there are reasons not touse Teflon lined pigtails in oxygen service. However, Log #223, theproposed 99-97 (4-3.1.1.3(d)) states that interior Teflon coatedstainless steel braided flexible connectors shall not be used, so thiscovers the specific number one in 4-3.1.1.3(a). The substantiation also says "a substantial problem has beenreported with 2. check valves with soft (polymeric) seats." We atVictor take issue that there has been a "substantial problem" withcheck valves with polymeric seats. We have not seen this. This isthe main provision of this proposed paragraph that we take issuewith. As written, the proposed paragraph is stating in reality thatpolymeric materials cannot be used in high pressure oxygensystems. There are no polymeric materials, to our knowledge, thathave a resistance to combustion not lower than Red Brass.Adherence to the proposed paragraph will require cylinder valvemanufacturers to remove polymeric materials from cylinder valves,and use metal to metal seats. Regulator manufacturers will have toremove polymeric materials from regulator seats, and attempt touse metal to metal seats. As a regulator manufacturer, I can tellyou that we do not believe satisfactory regulator performance canbe achieved by using metal to metal seats. We feel that polymericmaterials, when used correctly, can be used in high pressureoxygen systems with safety and acceptable performance. Although we take issue with the statement that "a substantialproblem has been reported with aluminum regulators", we have noissue with the third provision of the substantiation, therecommendation that aluminum regulators not be used. Wepropose, however, that the paragraph would be better served tostate that regulators, valves, and other like components should passapplicable industry tests for oxygen compatibility before being usedin high pressure oxygen systems. Victor Equipment Company urges you not to word the newparagraph in such a way that polymeric materials are not allowedin high pressure oxygen systems. Polymeric materials, when usedin properly designed systems and components, have been used foryears with success in these systems. There are no materials that canreplace these materials, and offer the user the advantages the

polymeric materials offer. ASTM, CGA, and UL standards andguides all state that polymers can be used in properly designedsystems for high pressure oxygen systems. If you leave theproposed paragraph as stated, you will be stating a NFPA positionthat polymeric materials not be used in high pressure oxygensystems. This will result in an unacceptable requirement forregulator and valve manufacturers.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The information as presented is notin mandatory language. Also the information can be found inCGA TB-12-1999.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 57 - (4-3.1.1.3(a), 4-3.1.1.3(a)2.a): Accept in PrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-96RECOMMENDATION: Revise text as follows: a. Portions of systems intended to handle oxygen at pressuresgreater than 2,070 kPa(>300 psig) shall contain no polymericmaterials be constructed of materials having adequate compatibilitywith the oxygen under the temperatures and pressures to which thecomponents may be exposed. Components include but are notlimited to containers, valves, valve seats, lubricants, fittings, gaskets,and interconnecting equipment including hoses. ASTM STP 1197may be used as a guide to help select materials. All componentsshall be made of materials having a resistance to combusiotn notlower than that of red brass in ASTM STP 1197-1993.SUBSTANTIATION: While ASTM STP 1197-1993 has a lot ofuseful information, it is not much more than a book of technicalpapers. The ASTM publication only covers a limited number ofmaterials that were part of the specific technical papers. It doesnot include information on enough materials to build all theequipment used in a gas supply system. A couple of differentignition techniques were used to evaluate materials. While some ofthe resultant data is useful, the question remains about whether theignition technique is appropriate to a hospital gas system. Whilethis publication can be used as a guide, it is too limited in scope tobe used as a design specification. The key note address in thebeginning of ASTM STP 1197-1993 clearly states that there is moreto oxygen ignition than selecting materials. Polymeric materials include plastics and elastomers. This changewill require that all seats, whether they are for check valves,regulators, or valves, be made out of metal. The use of packedvalves and Teflon lined cylinder leads would also eliminated. SinceTeflon tape is a polymeric, the proposed change would alsoeliminate the use of all pipe threads. Oxygen cylinders areassembled using packed valves, therefore, none of the cylindersconnected to the system would meet NFPA 99 requirements. I donot believe that the technology exists to meet this requirement. The list of metals evaluated in the ASTM publication is limited.There are very few comparison charts that can be used todetermine which materials have better resistance to combustionthan red brass. If the industry is limited to the materials evaluated,it would eliminate nearly all of the normal materials used forsprings that are used in check valves and regulators. This will havea direct impact of product cost and performance. It just isn’tpractical to impose this requirement. There is no concrete evidence that Teflon lined cylinder leads arenot suitable for oxygen service. If Teflon lined cylinder leads wereunsafe, the CGA E-9 pamphlet on Teflon lined leads would notallow their use in oxygen service. The design of the lead and thelocation of the check valve are critical to providing resistance todamage from rapid pressurization. Not allowing Teflon linedpigtails is attacking a symptom, not the problem. A properlydesigned Teflon lead is safe and should not be excluded from thespecification. If this type lead is excluded, the committee will besetting a precedent for the usage of this type product in the UnitedStates. I don’t believe that the committee has conducted aninvestigation, so I don’t think they can make the statement that thisproduct is unsafe. Please also see comments provided for Proposal 99-97(Log #223).


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COMMITTEE ACTION: Accept in Principle.Revise text as follows: a. Portions of systems intended to handle oxygen at pressuresgreater than 2,070 kPa(>300 psig) shall contain no polymericmaterials be constructed of materials having adequate compatibilitywith the oxygen under the temperatures and pressures to which thecomponents may be exposed. Components include but are notlimited to containers, valves, valve seats, lubricants, fittings andgaskets.COMMITTEE STATEMENT: Hoses containing poymeric materialhave exhibited hazards. See Committee Action taken on Comment99-59 (Log #12). ASTM STP 1197 has been deleted as a reference as it is notconsidered a complete document. Submitter’s substantiationprovided good reasons for deletion of the ASTM reference.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 58 - (4-3.1.1.3(a)2.(a)): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-97RECOMMENDATION: Add a new sentence to the end of 4-3.1.1.3(a)2.(a) to read as follows: Interconnecting hoses in systems intended to handle oxygen atpressures greater than 2070 kpa (300 psig) shall contain nopolymeric materials.SUBSTANTIATION: Hoses containing poymeric material haveexhibited hazards. The action on 99-57 (Log#11) allows the use ofpolymeric material on certain components. By contrast hoses arenot allowed to use polymeric materials for oxygen systems withpressures exceeding 2070 kpa (300 psi).COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 59 - (4-3.1.1.3(d), 4-3.1.1.3 (a)2.a): RejectSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-97RECOMMENDATION: Revise text as follows: a. Portions of systems intended to handle oxygen at pressuresgreater than 2,070 kPa(>300 psig) shall contain no polymericmaterials be constructed of materials having adequate compatibilitywith the oxygen under the temperatures and pressures to which thecomponents may be exposed. Components include but are notlimited to containers, valves, valve seats, lubricants, fittings, gaskets,and interconnecting equipment including hoses. ASTM STP 1197-1993 may be used as a guide to help select materials. Allcomponents shall be made of materials having a resistance tocombusition not lower than that of red brass in ASTM STP 1197-1993.SUBSTANTIATION: Contamination or abuse are usuallycontributing factors when failures of the type shown in theproposal occur. If a Teflon lined cylinder lead is abused (e.g.kinked) it will be subject to failure, no different than a kinked rigidlead. Teflon lined leads, however, provide superior flexibility thanthe rigid leads which are subject to work hardening. The proposalprovided a picture of a burst Teflon lined lead, however, noinformation was provided on why the lead actually burst. Usuallythis type of damage is caused by the ignition of some type ofcontaminant. If the heat generated was enough to ignite thecontaminant the fire might very well have occurred in a rigid leadas well. There is no concrete evidence that Teflon lined cylinder leads arenot suitable for oxygen service. If Teflon lined cylinder leads wereunsafe, the CGA E-9 pamphlet on Teflon lined leads would notallow their use in oxygen service. The design of the lead and thelocation of the check valve are critical to providing resistance todamage from rapid pressurization. Not allowing Teflon linedpigtails is attacking a symptom, not the problem. A properlydesigned Teflon lead is safe and should not be excluded from thespecification. If this type lead is excluded, the committee will be

setting a precedent for the usage of this type product in the UnitedStates. I don’t believe that the committee has conducted aninvestigation, so I don’t think they can make the statement that thisproduct is unsafe. Please also see comments provided for Proposal 99-96 (Log#164).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Hoses containing polymericmaterial have exhibited hazards. The action on Comment 99-57(Log #11) allows the use of polymeric material on certaincomponents. By contrast, hoses are not allowed to use polymericmaterials for oxygen systems with pressures exceeding 2070 kpa(300 psi)NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 60 - (4-3.1.1.4(e)): Accept in PartSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-71RECOMMENDATION: Revise text as follows: (e) If manifolds are located out of doors they shall be installedper the manufacturer’s requirements. The manufacturer’srecommended temperature limits may prohibit outdoorinstallation. Note: When manifolds are located outdoors andexposed to the elements (Not protected from direct contact withrain, sleet, snow, sun etc.) they shall be listed and approved foroutdoor use.SUBSTANTIATION: It appears that the intent of the proposal isto provide adequate protection for the components. Therequirements for each product will vary and the manufacturer’sinstructions should take precedence. The proposal also includedconcerns about temperature, which were not addressed by thechange as written. The term outdoors is not defined, and this proposed changeclarifies that ‘outdoors’ means unprotected and exposed to theelements. It is possible to protect equipment located outdoors,provided the protection meets the requirements of themanufacturer. Since there are several grades of outdoorenclosures, the actual protection of the equipment should be perthe manufacturer’s requirements.COMMITTEE ACTION: Accept in Part.Revise text as follows: (e) If manifolds are located out of doors they shall be installedper the manufacturer’s requirements. The first sentence of the recommendation was accepted. The remaining two sentences were rejected.COMMITTEE STATEMENT: See Committee Statement onComment 99-54 (Log #15).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 61 - (4-3.1.1.5): RejectSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-99RECOMMENDATION: Reconsider this proposal.SUBSTANTIATION: The single fault failure which this proposalattempts to address, albeit a human failure rather than anequipment failure, is not addressed by the current alarmingrequirement in any way.COMMITTEE ACTION: Reject.Accept Proposal 99-99 (Log #177).COMMITTEE STATEMENT: Acceptance of thiscomment/proposal would have effectively eliminated thesemiautomatic medical gas manifold technology.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 62 - (4-3.1.1.5): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-99RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: It would seem to me that a manufacturerrep. would know where the problems lie with their equipment.Committee should reconsider its action here.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-61 (Log #82).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 63 - (4-3.1.1.5): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-99RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Technical Committee Statement, being more explicit by citingreasons.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-61 (Log #82).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 64 - (4-3.1.1.6, 4-3.1.1.5 (b) 3): TCC NOTE: The Technical Committee's action is changed toAccept in Principle pursuant to NFPA Regulations GoverningCommittee Projects 4-4.7.1, and deletes the word "approximately"as found in the revised text, and inserts the word "nominal",pursuant to the intent of the Manual of Style.SUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-103RECOMMENDATION: Revise text as follows: A pressure relief valve shall be provided after the connection ofthe reserve header and before the final line pressure regulatingassembly. This relief valve shall be set approximately 50 percentabove the maximum expected inlet pressure at or below the reliefpressure for the cryogenic liquid cylinders.SUBSTANTIATION: All of the other relief valves required are setto protect downstream equipment. Setting the relief valve at orbelow the vessel pressure would indicate that it is being used toprotect the vessel not the downstream equipment. The relief valverequirements for the vessel are specified per DOT/CGArequirements and should be adequate for medical installations. There are currently two popular pressure ranges available, vesselswith 235 psig relief valves and ones with 350 psig relief valves. Themanufacturer of a system may have designed it so that it can beused with both types of cylinders. With this change, designing asystem that would allow either type cylinder would not be possible.Furthermore, if someone connected a 350 psig vessel on a 235 psigsystem, it would pop the relief valve open. We have received somefeedback indicating that a facility can’t always guarantee that theywill get a specific type (235 psig or 350 psig) of vessel. The pressure-building regulator is adjustable and each vesselusually is set a little different. If the set pressure of the system reliefis below the vessel relief, there is a chance that normal systempressure will open the system relief valve. This also reduces theavailable pressure range for the economizer circuit. Theeconomizer circuit is supposed to open and allow gas into thesystem before the relief valve on the vessel opens. Since the

economizer will have to open at a lower pressure and eachpressure building regulator is set differently, it is possible that gasmay bleed through the economizer circuit when it shouldn’t.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 65 - (4-3.1.1.8(b), 4-3.1.1.3 (a) 6.b): RejectSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-115RECOMMENDATION: Revise text as follows: e. A cylinder lead for each cylinder shall be provided with endfittings complying with CGA pamphlet V-1, Standard forCompressed Gas Cylinder Valve Outlet and Inlet Connections,(ANSI B57.1) Such fittings shall be permanently attached to thecylinder lead. The use of adapters or conversion fittings to adaptone gas specific fitting to another is prohibited.SUBSTANTIATION: Making the end connections permanentdoes not protect against tampering. If someone is willing todismantle a cylinder lead to change the gas fittings, they arecertainly able to create and replace an existing lead with one thathas the incorrect fittings permanently attached. The specificationrequires that the leads be gas specific at both ends and precludesthe use of adapters. Nothing else is required. If someone tampers with a lead, they are already violating thespecification requirements. In order to provide the safety that theproposal desires, every component in the piping system will have tobe made with permanent connections. It isn’t practical to makeevery joint in the entire system permanent. The original proposalalso limits the type of products that can be used, without providingany quantifiable increase in safety.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Cylinder lead ends shall bepermanently installed to prevent possible conversion in the field.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 66 - (4-3.1.1.8(e), 4-3.1.1.3(a)3.a): AcceptSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-119RECOMMENDATION: Revise text as follows: 4-3.1.1.3(a)3.a. be provided with duplex final line regulators,installed in parallel with isolation valves before each regulator andan isolation valve or check valve after each regulator permittingservice to either regulator without interruption of supply.(ADJUST FIGURES) each regulator outlet shall be provided with apressure gauge. A pressure gauge or indicator shall monitor theduplex final line regulator pressure. The gauge(s) or indicator(s)may either be located after each regulator, or be locatedimmediately downstream of the isolation valves or check valvesisolating the duplex line regulators. SUBSTANTIATION: Proposal 99-119 was to require gauges inareas that may require adjustment. The committee’s change was toadd a gauge after each duplex line regulator. In order to properlyset a regulator you need to be able to create a flow of gas. Thismeans that the regulator being adjusted needs to be the serviceregulator when it is being set. Therefore, the gauge on the backupregulator provides little or no benefit and should be made optionalat most. The specification should also permit the usage of digital displays(indicators) in place of gauges. The objective is to provideinformation on the pressure in the headers; therefore, thespecification should permit all acceptable technologies.COMMITTEE ACTION: Accept.Editorially change "may" to "shall".NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 67 - (4-3.1.1.8(e), 4-3.1.1.6 (c) 4-3.1.1.3 (a)6.g.ii ): Accept inPrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-119RECOMMENDATION: Revise text as follows: e. ii. A pressure regulator to reduce the pressure to anintermediate pressure under 300 psig. A gauge in this area isoptional. and an intermediate gauge.SUBSTANTIATION: While I can appreciate the desire to makethis gauge mandatory, it may cause more harm than good. If agauge is located in this area it is more likely that inexperiencedpersonnel may tamper/modify factory settings. Since pressure inthis area may change during normal operation, anunknowledgeable user may misinterpret the information and adjustsettings when the manifold is actually working properly.Furthermore, a qualified repair/maintenance person will have theequipment to service the system, including a test gauge assembly.COMMITTEE ACTION: Accept in Principle.Revise text as follows: "e. ii. A pressure regulator to reduce the pressure to anintermediate pressure under 300 psig."COMMITTEE STATEMENT: It is not necessary to state the gaugeis optional.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 68 - (4-3.1.1.8(e), figure 4-3.1.1.5, 4-31.1.3(a)6.e): Accept inPrincipleSUBMITTER: Dennis Huffman, Western EnterprisesCOMMENT ON PROPOSAL NO: 99-119RECOMMENDATION: Revise text as follows: e. a pressure gauge or display indicating header contents.SUBSTANTIATION: The specification should permit the usageof digital displays (indicators) in place of gauges. The objective isto provide information on the pressure in the headers; therefore,the specification should permit all acceptable technologies.COMMITTEE ACTION: Accept in Principle.Revise text as follows: "e. an indicator displaying header pressure."COMMITTEE STATEMENT: This will permit new technology todisplay header pressure.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 69 - (4-3.1.1.9): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-127RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: Why are we mandating a technology withfrequent maintenance requirements? What are the benefits if anyof this technology? Why are we looking for something which isn’tthere.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: CO is a known contaminant withsevere, acute effects that could harm patient health and could bedrawn into the medical air inlet and should be monitoredcontinuously.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: I agree with the submitters of these comments thatthe issue of CO has not been proven to be a prominent healthhazard at the levels we specify in our document. As a result ofMark Allen's comment the TC went even further and is now

specifying the CO monitors be tested and calibrated annually or asrequired by the manufacturer (CC10). The TC Comment on Log#31 is inadequate to justify the need for this test, test equipmentand the continued monitoring for CO. It appears as if thesubmitters did a better job of justifying why not to continuouslymonitor for CO than the TC did in justifying the existingrequirement.

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99- 70 - (Figure 4-3.1.1.9): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-127RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: Refer to Committee Statement: "Thecontinuous monitoring of CO is necessary for patient safety." If in over 16 years of testing many medical air systems we havenever found more than 1 or 2 ppm of CO where as USP limits are10 ppm-where is the problem of patient safety? CO monitors are expensive, must be calibrated regularly andrequire alarms that incur an extra cost to test.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-69 (Log #31).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my explanation of Negative on Comment 99-69(Log #31)

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99- 71 - (Figure 4-3.1.1.9): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-126RECOMMENDATION: The Technical Correlating Committeedirects this proposal be returned to Committee. a. It is not apparent where or why recommendation No. 2 wasnot accepted. b. It is not clear where recommendations 4 and 5 were insertedin the document. The Committee Statement should reflect thisaction. c. The Committee Statement cites a figure which was notincluded for review. d. Recommendation No. 5 says the note was omitted, but thenote was not included with the proposal for review.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 72 - (Figure 4-3.1.1.9, 4.3.1.1.9 (i)): RejectSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-127, 99-138, 99-139RECOMMENDATION: Delete the requirement for continuousCO monitoring and move to an annual test.SUBSTANTIATION: Carbon Monoxide Monitoring isproblematic in several respects: 1. The level being monitored is that set by USP (10 ppm). Thereis no available research which indicates this is a particular healthhazard, or to express it more bluntly that there is risk to patients at11 ppm which does not exist at 10 ppm. Home monitors for CO,


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clearly intended for protection against long term exposure, do notregister until above 20 ppm. 2. The original intent of the monitor was: A. To determine if the intake was placed in such a location as toingest large amounts of engine exhaust, etc. The monitor, at leastwhen new, does this well. This has been attested by the readingsexhibited in the factory or on a trade show floor when forklifts areoperating. However, it is unusual for the monitor to trip over the10 ppm reading even at such times. There are also undeniablycases where the CO Monitor has detected an incorrect intakelocation. CO’s efficacy as an indicator gas is undeniable, but thelevel is highly problematic. EPA reports there are cities whereambient CO levels can exceed 10 ppm for periods of time. For anysuch sites, the monitor is a simple nuisance and has lost anyrelevance in detecting a bad air intake location. B. To provide an early warning in the event of a lubricatedcompressor burning it’s oil. This application has become largelyirrelevant as these compressors have disappeared from medical airservice. Nevertheless, this function can be argued to still havesome relevance in oil free style compressors. 3. The normal method of monitoring for CO is sensor know as a"fuel cell", which has an effective life of two years. At the end ofthis time, the fuel cell must be replaced or the monitor ceases tooperate. In addition, all CO monitors require calibration (most atleast an annual calibration). Beacon Medical is the largest singlesupplier of medical air systems in the United States, so it wouldfollow that Beacon should also be a large supplier of replacementsensors and calibration kits. Without revealing confidential data, Iwould like to point out that in 2000, approximately 2% of Beacon’seligible customers (i.e., those with monitors over 2 years of age)purchased replacement CO sensors. This would imply that asmany as 98% of the monitors installed since 1993 are nowinaccurate or inoperative. But ignorance must be bliss, becauseequally few customers bought calibration kits. I believe othermanufacturers would report very similar results. Testing CO levels is very valid and should continue. It isespecially valid at startup, when a bad intake location can beidentified and corrected, and it is valid on an occasional basis toensure conditions have not changed. I do not support norpropose elimination of CO testing, but rather would prefer to see aperiodic test substituted for a continuous monitor. This issupported by our experience with these monitors and theconsequent conclusion that (1) periodic testing is equally valid,(2) periodic testing is more likely to be done and will give no falsereading, and (3) CO level needs to be interpreted. A level above10 ppm is not alone a sufficient cause for action. The hazardrepresented by CO level is relative to the ambient conditions,which a simple line monitor does not evaluate. The monitor may have some additional justification on oil freecompressors. Even this is problematic in light of the experience inthe field, since if the sensors are not renewed, this function is lostat the same time the compressor is most likely to exhibit theproblem. Nevertheless, retaining the CO monitor on oil freecompressors may be defensible as an additional, type specificprecaution.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-69 (Log #31).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my explanation of Negative on Comment 99-69(Log #31)

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99- 73 - (4-3.1.1.9(a)): Accept in PrincipleSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-128RECOMMENDATION: I recommend that we accept in principleinstead of just accepting. At the end of the submitter’s additionalwording, replace the period with a comma and add ", or forcalibration of anesthesia machines and respirators" SUBSTANTIATION: The strength of the submitter’s wordingcould potentially outlaw the common practice of medicalpersonnel calibrating anesthesia machines or respirators. Myrewording is an attempt to rectify this potential problem.

COMMITTEE ACTION: Accept in Principle.Revise the proposed wording as follows: "...,or for calibration of patient respiratory medical equipment."COMMITTEE STATEMENT: The modification was made toinclude all medical equipment dealing with patient respiratoryequipment.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 74 - (4-3.1.1.9(b)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-129RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: If the medical air piping must be cleanedfor oxygen service, then it certainly makes sense that the medical airintake should also be cleaned for oxygen service. Air flowingthrough a pipe with oil on its surface will pick up some of that oilpass it into the pipeline and ultimately to the patient.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Medical air systems upstream of thesource valve are not cleaned for oxygen service. Opening the inletpipe to atmosphere would void the oxygen cleanliness.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 75 - (4-3.1.1.9(b)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-129RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: I agree with the submitter that oil couldmigrate into compressors, so to eliminate any possibility of thiscommittee must require pre-cleaned tubing for compressorintakes.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-74 (Log #39).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 76 - (4-3.1.1.9(g)): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-134RECOMMENDATION: While the Committee Action was to acceptmy proposal, Mr. Frankel did bring up an interesting pointregarding changing the high dewpoint alarm set point. I would recommend the high dewpoint set point be lowered fromits current +39°F (+3.9°C) pressure dewpoint (4-3.1.2.2(d)2), to ahigh dewpoint of +25°F (-4°C) pressure dewpoint.SUBSTANTIATION: We need to remember that the prime reasonfor a high dewpoint alarm is to alert the facility that their medicalair drying equipment has degraded in function and needsattention. For instance, if dryers are installed that are processingthe air down to a dewpoint of +10°F PDP, an alarm at +25°F PDPgives a more than adequate warning to the facility that theirmachinery needs attention. Additionally, since the standard is a minimum document, afacility that installs dryers capable of much lower dewpointproduction can have their dewpoint alarms go off at aproportionally lower level.COMMITTEE ACTION: Reject.


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COMMITTEE STATEMENT: The existing alarm point issatisfactory for the new requirement as defined in Proposal 99-134(Log #281) and does not exclude any technology. Existing setpoints adequately handles the degradation of the dryer. NFPA 99 isa minimum standard and lower set points are acceptable. Dailymonitoring of existing system performance adequately handles thedegradation of the dryer.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 77 - (4-3.1.1.9(i)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-138RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: See my comments on Proposal 99-127 (Log#38).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-69 (Log #31).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my explanation of Negative on Comment 99-69(Log #31)

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99- 78 - (4-3.1.1.9(i)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-139RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: See my comments on Proposal 99-127.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-69 (Log #31).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my explanation of Negative on Comment 99-69(Log #31)

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99- 79 - (4-3.1.1.9(i)): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-138, 99-127, 99-139RECOMMENDATION: These three logs all speak to the sameissue of deleting the requirement for carbon monoxide analyzers inthe medical air stream.SUBSTANTIATION: The committee’s action has been to rejectall three of these logs on the basis that the continued monitoring ofcarbon monoxide is necessary for patient safety. The level that is in the standard is 10 ppm. This level isinsignificant relative to patient safety. The primary reason for evenhaving a carbon monoxide level requirement was to monitor thequality of intake air as relates to the location of the inlet to themedical air compressor system. Once a new medical air systemhas been put through the tests required in 4-3.1.4.3(j), it is notnecessary to continuously monitor carbon monoxide. Another point to consider is that the typical home carbonmonoxide alarm is designed to not alarm even when exposed tocarbon monoxide levels of 70 ppm for 30 days. Most homedetectors need to be exposed to levels of 400 ppm for between 4and 15 minutes before they will alarm. Per UL2034, Section 1-1.2,home detectors are designed to alarm before carbon monoxidelevels become dangerous.

COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-69 (Log #31).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my explanation of Negative on Comment 99-69(Log #31)

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99- 80 - (4-3.1.1.9(i).3): Accept in PrincipleSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-141RECOMMENDATION: Revise text to read as follows: "b. High water level in receiver (if so equipped) "SUBSTANTIATION: This is only required for liquid ringcompressors or if the compressor has water-cooled heads. Note 2under Table 4-3.4.1.4 in the 1996 edition also recommended itwhen water-cooled aftercoolers are in use. There was norequirement for this in the text however. Proposal 99-142 states thissame recommendation, but the committee statement referred backto action taken on an unrelated proposal number.COMMITTEE ACTION: Accept in Principle.Revise b. to read to read as follows: b. High water level in receiver under any of the followingconditions: 1. liquid ring air compressor 2. compressor with water cooled heads 3. water cooled aftercoolerCOMMITTEE STATEMENT: This change meets the submitter’sintent and coordinates with other portions of the standard.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 81 - (4-3.1.1.9(i)3): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-127RECOMMENDATION: Add new text as follows: "The C.O. monitor shall be tested and calibrated annually ormore often if recommended by the manufacturer."SUBSTANTIATION: The manufacturer's recommendationrequires semiannual testing of the C.O. monitor and replacementof the pod every two years. Less than 2 percent of their customershave replaced these pods. This relates to 98 percent of hiscustomers with a false sense of security with a piece of equipmentthat NFPA requires to maintain a continuous monitoring.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 82 - (4-3.1.1.10, 2-2 Instrument Air (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-143RECOMMENDATION: Technical Correlating Committee directsthe proposed definition be referred to the Technical Committee onAdministration for review and action.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.


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COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 83 - (4-3.1.1.10(a).4): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-143RECOMMENDATION: Revise 4-3.1.1.10 (a)4 to read as follows: "...simplex aftercooler, dryer, and receiver by-pass valves shall notbe required."SUBSTANTIATION: The system has inherent redundancy whenthe back-up manifold is installed therefore by-passing singlecomponents is not necessary.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 84 - (4-3.1.2, 4-5.1.2.10, 4-5.1.3): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-145RECOMMENDATION: In 4-3.1.2 change "Level 1,2,3, and 4 Gasand Vacuum Piping and Materials" to "Level 1 and 2 Gas andVacuum Piping and Materials." In the original proposal, do not delete 4-5.1.2.10 Gas Piping and4-5.1.3 Distribution for Gas Powered Devices.SUBSTANTIATION: The committee action was not properlytranscribed during the processing of the ROP. These sectionsshould not have been deleted.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 85 - (4-3.1.2 through 4-6.1.2.5): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-145RECOMMENDATION: The Technical Correlating Committeedirects the Committee to be more specific and complete in itsactions.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The Committee inserted all theaccepted proposals.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 86 - (4-3.1.2.1(c)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-147RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: While the amount of TSP used in re-cleaning of tubing is minimal, I agree with the submitter thatTSP’s use should be eliminated.

COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: No new information was presented.The material is readily available, and cleans equally as well aspresenting a limited environmental impact.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 87 - (4-3.1.2.1(f)2): AcceptSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-145RECOMMENDATION: Revise text to read as follows: " (2) Area Gauge. Vacuum gauges shall be located at each areavacuum alarm signal location , with this gauge connected upstream(on the terminal or inlet side) of any valve controlling that area.Those with normal range display..."SUBSTANTIATION: Recommend deleting the text about whichside of the zone valve the alarm gauge should be on. The currentwording is incorrect for anesthetizing locations. This is covered in4-3.2.2.9(d).COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 88 - (4-3.1.2.2(a)6): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-155RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to Committee forreconsideration. The Committee Action states Accept in Principle;the statement refers to 99-156 (Log #256). Proposal 99-156 (Log#256) does not address zone valves. The action is not consistentwith the Committee Statement.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The Technical Committee actiondeleted the requirement for demand check in zone valve boxessince the gauge could be changed by shutting of the valve.Proposal 99-156 (Log #256) requires demand checks only on mainline pressure gauges not at zone valves.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 89 - (4-3.1.2.2(a)6): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-156RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review and be more specific about what isbeing revised and why.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-88 (Log #154).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 90 - (4-3.1.2.3(b)): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-163RECOMMENDATION: Delete the last sentence in the paragraph: "A main line valve shall not be required where the source shutoffvalve is accessible from within the building. "SUBSTANTIATION: This valve was designed to be used in anemergency. In the 1993 edition, 4-4.1.2.2(c), it required that themain supply line shall be provided with a shutoff valve so located asto be accessible in an emergency. If the fire is located in thesource room and there is no main line valve, there is no way ofshutting down the source without going into the room that is onfire. Many sources of ignition may exist in the air compressormechanical room. There should not be any storage in a manifoldroom, but inspections have revealed Christmas decorations,document storage, or even acetylene bottles in medical gasmanifold rooms.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The submitter is in error as this isnot a fire safety valve. Two valves in series would be redundant.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 91 - (4-3.1.2.3(n)): AcceptSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-162RECOMMENDATION: Revise text to read as follows: "n 1 A zone valve shall be located outside each anesthetizinglocation in each medical gas line, so located as to be readilyaccessible at all times for use in an emergency. These valves shallbe so arranged that shutting off the supply of gas to any oneoperating room or anesthetizing location will not affect the others.All gas-delivery columns, hose reels, ceiling tracks, control panels,pendants, booms, alarm panels, or other special installations shallbe located on the patient side of the valve."SUBSTANTIATION: Alarm panels are not to be located on thepatient side of the zone valves for anesthetizing locations.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 92 - (4-3.1.2.8(b)4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-184RECOMMENDATION: The Technical Correlating Committeedirects the Technical Committee to clarify which items were notaccepted by the Technical Committee. The Committee Statementis not explicit, with specific information related to the submitter’srecommendation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The Committee deleted the word"Scotchbrite" as this is a proprietary product.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 93 - (4-3.1.2.8(b)7): AcceptSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-185RECOMMENDATION: I agree with committee’s action.SUBSTANTIATION: This paragraph has to do with the purgetest. The purity test follows in Pargarph 4-3.4.1.3(i).COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 94 - (4-3.1.2.8(b).7): Accept in PrincipleSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-185RECOMMENDATION: Revise 4-3.1.2.8(b)7 Exception, as follows: Exception: A final connection to an existing pipeline shall bepermitted to be made without the use of a nitrogen purge. Afterfinal connection, the affected downstream portions of the existingpipeline shall be tested in accordance with 4-3.4.1.3(i) and shallalso be tested for particulate matter in accordance with the pipingpurge test 4-3.4.1.3(e), using the gas of system designation.SUBSTANTIATION: I support the committee’s decision toaccept this proposal in principle. The removal of the test to checkgas concentrations downstream of the tie-in is my concern. Itwould be irresponsible to suggest that we not check gasconcentrations downstream after a tie-in, even though it is impliedin other areas of the standard. Consider, for example, an existingsystem where several different piped gases must be rerouted andthen tied back into themselves, affecting only the piping. Deletingthe text as suggested implies that existing outlets downstream neednot be tested for gas concentration, only particulate matter. Across connection in the system would not be discovered in thiscase.COMMITTEE ACTION: Accept in Principle.Revise to read as follows: Exception: A final connection to an existing pipeline shall bepermitted to be made without the use of a nitrogen purge. Afterfinal connection, an outlet in the immediate downstream zone ofthe pipeline shall be tested for particulate and the presence of thedesignated source gas per 4-3.1.4.3(i). Particulate shall be testedby intermittent purging into a clean, white cloth at source gaspressure. Following this test a filter test as described in 4-3.4.1.3(e)shall be performed to verify the cleanliness of the pipeline.COMMITTEE STATEMENT: The rewording includes theappropriate testing for particulates and concentration that appearin Sections 4-3.4.1.3 (e) and (i).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 95 - (4-3.1.2.9(i)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-190RECOMMENDATION: Delete the added text: "Horizontal rerouts from all mains and branches shall be takenoff above the centerline of the pipe and rise vertical or at an angleof not more than 45° from the vertical."SUBSTANTIATION: A. See my explanation of my negative vote. B. If we clean the medical gas pipelines as now mandated or tothe suggested new limits, there will be no foreign matter within thepiping systems that could cause an adverse effect on the overallperformance of the system’s operation.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The requirement adds enhancedsafety and it minimizes the transmission of foreign matterdownstream towards the outlets.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 96 - (4-3.1.2.9(i)): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-190RECOMMENDATION: Delete the following text: "Horizontal runouts from all mains and branches shall be takenoff above the center line of the pipe and rise vertical or at an angleof not more than 45 from the vertical... "SUBSTANTIATION: This will increase the cost of systemssubstantially in both materials and labor due to the increasednumbers of fittings and joints. These systems are designed to bedry systems so the recommended change of elevation is of nobenefit. These constant changes in piping elevation will also eat upvaluable ceiling space. It would be a good recommendation tobring Medical Air and Vacuum alarm lines off the top of thebranch lines to avoid contamination if liquid has entered thosepipelines.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-95 (Log #43).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 97 - (4-3.1.2.9(i)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-190RECOMMENDATION: Reject this proposal.SUBSTANTIATION: The submitter is trying to fix a "problem"that is not a problem. In my many years I have learned that "if itain’t broke don’t fix it." If the committee accepts this proposalthey will be trying to fix something which is not broken.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-95 (Log #43).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 98 - (4-3.1.2.10(a).2): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: Delete the new text.SUBSTANTIATION: Problem is that we should not bereferencing standards just because they are new. NFPA 99 hassufficient requirements for brazer qualification. I fully agree with the other negatives.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The ASSE 6000 covers all installationrequirements, not just brazing. The reference is not to a newstandard but to a set of certification requirements that aremandatory to medical gas system installations. There are manyother standards referenced in NFPA 99 that belong to otherstandards writing organizations.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The NFPA has in the past been very careful not toendorse the products or services of any company and organizationsand been very careful to keep a neutral viewpoint in developing thecodes. Historically the NFPA has deferred this type of regulationto the Authority Having Jurisdiction. The committee's justificationstatement says that ASSE 6000 provides guidelines which improvethe installation, reliability and safety of medical gas systems andneeds to be referenced in NFPA 99. If so this standard can bereferenced in Chapter 21 "Referenced Standards" of NFPA 99. It ismy belief that the present wording in NFPA 99 is adequate. As a

rebuttal to Mr. Mohile's comments regarding training of personnelinstalling this vital life support system, NFPA presently does notrequire installers of automatic fire sprinkler systems to be trainedby a NFPA specified standard and sprinkler systems are a vital lifesafety system. Additionally, NFPA does not specify the trainingrequired for the electricians installing NFPA 110 "Standard forEmergency and Standby Power Systems" Emergency Generatorswhich power the life safety and critical circuits of a health carefacility. It is my belief that the inclusion of ASSE 6000 seriesdocument into the NFPA 99 restricts trade and piping installationcompanies who are qualified, but not to ASSE 6000 seriesdocument, from working in healthcare facilities and does notprovide any greater benefits than the present wording of NFPA 99. There are many independent installers both union and open shopwho presently meet or exceed the ASSE Series 6000 standards, whilethere are installers who are certified under the ASSE Series 6000standards who have installed systems using copper water tubing,using non-oxygen clean pipe and fittings, have no policy andprocedure manuals and brazed the systems without nitrogen gaspurge. Certification does not deal with the problems of poorinstallers, internal contractor management, poor constructionmanagement /supervision and poor certification of systems. Therequirement for the installing contractor should be defined withinNFPA 99, Chapter 4, not through a third party standards makingbody.

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99- 99 - (4-3.1.2.10(a)2): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: Revise text to read as follows: "The installation shall be made by qualified, competenttechnicians experienced and trained in making such installations.and meeting the requirements of ANSI/ASSE Series 6000, Standard6010.SUBSTANTIATION: As a member of MGPHO (Medical GasProfessional Healthcare Organization), I do encourage theestablishing of professional criteria and training for both installersand verifiers. ASSE has created a good document to accomplishthis purpose. It should be allowed to stand on it’s own merit andnot be required by NFPA 99. The National Fire ProtectionAssociation has always been very careful not to endorse theproducts or services of any company or organization and to keep aneutral viewpoint. They defer to the Authority Having Jurisdictionin these matters. The enforcement of ASSE 6000 could be betterperformed by including it in the engineering specifications forremodel and construction of health care facilities. The AmericanSociety of Plumbing Engineers is a good vehicle to increase theawareness of this new standard among designers. If ASSE 6000 were to be required by NFPA 99, then NFPA wouldhave to accept any changes made to the ASSE document before thenext revision cycle of NFPA 99.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: ASSE 6000 provides guidelines whichimprove the installation, reliability and safety of medical gassystems and therefore needs to be referenced in NFPA 99.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-98(Log #44). ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).COMMENT ON AFFIRMATIVE: WAGNER: Subsequent changes to ANSI/ASSE Standard 6010 (orany other referenced standard) do not automatically affect thecurrent issue of NFPA 99. The referenced standards in Chapter 21include issue dates to indicate which edition of the standard isbeing referenced. If ASSE subsequently revises ANSI/ASSEStandard 6010, those changes will not be part of NFPA 99 untilthere is a proposal to update the referenced edition of 6010 duringthe next revision cycle of NFPA 99.

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99- 100 - (4-3.1.2.10(a)2): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: Reject this proposal.SUBSTANTIATION: I agree with Mr. Erickson that NFPA 99currently covers this and needs no additional qualifications.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-99 (Log #73).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-98(Log #44). ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 101 - (4-3.1.2.10(a).2): RejectSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: Revise text to read as follows: "The installation shall be made by qualified competenttechnicians experienced in such installations and meeting therequirements of ANSI/ASSE 6000 Series 6010 (see 4-3.1.2.12 forbrazer performance) and under the qualified supervision of anindividual meeting certification to a national standard, such asANSI/ASSE 6000 Standard 6010."SUBSTANTIATION: While I am concerned that the level ofexpertise in medical pipe line installation is not as high as it shouldbe, the proposal as written and accepted by the committee wouldadd a great deal of additional cost to medical pipe line installation.This proposal is presented as a compromise to the committee toreach the goal of higher quality without an undue rise in cost ofinstallation.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: A single individual can not supervisethe entire medical gas and vacuum system installation. TheANSI/ASSE standard requires each individual to be trained andcertified as a medical gas and vacuum system installer.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-98(Log #44). SMIDT: The committee rejected this proposal on the basis thatone person cannot supervise a medical gas and vacuum systeminstallation. With due respect, the plumbing and electricalindustries have allowed the concept for years. The revision aswritten would still require a brazers certificate and was offered as acompromise between the all or nothing proposals offered before.We need to address compliance with the code not try to achievecompliance by adding additional non-necessary layers to the code.

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99- 102 - (4-3.1.2.10(a).2): RejectSUBMITTER: Dale Woodin, ASHE-American Society forHealthcare Engineering of the American Hospital Association(AHA)COMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: The Technical Committee accepted thisproposal in principle. I object to this change and request that thecommittee reject the proposal, therefore striking the reference toASSE 6000 and returning the paragraph to its original wording inthe 1999 edition. Proposal 99-191 (Log #190) revised the text to:

"The installation shall be made by qualified, competenttechnicians experienced in making such installations and meetingthe requirements of ANSI/ASSE Series 6000, Standard 6010". SUBSTANTIATION: The substantiation of Proposal 99-191 (Log#190) is based on the fact that because a certification now exists itshould be written into the standard. This implies that the standardwas lacking and now that a certification exists the standard can nowbe made complete. The burden of proof must be substantiated byperformance. Are there documented cases where the actions of anon-ASSE certified installer have led to patient harm or a medicalincident? If not, it is purely speculative that ASSE certificationshould be the sole criteria for determining if an installer iscompetent. "The installation shall be made by qualified,competent technicians experienced in making such installations".That statement stands on its own as a requirement. Citing oneorganization as being the only measure of competency is shortsighted and creates a closed market. Time and time again, lack ofcompetition has led to increased fees and prevented, notenhanced, improvement. With accepting this proposal, thiscommittee moves from a technical standards committee to aregulatory body mandating what skills and knowledge areacceptable and rejecting all others. This committee shouldreaddress this issue and confine its activities to setting the technicalstandards, not controlling the market.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-99 (Log #73).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-98(Log #44).COMMENT ON AFFIRMATIVE: WAGNER: ANSI/ASSE Standard 6010 provides a means ofdetermining if installers are qualified and competent by theirknowledge of NFPA 99 medical gas and vacuum systems. If there isanother standard that equally addresses this issue, it can be addedto NFPA 99. In the case of qualification of brazers and brazing procedures,NFPA 99 references ASME and AWS procedures, both of which areconsidered to be acceptable.

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99- 103 - (4-3.1.2.10(a).10): AcceptSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-191RECOMMENDATION: We wish to comment in the affirmativeregarding this proposal to add the requirements of ANSI/ASSE6010 to the NFPA.SUBSTANTIATION: Mr. Mraulak has adequately rebutted thecomments regarding the consensus status of the American Societyof Sanitary Engineering Standards writing programs. I wish tospeak to the issue raised by Mr. Smidt regarding the cost of theadditional training being passed onto the health care facility. The 32 hour training program to meet the standard ofANSI/ASSE 6010 is currently provided in every plumber andsteamfitter local apprentice program in every state. In addition, the32 hour course is also offered in every state to open shop andhospital personnel. Successful completion of this course is a statestatute requirement in Washington, Montana, Nevada, Texas,Louisiana, Georgia, Alabama, Florida, Tennessee and 5 otherstates. Additionally, several additional states are close to passing orhave already passed similar statues including New Jersey,Connecticut, Ohio, etc. Government bodies such as the Navy aremandating compliance with ANSI/ASEE 6010. We have yet tocome across any company that is charging more for a job due tothe requirement for training of personnel. Current NFPA requirements only mandate that brazers haveproven proficiency in the actual act of brazing, not in knowledge ofNFPA requirement such as valve and alarm location, types oftubing and fittings, etc. It is time that NFPA becomes currentand/or proactive with respect to training of personnel working onvital life support gases. Facilities want their elevator installers and repairmen trained; airbalancers trained and certified; their electricians trained; backflow


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prevention installers trained. Why not their medical gas systeminstallers? And please note that the NFPA has for years been in the businessof specifying the professional qualifications of Fire Fighters (NFPA1001), Airport Fire Fighter (1003), Fire Fighter MedicalTechnicians (1004), etc. All we are doing here is standardizing thetraining of the personnel who will install vital life support systems.We specify what the systems shall consist of. Why not go furtherand mandate training of the installers? For the record, I am an instructor of this program for which Ireceive fees. I am also a verifier who has extensive experience withinstallations of medical gas systems around the country and haveseen what is done by personnel who do not have proper training.And while completion of this 32 hour course is not a guaranteethat all problems with installations will be eliminated, it is a giantstep in the right direction.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-98(Log #44).

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99- 104 - (4-3.1.2.11(c).5): AcceptSUBMITTER: Burton R. Klein , Burton Klein AssociatesCOMMENT ON PROPOSAL NO: 99-195RECOMMENDATION: Delete 4-3.1.2.11(c)5.SUBSTANTIATION: Error in printing of originalrecommendation. Only subpar. (c)5 should have been listed fordeletion as text in subpar. (c)5 is covered in par. 4-3.1.2.11(a).COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 105 - (4-3.1.2.13): RejectSUBMITTER: Burton R. Klein , Burton Klein AssociatesCOMMENT ON PROPOSAL NO: 99-201RECOMMENDATION: Accept Proposal 99-201SUBSTANTIATION: The last sentence (which is recommendedfor deletion) is redundant to sentence 1 of 4-3.1.2.13, as well as toparagraph 4-3.1.3.11(a). Also, last sentence, if strictly interpreted,could mean that ONLY non-standard pressure pipelines are to belabeled. And I do not believe this is the intent of the committee.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The submitter is incorrect in hisbelief. It is the committee’s intent to have pressure indicated ononly non-standard pressure pipe. See Committee Action onProposal 99-200 (Log #57).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 106 - (4-3.1.2.13): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-202RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review and be more specific in theCommittee Action. State what is accepted and what is notaccepted.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordance

with 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The committee was specific in thatthe last sentence of the proposal was not accepted.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 107 - (4-3.2.2(c)6): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-7RECOMMENDATION: Add new 4-3.4.2.2(c)6 as follows: "Station Inlet Test. All vacuum inlets shall be tested to assure aminimum flow rate of 3 scfm without reducing pressure below 12in. Hg. at an adjacent station inlet." Change reference "4-3.5.6.1(c)" to "4-3.4.2.2(c)6"SUBSTANTIATION: The committee applies flow specificationsto all of the pressure outlets, but failed to provide a test standardfor vacuum inlets.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 108 - (4-3.2.2.2): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: This proposal is for vacuum lines only.There is no fire hazard with the acceptance of this proposal.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Medical vacuum piping networks arepart of vital, life saving systems essential to patient safety and care.Vacuum piping networks are a permanent part of the facility, oftenremaining in service over the lifetime of the facility, and are oftenlocated in inaccessible areas. Vacuum piping networks passdegrading materials and must remain leak-free over the service life. Specifications for materials, installation, and testing for medicalgas and vacuum piping networks have been identical in thisstandard, including the use of brazed joints. To permit the use ofmechanical joints, for which there is no standard, would departfrom the proven safety history of brazed joints.NFPA 99 has developed extensive requirements for brazing,performance, brazer certification, and testing to assure thesuccessful performance of brazed joints. Flush seal gaskets suitable for vacuum service and press fit fittingsare proprietary products of specific manufacturers. There are noestablished criteria for their successful use in medical vacuumnetwork piping systems. Both technologies require training by themanufacturer for their proper application and installation. Neithertechnology solves a problem that is created by the use of brazedcopper joints. Permitting other than brazed copper joints willmake NFPA 99 performance-based with regards to medical vacuumpiping and will make the AHJ responsible for its successfuloperation. Ductile iron components used on copper piping networks aredissimilar metals, which are not permitted in this standard.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: The reason for the abstention is due to the TC'sdirection on eliminating all piping material and installationmethodologies other than brazed copper tubing. As mentioned inmany of the comments submitted, the use of other material forvacuum systems has not been an issue in the past nor has it been aconcern until the subject of the use of grooved pipe and synthetic


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seals were recommended. The substantiation given by the TC isflawed in many areas, such as: 1. Vacuum piping can be a permanent part of the facility but soare many other systems that need constant inspection and repair.We install HVAC systems in the same chases and ceiling spaces thatthe vacuum tube is installed, pneumatic tube systems, fire warningand safety system cabling, etc. Just because this is a "permanent"installation doesn't mean that materials other than copper tubingshould be eliminated from being an acceptable material. 2. The statement that to permit the use of a mechanical jointother than a brazed joint would depart from the proven safetyhistory is pure nonsense. How can a manufacturer provesomething will work if it is never permitted in the first place? Thetechnology has been proven in other applications and it does havea long history of safety, why are we going to outlaw it for vacuumsystems? 3. The statement that the technology requires training by themanufacturer therefore it should not be allowed is a very weakargument by a TC. If this were the case then we would never havea system installed in a health care facility as they all require trainedinstallers. If the ASSE 6000 certification passes, the training for theinstallation of all acceptable methodologies would need to beincluded. 4. The statement that permitting other than brazed joints willmake NFPA 99 a performance based standard with regard tovacuum systems is another weak statement made by a TC. Look atthe direction NFPA is going with regard to performance-basedstandards in the Life Safety Code, Building Code, etc. The wholemovement in NFPA is toward performance-based standards and weshould not be fighting that movement. If the authorities havingjurisdiction need to make the evaluation on a case by case basisbased on the material and location of installation, that is nothingnew and is consistent with the entire NFPA family of codes andstandards. 5. The last statement made in the substantiation about thestandardization of material will make the system installation safer,stronger, cleaner is not backed up with any references toinappropriate installed systems, historical data, facts, etc., it is allconjecture at this point. To further this argument the last line talksabout confusion of installing a positive pressure line with softsolder because the installer was confused. Isn't this why we arecertifying installers, inspectors, and verifiers?

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99- 109 - (4-3.2.2.2): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: After further consideration we wish tochange our position on the matter of the use of Victaulic© pipeand joints for vacuum systems.SUBSTANTIATION: As long as the application is vacuum only,and as long as the proper rubber gasket is provided and used, wehave no objection to Victaulic© pipe and joints being used in thehealth care industry.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-108 (Log #27).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 110 - (4-3.2.2.2): RejectSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: Accept Proposal 99-211 (Log #32) assubmitted by Mr. Sellers.SUBSTANTIATION: The committee did the industry a disfavorby rejecting this proposal. Victaulic has provided evidence that thistype of system will perform for the type of installation submitted.

To only allow brazed copper as the material of choice for vacuumsystems is limiting without any real good explanation. Groovedpipe system are routinely used in medical facilities for sprinklerwater line, to infer that only brazed copper will perform under fireconditions is not funded by the committee by any real empiricalevidence. The committee owes the health care industry, which itserves, alternatives when they will perform for the stated function.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-108 (Log #27).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 111 - (4-3.2.2.2): RejectSUBMITTER: Thomas J. Mraulak , Metropolitan Detroit PlumbingCOMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: None given.SUBSTANTIATION: I would like to respond to the five negativeballots returned on 99-211 (Log #32) - 4.3.2.2.2 concerning the useof victaulic or similar fitting systems on vacuum systems. To begin with the committee voted to accept the changeseliminating all materials and joining methods of vacuum pipingother than copper tubing joined by brazing. This change not onlyeliminates stainless steel and galvanized steel as materials it alsoeliminates welding, screwed and flanged joints, and soldering asjoining methods. This wording also eliminates Victaulic andVictaulic type products. In 1996, all reference to gasketed couplings was removed fromthe standard as a means of joining vacuum piping. Not being onthe committee then I don’t know why, but there must have been agood reason. Looking back into the 1995 ROPs and ROCs I couldfind no substantiation for removing it. In 1999 the committeerejected Victaulic for use on vacuum systems. The clamp (which makes contact directly onto the copper tube)that goes over the rubber gasket on a roll grooved joint is made outof a ductile iron, cast material that has been painted a coppercolor to try and make it look like copper. Our standard has saidfor years that dissimilar metals should not come into contact witheach other. In the section regarding hangars the standard says thatall hangars shall be copper coated to prevent corrosion. Inpotentially damp locations, copper tube hangars or supports shallbe plastic coated or otherwise insulated from the tube. Coppercolored paint does not protect couplings from corrosion and doesnot insulate the copper tube. Some of the negative comments stated that vacuum systems arenot positive gas systems and therefore they should not be treatedthe same, and there are no safety issues involved in a vacuumsystem. I also feel that they are not the same. If anything thevacuum system requirements for piping and installation should beas stringent or even more stringent than positive gas systems. Dr. David Lees made a statement to the committee last year sayingthat in his opinion the vacuum system is the most critical system ina hospital. Some patients could live for a while if any of thepositive gas systems were lost, but if a vacuum system was lost apatient could drown in their own fluids in a matter of minutes.This is a serious issue. A vacuum system could also contain justabout any disease known to man (i.e. aids, hepatitis etc.). Tie-inprocedures in many hospitals require workers tying a vacuum lineto dress up and take precautions as if they were dealing with ahazardous waste (which it could very well be). If a vacuum line is doubling as a WAGD line, I’m not sure thatthe gaskets could handle and be compatible with every anestheticgas that may be in that line without deteriorating the rubber gasket. Having installed thousands of feet of Victaulic and Victaulic typeproducts both grooved galvanized steel and roll grooved copper, Ithink that it is a great product for water lines, sludge lines, coolingwater lines, etc. but not for vacuum lines in a health care facility.In a fire can the gaskets in a roll grooved situation or the tworubber o-rings in a Pressfit system withstand the temperatures of afire and the possible consequences of the rubber melting? Thedocumentation that was submitted to the committee states that theyare only good up to a maximum temperature rating of 230°F.


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By using copper tube and brazing the joints, we make the vacuumsystem at least as safe as the positive gas systems. NOTE: Supporting material is available for review at NFPAheadquarters.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: No recommendation was given andthe comment was rejected per 4-3.5.1 of the Regulations GoverningCommitte Projects.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 112 - (4-3.2.2.2): RejectSUBMITTER: Dale Woodin, ASHE-American Society forHealthcare Engineering of the American Hospital Association(AHA)COMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: The Technical Committee rejected thisproposal. I object to this change and request that the committeeaccept the proposal as written.SUBSTANTIATION: The use of new materials and alternateinstallation methods represents competition and therefore offersthe potential for keeping the cost of medical gas systeminstallations reasonable. If the proposal establishes adequatetechnical substantiation as to the reliability and durability of theproduct, then this committee has a duty to only reject the proposalif this substantiation is not thorough or convincing or ifcontradictory evidence exists. In the absence of these elements thecommittee should allow the introduction of this product/methodand let the owner decide what is appropriate for their facility.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-108 (Log #27).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 113 - (4-3.2.2.2): RejectSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-211RECOMMENDATION: Accept Proposal 99-211 (Log #32) assubmitted by Mr. Sellers.SUBSTANTIATION: The committee did the industry a disfavorby rejecting this proposal. Victaulic has provided evidence that thistype of system will perform for the type of installation submitted.To only allow brazed copper as the material of choice for vacuumsystems is limiting without any real good explanation. Groovedpipe system are routinely used in medical facilities for sprinklerwater lines, to infer that only brazed copper will perform under fireconditions is not funded by the committee by any real empiricalevidence. The committee owes the health care industry, which itserves, alternatives when they will perform for the stated function.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-108 (Log #27).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 114 - (4-3.2.2.2): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-213RECOMMENDATION: Remove the words "soldered or".SUBSTANTIATION: This was inadvertantly left in and shouldhave been deleted.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 115 - (4-3.2.2.2, 4-3.2.2.2.(a)): RejectSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-211, 99-213RECOMMENDATION: Reverse the actions.SUBSTANTIATION: Having no interest in this matter other thanthe good name of the committee, which I believe has beendisgraced first by it’s inaction on 99-211 (Log #32), and second byso inadequate a substantiation in it’s final rejection, I wish tochallenge the actions on these two proposals, requesting thecommittee reconsider their actions on both these submissions [99-211 (Log #32) and 99-213 (Log #80)]. The proposal in 99-211 (Log #32) was submitted in good faith tothe committee, including presentations and the providing ofconsiderable subsequent information by the submitter to deal withcommittee questions. Nevertheless, the proposal was held for"further study" from the 1999 cycle. Regrettably, and for a variety ofreasons good and bad, the "further study" was not carried out. Thelater submission 99-213 (Log #80) is advanced as substantiation forrejecting this submission. The sum effect of 99-213 (Log #80) is to eliminate the use of anymaterial for vacuum piping other than copper tube, brazed as forpressure gases. This was verbally argued as desirable on thegrounds of patient safety in addition to the substantiation in theoriginal submission. However, there are inconsistencies in thearguments advanced: The proposed change eliminates the use of galvanized, stainlessor other piping materials previously allowed. This prohibition isargued on a) economic grounds and b) as desirable to harmonizevacuum and pressure gas requirements and c) on the grounds oftheoretical hazard of loss of vacuum under certain fire conditions. With respect to the economic arguments advanced as (a) above,the Technical Committee is not charged with making economicdecisions for the user. On cost grounds alone it cannot disallowmaterials which have served to general satisfaction and/or areknown to be otherwise satisfactory for the service. The user isentitled to make their own decisions on economic grounds as theywish. In any event if this assertion is true and given the state of theindustry today, the Committee need never fear that any but copperwill be used! With respect to the harmonization of vacuum and pressure gasesadvanced as (b) above, however desirable this harmonization is,there is no compulsion arising from safety hazards to harmonizethese requirements. Harmonization is a voluntary effort aimed atmaking the standard easier to use, not at changing technicalrequirements. That desirable harmonization between vacuum andpressure has been admirably handled in 99-145. With respect to the argument advanced as (c) above, i.e., that alocalized fire could result in vacuum pipeline separation andtherefore could endanger patients. Such a fire, hot enough to melt95-5 solder (450°F) must be assumed to exist in such a way as tomelt the joint(s) of the vacuum pipeline and cause separation butnot cause evacuation of the facility (e.g., procedures continue inother parts of the facility). Admitting this possibility (albeit highlyunlikely) paradoxically leads to an entirely opposite conclusion. Ifwe accept that this hazard is sufficiently real to make so dramatic amaterial change, then it is copper than should be precluded, ascopper to copper is the least fire resistant jointing methodcurrently allowed. Galvanized or stainless pipe joints are threadedor welded - a far more fire resistant jointing method than evenbrazing. The coupling systems envisioned under 99-211 (Log #32)will not separate under any fire scenario as limited as thatenvisioned above, which is demonstrated by actual testing (asshown in the original submission). Any leakage which might existin such a coupling were the elastomeric seal to be entirely burnt or


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melted away is certainly minimal enough to be discounted in thenear-disaster scenario envisioned. In short, no irrefutable argument has been advanced to justify thechange implied in the committee action on 99-213 (Log #80). If99-213 (Log #80) cannot stand scrutiny, then 99-211 (Log #32)cannot be rejected, especially so in light of the voluminous datasupplied by Victaulic with their submission in 1997. It isinappropriate for the committee to reject this submission withoutat least refuting the data submitted, and at best disrespectful to doso on so flimsy a substantiation.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Medical vacuum piping networks arepart of vital, life saving systems essential to patient safety and care.Vacuum piping networks are a permanent part of the facility, oftenremaining in service over the lifetime of the facility, and are oftenlocated in inaccessible areas. Vacuum piping networks passdegrading materials and must remain leak-free over the service life. Specifications for materials, installation, and testing for medicalgas and vacuum piping networks have been identical in thisstandard, including the use of brazed joints. To permit the use ofmechanical joints, for which there is no standard, would departfrom the proven safety history of brazed joints. NFPA 99 has developed extensive requirements for brazing,performance, brazer certification, and testing to assure thesuccessful performance of brazed joints. Flush seal gaskets suitable for vacuum service and press fit fittingsare proprietary products of specific manufacturers. There are noestablished criteria for their successful use in medical vacuumnetwork piping systems. Both technologies require training by themanufacturer for their proper application and installation. Neithertechnology solves a problem that is created by the use of brazedcopper joints. Permitting other than brazed copper joints willmake NFPA 99 performance-based with regards to medical vacuumpiping and will make the AHJ responsible for its successfuloperation. Ductile iron components used on copper piping networks aredissimilar metals, which are not permitted in this standard. The second proposal was rejected because the standardization ofmaterials will be safer, stronger, cleaner and may prevent confusionand mistakes by inadvertently soldering a positive pressure gas line.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 116 - (4-3.2.2.2(a)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-212RECOMMENDATION: Reject this proposal.SUBSTANTIATION: If we accept this proposal in principle, whatis next? Yearly forced detergent washing of vacuum systems.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The need for nitrogen purging is toeliminate copper oxides from forming on the interior of thevacuum tubing during brazing. A large vacuum system brazedwithout a nitrogen purge could accumulate as much as a trash bagfull of copper oxides. Requiring a nitrogen purge eliminates thisproblem and the cost of the nitrogen purge is less than a penny perfoot of pipe run.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 117 - (4-3.2.2.2(a)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-213RECOMMENDATION: Accept this proposal.SUBSTANTIATION: There is no indication to me thatelimination of certain materials for vacuum systems increases firesafety!COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The standardization of materials willbe safer, stronger, cleaner and may prevent confusion and mistakesby inadvertantly soldering a positive pressure gas line.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 118 - (4-3.2.2.2(a)): AcceptSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-211aRECOMMENDATION: We wish to speak in the affirmative to theissue of brazing copper tubing if it is used for vacuum systems.Since the installer is typically already up in the area of the joint andbrazing the oxygen and other lines, it is a simple matter to brazethe vacuum system as long as it is made of copper tubing. Theswitching back and forth from brazed joints to soft solder joint caninadvertently cause a positive pressure joint to be installed with softsolder. This can easily happen in the operating room where thereare many positive pressure and vacuum lines being installed.Although vacuum lines are supposed to be 3/4 in., many times thepositive pressure lines are also 3/4 in., especially nitrogen, and thepotential for mix up is great.SUBSTANTIATION: We would also stress that we are notmandating that the vacuum shall be only copper. We feel thatstainless steel, galvanized pipe or even Victaulic© are acceptablefor vacuum lines.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: Although no specificrecommendation was provided, see the substantiation forComment 99-115 (Log #84).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 119 - (4-3.2.2.2(a)): RejectSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-213RECOMMENDATION: Reject the Proposal 99-213 (Log #80) andrevert to the original text for Medical Vacuum piping materials.SUBSTANTIATION: The committee did the industry a disfavorby eliminating design choices as outlined in this proposal.Limiting the installation to copper brazed and eliminatingcorrosion resistant metal, galvanized, and stainless steel "cost"considerations is not the point. The performance of the material isthe purview of the committee not the cost. Market consideration ifcost is an issue will eliminate the material. Further this actioneliminates viable alternative and submitted in 99-211 (Log #32). Ifthe committee wants to eliminate soldered copper due toperformance do so, but do not eliminate these other materials thatclearly will perform in a fire scenario or in day to day operation.COMMITTEE ACTION: Reject.


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COMMITTEE STATEMENT: The standardization of materials willbe safer, stronger, cleaner and may prevent confusion and mistakesby inadvertantly soldering a positive pressure gas line.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 120 - (4-3.2.2.2(a)): RejectSUBMITTER: Ronald M. Smidt , Carolinas HealthCare SystemCOMMENT ON PROPOSAL NO: 99-212RECOMMENDATION: Reject the Proposal 99-212 (Log #79).SUBSTANTIATION: The proposal advocates use of a nitrogenpurge for vacuum installation. I can not find any sound reason todo this. This chapter clearly states that vacuum systems are neverto be converted to piped gas systems.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-119 (Log #112).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 121 - (4-3.2.2.2(a)): RejectSUBMITTER: Dale Woodin, ASHE-American Society forHealthcare Engineering of the American Hospital Association(AHA)COMMENT ON PROPOSAL NO: 99-213RECOMMENDATION: The technical committee accepted thisproposal in principle. I object to this change and request that thecommittee reject the proposal, therefore striking the changes andreturning the paragraph to its original wording in the 1999 edition.Proposal 99-213 (Log #80) revised the text to: (a) Vacuum Network Piping. Piping shall be corrosion resistantmetal such as seamless copper water tube (ASTM B 88, Type "K,""L" "M"), copper ACR tube (ASTM B280), copper medical gastube ( ASTM B 819), stainless steel tube or galvanized steel pipe [11/2 in. minimum size] (ASTM A53). Copper tube shall be harddrawn temper. Turns, offsets, and other changes in direction in1/2 in. minimum size (ASTM A53). Copper tube shall be harddrawn temper. Turns, offsets, and other changes in direction inpiping shall be made with fittings complying with 4-3.1.2.7(e).Joints in copper tube shall be soldered or brazed. Joints instainless steel tube shall be brazed or welded. Joints in galvanizedsteel pipe shall be treaded or flanged. Solder metal (ASTM B32)shall contain less than 0.2 percent lead. Brazing shall be inaccordance with 4.2.1.2.3(c) 4-3.1.2.12 except that nitrogen purgingwhile brazing shall not be required.SUBSTANTIATION: The substantiation of Proposal 99-213 (Log#80) is based on cost. Is this cost of material or cost ofinstallation? More pointedly, should not the Technical Committeerevise technical documents based on technical information?Galvanized pipe has been used successfully for years in hospitalsand has proven to be a reliable and durable material. It’s relativeease of install and modification during renovation, by competenthospital employed mechanics, makes it a cost effective alternativeto copper. Cost of installation is not a technical issue, it is adecision that should rightfully remain with the owner. Byaccepting proposal 99-213 (Log #80) this committee effectivelytakes the decision out of the hands of the owner.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The standardization of materials willbe safer, stronger, cleaner and may prevent confusion and mistakesby inadvertantly soldering a positive pressure gas line.

NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 122 - (4-3.2.2.8, 4-3.2.2.9, and 4-3.2.2.10): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-219RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement andprovide a more explicit explanation to their action.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: This was due to Manual of Styleformatting as mandated by Proposal 99-7 (Log #CP700).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 123 - (4-3.2.2.11 (d-g)): RejectSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-220RECOMMENDATION: Reconcile with actions on Proposal 99-213(Log #80).SUBSTANTIATION: See substantiation for Proposal 99-213 (Log#80).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The standardization of materials willbe safer, stronger, cleaner and may prevent confusion and mistakesby inadvertently soldering a positive pressure gas line.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 ABSTENTION: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF ABSTENTION: ERICKSON: See my explanation of abstention on Comment 99-108 (Log #27).

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99- 124 - (4-3.4.1.1): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-226RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: The submitter is trying to eliminate aconflict of interest between suppliers and testing agencies. Thecommittee is being very short sighted in just blindly letting thingsgo on as they are.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: It is beyond the scope of thecommittee to define the business relationship between individualentities. Safety and integrity of medical gas systems/equipment are notnecessarily compromised by a qualified verifier who also sellsequipment.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker


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EXPLANATION OF NEGATIVE: DAVIDSON: There is no valid argument in favor of allowing thesupplier to verify and test equipment that is supplied by thesupplier. In most cases the equipment is sold to the contractorwho installs the equipment and who contracts with the verifier(supplier of the equipment) to verify the equipment and relatedpiping system. The committee's justification statement is "it isbeyond the scope of the committee to define the businessrelationship between individual entities. Safety and integrity ofmedical gas systems/equipment are not necessarily compromisedby a qualified verifier who also sells equipment." It is absurd tothink that a supplier of equipment worth tens of thousands ofdollars who is hired as the equipment/system verifier by thecontractor who installed the system/equipment, the samecontractor will not get paid until the system/equipment has beenapproved by the verifier does not lead to a serious conflict ofinterest. Therefore, the supplier/verifier will not get paid until thesystem is certified by the supplier/verifier. What conflict ofinterest? ESHERICK: See my Explanation of Negative on Comment 99-148(Log #163) and Comment 99-142 (Log #98).

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99- 125 - (4-3.4.1.1): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-226RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: I cannot agree with the committeestatement, which is true in 1999 edition. The proposal is to changethat so there can not be a conflict of interest, expressed or implied.See CSA CAN 3-305.4-M85 Clause 4.2.2(e) which says: "The testing agency shall provide a written agreement to... (e) refrain from certifying any medical gas system in which thetesting agency or any affiliated company(-ies) has any materialinterest, so long as such a certification is intended to be thecertification required by clause 11 of CSA Standard Z 305.1."COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-124 (Log #30).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-124 (Log #30). ESHERICK: See my Explanation of Negative on Comment 99-148(Log #163) and Comment 99-142 (Log #98).

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99- 126 - (4-3.4.1.1): RejectSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-226RECOMMENDATION: Insert new text at the beginning of thefourth paragraph: "Testing authority shall not be affiliated in anyway with the supplier or vendor of equipment."SUBSTANTIATION: I am in opposition to the committee’sdecision to reject this proposal. There is no valid argument infavor of allowing a supplier to test his own equipment. The verifierwill not lose his ability to sell equipment, only the ability to test hisown. He will gain the responsibility of testing products supplied byothers. Who better than a verifier to test and scrutinize hiscompetitor’s equipment? The patient will immediately andultimately benefit by adoption of this proposal.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-125 (Log #45).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

EXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-124 (Log #30). ESHERICK: See my Explanation of Negative on Comment 99-148(Log #163) and Comment 99-142 (Log #98).

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99- 127 - (4-3.4.1.1): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-227RECOMMENDATION: The Technical Correlating Committeedirects that the Committee Action be revised to read as Accept InPriniciple.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 128 - (4-3.4.1.1, 4.3.4.1.3): RejectSUBMITTER: Mark Allen, Beacon Medical ProductsCOMMENT ON PROPOSAL NO: 99-226, 99-238RECOMMENDATION: In the various committee actions on thisproposal and in the past, there is a logical inconsistency which thiscommittee must resolve, and now is the ideal time. On the onehand, in 4-3.4.1.3 Paragraph 2 the installer has been prohibitedfrom performing their own verifications. This is justifiedirregardless of competence or lack thereof, but on the basis ofaverting a conflict of interest. On the other, the hospital ispermitted to verify for themselves, assuming adequate competence(4-3.4.1.3 paragraph 3), and without consideration of conflict ofinterest. Now Log 82 presents a third case, which would permit theverifier to supply equipment, or conversely, allow the supplier toverify their own equipment. The submitter’s argument regardingconflict of interest is rejected. In three substantially similar cases,opposed and irreconcilable actions have been taken. I argue forneither side per se, but rather argue that the standard must beconsistent in its treatment of all parties.SUBSTANTIATION: Reducing this issue to its simplest form, Allmust be trusted or none can be. The Committee cannot in allconscience assert that a verifier or a hospital staffer has someexclusive claim to virtue which is not shared by an installer, or thatconflict of interest can be submerged by a "competent" individual,or therefore the installers are by definition incompetent - "for thepurposes of this standard". Regrettably, there is more than adequate evidence to support theproposition that a system of checks and balances is desirable. Asthere were cases of installers shortchanging the certification, thereare cases of verifiers selling questionably necessary equipmentunder the at least implicit threat of non-certification, and there arecases where the verifier feels financial pressure to turn a "NelsonEye" to a "minor little infraction" as assurance toward securing thenext sale. The more reliant the verifier on equipment sales fortheir livelihood, the greater the pressure. There is no statementmore true or more damning than "most verifiers would go out ofbusiness if they lost their equipment sales." On the other hand, whatever is said for the verifier is equally truefor the installer. It is patent nonsense to assert that installers willuniversally ignore their own self respect - not to mention their ownconsiderable liabilities - just to cheat the owner with a crookedcertification. There are installers who qualifications exceed thoseof the verifiers they are forced to hire, and as the installers havebeen working with the ASSE 6000 series qualifications standard fora longer time, the numbers of "qualified" installers is growingrapidly. It is every bit as absurd to assert that hospital personnel, properlyqualified or not, have no motive for cutting corners, just as no onecould assume that they all would.


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All must be trusted or none can be. The committee must decidewhich principle they wish to uphold and carry it entirely throughthe document with appropriate forethought. If all are to be trusted, in 4-3.4.1.3 second paragraph, strike "suchtesting shall be performed by a party other than the installingcontractor." If none are to be trusted (i.e., the trend toward a system of checksand balances is to be continued) add to 4-3.4.1.1 a new paragraph:"Conflict of Interest. In order to prevent conflict of interest in thesupply, installation and verification of medical gas and vacuumsystems, the following limitations shall be observed. a. The Equipment Manufacturer, Manufacturer’s agent orDistributor(s), Installing contractor, Verifier and Facility shall eachbe independent, having no ownership interests one in another. b. Acting in one of the listed capacities shall preclude the sameentity (person or company) from acting in any other of thesecapacities on the same project."COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: There was no specific wordingpresented for making changes. The committee rejected thiscomment based on section 4-3.5.1 of the Regulations GoverningCommittee Projects.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ALLEN: I do not feel that the fundamental issue at stake here hasbeen addressed.

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99- 129 - (4-3.4.1.2(b)): AcceptSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-230RECOMMENDATION: Do not delete the text: "The source shutoff valves for the equipment shall be closed."SUBSTANTIATION: The source valve must be closed to avoidopening the 75 psi final line relief valve. Source piping is to betested per 4-3.4.1.4 at the highest system operating pressure for 2hours with no more than a 10 percent pressure drop.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 130 - (4-3.4.1.2(b)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-230RECOMMENDATION: The Technical Correlating Committeedirects that the Committee Action be revised to read as Accept inPrinciple in Part.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 131 - (4-3.4.1.3): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: Accept the proposal as written.

SUBSTANTIATION: Why must we continue to look for a needlein a haystack? If the hydrocarbons as methane and halogenatedhydrocarbons are not in medical gas systems how are we loweringsafety standards by not checking for?COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: There are three grounds on whichthis test is being retained: First, evidence has been presented which argues these tests haverevealed installation problems concerning improper use ofhydrocarbons and halogenated cleaning solvents used to cleanpipelines. Second, the risk of these compounds remaining in the pipeline isreal and the elimination of them is one of the primary goals of theinstallation and materials specified in this chapter. The simple factremains we have no other test which even circumstantially willcheck for the presence of these compounds. Third, because the installer knows someone is coming to checkfor these compounds, and is going to be doing a test with thesekinds of sensitivity, which will naturally tend to impose a disciplineand vigilance on the process which otherwise would never exist. Itis axiomatic (witness ISO 9000) that what is important should betested, and what is tested will be done. If the installer knows thereis little or no risk in ignoring the cleaning and good practicerequirements, then the liklihood of them not complying isconsequently enhanced. The committee also asserts that the ASSE 6030 credentialledverifier shall be conversant with the various methods used todifferentiate one gas from another and detect trace gaseouscontamination which is important for trouble shooting and theevaluation of hazards. Removal of this test has the undesirableconsequence of removing a whole category of knowledge thatought to be a primary qualification of a professional verifier. Eliminating either of these tests in favor of a single test (such asthe Flame Ionization Detector [Comment 99-165 (Log #79)],would be technology restrictive and would exclude otherapparently successful methods now in use.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: While the substantiation that these hydrocarbons areoccasionally found in the pipeline, the statistics don't prove theneed for this test on all newly installed or renovated systems. Ifthere is a doubt in the mind of the verifier that the properinstallation was not made or if in the review of the installer'smethods and techniques show a potential for the gaseoushydrocarbons then the verifier should perform this test. Theevidence given by the TC members against performing this test andthe evidence presented in the TC meetings was not sufficientenough for me to continue to support performing this test on allnew installations or system modifications. Once again it is up tothe TC to prove that a test is necessary as a minimum requirement. The statement in the committee substantiation that "removal ofthis test has the undesirable consequence of removing a wholecategory of knowledge that ought to be a primary qualification of aprofessional verifier" is not relevant to the argument as to whetheror not this test needs to be accomplished as a minimumrequirement. If the verifiers want to continue to be trained in howto perform this test then ASSE 6000 will make it a requirement ofcertification. ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in support of the committeeaction to reject this proposal. The Liberty Mutual Industrial Hygiene Laboratory performed1,432 hydrocarbon and halogen tests in the past year at 471 facilitiesusing the piping purity test. From this data, we conclude: 1. We and several verifiers testify that these tests do work as theyare currently specified and with it they have found cases of valvecontamination and improper use of hydrocarbon and chlorinatedhydrocarbons used in pipelines. 2. Halogen and hydrocarbon failures don't always happen at ahigh failure rate, but when they happen they do point to problems.We had 14 failures in the piping purity test last year within therange of 1.6 ppm to 7.5 ppm. These failures can have variableresults, where some of the outlets pass and some fail and themeasured levels go down after extensive purging only to increaseagain when the purging stops and liquid solvent remaining in thepipe or valve again evaporates. They also occur for other reasonsas mistakes are made during installation.


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3. Halogen and Hydrocarbon failures also happen at muchhigher concentrations, 3 cases of which involved expensive liabilityclaims and litigation for the hospital as well as the loss of use of thepiped gas system for extended times. This year we tested a linewhich had 5,000 ppm hydrocarbons. 4. The problems that have been identified on site have involvedsolvents such as trichloroetheylene or mineral spirits used to cleanout valves or regulators used in the pipeline. 5. If carefully done, these tests work- and can successfully detectproblems with contamination that are known to occur in theindustry. 6. The FDA Fresh Air 2000 document specifically supports suchtesting as required Current Good Manufacturing Practice. 7. Other know cases have occurred where solvents in the highpressure side of the oxygen lines have caused both severe bodilyinjury and property damage. If the committee wanted to assure atest to detect these problems as well- before they cause harm topatients, an additional Halogen and Hydrocarbon test should beadded to the Medical Gas Concentration Tests 4-3.4.1.3(i).

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99- 132 - (4-3.4.1.3): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-232RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: See my comment on Proposal 99-231 (Log #27).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).

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99- 133 - (4-3.4.1.3): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: This proposal does not lower the safety levelas evidenced by over 17 years experience as Independent Testerswhere in no halogenated hydrocarbons ever found andhydrocarbons as methane were well within the criteria for Federal(USP) limits. Also applies to: 99-232 Accept proposal as written. 99-252 Accept proposal as written.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-86(Log #99).

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99- 134 - (4-3.4.1.3): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-232RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: See committee on Proposal 99-231.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).

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99- 135 - (4-3.4.1.3): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-234RECOMMENDATION: Do not accept this proposal.SUBSTANTIATION: I agree with all negative explanations.Furthermore, if the Technical Committee wants to have the verifier"certified" - they should look at our Northern Neighbor-Canada.They have had such since September 1985: CAN3-Z305.4-M85."Qualification Requirements for Agencies Testing Non-flammableMedical Gas Piping Systems".COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: ASSE 6030 is based on the specificrequirements of NFPA 99 with regard to the verification of medicalgas and vacuum systems. In addition, it sets a benchmark for testequipment and procedures. ASSE 6000 provides guidelines whichimprove the installation, reliability and safety of medical gassystems and therefore needs to be referenced in NFPA 99.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 136 - (4-3.4.1.3): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-238RECOMMENDATION: We wish to continue to support therequirement that the Verifier shall not have any ties whatsoever tothe equipment supplier, installer or manufacturer.SUBSTANTIATION: None given.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-124 (Log #30).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The Verifier shall not have any ties whatsoever tothe equipment supplier, installer and/or manufacturer. Forobjective test, the testing agency should not have providedequipment, devices or labor for the system being installed ortested. The testing agency shall not have a financial interest in theresult of the testing, if a financial interest is present then the testingagency has a serious conflict of interest. It is absurd to think that asupplier of equipment worth tens of thousands of dollars who ishired as the equipment/system verifier by the contractor whoinstalled the system/equipment, the same contractor will not get


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paid until the system/equipment has been approved by the verifierdoes not lead to a serious conflict of interest. Therefore, thesupplier/verifier will not get paid for the equipment until thesystem is certified by the supplier/verifier. What conflict ofinterest? ESHERICK: See my Explanation of Negative on Comment 99-148(Log #163) and Comment 99-142 (Log #98).

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99- 137 - (4-3.4.1.3): AcceptSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-234RECOMMENDATION: We wish to speak in the affirmativeregarding this proposal. Several comments were offered in the negative for this proposaland we would like to offer the following. The ANSI/ASSE 6000 Standard 6030 is a level of knowledge forthe Verifiers. This has nothing to do with the medical gas pipelineinstaller’s requirements which is covered in Standard 6010. (Pleasesee our comments on 99-218 (Log #190). Therefore, thosecomments offered which referenced the installer portion of NFPAare incorrectly located in this Log. And the issue of ASSE being a non-consensus organization hasalso been addressed in 99-218 (Log 190).SUBSTANTIATION: The lengthy discussion of ProfessionalEngineering does not belong in this document. Buried withinthese paragraphs is a statement that the NFPA is trying tosubterfuge the individual State Registration Board of ProfessionalEngineers’ ability to certify a medical gas system in order tosafeguard life, health and property. I was not aware that any StateRegistration board is certifying anyone to specifically certifymedical gas systems. Merely because an engineer has obtained the P.E. designationdoes not make him or her a specialist in medical gas pipelinesystems. Nor does it make him or her a specialist in aircraft designor any other specialty. While I generally respect someone who hasthe patience to go through engineering school, graduate, and passthe P.E. examination, this does not make that engineer a specialistin medical gas pipeline systems. The ANSI/ASSE 6030 is acompilation of the specialized knowledge necessary to permitsomeone to adequately verify a medical gas pipeline system. AnyP.E. that I know that wants to work in a specific field usuallyobtains additional training and experience in that field from avariety of sources and then works within that field. Also as a point of information, the term used in the Standard isVerification, not Certification.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The requirements for the medical gas system andequipment "certifier" should be defined within NFPA 99, Chapter4, not through a third party standards making body. ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 138 - (4-3.4.1.3): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: We wish to speak in opposition on theCommittee’s action to reject this proposal to delete references tohydrocarbon testing.SUBSTANTIATION: Our original comment in response to thenegative that is published in the ROP is still valid. These tests areexpensive and unnecessary. We have performed over 2,300 of thesetests over the last 12 years and have not found a single instance ofcontamination.COMMITTEE ACTION: Reject.

COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).

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99- 139 - (4-3.4.1.3): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-234RECOMMENDATION: Revise text to read as follows: "The testing shall be conducted by a party technically competentand experienced in the field of medical gas pipeline testing andmeeting the requirements of ANSI/ASSE Series 6000, Standard6030.SUBSTANTIATION: As a member of MGPHO (Medical GasProfessional Healthcare Organization), I do encourage theestablishing of professional criteria and training for both installersand verifiers. ASSE has created a good document to accomplishthis purpose. It should be allowed to stand on it’s own merit andnot be required by NFPA 99. The National Fire ProtectionAssociation has always been very careful not to endorse theproducts or services of any company or organization and to keep aneutral viewpoint. They defer to the Authority Having Jurisdictionin these matters. The enforcement of ASSE 6000 could be betterperformed by including it in the engineering specifications forremodel and construction of health care facilities. The AmericanSociety of Plumbing Engineers is a good vehicle to increase theawareness of this new standard among designers. If ASSE 6000 were to be required by NFPA 99, then NFPA wouldhave to accept any changes made to the ASSE document before thenext revision cycle of NFPA 99.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-135 (Log #49).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The NFPA has in the past been very careful not toendorse the products or services of any company and organizationsand been very careful to keep a neutral viewpoint in developing thecodes. Historically, the NFPA has deferred this type of regulationto the Authority Having Jurisdiction. The committee's justificationstatement says that ASSE 6000 series standards provides guidelineswhich improve the installation, reliability and safety of medical gassystems and needs to be referenced in NFPA 99, if so this standardcan be referenced in Chapter 21 "Referenced Standards" of NFPA99. It is my belief that the present wording in NFPA 99 is adequate.Presently, NFPA does not require certifiers of automatic firesprinkler systems to be trained by a NFPA specified standard andsprinkler systems are a vital life safety system. Additionally, NFPAdoes not specify the training required for the "certifiers" of theemergency power systems in NFPA 110 "Standard for Emergencyand Standby Power Systems" Emergency Generators which powerthe life safety and critical circuits of a health care facility. It is mybelief that the inclusion of ASSE 6000 series document into theNFPA 99 restricts trade of companies who are qualified, but not toASSE 6000 series document, from working in healthcare facilitiesand does not provide any greater benefits than the present wordingof NFPA 99. ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 140 - (4-3.4.1.3): RejectSUBMITTER: Chris Swayze , Sherman Engineering Co.COMMENT ON PROPOSAL NO: 99-226RECOMMENDATION: Revise the text as follows: "Testing authority cannot shall not be supplier or vendor ofequipment being certified."SUBSTANTIATION: Separation of services provides a trueindependent check with is consistent with 4-3.4.1.3.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-124 (Log #30).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-139 (Log #74). ESHERICK: See my Explanation of Negative on Comment 99-142(Log #98).

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99- 141 - (4-3.4.1.3): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-237RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: See my explanation on Proposal 99-252 (Log#261).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-139 (Log #74). ESHERICK: Properly purged pipe lines will assure nohydrocarbons are present.

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99- 142 - (4-3.4.1.3): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-238RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: See my explanation on Proposal 99-226 (Log#82).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-124 (Log #30).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-139 (Log #74). ESHERICK: Separation of service provides a true independentcheck.

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99- 143 - (4-3.4.1.3): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-234RECOMMENDATION: Reject this proposal.SUBSTANTIATION: NFPA requirements are sufficient already.Further requirements are not required.

COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: ASSE 6030 is based on the specificrequirements of NFPA 99 with regard to the verification of medicalgas and vacuum systems. In addition, it sets a benchmark for testequipment and procedures. ASSE 6000 provides guidelines whichimprove the installation, reliability and safety of medical gassystems and therefore needs to be referenced in NFPA 99.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanation of Negative on Comment 99-139 (Log #74). ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 144 - (4-3.4.1.3): RejectSUBMITTER: Peter Wikoff, Environmental Testing Services, Inc.COMMENT ON PROPOSAL NO: 99-236RECOMMENDATION: Delete the following text to the firstparagraph, second sentence of the proposal: "The test gas shall beoil-free dry nitrogen or the gas of system designation. This also should apply to Paragraphs 4-3.4.1.3(a)1, (c)1, (d)2,and paragraph two of (e). The wording should be kept as originally stated in NFPA 99C,1999 Edition 4-3.4.1.3, the first paragraph, second sentence.SUBSTANTIATION: I am in opposition to the committee’sdecision to accept this proposal. The rationale of eliminatingnitrogen as a test gas as a means of cost savings to hospitals isflawed at best and possibly dangerous. The introduction of oxygenunder pressure into an untested piping system brings into play fourhazardous possibilities: 1. The introduction of oxygen under pressure in the presence ofan unknown hydrocarbon could generate enough heat to exceedthe flash point of that hydrocarbon. 2. In the presence of oxygen some VOCs (volatile organiccompounds) can become corrosive. 3. Some VOCs will readily undergo oxidation in the presence ofoxygen making their detection difficult if not impossible with someanalyzers. For this reason, nitrogen is almost universally used as acarrier gas for calibration standards containing hydrocarbons. Thestatement "The final result of such testing will be the sameregardless of which gas is used" is false. 4. Using the hospital system as the source of test gas riskscontaminating the existing hospital system if the new piping iscontaminated. ETS, Inc. this year has already found one hospital piping systemcontaminated with 280 PPM of total hydrocarbons from use of anunauthorized piping sealant. I know of no industry or agencyinvolved with compressed gas that would use or advocate use ofoxygen as a purge or test gas to verify an oxygen-clean system.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The use of gas on system at lowpressure has been acceptable in the past without incident. Thiswould not impinge on the validity of the gas purity test.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to reject this proposal. All 4-3.4.1.3 tests should remain in Nitrogen NF, except for theexception listed for "small projects affecting a limited number ofareas where the use of nitrogen is impractical." Nitrogen NF isreadily available in cleaned tanks. Conversations with the TexasDepartment of Health, Louisiana District FDA and FDA Center forDrug Evaluation and Research indicate Nitrogen NF would beeasily available to either a licensed plumber or a plumber with aMedical Gas Endorsement from the State Board of PlumbingExaminers. Moreover, testing in Nitrogen NF avoids possible fireproblems if oxygen is introduced to an unknown hydrocarbon thatcould be in the line and avoids allowing extensive crossconnection, outlet flow and piping purge tests with nitrous oxide.

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99- 145 - (4-3.4.1.3): RejectSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-236RECOMMENDATION: In the first paragraph revise text asfollows: "The test gas shall be oil-free dry nitrogen or the gas of systemdesignation.SUBSTANTIATION: I am in opposition to the committee’sdecision to accept this proposal. The system in place makesperfect sense and it works well. The use of nitrogen to test thesystem is not a financial burden to the hospital. It is just asexpensive as wasting the source gases and puts an unnecessaryburden on source equipment. The nitrogen and it’s deliverysystem should already be in place because the plumber is using itto keep the system clean. It is a common occurrence for theexisting systems to contain water, particulate matter andhydrocarbons. By using nitrogen to perform flow and purity tests,the plumber gets a piece of paper that says his pipe was cleanbefore he attached it to the hospital, protecting him from anexisting problem. At least twice a year we reject piping because of hydrocarboncontamination. The most common occurrence is caused by theplumber’s failure to remove the plastic end plugs before brazing.The odor and hydrocarbon residue caused by the melted plasticcan not be removed by purging, and the piping must be replaced.This problem is discovered during the nitrogen testing, protectingthe hospital. The use of nitrogen as a test gas is a benefit to boththe installer and to the hospital. By adopting this proposal, you aresuggesting that we build what is essentially a critical medical systemand attach it to the hospital before testing it. Many times, a complex shutdown must occur to attach the newpiping components. What will happen when the system fails apurity test after it is tied in to the hospital? It will probably have tobe removed and tested with nitrogen (as is currently practiced). In addition, the cross connection test is essentially performedtwice as the standard is currently written. Once with nitrogen, andonce when the presence of source gas is confirmed. Adoption ofthis proposal will lead to laziness or complacency among someindividuals and the number of cross connection tests will bereduced to one, seriously increasing the odds that a crossconnection will be missed.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-144 (Log #103).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to reject this proposal. See my comment on 99-144 (Log #103).

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99- 146 - (4-3.4.1.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, being more explicit by citing reasons.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).

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99- 147 - (4-3.4.1.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-237RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, being more explicit by citing reasons,i.e., how did it lower the level of safety.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log # 25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-141(Log #97).

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99- 148 - (4-3.4.1.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-238RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review and revise Committee Statement torespond to the submitter’s substantiation and provide reasons toanswer why.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-124 (Log #30).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: A conflict of interest arises if the verifier is thesupplier- he could look the other way.

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99- 149 - (4-3.4.1.3 Exception): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-240RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, being more explicit by citing reasons.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The use of a source gas, if approvedby the authority having jurisdiction, is appropriate. See Section 4-3.4.1.3, Exception.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 150 - (4-3.4.1.3(a)): Accept in Principle in PartSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-241RECOMMENDATION: Insert new text before Cross-ConnectionTest as (a) and bump existing sections down one letter, makingCross-Connection Test (b), etc. (a) Standpipe Pressure Test. Piping systems shall be subjected toa 10 minute standing pressure test at operating line pressure. Thetest gas shall be oil-free, dry nitrogen (see Section 2-2 Definitions). 1. After the piping system is filled with test gas, the supply valve,the zone valve, and all outlets shall be closed. The piping systemshall remain leak-free for 10 minutes. 2. Leaks, if any, shall be located, repaired, and retested inaccordance with 4-3.4.1.2(c). SUBSTANTIATION: The verifier performs no pressure test of thenew system. We recently certified a multiple story hospitalexpansion. The installer supplied all of his test documentation,including the 24 hour leak test. After the plumbers leak test, butbefore the verification process began, the cabinet maker installeddecorative boxes with sliding doors over the medical gas outlets.The leak test as described above was performed on each zone.Eight oxygen leaks and three vacuum leaks were located inside thewalls because the cabinet maker used self tapping screws that weretoo long for the installation. This is not an isolated example. Ifeveryone had performed their jobs to current NFPA specification, aserious fire hazard would exist in that building. This test is simple,easy to perform, and will cause no significant increase in costs. Aleak test is the only installer test that the verifier does not repeat,and it should be added to the standard.COMMITTEE ACTION: Accept in Principle in Part.Revise as follows: Insert new text before Cross-Connection Test as (a) and bumpexisting sections down one letter, making Cross-Connection Test(b), etc. (a) Standing Pressure Test. Piping systems shall be subjected toa 10 minute standing pressure test at operating line pressure. Thetest gas shall be oil-free, dry nitrogen (se e Section 2-2 Definitions). 1. After the piping system is filled with nitrogen or source gas, thesupply valve, the zone valve, and all outlets shall be closed. Thepiping system shall remain leak-free for 10 minutes. 2. Leaks, if any, shall be located, repaired, and retested inaccordance with 4-3.4.1.2(c).COMMITTEE STATEMENT: Changing the word "standpipe" to"standing" is more correct. The test gas of oil free, dry nitrogenwas deleted because (a) makes it mandatory to use nitrogen. Inpart 1, we added nitrogen or source gas to comply with Section 4-3.4.1.3 Exception. In part 2, the reference to 4-3.4.1.2(c) is a brazing repair whichmay not be the problem.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 151 - (4-3.4.1.3(a)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-241RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, providing explict reasons explainingwhy.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Action taken onComment 99-150 (Log #110).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 152 - (4-3.4.1.3(e)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-244RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: In a period of 2 years my firm has tested8376 pressure gas outlets. This would equal approximately 500locations for the 25 percent of zones tested. In all of these outletsand zones we have found that if you can see any dirt on filter it willhave too much particulate matter. Otherwise if your filter startsclean and white and ends up the same you have a clean system. Iagree that the standard is going overboard with the requirements,so I agree that the 0.001 gram should be reduced to 0.01 gram.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Level of 1 milligram total particulatematter for this high velocity test will assure the cleaniness of thepipeline.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: Properly purged pipe lines will assure no particulatematter is present. When weighing clean filters show no increase inweight.COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committee action toincrease the allowable particulate level from the present 0.1mg/m3 . The Liberty Mutual Industrial Hygiene Laboratory performed1,354 particulate tests in the past year at 471 facilities. From thisdata, we conclude: 1. Taken in a careful manner, the existing particulate test reliablydetects particulates in medical gas installations prior to their use.It is an objective, reproducible measurement whereby differentpeople doing the same test in different parts of the country canhave a reasonable expectation that they will detect the sameamounts of material if it is present. 2. Particulate failures don't happen all the time, but at thecurrent level of 0.1 mg/m 3, the failure rate for our tests were 2.65%.That means that we found 36 failures occurring in the pipingparticulate test we did this year. 3. The existing 0.1 mg/m3 limit more closely matches theappropriate health limits for most of the contaminants theparticulates are actually made of and you could expect to findwithin the assembled pipeline. The makeup of what theparticulates are made of is listed below, along with thecorresponding concentration limits for health affects:

Contaminant Health Limit (mg/m 3 ) Arsenic 0.01

Beryllium 0.0002Borates 1.0

Cadmium 0.002Calcium 2.0

Chromium III 0.5Chromium VI 0.01

Copper 0.2Iron 5.0

Manganese 0.2Nickel 0.1

Tin 2.0Oil Mist 0.2

Phosphorus 0.1Fluorides 2.5

Although this test is in nitrogen which is not delivered to patients,this is the only objective test of the pipeline particulate cleanlinessprior to filling it with the system gas and readied for patient use.Therefore, the test is for the cleanliness of the pipeline installation,not of the nitrogen gas. Although these tests discussed above are piping purity, whenparticulate tests are actually done with the system gas, we find aneven greater percent of particulate failure when the test is doneusing oxygen, air or nitrous oxide in the lines. We cannot say ifthese pipes were dirty to begin with or if these gases react withmaterial in the lines to create or loosen scale off the pipes, creatingmore particulates. If it is true that reactive gases such as oxygenand air create or loosen scale creating more particulate, thecommittee should consider instituting an additional particulate testwithin the existing Medical Gas Concentration Tests 4-3.4.1.3(i).

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99- 153 - (4-3.4.1.3(e)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-245RECOMMENDATION: Accept proposal as written.SUBSTANTIATION: See my comment on Proposal 99-244 (Log #26).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-152 (Log #23).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-152(Log #23).COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to increase the allowable particulate level from the present0.1 mg/m3. See my comment on 99-152 (Log #23).

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99- 154 - (4-3.4.1.3(e)): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-244RECOMMENDATION: We continue to feel that this revisednumber of .001 gram should be further reduced to .01 gram.There was some considerable discussion regarding the amount ofparticulate matter acceptable and we still feel that a level of .01gram is more than adequate to protect patient safety.SUBSTANTIATION: We remind Committee members that a levelof .01 gram in a total of 35 ft3 of gas would equate to less than.000001 grams of matter per liter. It is still a very small amount ofmatter and more easily measured in the field by the verifiers whoare performing this test, which would provide more immediatefeedback for facilities who are in a rush to open and acceptpatients. Another point to consider is that we only require filters on airsystems that filter down to 1 micron with 98 percent efficiency (4-3.1.1.9(g)). Anything smaller than 1 micron, regardless of howmuch there is of the matter, would pass through the filter and intothe pipeline. Even the definition of medical air in our standard permits 5 mgper m3 of particulate at 1 micron or greater. Why are we mandating a measurement that is 1,000 times greaterthan what we permit in our current standard for air?COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-152 (Log #23).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: Level of 0.01 gram will more than adequately assurea very clean pipeline.COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to increase the allowable particulate level from the present0.1 mg/m3. See my comment on 99-152 (Log #23).

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99- 155 - (4-3.4.1.3(e)): AcceptSUBMITTER: Edward D. Golla , Texas Research EnvironmentalCOMMENT ON PROPOSAL NO: 99-244RECOMMENDATION: Revise text as follows: "...The filter shall accrue no more than 0.1 1.0 mg of matter fromany outlet."

SUBSTANTIATION: It is difficult if not impossible to accuratelyweigh 0.1 mg in the field and even if samples are returned to thelab it is difficult to prevent contamination and get accurate results.If it were necessary to measure this small amount then thesedifficulties might be worthwhile, but this small amount is belowwhat most experts in the field would believe is necessary. Theamount allowed in divers breathing air is 5 mg per m3. This is 50times the amount in this specification and is allowed on acontinuous basis. I believe an amount of 1.0 mg is more realistic,with any more being an indication of a poor installation job.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanantion of Negative on Comment 99-14 (Log #37). ESHERICK: See my Explanation of Negative on Comment 99-154(Log #63) and Comment 99-152 (Log #23).COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to increase the allowable particulate level from the present0.1 mg/m3. See my comment on 99-152 (Log #23).

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99- 156 - (4-3.4.1.3(e)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-246RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: If you start with a clean white 0.45 micronfilter and run a measured amount of gas through it and filter isa asclean after as before there is no reason to weigh this.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Not all contaminants are visible on awhite filter test. Weighing the filter has found pipelinecontamination which was not visible on the filter. Weighingprovides quantifiable results.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: The committee is looking for very tiny "straws" thatdo not exist in a properly purged pipeline. When our filtersremain white after 35 cu. ft., we never find any weight difference.

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99- 157 - (4-3.4.1.3(e)): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-249RECOMMENDATION: Accept this proposal as written.SUBSTANTIATION: If you start with a clean white 0.45 micronfilter and run a measured amount of gas through it and filter is asclean after as before there is no reason to weigh this.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-156 (Log #95).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-156(Log #95), Comment 99-154 (Log #63) and Comment 99-152 (Log#23).

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99- 158 - (4-3.4.1.3(e)): RejectSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-244RECOMMENDATION: Revise text as follows: "The filter shall accrue no more than 0.001 grams (1 milligram)0.0005 gram (0.5 milligram) of particulate matter from any outlettested."SUBSTANTIATION: I am in opposition to the committee’sdecision to accept this proposal. Determining the amount ofparticulate matter currently allowed is difficult, but it is achievableand occurs many times each day. Increasing the allowable level ofparticulate matter to make the test easy to perform is the wrongreason to change the standard. The current standard allows whatis virtually zero particulate matter. This is obviously a safe level,and the system is working. There are many documented incidentsof failure of patient care equipment due to particulate matter. Itdoes not seem prudent to increase the allowable level of particulatematter by a factor of 10. Increasing the allowable particulate levelby a factor of 5 (to .5mg/m3) is a more reasonable degree ofincrease until we can be sure that patient systems will not beaffected.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-152 (Log #23).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: See my Explanantion of Negative on Comment 99-14 (Log #37).

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99- 159 - (4-3.4.1.3(e)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-244RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, providing explict reasons explainingwhy.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-152 (Log #23).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerCOMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to increase the allowable particulate level from the present0.1 mg/m3. See my comment on 99-152 (Log #23).

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99- 160 - (4-3.4.1.3(e)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-246RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, providing explict reasons explainingwhy.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.

COMMITTEE STATEMENT: See Committee Statement onComment 99-156 (Log #95).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-156(Log #95), Comment 99-154 (Log #63) and Comment 99-152 (Log#23).COMMENT ON AFFIRMATIVE: STEVENSON: I wish to speak in opposition of the committeeaction to increase the allowable particulate level from the present0.1 mg/m3. See my comment on 99-152 (Log #23).

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99- 161 - (4-3.4.1.3(e)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-250RECOMMENDATION: The Technical Correlating Committeedirects the Committee to reflect the submitter’s substantiation inthe Committee Statement, providing explict reasons explainingwhy.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: Testing 25 percent of the zones willprovide verification of the quality of the installation of the medicalgas pipeline.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 162 - (4-3.4.1.3(f)): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-252RECOMMENDATION: Accept the proposal as written.SUBSTANTIATION: See committee on Proposal 99-231.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-131(Log #25).COMMENT ON AFFIRMATIVE: STEVENSON: See my comment on 99-131 (Log #25).

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99- 163 - (4-3.4.1.3(f)): RejectSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-252RECOMMENDATION: I do not agree with the Committee’saction on this proposal to delete the expensive testing forhydrocarbons and I agree with Mr. McWhinnie and Mr. Esherick intheir reasoning for deleting these tests. And I agree that this willnot lower the standard for patient safety.SUBSTANTIATION: Since we have to purge the pipeline at flowrates much higher than would ever be used in the hospitalinnumerable times, and then include a purge with source gases inthe pipeline, there is no longer any risk involved since these


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gaseous hydrocarbons, if at all present at one time, are gone fromthe purging.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-131 (Log #25).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-131(Log #25).

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99- 164 - (4-3.4.1.3(f)): Accept in PrincipleSUBMITTER: Edward D. Golla , Texas Research EnvironmentalCOMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: Keep the reference to TotalHydrocarbons, but change Dew Point in Table 4-3.4.1.3(f) toMoisture Content and set the value to 50 ppm.SUBSTANTIATION: The problem is that the current value of amaximum Dew point variation of 5°C @ 50 psig is undefined. Thisspec. can mean anything from a few ppb to hundreds of ppmdepending on the water content of the Nitrogen used in the test.The test should use a defined amount of water and I believe frompast experience that 50 ppm would indicate a system that iscompletely dry for all practical purposes. The use of ppm insteadof a Dew point eliminates any question that might result frompressure variations in different systems.COMMITTEE ACTION: Accept in Principle.Revise to read as follows: "Keep the reference to Total Hydrocarbons, but change DewPoint in Table 4-3.4.1.3(f) to Moisture Content and set the value to500 ppm (-12° C at 50 psig)."COMMITTEE STATEMENT: An actual moisture level is moredefinitive as opposed to a differential test. Measurement ofmoisture level in ppm is independent of pipline pressure.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-131(Log #25).

___________________(Log #79)

Committee: HEA-PIP99- 165 - (4-3.4.1.3(f)): RejectSUBMITTER: Edward D. Golla , Texas Research EnvironmentalCOMMENT ON PROPOSAL NO: 99-231RECOMMENDATION: Delete the reference to HalogenatedHydrocarbons in Table 4-3.4.1.3(f).SUBSTANTIATION: Eliminate an unnecessary and costly test. Halogenated Hydrocarbons are hydrocarbons and they will bepicked up with a Flame Ionization Detector. Even those with thelowest FID response (CC14, etc), have a response greater than 50%of the response of methane on a ppm basis, therefore, it would beimpossible to pass a 1 ppm Total Hydrocarbon test and fail a2ppm Halogenated Hydrocarbon test. This is true of a FID, but isnot true if you are using an Infrared Instrument. In the case of IR,you would have to do a separate test for HalogenatedHydrocarbons.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement onComment 99-165 (Log #79).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ERICKSON: See my Explanation of Negative on Comment 99-131(Log #25). ESHERICK: See my Explanation of Negative on Comment 99-131(Log #25).

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99- 166 - (4-3.4.1.3(f)): RejectSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-253RECOMMENDATION: Delete test as follows: "The test shall beperformed with the use of gas of system oil free dry nitrogen."SUBSTANTIATION: I am in opposition to the committee’sdecision to accept this proposal. There are many reasons to notuse source gas as the test gas, including the safety of the verifier.Please refer to my comments on Proposal 99-236.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The use of gas of systems at lowpressure has been acceptable in the past without incident. Thiswould not impinge on the validity of the gas purity test.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: STEVENSON: All 4-3.4.1.3 tests should remain in Nitrogen NF,except for the exception listed for "small projects affecting alimited number of areas where the use of nitrogen is impractical."Nitrogen NF is readily available in cleaned tanks. Conversationswith the Texas Department of Health, Louisiana District FDA andFDA Center for Drug Evaluation and Research indicate NitrogenNF would be easily available to either a licensed plumber or aplumber with a Medical Gas Endorsement from the State Board ofPlumbing Examiners. Moreover, testing in Nitrogen NF avoidspossible fire problems if oxygen is introduced to an unknownhydrocarbon that could be in the line and avoids allowing extensivecross connection, outlet flow and piping purge tests with nitrousoxide.

___________________(Log #169)

Committee: HEA-PIP99- 167 - (4-3.4.1.3(f)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-252RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review and reflect the submitter’ssubstantiation in the Committee Statement, providing explicitreasons explaining why.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Statement onComment 99-162 (Log #48).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-131(Log #25).

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99- 168 - (4-3.4.1.3(k)): AcceptSUBMITTER: David Mohile, Medical Engineering Services, Inc.COMMENT ON PROPOSAL NO: 99-257RECOMMENDATION: I support the Committee’s action inrejecting the proposal to add piping to the requirements of labelchecking by the Verifier.SUBSTANTIATION: If the proposed wording were added to theStandard, the Verifier would be responsible for checking everylabel on the tubing, including tubing that is installed behindpermanent ceilings in OR’s, in enclosed pipe chases, installed inheadwalls, etc. This would mean that the installing contractor would have to hirethe Verifier to come to the jobsite for additional visits duringconstruction to verify the label installation. In the case ofheadwalls and ceiling booms it would mean that the contractor


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would have to take these devices apart for the Verifier to check forthe presence of labels. And on larger projects where the pipeline is installed in phases itwould mean many extra visits to the jobsite. This would addconsiderably to the cost of a project.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: DAVIDSON: The verifier should check the labeling of themedical gas system piping, not every foot of medical system piping,but at least 25 percent of the piping on a random basis as a spotcheck of the installing contractor. From experience in the field asan expert witness in medical gas system mishaps mislabeling ofmedical gas system piping has led to mishaps and fatalities, usuallylinked to modifications of medical gas systems at a date afteroriginal system installation.

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99- 169 - (Table 4-3.4.1.4): Accept in Principle in PartSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-260RECOMMENDATION: The WAGD signal needs to be movedfrom the area alarms to either master or local alarms as there is norequirement for WAGD area alarm.SUBSTANTIATION: WAGD may be performed by a variety ofvacuum levels based on the type of source equipment used. Noone single vacuum level has been established as a minimum tomonitor with a vacuum switch at an area alarm panel. WAGD isnot even required to be a piped system.COMMITTEE ACTION: Accept in Principle in Part.The committee did not accept the deletion of the area alarm.The committee did move the signal to both the area and masteralarm.COMMITTEE STATEMENT: See the Committee Action taken onComment 99-188 (Log #CC6).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 170 - (4-3.4.3(a).3): RejectSUBMITTER: Fritz Koppenberger, Environmental Testing ServicesInc.COMMENT ON PROPOSAL NO: 99-243RECOMMENDATION: Delete text as follows: 4-3.4.3(a)3): A third method of testing to insure that no crossconnections to other piping systems exists follows: "An Oxygenanalyzer, or similar device, known to be accurate at 0 percent, 21percent, and 100 percent oxygen is a suitable test instrument.SUBSTANTIATION: I am in opposition to the committee’sdecision to accept this proposal. The comparison of theanesthesia machine test standard is not an appropriate comparisonto medical gas piping verification. The individual testing ananesthesia machine is using medical gas outlets that have alreadybeen certified, and he is testing less than two feet of pipe inside themachine. The verifier has the ultimate responsibility of removing all testnitrogen from the pipeline and assuring that the patient will receivepure gas. An oxygen analyzer cannot tell the difference betweennitrogen, nitrous oxide, carbon dioxide, or any of the otherspecialty gases being introduced to the medical field. What criteriawould you use other than a gas specific analyzer to confirm that theverifier has removed all of the nitrogen from what can sometimesbe miles of piping and certify that the patient will receive pureproduct? A verifier cannot rely on his sense of smell or years ofexperience to assure that pure product is being delivered. Thisanalysis must be performed with a gas specific instrument.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Gas specific analyzers are stillrequired to comply with Section 4-.3.4.1.3.(i).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24

VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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(Log #170)Committee: HEA-LAB

99- 171 - (4-3.5.2.1(e)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-265RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review and comment.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 172 - (4-3.5.4.1): RejectSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-267RECOMMENDATION: Reject this proposal.SUBSTANTIATION: There is no reason for the pressure of gas tobe labeled on pipe every 20 feet etc.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The reader should refer to Proposal99-200 (Log #57) and Proposal 99-266 (Log #101) as the actions onthese proposals accomplished the submitter’s intent.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 173 - (4-3.12 through 4-6.1.2.5): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-145RECOMMENDATION: In both Paragraphs 4-3.1.2.7 and 4-3.1.2.8references to other vacuum piping materials and to soldering havebeen deleted.SUBSTANTIATION: This appears to be an oversight. Does thecommittee want to force the use of only pre-cleaned copper anddoes the committee want to force all joints to be brazed in vacuumpiping systems? Reference see Paragraph 4-3.1.2.7 (vacuum systempiping) Pg. 673 and 4-3.1.2.8. No reference to vacuum systempiping may be soldered under "Exceptions: Level 1 and 2 vacuumand WAGD system Pg. 674. See Committee Action on Proposal 99-213 (Pg 715).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Medical vacuum piping networks arepart of vital, life saving systems essential to patient safety and care.Vacuum piping networks are a permanent part of the facility, oftenremaining in service over the lifetime of the facility, and are oftenlocated in inaccessible areas. Vacuum piping networks passdegrading materials and must remain leak-free over the service life. Specifications for materials, installation, and testing for medicalgas and vacuum piping networks have been identical in thisstandard, including the use of brazed joints. To permit the use ofmechanical joints, for which there is no standard, would departfrom the proven safety history of brazed joints.NFPA 99 has developed extensive requirements for brazing,performance, brazer certification, and testing to assure thesuccessful performance of brazed joints. Flush seal gaskets suitable for vacuum service and press fit fittingsare proprietary products of specific manufacturers. There are noestablished criteria for their successful use in medical vacuum


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network piping systems. Both technologies require training by themanufacturer for their proper application and installation. Neithertechnology solves a problem that is created by the use of brazedcopper joints. Permitting other than brazed copper joints willmake NFPA 99 performance-based with regards to medical vacuumpiping and will make the AHJ responsible for its successfuloperation. Ductile iron components used on copper piping networks aredissimilar metals, which are not permitted in this standard. The second proposal was rejected because the standardization ofmaterials will be safer, stronger, cleaner and may prevent confusionand mistakes by inadvertantly soldering a positive pressure gas line.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: The committee statement: "Medical vacuum...vitallife saving systems...patient safety and care." is absolutely correct.The rest of the statement is full of holes. Vacuum piping has beensoldered for years with no problems. Our NFPA representativewho is with the American Society of Healthcare Engineering hasadvised that the proprietary "Victaulic" method of joining vacuumpiping has been successfully used many times. NFPA is certainlyshowing ignorance in not allowing a newer method of joiningtubing. No substantiation of "...safer, stonger, cleaner...gas line." isgiven.

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99- 174 - (4-5.1.1.3(e)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-274RECOMMENDATION: The Technical Correlating Committeedirects that the Committee Action be revised to read as Accept inPriniciple.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 175 - (4-5.1.2.10(a)): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-281RECOMMENDATION: The Technical Correlating Committeedirects that the proposal be returned to committee. The proposaland Committee Action are difficult to decipher; the CommitteeStatement is not germane to the proposal or Committee Action.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: See Committee Action on Comment99-176 (Log #CC13) for final wording.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

___________________(Log #CC13)

Committee: HEA-PIP99- 176 - (4-5.1.2.10(a)): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-281RECOMMENDATION: Modify the Committee Action onProposal 99-281 (Log #239) as follows: 3. Piping shall be ASTM B819 specificaton hard copper seamlessmedical gas tubing; ASTM B819 tubing is identified by the

markings "OXY", "MED", "OXY/MED", "OXY/ACR", or"ACR/MED", in green (Type K) or blue (Type L). Mains andbranches shall be not less than 1/2 in. nominal size 1/2 in. O.D.(3/8 in. nominal) size for oxygen tne 3/8 in. O.D. (1/4 in.nominal) size for other gases and vaccuum . Factory-installed tubeon station outlets or inlets extending no more than 8 in. from theoutlet/ inlet body shall be permitted to be 38 in. O.D. (1/4 in.nominal) size. Connections to Connecting tube for gauges andalarm switches and runouts to alarm panels shall be permitted tobe 3/8 in. O.D. (1/4 in. nominal) size. Exception: For systems operated at pressures between 200 and300 psig (1380 and 2070 kPa, respectively), ASTM B819, Type Kcopper shall be used. 4. Copper tube shall, wherever possible, be installed overhead orbelow floor level. Only where the installation requires installing ina slab, exceptions below are permitted to apply: a. Annealed (soft temper) ASTM B88 (Type K or L) coppertube, up to 1/2 in. O.D. (3/8 in. nominal) size, that has beenprepared for oxygen service according to CGA Pamphlet G-4.1,Cleaning Equipment for Oxygen Service, shall be permitted to beused. up to 1/2 in. O.D. (3/8 in. nominal) size b. The tube shall be installed in conduit sufficiently large toaccept the following gases (if used) O2, N2O1, N2, MA, DA, Level3 vacuum. A conduit(s) shall be embedded in the floor slab that issufficiently large and has adequate bend radii to permit subsequentinstallation of the necessary gas and/or vacuum lines. c. The pipe shall be a continuous run from entry to exit of theconduit. PVC conduit shall be permitted for Level 3 vacuum only.Every line pulled into the conduit shall be a continuous length oftube having no joints within the conduit. d. All station outlets (inlets) shall be permitted to be completedafter the slab is complete. e. All tests shall be completed per 4.5.4.1.2. 4. 5. Except as provided... 5. 6. Valves, fittings, and other... 6. 7. Piping systems shall... 7. 8. Piping shall be supported... 8. 9. Listed or approved... 9. 10. Turns, offsets, and other... 10. 11. Piping shall be protected... 11. 12. Medical gas risers... 12. 13. Piping shall not be installed... 13. 14. Medical gas piping shall be... 14. 15. Piping exposed in corridors... 15. 17. Where a system...SUBSTANTIATION: Pursuant to the Technical CorrelatingCommittee’s direction, the text has been rewritten to clarify theTechnical Committee’s intent.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerCOMMENT ON AFFIRMATIVE: DAVIDSON: "Item No. 4 Copper tubing shall be installedoverhead or below floor level." Is in conflict with my interpretationof NFPA 99 paragraph 4-3.1.2.3 Gas Shutoff Valves, item d. "ZoneValve. Station outlets shall not be supplied directly from a riserunless a manual shutoff valve located in the same story is installedbetween the riser and the outlet with a wall intervening betweenthe valve and the outlet (see Figure 4-3.1.2). This valve shall bereadily operable from a standing position in the corridor on thesame floor it serves. Each lateral branch line serving patient roomsshall be provided with a shutoff valve that controls the flow ofmedical gas to the patient rooms. Zone valves shall be so arrangedthat shutting off the supply of medical gas to one zone will notaffect the supply of medical gas to the rest of the system." and Iteme "Service Valves. Service shutoff valves shall be placed where thelateral branches off of the riser prior to any zone valve boxassembly on that branch." It is also in conflict with Figure 4-3.1.2"Location of valves, pressure switches, and piping for medical gassystems (schematic). (Level 1 Gas Systems)" leads this reader tobelieve that branch line (lateral) piping as a lateral feed from theriser and feeding laterally within the same story as the lateral feedfrom the riser to the zone valves and relates gas system terminals.


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Additionally, the definition of Branch (lateral) Lines on Page No.3 in the "New" Chapter 5 section sent in the package for the ROCBallot is "Those sections or portions of the piping system that servea room or group of rooms on the same story of a facility. Onpiping system, "There appears to be a conflict with the wording ofItem No. 4. To eliminate conflicting wording add after the word"or" the following "below the finished floor level but within thefloor slab."

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99- 177 - (4-5.1.2.10(b)12): AcceptSUBMITTER: David Esherick , Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-288RECOMMENDATION: The committee should reconsider andaccept this proposal.SUBSTANTIATION: If someone is brazing a "medical gas line"they should meet all of the braze-requirments...levels notwithstanding.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 19 NEGATIVE: 2 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: QUARNSTROM: The comment submitted to the Committee toreconsider proposal 99-288 which the Committee already discussedand rejected in the ballot on ROP. In the submission forreconsideration, no new information was included to support theneed to change the current document by adding a new section 4-5.1.2.10 (b)12. The current document provides requirements thatare adequate and no information has been provided by thesubmitter to show inadequacy of the current requirements. FRAN: The comment submitted to the Committee to reconsiderproposal 99-288 which the Committee already discussed andrejected in the ballot on ROP. In the submission forreconsideration, no new information was included to support theneed to change the current document by adding a new section 4-5.1.2.10(b)12. The current document provides requirements thatare adequate and no information has been provided by thesubmitter to show inadequacy of the current requirements.

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99- 178 - (4-5.4.1.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-303RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to Committee. Thecommittee’s action was not clear. Are paragraph headers beingrevised, or text and substantiation being revised, or are therequirements of paragraph 4-5.4.1.3 being deleted?SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The paragraghs are being relocatedto conform to the new format of Chapter 5.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 179 - (4-6): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-308RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The Technical Committee on Pipingis going to extract 4-6.2.2 the language of 4-6.2.2 and insert it intoChapter 11, Laboratories.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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(Log #174a)Committee: HEA-LAB

99- 180 - (4-6): Accept in PartSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-308RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept in Part.Accept the move of 4-6 to Chapter 10 (new 11).Reject retention of 4-6.2.2 in Chapter 4.COMMITTEE STATEMENT: The requirements of 4-6.2.2 shouldbe kept with the laboratory piped gas system requirements becauseit deals with the connection of laboratory systems.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 181 - (4-6.1.2.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-309RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 182 - (4-6.1.2.3): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-309RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 183 - (4-6.2.3 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-310RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 184 - (4-6.2.3 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-310RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 185 - (4-6.4.3 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-311RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 186 - (4-6.4.3 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-311RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The committee recognizes thepotential application (i.e. during animal research) in a laboratorylocated within a hospital building.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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NFPA 99 —November 2001 ROC — Copyright 2001, NFPA

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99- 187 - (Chapter 5): Accept TCC NOTE: The TCC understands the time constraints placedupon the committee and applauds the heroic efforts of the taskgroup. The MOS revision is accepted, recognizing that editorialchanges will be made.SUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-7RECOMMENDATION: Restructure entire Chapter 5 of thedocument incorporating committee actions on proposals andcomments to comply with the NFPA Manual of Style as follows: 1. Chapter 1 to contain administrative text only. 2. Chapter 2 to contain only referenced publications cited in themandatory portions of the document. 3. Chapter 3 to contain only definitions. 4. All mandatory sections of the document must be evaluated forusability, adoptability, and enforceability language. Generatenecessary committee proposals. 5. All units of measure in the document are converted to SI unitswith inch/pound units in parentheses. 6. Appendices restructured and renamed as "Annexes." Manual of Style changes as shown:DefinitionsThese are the definitions for which this committee has responsibility. Allothers are expected to appear after actions by their respective committees.Staff to ensure inclusion.

ACFM. Actual cubic feet per minute.

Alarm Systems.

Area Alarm. A warning system within an area of use that providescontinuous visible and audible surveillance of Level 1 and Level 2medical gas and vacuum systems. (PIP)

Level 3 Alarm. A warning system within an area of use thatprovides continuous visible and audible surveillance of Level 3medical gas systems. (PIP)

Local Alarm. A warning system that provides continuous visibleand audible surveillance of medical gas and vacuum system sourceequipment at the equipment site. (PIP)

Master Alarm. A warning system that monitors the operation andcondition of the source of supply, the reserve source (if any), andthe pressure in the main lines of each medical gas and vacuumpiping system. (PIP)

Bulk System. An assembly of equipment, such as storagecontainers, pressure regulators, pressure relief devices, vaporizers,manifolds, and interconnecting piping, that terminates at the pointwhere the system gas at service pressure first enters the facilitysupply line. Bulk systems contain more than 566,335 L (20,000 ft 3 )of oxygen or 1452 kg (3200 lbs) of nitrous oxide includingunconnected reserves on the site. (PIP)

D.I.S.S. Connector. A system of non-interchangeable medical gasand vacuum connectors complying with CGA Pamphlet V-5,Diameter Index Safety System – Non-Interchangeable Low PressureConnections for Medical Gas Applications. (PIP)

Evacuation – Waste Gas. See definition of Waste Anesthetic GasDisposal.

Emergency Oxygen Supply Connection. An assembly ofequipment which permits a gas supplier to make a temporaryconnection to supply oxygen to a building which has had it’snormal source of oxygen disconnected.

Gas Powered Source System. A Level 3 source system that deliverscompressed air or nitrogen at <1100 kPa (<160 psi) gage pressureto power such devices as hand pieces, syringes, and cleaningdevices. (PIP)

Instrument Air. For the purposes of this standard, instrument airis air intended for the powering of medical devices unrelated tohuman respiration (eg. Surgical tools, ceiling arms, etc.) Medicalair and instrument air are distinct systems for mutually exclusiveapplications. (PIP)

Local Signal . A visible indication of the operating status ofequipment. Examples would include a light to indicate acompressor is operating or a cylinder header is in use or a flag

attached to a manual changeover valve to indicate which side is inuse. (PIP)

Manifold . A device for connecting the outlets of one or more gascylinders to the central piping system for that specific gas. (PIP)

Manufactured Assembly. A factory-assembled product designed foraesthetics or convenience that contains medical gas or vacuumoutlets, piping or other devices related to medical gases. (PIP)

Medical Air. For purposes of this standard medical air is airsupplied from cylinders, bulk containers, medical air compressors,or has been reconstituted from oxygen USP and oil free, dryNitrogen NF.

Nitrogen, Oil-Free, Dry (Nitrogen for Brazing and Testing).Nitrogen complying as a minimum with Oil free, dry Nitrogen NF.

Medical Gas System. An assembly of equipment and piping for thedistribution of nonflammable medical gases such as oxygen,nitrous oxide, compressed air, carbon dioxide, and nitrogen.(PIP)

Medical/Surgical Vacuum System. An assembly of central vacuumproducing equipment and a network of piping for patient suctionin medical, medical-surgical, and waste anesthetic gas disposal(WAGD) applications. (PIP)

Gas Powered System. A Level 3 gas distribution system comprisedof component parts including but not limited to cylinders,manifolds, air compressor, motor, receivers, controls, filters,dryers, valves and piping that delivers compressed air or nitrogen atpressures less than 1100 kPa (less than 160 psi) gage] to powerdevices (e.g. hand pieces, syringes, cleaning devices) as a powersource. (PIP)

Level 1 Medical Piped Gas and Vacuum Systems. Systems servingoccupancies where interruption of the piped medical gas andvacuum system would place patients in imminent danger ofmorbidity or mortality. (PIP)

Level 2 Medical Piped Gas and Vacuum Systems. Systems servingoccupancies where interruption of the piped medical gas andvacuum system would place patients at manageable risk ofmorbidity or mortality. (PIP)

Level 3 Piped Gas Systems. Systems serving occupancies whereinterruption of the piped medical gas would terminate proceduresbut would not place patients at risk of morbidity or mortality.(PIP)

Level 3 Piped Vacuum Systems . A Level 3 vacuum distributionsystem that can be either a wet system, designed to remove liquidsair/gas or solids from the treated area or a dry system designed totrap liquid and solids before the service inlet and to accommodateair/gas only through the service inlet. (PIP)

Supply Source.

Primary Supply . That portion of the source equipment thatactually supplies the system. (PIP)

Secondary Supply. Where provided, that portion of the sourceequipment that automatically supplies the system when the primarysupply becomes exhausted. (PIP)

Reserve Supply. Where provided, that portion of the sourceequipment that automatically supplies the system in the event offailure of the primary and secondary operating supply. (PIP)

Main Lines. The piping that connects the source (pumps, receiversetc.) to the risers or branches or both. (PIP)

Risers . The vertical pipes connecting the system main line(s) withthe branch lines on the various levels of the facility. (PIP)

Branch (Lateral) Lines . Those sections or portions of the pipingsystem that serve a room or group of rooms on the same story of afacility. (PIP)

Remote. A Level 3 source of supply which is accessed by exiting thesingle or multiple treatment facility. (PIP)

SCFM. Standard cubic feet per minute.


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Scavenging . An alternate term for WAGD often applied in Level 3.(PIP)

Semi-permanent Connection . A non interchangeable connection,usually a D.I.S.S. connector which is the termination of thepipeline and that is intended to be detached only for service. It isnot the point at which the user makes connections ordisconnections. (PIP)

Service Inlet . The pneumatic terminus of a Level 3 piped vacuumsystem. (PIP)

Service Outlet. The pneumatic terminus of a piped gas system forother than critical, continuous duty, nonflammable medical lifesupport type gases such as oxygen, nitrous oxide or medical air.(PIP)

Single Treatment Facility. A diagnostic or treatment complexunder a single management comprising a number of use points,but confined to a single contiguous group of use points (i.e. doesnot involve widely separated locations or separate distinctpractices). (PIP)

Multiple Treatment Facility. A diagnostic or treatment complexunder a single management comprising a number of singletreatment facilities, which can be accessed one from the otherwithout exiting the facility (i.e. does not involve widely separatedlocations or separate distinct practices).

Station Inlet . An inlet point in a piped medical/surgical vacuumdistribution system at which the user makes connections anddisconnections. (PIP)

Station Outlet. An outlet point in a piped medical gas distributionsystem at which the user makes connections and disconnections.(PIP)

Surface-Mounted Medical Gas Rail. A surface-mounted gasdelivery system intended to provide ready access for two or moregases through a common delivery system to provide multiple gasstation outlet locations within a single patient room or critical carearea. (PIP)

Use Point. A location with any number of station outlets and inletsarranged for access by a practicioner during treatment of a patient.(PIP)

Utility Center (J Box). A type of terminal enclosure for utilities(e.g., gas power, vacuum, water, electrical power, etc.) used inoffice-based occupancies. (PIP)

WAGD Interface . A device provided on the anesthesia gas machinethat connects the WAGD network to the patient breathing circuit.(PIP)

Waste Anesthetic Gas Disposal (WAGD). The process of capturingand carrying away gases vented from the patient breathing circuitduring the normal operation of gas anesthesia or analgesiaequipment. (PIP)

Chapter 5

5.1 Level 1 Piped Gas and Vacuum Systems

5.1.1 Applicability

5.1.1.1 These requirements apply to health care facilities requiringLevel 1 systems as referenced in Chapters 13 through 21.

5.1.1.2 Wherever the terms medical gas or vacuum occur, theprovisions shall apply to all piped systems for oxygen, nitrousoxide, medical air, carbon dioxide, helium, nitrogen,medical/surgical vacuum, waste anesthetic gas disposal, andmixtures thereof. Wherever the name of a specific gas or vacuumservice occurs, the provision applies only to that gas.

5.1.1.3 An existing system that is not in strict compliance with theprovisions of this standard shall be permitted to be continued inuse as long as the authority having jurisdiction has determined thatsuch use does not constitute a distinct hazard to life.

5.1.2 Nature of Hazards of Gas and Vacuum Systems .* Potentialfire and explosion hazards associated with medical gas centralpiping systems and medical-surgical vacuum systems shall be

considered in the design, installation, testing, operation andmaintenance of these systems.

5.1.3 Level I Sources

5.1.3.1 Central Supply System Identification and Labeling

5.1.3.1.1 Only cylinders and containers constructed, tested, andmaintained in accordance with U.S. Department of Transportationspecifications and regulations shall be permitted to be used.

5.1.3.1.2 Cylinder contents shall be identified by attached labels orstencils naming the contents in accordance with CGA Pamphlet C-7, Guide to the Preparation of Precautionary Labeling and Markingof Compressed Gas Containers.

5.1.3.1.3 Contents of cylinders and containers shall be verifiedprior to use.

5.1.3.1.4 Labels shall not be defaced, altered, or removed, andconnecting fittings shall not be modified.

5.1.3.1.5 Locations containing medical gases other than oxygenand medical air shall have their door(s) labeled substantially asfollows:

CAUTIONMedical Gases

No Smoking or Open FlameRoom May have Insufficient Oxygen

Open Door and Allow Room to Ventilate before Entering

5.1.3.1.6 Locations containing central supply systems or cylinderscontaining only oxygen or medical air shall have their door(s)labeled as follows:


NO Smoking or Open Flame

5.1.3.2 Central Supply System Operations

5.1.3.2.1 The use of adapters or conversion fittings to adapt one gasspecific fitting to another shall be prohibited.

5.1.3.2.2 Cylinders and containers shall be handled in strictaccordance with 5.1.13.

5.1.3.2.3 Only medical gas cylinders, reusable shipping containers,and their accessories shall be permitted to be stored in roomscontaining central supply systems or medical gas cylinders.

5.1.3.2.4 No flammable materials, cylinders containing flammablegases or containers containing flammable liquids shall be stored inrooms with medical gas cylinders.

5.1.3.2.5 Wooden racks for cylinder storage shall be permitted.

5.1.3.2.6 If cylinders are wrapped when received, the wrappersshall be removed prior to storage.

5.1.3.2.7 Cylinders not in use shall have their valve protection capssecured tightly in place.

5.1.3.2.8 Cylinders without correct markings or whose markingsand gas specific fittings do not match shall not be used.

5.1.3.2.9 Cryogenic liquid storage units intended to supply gas tothe facility shall not be used to transfill other liquid storage vessels.

5.1.3.3 Central Supply System Locations

5.1.3.3.1 Central Supply Systems shall be located to meet thefollowing criteria:

5.1.3.3.1.1 Any of the following systems shall be permitted to belocated together in the same outdoor enclosure:

(1) Manifolds for gas cylinders without reserve supply. (See5.1.3.4.9.)

(2) Manifolds for gas cylinders with reserve supply(3) Manifolds for Cryogenic Liquid Cylinders. (See 5.1.3.4.10.)(4) Bulk Cryogenic Liquid Systems. (See 5.1.3.4.11.)


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5.1.3.3.1.2 Any of the following systems shall be permitted to belocated together in the same indoor enclosure:

(1) Manifolds for Gas Cylinders without Reserve Supply. (See5.1.3.4.9.)

(2) Manifolds for Gas Cylinders with Reserve Supply(3) Manifolds for cryogenic liquid cylinders. (See 5.1.3.4.10.)(4) In-building emergency reserves. (See 5.1.3.4.13.)(5) Instrument air standby headers. (See 5.1.3.8.4.)

5.1.3.3.1.3 Any of the following systems shall be permitted to belocated together in the same room:

(1) Medical air compressor supply sources. (See 5.1.3.5.3.)(2) Medical/surgical vacuum sources. (See 5.1.3.6.)(3) Waste anesthetic gas disposal (WAGD) sources (see

5.1.3.7)(4) Instrument air sources. (See 5.1.3.8.)

5.1.3.3.1.4 Any system listed under 5.1.3.3.1.3 shall not be locatedin the same room with any system listed under 5.1.3.3.1.1 or5.1.3.3.1.2, except medical air or instrument air reserve headerscomplying with 5.1.3.4.13.

5.1.3.3.1.5 Locations shall be chosen to permit access by deliveryvehicles and management of cylinders (e.g., proximity to loadingdocks, access to elevators, passage of cylinders through publicareas).

5.1.3.3.1.6 Indoor locations for oxygen, nitrous oxide, andmixtures of these gases shall not communicate with the following:

(1) Areas involved in critical patient care(2) Anesthetizing locations(3) Locations storing flammables(4) Rooms containing open electrical contacts or transformers(5) Storage tanks for flammable or combustible liquids(6) Engines(7) Kitchens(8) Areas with open flames

5.1.3.3.1.7 Cylinders in use and in storage shall be prevented fromreaching temperatures in excess of 54°C (130°F).

5.1.3.3.1.8 Central supply systems for nitrous oxide and carbondioxide shall be prevented from reaching temperatures lower thanthe recommendations of the central supply system’s manufacturer,but shall never be lower than –7°C (20°F) or greater than 54°C(130°F).

5.1.3.3.1.9 Central supply systems for oxygen with a total capacityconnected and in storage of 566,335 L (20,000 ft3) or more atStandard Temperature and Pressure (STP) shall comply withNFPA 50, Standard for Bulk Oxygen Systems at Consumer Sites.

5.1.3.3.1.10 Central supply systems for nitrous oxide with a totalcapacity connected and in storage of 1,451 kg (3,200 lbs) or moreshall comply with CGA G8.1, Standard for the Installation of NitrousOxide Systems at Consumer Sites.

5.1.3.3.2 Design and Construction. Locations for central supplysystems and the storage of medical gases shall meet the followingrequirements:

(1) Be constructed with access to move cylinders, equipment,etc., in and out of the location.

(2) Be secured with lockable doors or gates or otherwisesecured.

(3) If outdoors, be provided with an enclosure (wall orfencing) constructed of non-combustible materials.

(4) If indoors, be constructed and using interior finishes ofnon-combustible or limited combustible materials such that allwalls, floors, ceilings and doors are of a minimum one-hour fireresistance rating.

(5) Be compliant with NFPA 70, National Electrical Code forordinary locations, with electrical devices located at or above 1,520mm (5 ft) above finished floor to avoid physical damage.

(6) Be heated by indirect means (e.g., steam, hot water) if heatis required.

(7) Be provided with racks, chains, or other fastenings toindividually secure all cylinders, whether connected, unconnected,full, or empty, from falling.

(8) Be supplied with electrical power compliant with therequirements for Essential Electrical Systems as described inChapter 4 of this document.

(9) Have racks, shelves, and supports, where provided,constructed of non-combustible materials or limited combustiblematerials.

5.1.3.3.3 Ventilation

5.1.3.3.3.1 Ventilation of Locations for Manifolds . Locationscontaining central supply systems or used for storing medical gascontainers shall be ventilated to prevent the accumulation ofmedical gases from leaks and operation of cylinder or manifoldoverpressure safety devices as follows:

(1) Indoor supply systems shall have all relief valves vented per5.1.3.4.5.1 (5) through (9).

(2) Where the total volume of medical gases connected and instorage is greater than 84,950 L (3,000 ft 3) at STP, indoor supplylocations shall be provided with dedicated mechanical ventilationsystems that draw air from within 300 mm (1 ft) of the floor andoperate continuously.

(3) The power supply for mechanical ventilation fans shallconform to the requirements of an essential electrical system asdescribed in Chapter 4 of this document.

(4) Where the total volume of medical gases connected and instorage is less than 84,950 L (3,000 ft 3) at STP or the onlycompressed gas in the room is medical air, natural ventilation shallbe permitted to be employed.

(5) Where natural ventilation is permitted, it shall consist of twolouvered openings, each having a minimum free area of 46,500mm2 (72 in. 2), with one located within 300 mm (1 ft) of the floorand one located within 300 mm (1 ft) of the ceiling.

(6) Louvered natural ventilation openings shall not be located inan exit access corridor.

(7) Mechanical ventilation shall be provided if the requirementsof 5.1.3.3.3.1 (6) cannot be met.

5.1.3.3.3.2 Ventilation for Motor Driven Equipment. Thefollowing source locations shall be adequately ventilated to preventaccumulation of heat:

(1) Medical Air Sources. (See 5.1.3.5)(2) Medical/Surgical vacuum Sources. (See 5.1.3.6)(3) Waste Anesthetic Gas Disposal (WAGD) Sources. (See

5.1.3.7)(4) Instrument Air Sources. (See 5.1.3.8)

5.1.3.3.3.3 Ventilation for Outdoor Locations . Outdoor locationssurrounded by impermeable walls shall have protected ventilationopenings located at the base of each wall to allow free circulationof air within the enclosure.

5.1.3.3.4 Storage

5.1.3.3.4.1 Full or empty medical gas cylinders when notconnected shall be stored in locations complying with 5.1.3.3.2through 5.1.3.3.3 and shall be permitted to be in the same roomsor enclosures as their respective central supply systems.

5.1.3.4 Central Supply Systems. (see Fig A-5.1.3.4) Central supplysystems shall be permitted to consist of the following:

(1) Cylinder manifolds for gas cylinders per 5.1.3.4.9(2) Manifolds for cryogenic liquid cylinders per 5.1.3.4.10(3) Bulk cryogenic liquid systems per 5.1.3.4.11(4) Medical air compressor systems per 5.1.3.5(5) Medical/Surgical vacuum producers per 5.1.3.6(6) WAGD producers per 5.1.3.7(7) Instrument Air compressor systems per 5.1.3.8.

5.1.3.4.1 Central supply systems shall be obtained from andinstalled in accordance with the instructions of a supplier familiarwith their proper construction and use.

5.1.3.4.2 Central supply systems for oxygen, medical air, nitrousoxide, carbon dioxide, nitrogen and all other medical gases shallnot be piped to, or used for, any purpose except patient careapplications.

5.1.3.4.3 Materials used in central supply systems shall meet thefollowing requirements:

(1) In those portions of systems intended to handle oxygen atpressures greater than 2070 kPa (300 psi) gage, be made ofmaterials having a resistance to combustion not lower than that ofred brass in ASTM STP 1197 and contain no polymeric materials.

(2)* In those portions of systems intended to handle oxygen ornitrous oxide at pressures less than 2070 kpa (300 psi) gage, beconstructed of materials that are compatible with oxygen under thetemperatures and pressures to which the components may beexposed in the containment and use of oxygen, nitrous oxide,mixtures of these gases, or mixtures containing more than 23.5percent oxygen.


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(3) If potentially exposed to cryogenic temperatures, bedesigned for low temperature service.

(4) If intended for outdoor installation, be listed and approvedfor outdoor use.

5.1.3.4.4 Regulators

5.1.3.4.4.1 All positive pressure central supply systems shall beprovided with duplex final line pressure regulators, installed inparallel with isolation valves before each regulator and an isolationor check valve after each regulator permitting service to eitherregulator without interruption of supply.

5.1.3.4.4.2 The pressure indicator(s) shall be located downstreamof each regulator or immediately downstream of the isolating valvesfor the regulators.

5.1.3.4.5 Relief Valves

5.1.3.4.5.1 All positive pressure central supply systems shall beprovided with at least one relief valve that meets the followingrequirements:

(1) Is of brass, bronze, or stainless steel construction(2) Is designed for the gas service(3) Is located between the final line regulator outlet valve and

the source valve.(4) Is set at 50 percent above the normal system operating

pressure. (See Table 5.1.11.)(5) Is vented to the outside of the building, except that relief

valves for air systems having less than 84,950 L (3,000 ft3) at STPshall be permitted to be diffused locally.

(6) Is connected, when vented outside, to a vent line sized atleast at the full size of the relief valve outlet.

(7) Where multiple relief valves discharge into a common ventline, have a cross-sectional internal area of the common line thatequals or exceeds the aggregate internal discharge areas of all ofthe relief valves served.

(8) When vented outside, discharges in areas away fromflammable materials and not where a passerby may be endangeredby the discharge.

(9) When vented outside, is turned down and screened at thedischarge end to prevent the entry of water or vermin.

5.1.3.4.5.2 When vented outside, materials for relief valve vent linesshall comply with 5.1.10.1.

5.1.3.4.6 Multiple Pressures . Where a single central supply systemsupplies two piped distribution networks operating at differentpressures, each piped distribution network shall be separatelyprovided with all elements in 5.1.3.4.

5.1.3.4.7 Local Signals

5.1.3.4.7.1 The following systems shall have local signals located atthe source equipment:

(1) Manifolds for gas cylinders without reserve supply (see5.1.3.4.9)

(2) Manifolds for gas cylinders with reserve supply(3) Manifolds for cryogenic liquid cylinders. (See 5.1.3.4.10.)(4) Bulk cryogenic liquid systems (See 5.1.3.4.11.)(5) In-building emergency reserves (See 5.1.3.4.13.)(6) Instrument air headers. (See 5.1.3.8.4.)

5.1.3.4.7.2 The local signals shall meet the following requirements:(1) Provide visual indicat ion only.(2) Be labeled for the service and condition being monitored.(3) If used outdoors, be listed and approved for outdoor use.

5.1.3.4.8 Headers. [See Figure A-5.1.3.4.8] In central supplysystems using cylinders containing either gas or liquid, each headershall include the following:

(1) Cylinder connections in the number required for theheader’s application.

(2) A cylinder lead for each cylinder constructed of materialscomplying with 5.1.3.4.3 and provided with end fittingspermanently attached to the cylinder lead complying with CGAPamphlet V-1 , Standard for Compressed Gas Cylinder Valve Outlet andInlet Connections, (ANSI B57. 1).

(3) A filter of a material complying with 5.1.3.4.3 to prevent theintrusion of debris into the manifold controls.

(4) A header shutoff valve downstream of the nearest cylinderconnection, but upstream of the point at which the headerconnects to the central supply system.

(5) A pressure indicator indicating header contents.

(6) A check valve to prevent backflow into the header and topermit service to the header.

(7) If intended for gas cylinder service, a check valve at eachconnection for the cylinder lead in 5.1.3.4.8(2) to prevent loss ofgas in the event of damage to the cylinder lead or operation of anindividual cylinder relief valve.

(8) If intended for gas cylinder service, a pressure regulator toreduce the cylinder pressure to an intermediate pressure under2070 kPa (300 psi) gage.

(9) If intended for service with cryogenic liquid cylinders, apressure relief valve, with no check valve for each cylinder lead.

5.1.3.4.9 Manifolds for Gas Cylinders without Reserve Supply (SeeFigure A.5.1.3.4.9.)

5.1.3.4.9.1 The manifolds in this category shall be located inaccordance with 5.1.3.3.1and the following:

(1) If located outdoors, be installed in an enclosure used onlyfor this purpose and sited to comply with minimum distancerequirements in Table A-2.2 in NFPA 50, Standard for Bulk OxygenSystems at Consumer Sites.

(2) If located indoors, be installed within a room used only forthis purpose.

5.1.3.4.9.2 The manifold locations in this category shall beconstructed in accordance with 5.1.3.3.2.

5.1.3.4.9.3 The manifolds locations in this category shall beventilated in accordance with 5.1.3.3.3.

5.1.3.4.9.4 The manifolds in this category shall consist of thefollowing:

(1) Two equal headers in accordance with 5.1.3.4.8, with eachhaving a sufficient number of gas cylinder connections for anaverage day’s supply but not fewer than two connections, and withthe headers connected to the final line pressure regulator assemblyin such a manner that either header may supply the system.

(2) An intermediate relief valve(s), piped to the outside inaccordance with 5.1.3.4.5.1(5-9), that protects the piping betweenthe header pressure regulator and the line pressure regulatorassembly, and protects the line pressure regulators from overpressure in the event of a header regulator failure.

5.1.3.4.9.5 The manifolds in this category shall include anautomatic means of alternating the two headers to accomplish thefollowing in normal operation:

(1) One header is the primary and the other is the secondary,with either being capable of either role.

(2) When the primary header is supplying the system, thesecondary header is prevented from supplying the system.

(3) When the primary header is depleted, the secondary headershall automatically begin to supply the system.

5.1.3.4.9.6 The manifolds in this category shall actuate a localsignal and shall activate an indicator at all master alarm panelswhen or at a predetermined set point before the secondary headerbegins to supply the system, indicating changeover has occurred oris about to occur.

5.1.3.4.9.7 If manifolds in this category are located outdoors, theyshall be listed and approved for outdoor use.

5.1.3.4.10 Manifolds for Cryogenic Liquid Cylinders (see FigureA-5.1.3.4.10).

5.1.3.4.10.1 The manifolds in this category shall be located inaccordance with 5.1.3.3.1 and the following:

(1) If located outdoors, be installed in an enclosure used onlyfor this purpose and sited to comply with minimum distancerequirements in Table A-2.2 in NFPA 50, Standard for Bulk OxygenSystems at Consumer Sites.

(2) If located indoors, be installed within a room used only forthis purpose.

5.1.3.4.10.2 The manifolds in this category shall have their primaryand secondary headers located in the same enclosure.

5.1.3.4.10.3 The reserve header shall be permitted to be located inthe same enclosure as the primary and secondary headers or inanother enclosure compliant with 5.1.3.4.10.1.


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5.1.3.4.10.4 The manifolds in this category shall consist of thefollowing:

(1) Two equal headers per 5.1.3.4.8 each having sufficientnumber of liquid cylinder connections for an average day’s supplybut not fewer than two connections, and with the headersconnected to the final line pressure regulator assembly in such amanner that either header may supply the system.

(2)* A reserve header per 5.1.3.4.8 having sufficient number ofgas cylinder connections for an average day’s supply but not fewerthan three connections, and connected downstream of theprimary/secondary headers and upstream of the final line pressureregulators.

(3) A pressure relief valve set at or below the relief pressure forthe cryogenic liquid cylinders and installed downstream of theconnection of the reserve header and upstream of the final linepressure regulating assembly.

5.1.3.4.10.5 The manifolds in this category shall include anautomatic means of controlling the three headers to accomplishthe following during normal operation:

(1) One cryogenic liquid header is the primary and the other isthe secondary, with either being capable of either role.

(2) When the primary header is supplying the system, thesecondary header is prevented from supplying the system.

(3) When the primary header is depleted, the secondary headershall automatically begin to supply the system.

5.1.3.4.10.6 The manifolds in this category shall be equipped witha means to conserve the gas produced by evaporation of thecryogenic liquid in the secondary header. This mechanism shalldischarge the conserved gas into the system upstream of the finalline regulator assembly.

5.1.3.4.10.7 The manifolds in this category shal l include a manualor automatic means to place either header into the role as primaryheader and the other in the role of secondary header.

5.1.3.4.10.8 The manifolds in this category shall include a means toautomatically activate the Reserve Header if for any reason theprimary and secondary headers cannot supply the system.

5.1.3.4.10.9 The manifolds in this category shall actuate a localsignal and shall activate an indicator at all master alarms under thefollowing conditions:

(1) When or at a predetermined set point before, the secondaryheader begins to supply the system, indicating changeover.

(2) When or at a predetermined set point before the reserveheader begins to supply the system, indicating reserve is in use.

(3) When or at a predetermined set point before the reserveheader contents fall to one day’s average supply, indicating reservelow.

5.1.3.4.11 Bulk Cryogenic Liquid Systems (See Figure A-5.1.3.4.11.)

5.1.3.4.11.1 Bulk Cryogenic Liquid Systems shall be locatedoutdoors as follows:

(1) In an enclosure sited to comply with minimum distancerequirements in Table A-2.2 in NFPA 50, Standard for Bulk OxygenSystems at Consumer Sites.

(2) In an enclosure constructed per 5.1.3.3.2 (1) through (3)and (5), (8) (9).

(3) In an enclosure ventilated per 5.1.3.3.3.3.(4) In compliance with CGA, Guidelines for Medical Gas

Installations at Consumer Sites.

5.1.3.4.11.2 Bulk cryogenic liquid systems shall be sited as follows:(1) The supply system shall be anchored firmly to a poured

concrete pad, appropriate for the weight, surface loading andcomplying with local seismic requirements.

(2) The site shall be completely enclosed as per 5.1.3.3.2(3)with the poured concrete pad (equipment pad) completely fillingthe enclosed space.

(3)* The location intended for the delivery vehicle (the vehiclepad) shall comply with NFPA 50.

(4) The location intended for the delivery vehicle connectionshall be concrete.

(5) Drainage from the equipment pad and vehicle pad shall beaway from any building, parked vehicles, or other potential sourcesof ignition.

(6) No drain shall be located within the pad or closer than 2450mm (8 ft) from the edge of the pad.

5.1.3.4.11.3 Bulk cryogenic liquid sources shall consist of thefollowing:

(1) One or more main supply vessel(s), whose capacity shall bedetermined after consideration of delivery schedules, proximity ofthe facility to alternate supplies, and the emergency plan.

(2) A contents gauge on each of the main vessel(s).(3) A reserve supply sized for greater than an average day’s

supply, with the appropriate size of vessel or number of cylindersbeing determined after consideration of delivery schedules,proximity of the facility to alternate supplies, and the facility’semergency plan.

5.1.3.4.11.4 Bulk cryogenic liquid sources shall include a reservesupply including either or both of the following:

(1) A second cryogenic liquid vessel, including an actuatingswitch/sensor monitoring internal pressure, a contents gauge, anda check valve to prevent backflow into the reserve system.

(2) A cylinder header per 5.1.3.4.8 having sufficient gas cylinderconnections for an average day’s supply but not fewer than threeand including a contents pressure switch.

5.1.3.4.11.5 Bulk cryogenic liquid sources shall operate so as toprovide the following functions:

(1) When the main supply is supplying the system, the reservesupply shall be prevented from supplying the system until the mainsupply fails or is depleted, at which point the reserve supply shallautomatically begin to supply the system.

(2) Where there is more than one main supply vessel, thesystem shall operate as described in 5.1.3.4.10 for primary /secondary / reserve operation.

(3) Two or more cryogenic vessels shall be permitted toalternate (e.g. on a timed basis) in the roles of primary, secondaryand reserve, providing an operating cascade (primary-secondary-reserve) as required in 5.1.3.4.10.4 is maintained at all times.

(4) In the case of a cryogenic vessel used as the reserve, thereserve vessel shall include a means to conserve the gas producedby evaporation of the cryogenic liquid in the reserve vessel and todischarge the gas into the line upstream of the final line regulatorassembly as required in 5.1.3.4.10.6.

5.1.3.4.11.6 The bulk systems shall actuate a local signal and analarm at the required master alarms under the followingconditions:

(1) When or at a predetermined set point before the mainsupply reaches an average day’s supply, indicating low contents.

(2) When or at a predetermined set point before the reservesupply begins to supply the system, indicating reserve is in use.

(3) When or at a predetermined set point before the reservesupply contents fall to one day’s average supply, indicating reservelow.

(4) If the reserve is a cryogenic vessel, when or at apredetermined set point before the reserve internal pressure fallstoo low for the reserve to operate properly, indicating reservefailure.

(5) Where there is more than one main supply vessel, when orat a predetermined set point before the secondary vessel begins tosupply the system, indicating changeover.

5.1.3.4.12 Emergency Oxygen Supply Connection (EOSC) (SeeFigure A-5.1.3.4.12.) EOSC(s) shall be installed to permitconnection of a temporary auxiliary source of supply for emergencyor maintenance situations under the following conditions:

(1) Where the bulk cryogenic liquid central supply system isoutside of and remote from the building which the oxygen supplyserves.

(2) Where there is not in the building a connected oxygenreserve sufficient for an average day’s supply. (See 5.1.3.4.13 forrequirements for such reserves.)

(3) Where multiple freestanding buildings are served from asingle oxygen source such that damage to the interconnectingoxygen line could result in one or more buildings losing oxygensupply.

(4) In this situation, each building shall be provided with aseparate emergency connection.

5.1.3.4.12.1 EOSCs shall be located as follows:(1) On the exterior of the building served in a location

accessible by emergency supply vehicles at all times in all weatherconditions.

(2) Be connected to the main supply line immediatelydownstream of the main shutoff valve.


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5.1.3.4.12.2 EOSCs shall consist of the following:(1) Physical protection to prevent unauthorized tampering.(2) A female DN (NPS) inlet for connection of the emergency

oxygen source that is sized for 100 percent of the system demand atthe emergency source gas pressure.

(3) A manual shutoff valve to isolate the EOSC when not inuse.

(4) Two check valves, One downstream of the EOSC and onedownstream of the main line shutoff valve, with both upstreamfrom the tee connection for the two pipelines.

(5) A relief valve sized to protect the downstream piping systemand related equipment from exposure to pressures in excess of 50percent higher than normal line pressure.

(6) Any valves necessary to allow connection of an emergencysupply of oxygen and isolation of the piping to the normal sourceof supply.

5.1.3.4.13 In-Building Emergency Reserves

5.1.3.4.13.1 In building emergency reserves shall not be used assubstitutes for bulk gas reserves as required in 5.1.3.4.11.4.

5.1.3.4.13.2 If a reserve is provided inside the building as asubstitute for the Emergency Oxygen Supply Connection, it shall belocated in accordance with 5.1.3.3 as follows:

(1) In a room or enclosure constructed per 5.1.3.3.2.(2) In a room or enclosure ventilated per 5.1.3.3.3.

5.1.3.4.13.3 In-building emergency reserves shall consist of eitherof the following:

(1) A gas cylinder header per 5.1.3.4.8 with sufficient cylinderconnections to provide for at least an average days supply.

(2) A manifold for gas cylinders complying with 5.1.3.4.9.

5.1.3.4.13.4 In-building emergency reserves shall include a checkvalve in the main line placed on the distribution system side of theordinary source’s main line valve to prevent flow of gas from theEmergency Reserve to the ordinary source.

5.1.3.4.13.5 In-building emergency reserves shall actuate a loca lsignal and at all master alarms when or just before it begins toserve the system.

5.1.3.5 Level 1 Medical Air Supply Systems

5.1.3.5.1 * Quality of Medical Air. Medical air shall comply withthe following:

(1) Is supplied from cylinders, bulk conta iners, medical aircompressor sources, or has been reconstituted from oxygen USPand oil free, dry Nitrogen NF.

(2) Meets the requirements of Medical Air USP.(3) Has no detectable liquid hydrocarbons.(4) Has less than 25 ppm gaseous hydrocarbons.(5) Has equal to or less than 5 milligrams/cubic meter of

permanent particulates sized 1 micron or larger in the air atnormal atmospheric pressure.

5.1.3.5.2 Medical air sources shall be connected to the medical airdistribution system only and shall be used only for air in theapplication of human respiration, and calibration of medicaldevices for respiratory application.

5.1.3.5.3 Medical Air Compressor Sources. (See Figure A-5.1.3.5)

5.1.3.5.3.1 Medical air compressor systems shall be located per5.1.3.3 as follows:

(1) Indoors in a dedicated mechanical equipment area,adequately ventilated and with any required utilities (e.g. electricity,drains, lighting, etc)

(2) In a room constructed per 5.1.3.3.2.(3) In a room ventilated per 5.1.3.3.3.2 .(4) For air-cooled equipment, in a room designed to maintain

the ambient temperature range as recommended by themanufacturer.

5.1.3.5.3.2 Medical air compressor systems shall consist of thefollowing:

(1) Components complying with 5.1.3.5.4 through 5.1.3.5.10arranged per 5.1.3.5.11

(2) An automatic means to prevent backflow from all on-cyclecompressors through all off-cycle compressors

(3) A manual shut-off valve to isolate each compressor from thecentrally piped system and from other compressors formaintenance or repair without loss of pressure in the system.

(4) Intake filter-muffler(s) of the dry type.(5) Pressure relief valve(s) set at 50 percent above line pressure.(6) Piping between the compressor and the source shutoff valve

shall be compatible with oxygen, not contribute to contaminantlevels and be cleaned for oxygen use.

5.1.3.5.3.3 Medical air compressor systems shall preclude the

condensation of water vapor in the piping distribution system by

the selection of the air drying equipment.

5.1.3.5.4 Compressors for Medical Air.

5.1.3.5.4.1 Compressors for medical air shall be designed toprevent the introduction of contaminants or liquid into thepipeline by either of the following methods:

(1) Elimination of oil anywhere in the compressor (e.g., liquidring and permanently sealed bearing compressors).

(2)* Separation of the oil-containing section from thecompression chamber by at least two seals creating an area open toatmosphere that allows the following:

a. direct and unobstructed visual inspection of theinterconnecting shaft through vent and inspection openings nosmaller than 1.5 shaft diameters in size.

b. the facility operators to confirm proper seal operation bydirect visual inspection through the above shaft opening, withoutdisassembly of the compressor (e.g., extended head compressorswith an atmospheric vent between the compression chamber andthe crankcase).

5.1.3.5.4.2 For liquid ring compressors, service water and sealwater of a quality recommended by the compressor manufacturershall be used.

5.1.3.5.4.3 Compressors shall be permitted to be constructed offerrous and/or non-ferrous materials.

5.1.3.5.4.4 Anti-vibration mountings shall be installed forcompressors as required by equipment dynamics or location andin accordance with the manufacturer’s recommendations.

5.1.3.5.4.5 Flexible connectors shall connect the air compressorswith their intake and outlet piping.

5.1.3.5.5 Aftercoolers. Aftercoolers, where required, shall beprovided with individual condensate traps. The receiver shall notbe used as an aftercooler or aftercooler trap.

5.1.3.5.5.1 Aftercoolers shall be permitted to be constructed offerrous and/or non-ferrous materials.

5.1.3.5.5.2 Anti-vibration mountings shall be installed foraftercoolers as required by equipment dynamics or location and inaccordance with the manufacturer’s recommendations.

5.1.3.5.6 Medical Air Receivers . Receivers for medical air shallmeet the following requirements:

(1) Be made of corrosion resistant materials or otherwise madecorrosion resistant.

(2) Comply with Section VIII, Unfired Pressure Vessels, of theASME Boiler and Pressure Vessel Code

(3) Be equipped with a pressure relief valve, automatic drain,manual drain, sight glass, and pressure indicator.

(4) Be of a capacity sufficient to prevent the compressors fromshort-cycling.

5.1.3.5.7 Medical Air Dryers . Medical air dryers shall meet thefollowing requirements:

(1) Be designed to provide air at a maximum dew point whichis below the frost point (0°C {32°F}) at any level of demand.

(2) Be sized for 100 percent of the system peak calculateddemand at design conditions.

(3) Be permitted to be constructed of ferrous and/or non-ferrous materials.

(4) Be provided with anti-vibra tion mountings installed asrequired by equipment dynamics or location and in accordancewith the manufacturer’s recommendations.


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5.1.3.5.8 Medical Air Filters. Medical air filters shall meet thefollowing requirements:

(1) Be appropriate for the intake air conditions.(2) Be located upstream of the final line regulators.(3) Be sized for 100 percent of the system peak calculated

demand at design conditions and shall be rated for a minimum of98 percent efficiency at 1 micron or greater.

(4) Be equipped with a continuous visual indicator showing thestatus of the filter element life.


5.1.3.5.8.1 Compressors complying with 5.1.3.5.4.1(2) shall beprovided with:

(1) Coalescing Filters with element change indicators.(2) Charcoal absorbers with colormetric hydrocarbon indicators.

5.1.3.5.9 Medical Air Regulators. Medical air regulators shall meetthe following requirements:

(1) Be sized for 100 percent of the system peak calculateddemand at design condition.


(3) Be equipped with a pressure indicator indicating deliverypressure.

5.1.3.5.10 Medical Air Local Alarm . A local alarm complying with5.1.9.4 shall be provided for the medical air compressor source.

5.1.3.5.11 Piping Arrangement and Redundancies

5.1.3.5.11.1 Component arrangement shall be as follows:(1) Components shall be arranged to permit service and a

continuous supply of Medical Air in the event of a single faultfailure.

(2) Component arrangement shall be permitted to vary asrequired by the technology(ies) employed, provided an equal levelof operating redundancy and Medical Air quality is maintained.

5.1.3.5.11.2 Medical air compressors shall be sufficient to serve thepeak calculated demand with the largest single compressor out ofservice. In no case shall there be fewer than 2 (two) compressors.

5.1.3.5.11.3 When aftercoolers are provided, they shall be sufficientto serve the peak calculated demand with the largest singleaftercooler out of service and provided with valves adequate toremove them from the system without shutting down supply ofmedical air.

5.1.3.5.11.4 Medical air receiver(s) shall be provided with a three-valve bypass to permit service to the receiver without shutting downthe medical air system.

5.1.3.5.11.5 Dryers, filters, and regulators shall be at least duplexedwith each component sized to serve the peak calculated demandwith the largest of each component out of service.

5.1.3.5.11.6 (see Figure A-5.1.3.5.11.6) Dryers, filters, andregulators shall be provided with manual valves upstream andmanual valves or check valves downstream to allow service to thecomponents without shutting down the system as follows:

(1) Installed for each component, upstream and downstream ofeach component allowing each to be individually isolated, or

(2) Installed upstream and downstream of components inseries so as to create redundant parallel branches of components.

5.1.3.5.11.7 Three way, indexed to flow, full port valves shall bepermitted to be used to isolate one branch or component for thepurposes of 5.1.3.5.11.6.

5.1.3.5.11.8 Under normal operation, only one aftercooler shallbe open to airflow with the other aftercooler valved off.

5.1.3.5.11.9 Under normal operation, only one dryer-filter(s)-regulator sequence shall be open to airflow with the othersequence valved off.

5.1.3.5.11.10 If the relief valve required in 5.1.3.5.3.2(5) and5.1.3.5.6 (3) can be isolated from the system by the valvearrangement used to comply with 5.1.3.5.11.6, then redundantrelief valve(s) shall be installed in the parallel sequence.

5.1.3.5.11.11 A DN8 (NPS 1/4) valved sample port shall beprovided downstream of the final line pressure regulators, DewPoint Monitor, and Carbon Monoxide Monitor and upstream ofthe source shutoff valve to allow for sampling of the medical air.

5.1.3.5.11.12 Medical air source systems shall be provided with asource valve per 5.1.4.4.

5.1.3.5.11.13 Where medical air piping systems at differentoperating pressures are required, the piping shall separate after thefilters, but shall be provided with separate line regulators, dewpoint monitors, relief valves, and source shutoff valves.

5.1.3.5.12 Electrical Power and Control

5.1.3.5.12.1 Additional compressor(s) shall automatically activatewhen the compressor(s) in operation is(are) incapable ofmaintaining the required pressure.

5.1.3.5.12.2 Automatic or manual alternation of compressors shallallow division of operating time. If automatic alternation ofcompressors is not provided, the facility staff shall arrange aschedule for manual alternation.

5.1.3.5.12.3 Each compressor motor shall be provided withelectrical components including but not limited to the following:

(1) A dedicated disconnect switch installed in the electricalcircuit ahead of each motor starter.

(2) Motor starting device.(3) Overload protection.(4) Where compressor systems having two or more compressors

employ a control transformer or other voltage control powerdevice, at least two such devices shall be installed.

(5) Control circuits arranged in such a manner that theshutdown of one compressor does not interrupt the operation ofanother compressor.

5.1.3.5.12.4 Electrical installation and wiring shall conform to therequirements of NFPA 70, National Electrical Code.

5.1.3.5.12.5 Emergency electrical service for the compressors shallconform to the requirements of the essential electrical system asdescribed in Chapter 4 of this document.

5.1.3.5.13 Compressor Intake.

5.1.3.5.13.1 The Medical Air compressors shall draw their air froma source of clean air located where no contamination is anticipatedfrom engine exhausts, fuel storage vents, Medical/Surgical vacuumsystem discharges, particulate matter, or odor of any type.

5.1.3.5.13.2 The compressor air intake shall be located outdoorsabove roof level, at a minimum distance of 3050 mm (10 ft) fromany door, window, exhaust, other intake, or opening in thebuilding and a minimum distance of 6100 mm (20 ft) above theground.

5.1.3.5.13.3 If an air source equal to or better than outside air(e.g., air already filtered for use in operating room ventilatingsystems) is available, it shall be permitted to be used for themedical air compressors provided:

(1) This alternate source of supply air shall be available on acontinuous 24-hour-per-day, 7-day-per-week basis.

(2) Ventilating systems having fans with motors or dr ive beltslocated in the air stream shall not be used as a source of medicalair intake.

5.1.3.5.13.4 Compressor intake piping shall be of materialsapproved for vacuum piping under 5.1.10.2.1 that will not addcontaminants in the form of particulate matter, odor, or othergases.

5.1.3.5.13.5 Air intakes for separate compressors shall be permittedto be joined together to one common intake if the followingconditions are met:

(1) The common intake is sized to minimize back pressure inaccordance with the manufacturer’s recommendations.

(2) Each compressor can be isolated by manual or check valve,blind flange, or tube cap to prevent open inlet piping whencompressor(s) are removed for service and consequent backflow ofroom air into the other compressor(s).


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5.1.3.5.14 Operating Alarms and Local Signals. Medical Airsystems shall be monitored for conditions that may affect air qualityduring use or in the event of failure, based on the type ofcompressor(s) used in the system.

5.1.3.5.14.1 Where liquid ring air compressors, compressorshaving water-cooled heads, or water cooled aftercoolers are used,air receivers shall be equipped with a high water level sensor thatshuts down the compressor system and activates a local alarmindicator. [See 5.1.9.4.3 (7)]

5.1.3.5.14.2 Where liquid ring compressors are used, eachcompressor shall have a liquid level sensor in each air/waterseparator which, when the liquid level is above the design level,shuts down its compressor and activates a local alarm indicator.[See 5.1.9.4.3(8)]

5.1.3.5.14.3 Where non-liquid ring compressors compliant with5.1.3.5.4.1 (1) are used, the air temperature at the immediate outletof each compressor cylinder shall be monitored by a hightemperature sensor that shuts down that compressor and activates alocal alarm indicator. [See 5.1.9.4.3(9)] The temperature settingshall be as recommended by the compressor manufacturer.

5.1.3.5.14.4 Where compressors compliant with 5.1.3.5.4.1 (2) areused, the following requirements shall apply:

(1) The air temperature at the immediate outlet of eachcompressor cylinder shall be monitored by a high temperaturesensor that shuts down that compressor and activates a local alarmindicator. [see 5.1.9.4.3 (9)] The temperature setting shall be asrecommended by the compressor manufacturer.

(2) Coalescing filters with element change indicator shall beprovided.

(3) Charcoal filters with colorimetric hydrocarbon indicatorshall be provided.

(4) Liquid hydrocarbons shall be monitored on a continuousbasis by pigment indicator or other type of instrument permanentlyinstalled downstream of each compressor and shall be inspectedand documented daily.

(5) Gaseous hydrocarbons shall be monitored on a quarterlybasis.

5.1.3.5.14.5 When the backup or lag compressor is running, a localalarm shall activate [See 5.1.9.4.3(1)]

5.1.3.5.15 Medical Air Quality Monitoring. Medical air qualityshall be monitored downstream of the Medical Air regulators andupstream of the piping system as follows:

(1) Dew point shall be monitored and shall activate a localalarm and all master alarms when the dew point at system pressureexceeds +4°C (+39°F).

(2) Carbon monoxide shall be monitored and shall activate alocal alarm [See 5.1.9.4.3 (2)] when the CO level exceeds 10 ppm.

5.1.3.6 Medical/Surgical Vacuum Supply Systems

5.1.3.6.1 Medical/Surgical Vacuum Sources . (See Fig. A-5.1.3.6.)

5.1.3.6.1.1 Medical/surgical vacuum sources shall be located per5.1.3.3 as follows:

(1) Indoors in a dedicated mechanical equipment area,adequately ventilated and with any required utilities.

(2) In a room constructed per 5.1.3.3.2.(3) In a room ventilated per 5.1.3.3.3.2.(4) For air-cooled equipment, in a room designed to maintain

the ambient temperature range as recommended by the equipmentmanufacturer.

5.1.3.6.1.2 Medical/surgical vacuum sources shall consist of thefollowing:

(1) Two or more vacuum pumps sufficient to serve the peakcalculated demand with the largest single vacuum pump out ofservice.

(2) An automatic means to prevent backflow from any on-cyclevacuum pumps through any off-cycle vacuum pumps.

(3) A shut-off valve or other isolation means to isolate eachvacuum pump from the centrally piped system and other vacuumpumps for maintenance or repair without loss of vacuum in thesystem.

(4) A vacuum receiver.(5) Piping between the vacuum pump and the source shutoff

valve complying with 5.1.10.2, except that stainless steel shall bepermitted to be used as a piping material.

5.1.3.6.2 Vacuum Pumps

5.1.3.6.2.1 Vacuum pumps shall be permitted to be made offerrous and/or non-ferrous materials.

5.1.3.6.2.2 Anti-vibration mountings shall be installed for vacuumpumps as required by equipment dynamics or location and inaccordance with the manufacturer’s recommendations.

5.1.3.6.2.3 Flexible connectors shall connect the vacuum pumpswith their intake and outlet piping.

5.1.3.6.2.4 For liquid ring vacuum pumps, seal water shall be of aquality recommended by the vacuum pump manufacturer.

5.1.3.6.3 Vacuum Receivers. Receivers for vacuum shall meet thefollowing requirements:

(1) Be made of ferrous and/or non-ferrous materials.(2) Comply with Section VIII, Unfired Pressure Vessels, of the

ASME Boiler and Pressure Vessel Code.(3) Be capable of withstanding 415 kPa (60 psi) gage pressure

and 760 mm (29.9 in) HgV vacuum.(4) Be equipped with a manual drain.(5) Be of a capacity based on the technology of the pumps.

5.1.3.6.4 Vacuum Local Alarm. A local alarm complying with5.1.9.4 shall be provided for the vacuum source.

5.1.3.6.5 Piping Arrangement and Redundancies.

5.1.3.6.5.1 Piping arrangement shall be as follows:(1) Piping shall be arranged to permit service and a continuous

supply of Medical/Surgical Vacuum in the event of a single faultfailure.

(2) Piping arrangement shall be permitted to vary based on thetechnology(ies) employed, provided an equal level of operatingredundancy is maintained.

5.1.3.6.5.2 The Medical/Surgical Vacuum receiver(s) shall beserviceable without shutting down the Medical/Surgical Vacuumsystem by either of the following methods:

(1) By providing an isolation valve where the receiver is tee'd

into the main line.(2) By piping the receiver at the end of a valved isolation line.

5.1.3.6.5.3 Medical /Surgical Vacuum source systems shall beprovided with a source shutoff valve per 5.1.4.4.


5.1.3.6.6.1 Additional pumps shall automatically activate when thepump(s) in operation is(are) incapable of adequately maintainingthe required vacuum.

5.1.3.6.6.2 Automatic or manual alternation of pumps shall allowdivision of operating time. If automatic alternation of pumps isnot provided, the facility staff shall arrange a schedule for manualalternation.

5.1.3.6.6.3 Each pump motor shall be provided with electricalcomponents including but not limited to the following:


(2) Motor starting device.(3) Overload protection.(4) Where pump systems having two or more pumps employ a

control transformer or other voltage control power device, at leasttwo such devices are required.

(5) Control circuits arranged in such a manner that theshutdown of one pump does not interrupt the operation of anotherpump.


5.1.3.6.6.5 Emergency electrical service for the pumps shallconform to the requirements of the essential electrical system asdescribed in Chapter 4 of this document.


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5.1.3.6.7 Medical/Surgical Vacuum Source Exhaust

5.1.3.6.7.1 The Medical/surgical vacuum pumps shall exhaust in amanner and location that will minimize the hazards of noise andcontamination to the facility and it’s environment.

5.1.3.6.7.2 The exhaust shall be located as follows:(1) Outdoors.(2) At least 3050 mm (10 feet) from any door, window, air

intake, or other openings in buildings.(3) At a level different from air intakes.(4) Where prevailing winds, adjacent buildings, topography or

other influences that would not divert the exhaust into occupiedareas or prevent dispersion of the exhaust.

5.1.3.6.7.3 The end of the exhaust shall be turned down andscreened or otherwise be protected against the entry of vermin,debris or precipitation by screening fabricated or composed of anon-corroding material.

5.1.3.6.7.4 The exhaust shall be piped of materials approved formedical/surgical Vacuum piping under 5.1.10.2.

5.1.3.6.7.5 The exhaust shall be free of dips and loops that mighttrap condensate or oil. Where such low points are unavoidable, adrip leg and valved drain shall be installed.

5.1.3.6.7.6 Vacuum exhausts from multiple pumps shall bepermitted to be joined together to one common exhaust if thefollowing conditions are met:

(1) The common exhaust is sized to minimize back pressure inaccordance with the pump manufacturer’s recommendations.

(2) Each pump can be isolated by manual or check valve, blindflange, or tube cap to prevent open exhaust piping when pumps(s)are removed for service and consequent flow of exhaust air into theroom.

5.1.3.6.8 Operating Alarms . Medical/surgical vacuum systems shallactivate a local alarm when the backup or lag pump is running per5.1.9.4.

5.1.3.7 Waste Anesthetic Gas Disposal (WAGD)

5.1.3.7.1 Sources. *WAGD sources shall be chosen inconsultation with the medical staff having knowledge of therequirements to determine the type of system, number andplacement of terminals and other required safety and operatingdevices.

5.1.3.7.1.1 WAGD shall be permitted to be produced by adedicated producer, through the Medical/Surgical vacuum sourceor by venturi.

5.1.3.7.1.2 If WAGD is produced by the medical/surgical vacuumsource, the following shall apply:

(1) The medical/surgical vacuum source shall comply with5.1.3.6.

(2) Flammable anesthetics or other flammable vapors shall bediluted below the lower flammable limit prior to disposal into theMedical/Surgical Vacuum system.

(3) The medical/surgical vacuum source shall be sized toaccommodate the additional volume.

5.1.3.7.1.3 If WAGD is produced by a dedicated WAGD producer,the following shall apply:

(1) The WAGD source shall be located in accordance with5.1.3.3.

(2) The WAGD source shall be indoors in a dedicatedmechanical equipment area with any required utilities.

(3) The WAGD source shall be in a room constructed per5.1.3.3.2.

(4) The WAGD source shall be ventilated per 5.1.3.3.3.2 .(5) For air-cooled equipment, the WAGD source shall be

located to maintain the ambient temperature range asrecommended by the manufacturer.

5.1.3.7.1.4 For liquid ring pumps in WAGD service, seal watershall be of a quality as recommended by the pump manufacturer.

5.1.3.7.1.5 The WAGD source shall consist of the following:(1) Two or more WAGD producers sufficient to serve the peak

calculated demand with the largest single WAGD producer out ofservice.

(2) An automatic means to prevent backflow from any on-cycleWAGD producers through any off-cycle WAGD producers.

(3) A shut-off valve to isolate each WAGD producer from thecentrally piped system and other WAGD producers formaintenance or repair without loss of Medical/Surgical Vacuum inthe system.

(4) Piping between the WAGD producers and the sourceshutoff valve compliant with 5.1.10.2, except that stainless steel shallbe permitted to be used as a piping material.

(5) Anti-vibration mountings shall be installed for WAGDproducers as required by equipment dynamics or location and inaccordance with the manufacturer’s recommendations.

(6) Flexible connectors interconnecting the producers withtheir intake and outlet piping as required by equipment dynamicsor location, in accordance with the WAGD producermanufacturer’s recommendations.

5.1.3.7.1.6 If WAGD is produced by a venturi, the following shallapply:

(1) The venturi shall not be user adjustable (i.e., shall requirethe use of special tools).

(2) The venturi shall be driven using inert gas, instrument air orother dedicated air source.

(3) Medical air shall not be used to power the venturi.

5.1.3.7.2 Dedicated WAGD Producers. Dedicated WAGDproducers shall be designed of materials and using lubricantswhere needed that are inert in the presence of oxygen, nitrousoxide and halogenated anesthetics.

5.1.3.7.3 WAGD Alarms . When the WAGD system is served by acentral source(s), a local alarm complying with 5.1.9.4 shall beprovided for the WAGD source.

5.1.3.7.3.1 A WAGD source system shall activate a local alarmwhen the backup or lag producer is running.


5.1.3.7.4.1 Additional producers shall automatically activate whenthe producer(s) in operation is(are) incapable of maintaining therequired vacuum.

5.1.3.7.4.2 Automatic or manual alternation of producers shallallow division of operating time. If automatic alternation ofproducers is not provided, the facility staff shall arrange a schedulefor manual alternation.

5.1.3.7.4.3 Each producer motor shall be provided with electricalcomponents including but not limited to the following:


(2) Motor starting device.(3) Overload protection.(4) Where WAGD systems having two or more producers

employ a control transformer or other voltage control powerdevice, at least two such devices.

(5) Control circuits arranged in such a manner that theshutdown of one producer does not interrupt the operation ofanother producer.


5.1.3.7.4.5 Emergency electrical service for the producers shallconform to the requirements of the essential electrical system asdescribed in Chapter 4 of this document.

5.1.3.7.5 WAGD Exhaust. The WAGD pumps shall exhaust incompliance with 5.1.3.6.7.

5.1.3.8 Instrument Air Supply Systems


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5.1.3.8.1 Instrument air shall be of a quality which:(1) complies with Instrument Air in ANSI/ISA S-7.0.01 1996.(2) is filtered to 0.01 microns.(3) is free of liquids (eg. Water, hydrocarbons, solvents, etc.)(4) is free of hydrocarbon vapors.(5) is dry to a dew point of –40°.

5.1.3.8.2 General (See Fig. A-5.1.3.8).

5.1.3.8.2.1 Instrument air shall be permitted to be used for anymedical support purpose, (eg. to operate tools, air driven booms,pendants or similar applications) and (if appropriate to theprocedures) to be used in laboratories.

5.1.3.8.2.2 Instrument air supply systems shall be located per5.1.3.3 as follows:

(1) Indoors in a dedicated mechanical equipment area,adequately ventilated and with any required utilities.

(2) In a room constructed per 5.1.3.3.2.(3) In a room ventilated per 5.1.3.3.3.2.(4) For air-cooled equipment, in a room designed to maintain

the ambient temperature range as recommended by the equipmentmanufacturer.

5.1.3.8.2.3 Instrument Air systems shall be prohibited:(1) from being interconnected with medical air systems.(2) from being used for any purpose where the air will be

intentionally respired by patients or staff.

5.1.3.8.3 Instrument Air Source

5.1.3.8.3.1 Instrument air sources shall produce air at not less than1,380 kPa gage (200 psi) gage output pressure.

5.1.3.8.3.2 Instrument air sources shall provide air meeting thedefinition of “Instrument Air” in Chapter 3.

5.1.3.8.3.3 Instrument air sources shall be permitted to include atleast two compressors or one compressor and a standby headercomplying with 5.1.3.8.4.

5.1.3.8.3.4 Instrument air sources shall comply with 5.1.3.5.3 withexceptions as specified in 5.1.3.8.

5.1.3.8.4 Instrument Air Compressors . Instrument aircompressors shall be permitted to be of any type capable of notless than 1,380 kPa gage (200 psi) gage output pressure and ofproviding air meeting the definition of instrument air in Chapter 3.

5.1.3.8.5 Instrument Air Standby Headers

5.1.3.8.5.1 Where instrument air systems are provided with astandby header, the header shall meet the following requirements:

(1) Comply with 5.1.3.4.8, except that the number of attachedcylinders shall be sufficient for one hour normal operation.

(2) Use connectors as for Medical Air in CGA Pamphlet V-1,Standard for Compressed Gas Cylinder Valve Outlet and InletConnections, (ANSI B57. 1).

(3) Enter the system upstream of the final line regulators. (seeFig. A.5.1.3.8).

(4) Automatically serve the system in the event of a failure of thecompressor.

5.1.3.8.6 Intake Air. *Intake air for instrument air compressorsshall be permitted to be drawn from the equipment location.

5.1.3.8.7 Instrument Air Filters

5.1.3.8.7.1 Instrument air sources shall be filtered with activatedcarbon filters that meet the following requirements:

(1) Be located upstream of the final line filters.(2) Be sized for 100 percent of the system peak calculated

demand at design conditions.(3) Be permitted to be constructed of ferrous and/or non-

ferrous materials.

5.1.3.8.7.2 Final line filters shall meet the following requirements:(1) Be located upstream of the final line regulators and

downstream of the carbon filters.(2) Be sized for 100 percent of the system peak calculated

demand at design conditions.(3) Be rated for a minimum of 98 percent efficiency at 0.01

micron.

(4) Be equipped with a continuous visual indicator showing thestatus of the filter element life.


5.1.3.8.7.3 Filters combining the function of 5.1.3.8.6.1 and5.1.3.8.6.2 shall be permitted to be used.

5.1.3.8.8 Instrument Air Accessories. Accessories used forinstrument air sources shall comply with:

(1) 5.1.3.5.5 for aftercoolers.(2) 5.1.3.5.6 for air receivers.(3) 5.1.3.5.7 for air dryers.(4) 5.1.3.5.9 for air regulators.

5.1.3.8.9 Instrument Air Piping Arrangement andRedundancies. Instrument air sources shall comply with 5.1.3.5.11except for the following:

(1) Systems employing a standby header shall be permitted tohave simplex aftercoolers and dryers.

(2) Standby headers, where provided, shall be isolated from thecompressor by a check valve to prevent back flow through thecompressor.

5.1.3.8.10 Instrument Air Monitoring and Alarms

5.1.3.8.10.1 Instrument air sources shall include the followingalarms:

(1) A local alarm that activates when or just before the backupcompressor (if provided) activates, indicating that the lagcompressor is in operation.

(2) A local alarm and alarms at all master alarm panels thatactivates when the dew point at system pressure exceeds -30°C(–22°F), indicating High Dew Point.

5.1.3.8.10.2 For sources with standby headers, the followingadditional conditions shall activate a local alarm at the compressorsite, a local signal at the header location and alarms at all masteralarm panels:

(1) an alarm that activates when or just before the reservebegins to supply the system, indicating Reserve in Use.

(2) an alarm that activates when or just before the reserve fallsbelow an average hours supply, indicating Reserve Low.

5.1.4 Valves (See Fig. A-5.1.4.)

5.1.4.1 Gas and Vacuum Shutoff Valves . Shutoff valves shall beprovided to isolate sections or portions of the piping system formaintenance, repair, or planned future expansion need, and tofacilitate periodic testing.

5.1.4.2 Accessibility. All valves except valves in zone valve boxassemblies shall be located in secured areas such as locked pipedchases, or be locked or latched in their operating position, and belabeled as to gas supplied and the area(s) controlled.

5.1.4.2.1 Shutoff valves accessible to other than authorizedpersonnel shall be installed in valve boxes with frangible orremovable windows large enough to permit manual operation ofvalves.

5.1.4.2.2 Shutoff valves for use in certain areas, such as psychiatricor pediatric, shall be permitted to be secured with the approval ofthe authority having jurisdiction to prevent inappropriate access.

5.1.4.2.3 Valves for nonflammable medical gases shall not beinstalled in the same zone valve box assembly with flammablegases.

5.1.4.3 Valve Types. New or replacement shutoff valves shall be asfollows:

(1) quarter turn, full ported, ball type.(2) of brass or bronze construction.(3) have extensions for brazing.(4) have a handle indicating open or closed.(5) consist of three-pieces permitting inline serviceability.

5.1.4.3.1 Valves for positive pressure gases shall be cleaned foroxygen service by the manufacturer.

5.1.4.3.2 Valves for vacuum or WAGD service shall:(1) be permitted to be ball or butterfly type.(2) not be required to be cleaned for oxygen service.


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5.1.4.4 Source Valve. A shutoff valve shall be placed at theimmediate connection of each source system to the distributionpiping to permit the entire source, including all accessory devices(such as air dryers, final line regulators, etc.), to be isolated fromthe facility.

5.1.4.4.1 The source valve shall be located in the immediatevicinity of the source equipment.

5.1.4.4.2 The source valve shall be labeled in accordance with5.1.11.2.

5.1.4.5 Main Line Valve. A shutoff valve shall be provided in themain supply line inside of the building when the source shutoffvalve is not accessible from within the building.

5.1.4.5.1 The main line valve shall be located to permit access byauthorized personnel only (e.g., by locating above a ceiling orbehind a locked access door).

5.1.4.5.2 The main line valve shall be located on the facility side ofthe source valve and outside of the source room, enclosure, orwhere the main line first enters the building.

5.1.4.5.3 The main line valve shall be labeled in accordance with5.1.11.2.

5.1.4.5.4 A main line valve shall not be required where the sourceshutoff valve is accessible from within the building.

5.1.4.6 Riser Valve . Each riser supplied from the main line shall beprovided with a shutoff valve in the riser adjacent to the main line.

5.1.4.6.1 Riser valves shall be permitted to be located aboveceilings, but shall remain accessible and not be obstructed.

5.1.4.6.2 The riser valve shall be labeled in accordance with5.1.11.2.

5.1.4.7 Service Valves. Service valves shall be installed to allowservicing or modification of lateral branch piping from a main orriser without shutting down the entire main, riser or facility.

5.1.4.7.1 Only one service valve shall be required for each branchoff of a riser regardless of how many zone valve boxes are installedon that lateral.

5.1.4.7.2 Service valves shall be placed in the branch piping priorto any zone valve box assembly on that branch.

5.1.4.7.3 Service valves shall be located as follows:(1) behind a locked access door, or(2) locked open above a ceiling, or(3) locked open in a secure area.

5.1.4.7.4 Service valves shall be labeled in accordance with 5.1.11.2.

5.1.4.7.5 Sensors for area alarm panels as required in 5.1.9.3.4shall be permitted to be placed in any relationship to service valves(if installed).

5.1.4.8 Zone Valve . All station outlets/inlets shall be suppliedthrough a zone valve as follows:

(1) The zone valve shall be placed such that a wall intervenesbetween the valve and outlets/inlets that it controls.

(2) The zone valve shall serve only outlets/inlets located on thatsame story.

5.1.4.8.1 Zone valves shall be readily operable from a standingposition in the corridor on the same floor they serve.

5.1.4.8.2 Zone valves shall be so arranged that shutting off thesupply of medical gas or vacuum to one zone will not affect thesupply of medical gas or vacuum to another zone or the rest of thesystem.

5.1.4.8.3 A pressure/vacuum indicator shall be provided on thestation outlet/inlet side of each zone valve.

5.1.4.8.4 Zone valve boxes shall be installed where they are visibleand accessible at all times.

5.1.4.8.5 Zone valve boxes shall not be installed behind normallyopen or normally closed doors, or otherwise hidden from plainview.

5.1.4.8.6 Zone valve boxes shall not be located in closed or lockedrooms, areas or closets.

5.1.4.8.7 A zone valve shall be located immediately outside eachvital life-support, critical care, and anesthetizing location in eachmedical gas and/or vacuum line, and located so as to be readilyaccessible in an emergency.

5.1.4.8.7.1 All gas-delivery columns, hose reels, ceiling tracks,control panels, pendants, booms, or other special installationsshall be located downstream of the zone valve.

5.1.4.8.7.2 These zone valves shall be so arranged that shutting offthe supply of gas to any one operating room or anesthetizinglocation will not affect the others.

5.1.4.8.8 Zone valves shall be labeled in accordance with 5.1.11.2.

5.1.4.9 In-Line Valves. Optional in-line valves shall be permittedto be installed to isolate or shut off piping for servicing ofindividual rooms or areas.

5.1.4.9.1 In-line shutoff valves intended for use to isolate piping formaintenance or modification shall be located in a restricted area,be locked or latched open, and be identified in accordance with5.1.11.2.

5.1.4.9.2 Sensors for area alarm panels as required in 5.1.9.3.4shall be permitted to be placed in any relationship to in-line valves(if installed).

5.1.4.10 Valves for Future Connections. Shutoff valves providedfor the connection of future piping shall be located in a restrictedarea, be locked or latched closed, and be identified in accordancewith 5.1.11.2.

5.1.4.10.1 Future connection valves shall be labeled as to gascontent.

5.1.4.10.2 Downstream piping shall be closed with a brazed capwith tubing allowance for cutting and rebrazing.

5.1.5 Station Outlet/Inlets

5.1.5.1 Each station outlet/inlet for medical gases or vacuum,whether threaded or non-interchangeable quick-coupler shall begas specific.

5.1.5.2 Each station outlet shall consist of a primary and asecondary valve (or assembly).

5.1.5.3 Each station inlet shall consist of a primary valve (orassembly) only.

5.1.5.4 The secondary valve (or unit) shall close automatically tostop the flow of medical gas or vacuum when the primary valve (orunit) is removed.

5.1.5.5 * Each outlet/inlet shall be legibly identified in accordancewith 5.1.11.3.

5.1.5.6 Threaded outlets/inlets shall be non-interchangeableconnections complying with CGA Pamphlet V-5, Diameter-IndexSafety System — Non-Interchangeable Low Pressure Connections forMedical Gas Applications .

5.1.5.7 Each station outlet/inlet, including those mounted incolumns, hose reels, ceiling tracks, or other special installations,shall be designed so that parts or components that are required tobe gas-specific for compliance with 5.1.5.1 and 5.1.5.9 cannot beinterchanged between station outlet/inlet for different gases.

5.1.5.8 The use of common parts in outlets/inlets, such as springs,O-rings, fasteners, seals, and shutoff poppets, shall be permitted.

5.1.5.9 Components of a vacuum station inlet necessary for themaintenance of vacuum specificity shall be legibly marked toidentify them as components or parts of a vacuum or suctionsystem.


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5.1.5.10 Components of inlets not specific to vacuum shall not berequired to be marked.

5.1.5.11 Factory Installed tubes on station outlets extending nofurther than 205mm (8 in.) from the body of the terminal shall benot less than DN8 (NPS 1/4) (3/8 in. O.D.) size, with 8 mm (0.3in.) minimum inside diameter.

5.1.5.12 Factory Installed tubes on station inlets extending nofurther than 205mm (8 in.) from the body of the terminal shall benot less than DN10 (NPS 3/8) (1/2 in. O.D.) size, with 10 mm(0.4 in.) minimum inside diameter.

5.1.5.13 Station outlets/inlets shall be permitted to be recessed orotherwise protected from damage.

5.1.5.14 When multiple wall outlets/inlets are installed, they shallbe spaced to permit the simultaneous use of adjacent outlets/inletswith any of the various types of therapy equipment.

5.1.5.15 Station Outlets in systems in systems having non-standardoperating pressures shall meet the following additionalrequirements:

(1) Be gas specific.(2) Be pressure specific where a single gas is piped at more

than one operating pressure [e.g. a station outlet for oxygen, 550kPa (80 psi) shall not accept an adapter for oxygen, 345 kPa (50psi)].

(3) If operated at a pressure in excess of 550 kPa (80 psi), beeither DISS or comply with (4) below.

(4) If operated at a pressure between 1380 kPa (200 psi) gageand 2070 kPa (300 psi) gage, the station outlet shall be so designedas to prevent the removal of the adapter until the pressure has beenrelieved, to prevent the adapter injuring the user or others whenremoved from the outlet.

5.1.6 Manufactured Assemblies (Fig. A-5.1.6)

5.1.6.1 Manufactured Assemblies shall be pre-tested by themanufacturer prior to arrival at the installation site as follows:

(1) Initial blowdown test per 5.1.12.2.2.(2) Initial pressure test 5.1.12.2.3.(3) Piping purge test per 5.1.12.2.5.(4) Standing pressure test per 5.1.12.2.6 or 5.1.12.2.7 except as

permitted under 5.1.6.2.

5.1.6.2 The standing pressure test under 5.1.6.1 (4) shall bepermitted to be performed by any testing method that will assure apressure decay of less than 1 percent in 24 hours.

5.1.6.3 The manufacturer of the assembly shall providedocumentation certifying the performance and successfulcompletion of the tests required in 5.1.6.1.

5.1.6.4 Manufactured Assemblies employing flexible hoses shall usehoses and flexible connectors with a minimum burst pressure of6895 kPa (1000 psi) gage.

5.1.6.5 Manufactured Assemblies shall have a flame spread ratingof not greater than 200 when tested in accordance with NFPA 255Standard Method of Test of Surface Burning Characteristics of BuildingMaterials.

5.1.6.6 Manufactured Assemblies employing flexible hoses ortubing shall be attached to the pipelines using station outlets(inlets).

5.1.6.7 Manufactured assemblies employing hoses or flexibleconnectors, where the station outlet (inlet) attached to the pipingis not fully and immediately accessible (I.e. cannot be manipulatedwithout the removal of panels, doors, etc.), shall have stationoutlets (inlets) with the following additional characteristics:

(1) Be DISS connectors.(2) Be permitted to omit the secondary check required in

5.1.5.2.(3) Be provided with a second terminal at which the user

connects and disconnects complying with 5.1.5 except 5.1.5.2.

5.1.6.8 Manufactured Assemblies connected to the pipeline bybrazing shall have station outlets (inlets) which comply with 5.1.5in all respects.

5.1.6.9 The installation of Manufactured Assemblies shall be testedin accordance with 5.1.12.

5.1.7 Surface Mounted Medical Gas Rails (MGR)

5.1.7.1 MGR Assemblies shall be permitted to be installed wheremultiple use of medical gases and vacuum at a single patientlocation are required or anticipated.

5.1.7.2 MGR assemblies shall be entirely visible in the room, notpassing into or through walls, partitions, etc.

5.1.7.3 MGR assemblies shall be made of materials with a meltingpoint at least 538°C (1000°F).

5.1.7.4 MGR Assemblies shall be cleaned per 5.1.10.1.1.

5.1.7.5 Station outlets or inlets shall not be placed on the ends ofMGR assemblies.

5.1.7.6 Openings for station outlets/inlets in the MGR shall be gasspecific.

5.1.7.7 Openings in the MGR not occupied by stationoutlets/inlets (e.g. for future use) shall be capped or plugged sothat a special tool is required for removal. (e.g. cannot beremoved by a wrench, pliers, screwdriver or other common tools).

5.1.7.8 MGR Assemblies shall connect to the pipeline throughfittings which are brazed to the pipeline.

5.1.7.9 * Where the pipeline and the MGR assembly are ofdissimilar metals, the connections shall be plated or otherwiseprotected from interaction between the metals.

5.1.7.10 The installation of the MGR shall be tested in accordancewith 5.1.12 and 5.1.13.

5.1.8 Pressure and Vacuum Indicators

5.1.8.1 General

5.1.8.1.1 Pressure indicators and manometers for medical gaspiping systems shall be cleaned for oxygen service.

5.1.8.1.2 Gauges shall comply with ANSI/ASME B-40.1, Gauges,Pressure Indicating Dial-Type, Elastic Elements .

5.1.8.1.3 The scale range of positive pressure analog indicatorsshall be such that the normal reading falls within the middle 50percent of the scale.

5.1.8.1.4 The scale range of digital indicators shall be not morethan two times the working pressure of the piping system.

5.1.8.1.5 The scale range of vacuum indicators shall be 0-760mm (0–29.9 in.) gage HgV, except that indicators with a “normalrange” display shall indicate “normal” only above 300 mm (12 in.)gage HgV.

5.1.8.1.6 Indicators adjacent to master alarm actuators and areaalarms shall be labeled to identify the name of or chemical symbolfor the particular piping system that they monitor.

5.1.8.1.7 The rated accuracy of indicators used for testing shallbe one percent (full scale) or better at the point of reading.

5.1.8.2 Locations

5.1.8.2.1 Pressure and vacuum indicators shall be readable from astanding position.

5.1.8.2.2 Pressure/vacuum indicators shall be provided at thefollowing locations, as a minimum:

(1) Adjacent to the alarm initiating device for source main linepressure and vacuum alarms in the master alarm system.

(2) At or in area alarm panels to indicate the pressure/vacuumat the alarm activating device for each system that is monitored bythe panel.

(3) On the station outlet/station inlet side of zone valves.

5.1.9 Level 1 Warning Systems (See Fig. A-5.1.4.)


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5.1.9.1 General. All master, area and local alarm systems used formedical gas and vacuum systems shall include the following:

(1) Separate visual indicators for each condition monitored,except as permitted in 5.1.9.4.2 for local alarms that are displayedon master alarm panels.

(2) Visual indicators that remain in alarm until the situationwhich has caused the alarm is resolved.

(3) A cancelable audible indication of each alarm conditionthat produces a sound with a minimum level of 80 dBA at 920 mm(3 ft).

(4) A means to visually indicate a lamp or LED failure.(5) Visual and audible indication that the wiring to an alarm

initiating device is disconnected.(6) Labeling of each indicator, indicating the condition

monitored.(7) Labeling of each alarm panel for its area of surveillance.(8) Re-initiation of the audible signal if another alarm

condition occurs while the audible alarm is silenced.(9) Power from the life safety branch of the emergency

electrical system as described in Chapter 4, Electrical Systems.(10) Wiring from switches or sensors that is supervised or

protected as required by Section 517-30(c)(3) of NFPA 70, NationalElectrical Code , for emergency system circuits.

(11) Assurance by the responsible authority of the facility that thelabeling of alarms, where room numbers or designations are used,is accurate and up-to-date.

(12) Provisions for automatic restart after a power loss of 10seconds (e.g., during generator startup) without giving false signalsor requiring manual reset.

5.1.9.2 Master Alarms. (See Table A-5.1.9.2.) A master alarmsystem shall be provided to monitor the operation and condition ofthe source of supply, the reserve source (if any), and the pressurein the main lines of each medical gas and vacuum piping system.

5.1.9.2.1 The master alarm system shall consist of two or morealarm panels located in at least two separate locations:

(1) One master alarm panel shall be located in the office orwork space of the individual responsible for the maintenance of themedical gas and vacuum piping systems.

(2) In order to assure continuous surveillance of the medicalgas and vacuum systems while the facility is in operation the secondmaster alarm panel shall be located in an area of continuousobservation (e.g., the telephone switchboard, security office, orother continuously staffed location).

5.1.9.2.2 A centralized computer (e.g., a building managementsystem) shall not be permitted to be substituted for any of thepanels required in 5.1.9.2.1, but shall be permitted to be used tosupplement the medical gas and vacuum alarm systems.

5.1.9.2.3 The master alarm panels required in 5.1.9.2.1 shallconnect directly to the alarm initiating devices that they monitor.

(a) Master alarm signals shall not be relayed from one masteralarm panel to another.

(b) Where multi-pole alarm relays are used to isolate the alarminitiating signals to master alarm panels, the control power sourcefor the relays shall be independent of any of the master alarmpanels.

5.1.9.2.4 Master alarm panels for medical gas and vacuum systemsshall each include the following signals:

(1) An alarm indication when, or just before, changeoveroccurs in a medical gas system that is supplied by a manifold orother alternating-type bulk system that has as a part of its normaloperation a changeover from one portion of the operating supplyto another.

(2) An alarm indication for a bulk cryogenic liquid systemwhen the main supply reaches an average days supply, indicatinglow contents.

(3) An alarm indication when, or just before, the changeover tothe reserve supply occurs in a medical gas system that consists ofone or more units that continuously supply the piping system whileanother unit remains as the reserve supply and operates only in thecase of an emergency .

(4) Where a cryogenic liquid storage unit is used as a reservefor a bulk supply system, an alarm indication when the contents ofthe reserve is reduced to one average day’s supply.

(5) Where a cryogenic liquid storage unit is used as a reservefor a bulk supply system, an alarm indication when the gas pressureavailable in the reserve unit is below that required for the medicalgas system to function.

(6) An alarm indication when the pressure in the main line ofeach separate medical gas system increases 20 percent or decreases20 percent from the normal operating pressure.

(7) An a larm indication when the medical/surgical vacuumpressures in the main line of each vacuum system drops to orbelow 300 mm (12 in.) gage HgV.

(8) An alarm indication(s) from the local alarm panel(s) asdescribed in 5.1.9.4.2 to indicate when one or more of theconditions being monitored at a site is in alarm.

(9) A medical air dew point high alarm from each compressorsite to indicate when the line pressure dew point is greater than+4°C (+39°F).

(10) A WAGD low alarm when the WAGD vacuum level or flowis below effective operating limits.

(11) An instrument air dew point high alarm from eachcompressor site to indicate when the line pressure dew point isgreater than -30°C (-22°F).

5.1.9.2.5 The alarm indications required in 5.1.9.4.3 (5) and (6)shall originate from sensors installed in the main lines immediatelydownstream (on the facility side) of the source valves. Where it isnecessary to install a main line valve in addition to a source valve(see 5.1.4.5 and 5.1.4.5.4), the sensors shall be located downstream(on the facility side) of the main valve.

5.1.9.3 Area Alarms . (See Table A-5.1.9.3.) Area alarm panelsshall be provided to monitor all medical gas, Medical/Surgicalvacuum and piped WAGD systems supplying anesthetizinglocations, and other vital life support and critical areas such as postanesthesia recovery, intensive care units, emergency departments,etc.

5.1.9.3.1 Area alarms shall be located at a nurse’s station or otherlocation that will provide for continuous responsible surveillance.

5.1.9.3.2 Area alarm panels for medical gas systems shall indicate ifthe pressure in the lines in the area being monitored increases ordecreases by 20 percent from the normal line pressure.

5.1.9.3.3 Area alarm panels for medical/surg ical vacuumsystems shall indicate if the vacuum in the area drops to or below300 mm (12 in.) gage HgV.

5.1.9.3.4 Sensors for area alarms shall be located as follows:(a) Vital life support and critical areas shall have the alarm

sensors installed on the outlet side of any of the individual zonevalve box assemblies.

(b) Areas for anesthetizing gas delivery shall have the sensorsinstalled on the source side of any of the individual room zonevalve box assemblies, so that shutting down one or more of theanesthetizing area zone valves will not cause an alarm.

(c) The placement of the sensors shall not be affected by valveslocated in areas accessible to authorized personnel only, such asservice valves (see 5.1.4.7) or in-line valves (see 5.1.4.9).

5.1.9.4 Local Alarms. (See Table 5.1.9.4.) Local alarms shall beinstalled to monitor the function of the air compressor systems(s)medical/surgical vacuum pump systems(s), WAGD systems andinstrument air systems.

Table 5.1.9.4 Requirements for Level 1 Local AlarmsLocal Alarms

Medical Air Compressors

Alarm ConditionOil-less

(Sealed Bearing)per

5.1.3.5.4.1(1)

Oil-Free(separated)

per5.1.3.5.4.1(2)

Liquid Ring(watersealed)

per5.1.3.5.4.1(1)

Instrument AirCompressors

MedicalSurgicalVacuumPumps

WAGDProducers

Backup (lag) compressor in operation 5.1.3.5.14.55.1.9.4.3(1)

5.1.3.5.14.55.1.9.4.3(1)

5.1.3.5.14.55.1.9.4.3(1)

Backup (lag) med/surg vacuum pump in operation 5.1.3.6.85.1.9.4.3(4)

Backup (lag) WAGD producer in operation 5.1.3.7.3.15.1.3.7.3.3

5.1.9.4.3(5)Backup (lag) instrument air compressor in operation 5.1.3.8.9.1(1)

5.1.9.4.3(1)Carbon monoxide high 5.1.3.5.15(2)

5.1.9.4.3(3)5.1.3.5.15(2)5.1.9.4.3(2)

5.1.3.5.15(2)5.1.9.4.3(2)

High discharge air temperature 5.1.3.5.14.35.1.9.4.3(9)

5.1.3.5.14.4(1)5.1.9.4.3(9)

High water in receiver 5.1.3.5.14.15.1.9.4.3(7)

5.1.3.5.14.15.1.9.4.3(7)

5.1.3.5.14.15.1.9.4.3(7)

High water in separator 5.1.3.5.14.25.1.9.4.3(8)

Medical Air dew point high 5.1.3.5.15(1)5.1.9.4.3(3)

5.1.3.5.15(1)5.1.9.4.3(3)

5.1.3.5.15(1)5.1.9.4.3(3)

Instrument air dew point high 5.1.3.8.9.1(2)5.1.9.4.3(6)


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5.1.9.4.1 The signals referenced in 5.1.9.4.4 shall be permitted tobe located as follows:

(1) on or in the control panel(s) for the machinery beingmonitored.

(2) within a monitoring device (e.g. dew point monitor orCarbon monoxide monitor).

(3) on a separate alarm panel(s).

5.1.9.4.2 At least one signal from each local alarm system shall beconnected to the master alarm panels to indicate that a problem ispresent with the source equipment at this location.

5.1.9.4.3 If there is more than one medical air compressor systemand/or more than one medical/surgical vacuum pump system atdifferent locations in the facility, or if the medical air compressorsand/or medical/surgical vacuum pumps are in different locationsin the facility, it shall be necessary for each location to haveseparate alarms at the master panels.

5.1.9.4.4 The following functions shall be monitored at each localalarm site:

(1) Back up or lag compressor in operation to indicate whenthe primary or lead air compressor is incapable of satisfying thedemand of the requirements of the system, except when themedical air system consists of three or more compressors then theback up or lag signal shall be permitted to energize when the lastcompressor has been signaled to start.

(2) High carbon monoxide level to indicate when the carbonmonoxide level in the medical air system is 10 ppm or higher.

(3) Medical air dew point high to indicate when the linepressure dew point is greater than +4°C (+39°F).

(4) Back up or lag vacuum pump in operation to indicate whenthe primary or lead vacuum pump is incapable of satisfying thedemand of the requirements of the system, except when thevacuum pump system consists of three or more pumps then theback up or lag signal shall be permitted to energize when the lastpump has been signaled to start.

(5) When a central dedicated WAGD producer is provided per5.1.3.7.1.3, WAGD Lag in Use.

(6) Instrument air dew point high to indicate when the linepressure dew point is greater than -30°C (-22°F).

(7) For compressor systems using liquid ring compressors orcompressors with water cooled components, high water in thereceiver tank to indicate when the water level in the receiver tankhas reached a level determined to be detrimental to the operationof the system.

(8) For compressor systems using liquid ring compressors, highwater in the separators.

(9) For compressor systems using other than liquid ringcompressors, high discharge air temperature.

5.1.10 Level 1 Distribution

5.1.10.1 Piping Materials for Field Installed Positive PressureMedical Gas Systems

5.1.10.1.1 Tubes, valves, fittings, station outlets, and other pipingcomponents in medical gas systems shall have been cleaned foroxygen service by the manufacturer prior to installation inaccordance with CGA 4.1 Cleaning Equipment for Oxygen Service.Except that fittings shall be permitted to be cleaned by a supplieror agency other than the manufacturer.

5.1.10.1.2 Each length of tube shall be delivered plugged orcapped by the manufacturer and kept sealed until prepared forinstallation.

5.1.10.1.3 Fittings, valves and other components shall be deliveredsealed, labeled and kept sealed until prepared for installation.

5.1.10.1.4 Tubes shall be hard drawn seamless copper ASTM B 819medical gas tube, Type L, except that where operating pressuresare above 1275 kPa (185 psi) gage, Type K shall be used for sizeslarger than DN80 (NPS 3) (3-1/8 in. O.D.).

5.1.10.1.5 ASTM B 819 medical gas tube shall be identified by themanufacturer’s markings “OXY”, “MED”, “OXY/MED”,“OXY/ACR”, or “ACR/MED” in blue (Type L) or green (Type K).

5.1.10.1.6 The installer shall furnish documentation certifying thatall installed piping materials comply with the requirements of5.1.10.1.1.

5.1.10.2 Piping Materials for Field Installed Medical/SurgicalVacuum Systems

5.1.10.2.1 Vacuum tubes shall be hard drawn seamless copper,either ASTM B 819 medical gas tube, ASTM B 88 water tube (TypeK, L, or M), or ASTM B 280 ACR tube.

5.1.10.3 Fittings

5.1.10.3.1 Turns, offsets, and other changes in direction in medicalgas and vacuum piping shall be made with brazed wrought coppercapillary fittings complying with ANSI B16.22 , Wrought Copper andCopper Alloy Solder-Joint Fittings , or brazing fittings complying withMSS SP-73, Brazed Joints for Wrought and Cast Copper Alloy Solder JointPressure Fittings .

5.1.10.3.2 Cast copper alloy fittings shall not be permitted.

5.1.10.3.3 Branch connections in vacuum piping systems shall bepermitted to be made using mechanically formed, drilled andextruded tee-branch connections that are formed in accordancewith the tool manufacturer’s instructions, and brazed.

5.1.10.4 Threaded Joints. Threaded joints in medical gas andvacuum distribution piping shall be:

(a) limited to connections to pressure/vacuum indicators,alarm devices, and source equipment.

(b) tapered pipe threads complying with ANSI B1.20.1 , PipeThreads, General Purpose.

(c) made up with polytetraflouroethylene (such as Teflon™)tape or other thread sealant recommended for oxygen service, withthe sealant applied to the male threads only.

5.1.10.5 Brazed Joints

5.1.10.5.1 General Requirements

5.1.10.5.1.1 Brazed joints shall be made using a brazing alloy thatexhibits a melting temperature in excess of 538° C (1000° F) toretain the integrity of the piping system in the event of fireexposure.

5.1.10.5.1.2 Brazed tube joints shall be the socket type.

5.1.10.5.1.3 Filler metals shall bond with and be metallurgicallycompatible with the base metals being joined.

5.1.10.5.1.4 Filler metals shall comply with ANSI/AWS A.5.8,Specification for Brazing Filler Metal.

5.1.10.5.1.5 Copper-to-copper joints shall be brazed using acopper-phosphorus or copper-phosphorous-silver brazing fillermetal (BCuP series) without flux.

5.1.10.5.1.6 Joints to be brazed in place shall be accessible fornecessary preparation, assembly, heating, filler application,cooling, cleaning, and inspection.

5.1.10.5.2 Cutting Tube Ends

5.1.10.5.2.1 Tube ends shall be cut square using a sharp tubingcutter to avoid deforming the tube.

5.1.10.5.2.2 The cutting wheels on tubing cutters shall be free fromgrease, oil, or other lubricant not suitable for oxygen service.

5.1.10.5.2.3 The cut ends of the tube shall be deburred with asharp, clean deburring tool, taking care to prevent chips fromentering the tube.

5.1.10.5.3 Cleaning Joints for Brazing

5.1.10.5.3.1 The interior surfaces of tubes, fittings and othercomponents that are cleaned for oxygen service shall be stored andhandled to avoid contamination prior to assembly and brazing.

5.1.10.5.3.2 The exterior surfaces of tube ends shall be cleanedprior to brazing to remove any surface oxides.

5.1.10.5.3.3 When cleaning the exterior surfaces of tube ends, nomatter shall be permitted to enter the tube.


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5.1.10.5.3.4 If the interior surfaces of fitting sockets becomecontaminated prior to brazing, they shall be recleaned for oxygenin accordance with 5.1.10.5.3.10 and be cleaned for brazing with aclean, oil-free wire brush.

5.1.10.5.3.5 Non-abrasive pads (such as Scotchbrite™) shall beused to clean the exterior surfaces of tube ends.

5.1.10.5.3.6 The use of steel wool or sand cloth shall beprohibited.

5.1.10.5.3.7 The cleaning process shall not result in grooving of thesurfaces to be joined.

5.1.10.5.3.8 After being abraded, the surfaces shall be wiped usinga clean, lint-free white cloth.

5.1.10.5.3.9 Tubes, fittings, valves, and other components shall bevisually examined internally before being joined to verify that theyhave not become contaminated for oxygen service and that they arefree of obstructions or debris.

5.1.10.5.3.10 The interior surfaces of tube ends, fittings, and othercomponents that were cleaned for oxygen service by themanufacturer, but become contaminated prior to being installed,shall be permitted to be recleaned on-site by the installer bythoroughly scrubbing the interior surfaces with a clean, hotwater/alkaline solution, such as sodium carbonate or trisodiumphosphate 450 g to 11 liters (1 lb to 3 gal) of potable water andthoroughly rinsing them with clean, hot potable water.

5.1.10.5.3.11 Other aqueous cleaning solutions shall be permittedto be used for on-site recleaning permitted in 5.1.10.5.3.10provided that they are as recommended in CGA Pamphlet G-4.1,Cleaning Equipment for Oxygen Service , and are listed in CGAPamphlet O2-DIR, Directory of Cleaning Agents for Oxygen Service.

5.1.10.5.3.12 Material that has become contaminated internally andis not clean for oxygen service shall not be installed.

5.1.10.5.3.13 Joints shall be brazed within one hour after thesurfaces are cleaned for brazing.

5.1.10.5.4 Brazing Dissimilar Metals

5.1.10.5.4.1 Flux shall only be used when brazing dissimilar metalssuch as copper and bronze or brass, using a silver (BAg series)brazing filler metal.

5.1.10.5.4.2 Surfaces shall be cleaned for brazing in accordancewith 5.1.10.5.3.

5.1.10.5.4.3 Flux shall be applied sparingly to minimizecontamination of the inside of the tube with flux.

5.1.10.5.4.4 The flux shall be applied and worked over the cleanedsurfaces to be brazed using a stiff bristle brush to ensure completecoverage and wetting of the surfaces with flux.

5.1.10.5.4.5 Where possible, short sections of copper tube shall bebrazed on to the non-copper component and the interior of thesubassembly shall be cleaned of flux prior to installation in thepiping system.

5.1.10.5.4.6 On joints DN20 (NPS 3/4) (7/8 in. O.D.) size andsmaller, flux-coated brazing rods shall be permitted to be used inlieu of applying flux to the surfaces being joined.

5.1.10.5.5 Nitrogen Purge

5.1.10.5.5.1 While being brazed, joints shall be continuouslypurged with oil free, dry Nitrogen NF to prevent the formation ofcopper oxide on the inside surfaces of the joint.

5.1.10.5.5.2 The source of the purge gas shall be monitored andthe installer shall be audibly alerted when the source content islow.

5.1.10.5.5.3 The purge gas flow rate shall not produce a positivepressure in the piping system.

5.1.10.5.5.4 The purge gas flow rate shall be controlled by the useof a pressure regulator and flow meter or combination thereof.

5.1.10.5.5.5 Pressure regulators alone shall not be used to controlpurge gas flow rates.

5.1.10.5.5.6 During and after installation, openings in the pipingsystem shall be kept sealed to maintain a nitrogen atmospherewithin the piping to prevent debris or other contaminants fromentering the system.

5.1.10.5.5.7 While a joint is being brazed, a discharge openingshall be provided on the opposite side of the joint from where thepurge gas is being introduced.

5.1.10.5.5.8 The flow of purge gas shall be maintained until thejoint is cool to the touch.

5.1.10.5.5.9 After the joint has cooled, the purge dischargeopening shall be sealed to prevent contamination of the inside ofthe tube and maintain the nitrogen atmosphere within the pipingsystem.

5.1.10.5.5.10 The final connection of new piping to an existing, in-use pipeline shall be permitted to be made without the use of anitrogen purge.

5.1.10.5.5.11 After a final connection in a positive pressure medicalgas pipeline is made without a nitrogen purge, an outlet in theimmediate downstream zone of the affected portion(s) of both thenew and existing in-use piping shall be tested in accordance with5.1.13.3.9 Final Tie-in Test .

5.1.10.5.6 Assembly and Heating Joints

5.1.10.5.6.1 Tube ends shall be inserted fully into the socket of thefitting.

5.1.10.5.6.2 Where flux is permitted, the joint shall be heatedslowly until the flux has liquefied.

5.1.10.5.6.3 After flux is liquefied, or where flux is not permitted tobe used, the joint shall be heated quickly to the brazingtemperature, taking care not to overheat the joint.

5.1.10.5.6.4 Techniques for heating the joint, applying the brazingfiller metal, and making horizontal, vertical, and large-diameterjoints shall be as stated in sections on “Applying Heat and Brazing”and “Horizontal and Vertical Joints” in Chapter VII - “BrazedJoints” in the CDA Copper Tube Handbook .

5.1.10.5.7 Inspection of Brazed Joints

5.1.10.5.7.1 After brazing, the outside of all joints shall be cleanedby washing with water and a wire brush to remove any residue andpermit clear visual inspection of the joint.

5.1.10.5.7.2 Where flux has been used, the wash water shall be hot.

5.1.10.5.7.3 Each brazed joint shall be visually inspected aftercleaning the outside surfaces.

5.1.10.5.7.4 Joints exhibiting the following conditions shall not bepermitted:

(1) Flux or flux residue (when flux or flux coated BAg seriesrods are used with dissimilar metals).

(2) Base metal melting or erosion.(3) Unmelted filler metal.(4) Failure of the filler metal to be clearly visible all the way

around the joint at the interface between the socket and the tube.(5) Cracks in the tube or component.(6) Cracks in the braze filler metal.(7) Failure of the joint to hold the test pressure under the

installer performed initial pressure test (5.1.12.2.3) and standingpressure test (5.1.12.2.6 or 5.1.12.2.7).

5.1.10.5.7.5 Brazed joints that are identified as defective under5.1.10.5.7.4, conditions (2) or (5) shall be replaced.

5.1.10.5.7.6 Brazed joints that are identified as defective under5.1.10.5.7.4, conditions (1), (3), (4), (6) or (7) shall be permittedto be repaired, except that no joint shall be reheated more thanonce before being replaced.

5.1.10.5.8 Special Fittings. The following special fittings shall bepermitted to be used in lieu of brazed joints:


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(1) memory-metal couplings having temperature and pressureratings joints not less than that of a brazed joint.

(2) listed or approved metallic gas tube fittings that, when madeup, provide a permanent joint having the mechanical, thermal, andsealing integrity of a brazed joint.

(3) dielectric fittings where required by the manufacturer ofspecial medical equipment to electrically isolate the equipmentfrom the piping distribution system.

5.1.10.5.9 Prohibited Joints. The following joints shall beprohibited throughout medical gas and vacuum distributionpipeline systems:

(1) flared and compression-type connections, includingconnections to station outlets and inlets, alarm devices, and othercomponents.

(2) other straight-threaded connections, including unions.

5.1.10.6 Installation of Piping and Equipment

5.1.10.6.1 Pipe Sizing

5.1.10.6.1.1 Piping systems shall be designed and sized to deliverthe required flow rates at the utilization pressures.

5.1.10.6.1.2 Mains and branches in medical gas piping systemsshall be not less than DN15 (NPS 1/2) (5/8 in. O.D.) size.

5.1.10.6.1.3 Mains and branches in medical-surgical vacuumsystems shall be not less than DN20 (NPS 3/4) (7/8 in. O.D.) size.

5.1.10.6.1.4 Drops to individual station outlets and inlets shall benot less than DN15 (NPS 1/2 ) (5/8 in. O.D.) size.

5.1.10.6.1.5 Runouts to alarm panels and connecting tubing forgauges and alarm devices shall be permitted to be DN8 (NPS 1/4)(3/8 in. O.D.) size.

5.1.10.6.2 Protection of Piping. Piping shall be protected againstfreezing, corrosion, and physical damage.

5.1.10.6.2.1 Piping exposed in corridors and other areas wheresubject to physical damage from the movement of carts, stretchers,portable equipment, or vehicles shall be protected.

5.1.10.6.2.2 Piping underground within buildings or embedded inconcrete floors or walls shall be installed in a continuous conduit.

5.1.10.6.3 Location of Piping

5.1.10.6.3.1 Piping risers shall be permitted to be installed in pipeshafts if protected from physical damage, effects of excessive heat,corrosion, or contact with oil.

5.1.10.6.3.2 Piping shall not be installed in kitchens, electricalswitchgear rooms, elevator shafts, and areas with open flames.

5.1.10.6.3.3 Medical gas piping shall be permitted to be installed inthe same service trench or tunnel with fuel gas lines, fuel oil lines,electrical lines, steam lines, and similar utilities provided that thespace is ventilated (naturally or mechanically) and the ambienttemperature around the medical gas piping is limited to 54ºC(130ºF) maximum.

5.1.10.6.3.4 Medical gas piping shall not be located where subjectto contact with oil, including flooding in the case of a major oilleak.

5.1.10.6.4 Pipe Support

5.1.10.6.4.1 Piping shall be supported from the building structurein accordance with MSS Standard Practice SP-69 , Piping Hangersand Supports - Selection and Application.

5.1.10.6.4.2 Hangers and supports shall comply with MSS StandardPractice SP-58 - Pipe Hangers and Supports - Materials, Design, andManufacture.

5.1.10.6.4.3 Hangers for copper tube shall have a copper finish andbe sized for copper tube.

5.1.10.6.4.4 In potentially damp locations, copper tube hangers orsupports that are in contact with the tube shall be plastic-coated orotherwise be insulated from the tube.

5.1.10.6.4.5 Maximum support spacing shall be in accordance withTable 5.1.10.6.4.5.

Table 5.1.10.6.4.5 Maximum Pipe Support SpacingPipe Size Hanger Spacing

DN8 (NPS 1/4) (3/8 in. O.D.) 1520 mm (5 ft)DN10 (NPS 3/8) (1/2 in. O.D.) 1830 mm (6 ft)DN15 (NPS 1/2) (5/8) in. O.D. 1830 mm (6 ft)DN20 (NPS 3/4) (7/8 in. O.D.) 2130 mm (7 ft)DN25 (NPS 1) (1-1/8 in. O.D.) 2440 mm (8 ft)DN32 (NPS 1-1/4) (1-3/8 in.O.D.)

2740 mm (9 ft)

DN40 (NPS 1-1/2) (1-5/8 in.O.D.) and larger

3050 mm (10 ft)

Vertical risers, all sizes Every floor but not toexceed 4570 mm (15 ft)

5.1.10.6.4.6 Where required, medical gas and vacuum piping shallbe seismically restrained against earthquakes in accordance withthe applicable building code.

5.1.10.6.5 Underground Piping Outside of Buildings

5.1.10.6.5.1 Buried piping outside of buildings shall be installedbelow the local level of frost penetration.

5.1.10.6.5.2 Underground piping shall be installed in acontinuous enclosure to protect the pipe during backfilling.

5.1.10.6.5.3 The continuous enclosure shall be split or otherwiseprovide access at the joints during visual inspection and leaktesting.

5.1.10.6.5.4 Buried piping that will be subject to surface loads shallbe buried at a depth that will protect the piping and its enclosurefrom excessive stresses.

5.1.10.6.5.5 The minimum backfilled cover above the top of theenclosure for buried piping outside of buildings shall be 900 mm(36 in.), except that the minimum cover shall be permitted to bereduced to 450 mm (18 in.) where physical damage is otherwiseprevented.

5.1.10.6.5.6 Trenches shall be excavated so that the pipe enclosurehas firm, substantially continuous bearing on the bottom of thetrench.

5.1.10.6.5.7 Backfill shall be clean and compacted so as to protectand uniformly support the pipe enclosure.

5.1.10.6.5.8 A continuous tape or marker placed immediatelyabove the enclosure shall clearly identify the pipeline by specificname.

5.1.10.6.5.9 A continuous warning means shall also be providedabove the pipeline at approximately one-half the depth of bury.

5.1.10.6.5.10 Where underground piping is installed through awall sleeve, the ends of the sleeve shall be sealed to prevent theentrance of ground water into the building.

5.1.10.6.6 Branch Takeoffs. Runouts from horizontal piping shallbe taken off above the centerline of the main or branch pipe andrise vertically or at an angle of not less than 45 degrees fromvertical.

5.1.10.6.7 Hose and Flexible Connectors

5.1.10.6.7.1 Hose and flexible connectors, both metallic and non-metallic, shall be no longer than necessary and shall not penetrateor be concealed in walls, floors, ceilings, or partitions.

5.1.10.6.7.2 Flexible connectors, metallic or non-metallic, shallhave a minimum burst pressure of 6895 kPa (1000 psi) gage.

5.1.10.6.8 Prohibited System Interconnections

5.1.10.6.8.1 Two or more medical gas or vacuum pipingsystems shall not be interconnected for installation, testing or anyother reason.


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5.1.10.6.8.2 Leak testing shall be accomplished by separatelycharging and testing each individual piping system.

5.1.10.6.9 Manufacturer’s Instructions

5.1.10.6.9.1 The installation of individual components shall bemade in accordance with the instructions of the manufacturer.

5.1.10.6.9.2 Such instructions shall include directions andinformation deemed by the manufacturer to be adequate forattaining proper operation, testing, and maintenance of themedical gas and vacuum systems.

5.1.10.6.9.3 Copies of manufacturer’s instructions shall be left withthe system owner.

5.1.10.6.10 Changes in System Use

5.1.10.6.10.1 Where a positive pressure medical gas pipingdistribution system originally used or constructed for the use at onepressure and for one gas is converted for operation at anotherpressure or for another gas, all provisions of 5.1.10 shall apply as ifthe system were new.

5.1.10.6.10.2 A vacuum system shall not be permitted to beconverted for use as a gas system.

5.1.10.6.11 Qualification of Installers

5.1.10.6.11.1 The installation of medical gas and vacuum systemsshall be made by qualified, competent technicians who areexperienced in making such installations.

5.1.10.6.11.2 Installers of medical gas and vacuum systems shallmeet the requirements of ANSI/ASSE Standard 6010 - ProfessionalQualification Standard for Medical Gas and Vacuum System Installers.

5.1.10.6.11.3 Brazing shall be performed by individuals who arequalified under the provisions of 5.1.10.6.12.

5.1.10.6.11.4 Prior to any installation work, the installer of medicalgas and vacuum piping shall provide and maintain documentationon the job site for the qualification of brazing procedures andindividual brazers that is required under 5.1.10.6.12.

5.1.10.6.11.5 Health care organization personnel shall bepermitted to install piping systems if all of the requirements of5.1.10.6.11 are met during the installation.

5.1.10.6.12 Qualification of Brazing Procedures and Brazing

5.1.10.6.12.1 Brazing procedures and brazer performance for theinstallation of medical gas and vacuum piping shall be qualified inaccordance with either Section IX, Welding and BrazingQualifications, of the ASME Boiler and Pressure Vessel Code , or AWSB2.2, Standard for Brazing Procedure and Performance Qualifications ,both as modified below.

5.1.10.6.12.2 Brazers shall be qualified by visual examination of thetest coupon followed by sectioning.

5.1.10.6.12.3 The Brazing Procedure Specification shall addresscleaning, joint clearance, overlap, internal purge gas, purge gasflow rate, and filler metal.

5.1.10.6.12.4 The Brazing Procedure Specification and the Recordof Brazer Performance Qualification shall document filler metalused, cleaning, joint clearance, overlap, internal purge gas andflow rate during brazing of coupon, and the absence of internaloxidation in the completed coupon.

5.1.10.6.12.5 Brazing procedures qualified by a technicallycompetent group or agency shall be permitted under the followingconditions:

(1) The Brazing Procedure Specification and the ProcedureQualification Record meets the requirements of this standard.

(2) The employer obtains a copy of both the Brazing ProcedureSpecification and the supporting qualification records from thegroup or agency and signs and dates these records, therebyaccepting responsibility for the qualifications that were performedby the group or agency.

(3) The employer qualifies at least one brazer following eachBrazing Procedure Specification used.

5.1.10.6.12.6 An employer shall be permitted to accept BrazerQualification Records of a previous employer under the followingconditions:

(1) The brazer has been qualified following the same or anequivalent procedure that the new employer uses.

(2) The new employer obtains a copy of the record of BrazerPerformance Qualification tests from the previous employer andsigns and dates these records, thereby accepting responsibility forthe qualifications performed by the previous employer.

5.1.10.6.12.7 Performance qualifications of brazers shall remain ineffect indefinitely unless the brazer does not braze with thequalified procedure for a period exceeding 6 months, or there is aspecific reason to question the ability of the brazer.

5.1.11 Labeling and Identification (See Table 5.1.11 on thefollowing page.)

5.1.11.1 Pipe Labeling

5.1.11.1.1 Piping shall be labeled by stenciling or adhesive markersthat identify the medical gas or vacuum system.

5.1.11.1.2 Pipe labels shall show the name of the gas/vacuumsystem or the chemical symbol.

5.1.11.1.3 Where positive pressure gas piping systems operate atpressures other than the standard 345 to 380 kPa (50 to 55 psi) gageor to 1275 kPa (160 to 185 psi) gage for nitrogen, the pipe labelsshall include the nonstandard operating pressure in addition to thename of the gas.

5.1.11.1.4 Pipe labels shall be located as follows:(1) At intervals of not more than 6100 mm (20 ft).(2) At least once in or above every room.(3) On both sides of walls or partitions penetrated by the

piping.(4) At least once in every story height traversed by risers.

5.1.11.2 Shutoff Valves

5.1.11.2.1 Shutoff valves shall be identified as follows:(1) The name or chemical symbol for the specific medical gas or

vacuum system(2) The room or areas served.(3) A caution to not close or open the valve except in emergency.

5.1.11.2.2 Where positive pressure gas piping systems operate atpressures other than the standard 345 to 380 kPa (50 to 55 psi) gageor 1100 to 1275 kPa (160 to 185 psi) gage for nitrogen orinstrument air, the valve identification shall also include thenonstandard operating pressure.

5.1.11.2.3 Source valves shall be labeled in substance as follows:SOURCE VALVE FOR THE (SOURCE NAME).

5.1.11.2.4 Main line valves shall be labeled in substance as follows:MAIN LINE VALVE FOR THE (GAS/VACUUM NAME)SERVING THE (NAME OF THE BUILDING).

5.1.11.2.5 Riser valve(s) shall be labeled in substance as follows:RISER FOR THE (GAS/VACUUM NAME) SERVING (NAME OFTHE AREA/BUILDING SERVED BY THE PARTICULAR RISER).

5.1.11.2.6 Service valve(s) shall be labeled in substance as follows:SERVICE VALVE FOR THE (GAS/VACUUM NAME) SERVING(NAME OF THE AREA/BUILDING SERVED BY THEPARTICULAR VALVE).

5.1.11.3 Station Outlets and Inlets

5.1.11.3.1 Station outlets and inlets shall be identified as to thename or chemical symbol for the specific medical gas or vacuumprovided.

5.1.11.3.2 Where medical gas systems operate at pressures otherthan the standard 345 to 380 kPa (50 to 55 psi) gage or 1100 to 1275kPa (160 to 185 psi) gage for nitrogen, the station outletidentification shall include the nonstandard operating pressure inaddition to the name of the gas.

5.1.11.4 Alarm Panels. Labeling of alarm panels shall complywith the requirements of 5.1.9.1 (6) and (7).


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Table 5.1.11 Standard Designation Colors and Operating Pressures for Gas and Vacuum SystemsGas Service Abbreviated Name Colors

(Background/Text)Standard Pressure

Medical Air Yellow/Black 345-380 kPa(50-55 psi) gage

Carbon Dioxide CO 2 Grey/Black orGrey/White

345-380 kPa(50-55 psi) gage

Helium He Brown/White 345-380 kPa(50-55 psi) gage

Nitrogen N2 Black/White 1100-1275 kPa(160-185 psi) gage

Nitrous Oxide N2O Blue/White 345-380 kPa(50-55 psi) gage

Oxygen 02 Green/White orWhite/Green

345-380 kPa(50-55 psi) gage

Oxygen/CarbonDioxide Mixtures

02/CO 2 n%{n is % of CO 2}

Green/White 345-380 kPa(50-55 psi) gage

Medical-Surgical Vacuum White/Black 380 mm to 760 mm(15 in. to 30 in.) HgV

Waste AnaestheticGas Disposal

WAGD Violet/White Varies with system type

Other Mixtures Gas A % /Gas B% Colors as aboveMajor gas for background/

Minor gas for text

None

Non-Medical Air(Level 3 Gas Powered Device)

Air

Yellow & White DiagonalStripe/Black

None

Non-Medical and Level 3Vacuum

White & Black DiagonalStripe/Black Boxed

None

Laboratory Air Yellow and WhiteCheckerboard/Black

None

Laboratory Vacuum White and BlackCheckerboard/Black Boxed

None

Instrument Air Red/White 1100-1275 kPa (160-185 psi)gage


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5.1.12 Performance Criteria and Testing--Level 1 (Gases,Medical/Surgical Vacuum, and WAGD)

5.1.12.1 General

5.1.12.1.1 Inspection and testing shall be performed on all newpiped gas systems, additions, renovations, temporary installations,or repaired systems, to assure the facility, by a documentedprocedure, that all applicable provisions of this document havebeen adhered to and system integrity has been achieved ormaintained.

5.1.12.1.2 Inspection and testing shall include all components ofthe system or portions thereof including, but not limited to, gasbulk source(s), manifolds, compressed air source systems (e.g.,compressors, dryers, filters, regulators), source alarms andmonitoring safeguards, master alarms, pipelines, isolation valves,area alarms, zone valves, and station inlets (vacuum) and outlets(pressure gases).

5.1.12.1.3 All systems that are breached and components that aresubject to additions, renovations, or replacement (e.g., new gassources-bulk, manifolds, compressors, dryers, alarms) shall beinspected and tested.

5.1.12.1.4 Systems shall be deemed breached at the point ofpipeline intrusion by physical separation or by system componentremoval, replacement, or addition.

5.1.12.1.5 Breached portions of the systems subject to inspectionand testing shall be confined to only the specific altered zone andcomponents in the immediate zone or area that is locatedupstream for vacuum systems and downstream for pressure gases atthe point or area of intrusion.

5.1.12.1.6 The inspection and testing reports shall be submitteddirectly to the party that contracted for the testing, who shallsubmit the report through channels to the responsible authorityand any others that are required.

5.1.12.1.7 Reports shall contain detailed listings of all findings andresults.

5.1.12.1.8 The responsible facility authority shall review theseinspection and testing records prior to the use of all systems toassure that all findings and results of the inspection and testinghave been successfully completed.

5.1.12.1.9 All documentation pertaining to inspections and testingshall be maintained on-site within the facility.

5.1.12.1.10 Before piping systems are initially put into use, thehealth care facility authority shall be responsible for ascertainingthat the gas/vacuum delivered at the outlet/inlet is that shown onthe outlet/inlet label and that the proper connecting fittings areinstalled for the specific gas/vacuum service.

5.1.12.1.11 Acceptance of the verifier’s report shall be permitted tosatisfy the requirements in 5.1.12.1.10.

5.1.12.1.12 The removal of components within a source system forrepair and reinstallation, or the replacement of components likefor like shall be treated as new work for the purposes of testingwhenever such work involves cutting and/or brazing new piping.

5.1.12.1.12.1 Where no piping is changed, functional testing shallbe performed as follows:

(1) To verify the function of the replaced device.(2) To assure no other equipment in the system has been

adversely impacted.

5.1.12.1.12.2 Where no piping is changed, in addition to tests ofgeneral function required by 5.1.12.1.12.1, testing shall beperformed as follows:

(1) Pressure gas sources shall be tested for compliance with5.1.12.3.14.2 as applicable to the equipment type.

(2) Medical air and instrument air sources shall be tested to5.1.12.3.14.2(a).

(3) Vacuum and WAGD systems shall be tested to 5.1.12.3.14.4.(4) Alarm systems shall be tested to 5.1.12.3.5.2 and 5.1.12.3.5.3

.(5) All affected components shall be tested as appropriate the

that specific component (e.g. a replaced dew point monitor wouldbe tested to 5.1.3.5.15.

5.1.12.2 Installer Performed Tests

5.1.12.2.1 General

5.1.12.2.1.1 The tests required by this section shall be performedand documented by the installer prior to the tests listed in 5.1.12.3,System Verification.

5.1.12.2.1.2 The test gas shall be oil free, dry Nitrogen NF.

5.1.12.2.1.3 Where manufactured assemblies are to be installed,the tests required under this section shall be performed:

(1) After completion of the distribution piping but before thestanding pressure test.

(2) Prior to installation of manufactured assemblies suppliedthrough flexible hoses or flexible tubing.

(3) At all station outlets/inlets on installed manufacturedassemblies supplied through copper tubing.

5.1.12.2.2 Initial Blow Down. Piping in medical gas and vacuumdistribution systems shall be blown clear by means of oil free, dryNitrogen NF as follows:

(1) After installation of the distribution piping(2) Before installation of station outlets/inlets and other system

components (e.g., pressure/vacuum alarm devices,pressure/vacuum indicators, pressure relief valves, manifolds,source equipment).

5.1.12.2.3 Initial Pressure Test

5.1.12.2.3.1 Each section of the piping in medical gas and vacuumsystems shall be pressure tested.

5.1.12.2.3.2 Initial pressure tests shall be conducted as follows:(1) After installation of station outlets/inlets rough-in

assemblies. Test caps shall be permitted to be used.(2) Prior to the installation of components of the distribution

piping system that would be damaged by the test pressure (e.g.pressure/vacuum alarm devices, pressure/ vacuum indicators, linepressure relief valves, manufactured assemblies with flexible hoses,hoses, etc.)

5.1.12.2.3.3 The source shutoff valve shall remain closed duringthese tests.

5.1.12.2.3.4 The test pressure for pressure gases shall be 1.5 timesthe system working pressure but not less than 1035 kPa (150 psi)gage.

5.1.12.2.3.5 The test pressure for vacuum shall be not less than 415kPa (60 psi) gage

5.1.12.2.3.6 The test pressure shall be maintained until each jointhas been examined for leakage by means of soapy water or otherequally effective means of leak detection that is safe for use withoxygen.

5.1.12.2.3.7 Leaks, if any, shall be located, repaired (if permitted),replaced (if required), and re-tested.

5.1.12.2.4 Cross-Connection Test. It shall be determined that nocross connections exist between the various medical gas andvacuum piping systems.

5.1.12.2.4.1 All piping systems shall be reduced to atmosphericpressure.

5.1.12.2.4.2 Sources of test gas shall be disconnected from allpiping systems except for the one system being tested.

5.1.12.2.4.3 The system under test shall be charged with oil free,dry Nitrogen NF to 345 kPa (50 psi) gage.

5.1.12.2.4.4 After the installation of the individual faceplates, withappropriate adapters matching outlet/inlet labels each individualoutlet/inlet in each installed medical gas and vacuum pipingsystem shall be checked to determine that the test gas is beingdispensed only from the piping system being tested.

5.1.12.2.4.5 The cross–connection test referenced in 5.1.12.2.4shall be repeated for each installed medical gas and vacuum pipingsystem.


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5.1.12.2.4.6 The proper labeling and identification of systemoutlets/inlets shall be confirmed during these tests.

5.1.12.2.5 Piping Purge Test. The outlets in each medical gaspiping system shall be purged to remove any particulate matterfrom the distribution piping.

5.1.12.2.5.1 Using appropriate adapters, each outlet shall bepurged with an intermittent high-volume flow of test gas until thepurge produces no discoloration in a clean white cloth.

5.1.12.2.5.2 This purging shall be started at the furthest point fromthe zone valve.

5.1.12.2.6 Standing Pressure Test for Positive Pressure MedicalGas Piping. After successful completion of the initial pressure testsunder 5.1.12.2.3 medical gas distribution piping shall be subject toa standing pressure test.

5.1.12.2.6.1 Tests shall be conducted after the final installation ofstation outlet valve bodies, face plates, and other distributionsystem components (e.g. pressure alarm devices, pressureindicators, line pressure relief valves, manufactured assemblies,hoses, etc.)

5.1.12.2.6.2 The source valve shall be closed during this test.

5.1.12.2.6.3 The piping systems shall be subjected to a 24-hourstanding pressure test using oil free, dry Nitrogen NF.

5.1.12.2.6.4 Test pressures shall be 20 percent above the normalsystem operating line pressure.

5.1.12.2.6.5 At the conclusion of the tests, there shall be no changein the test pressure other than that attributed to changes of ambienttemperature, as permitted under 5.1.12.2.7.6.

5.1.12.2.6.6 Leaks, if any, shall be located, repaired (if permitted)or replaced (if required), and re-tested.

5.1.12.2.7 Standing Pressure Test for Vacuum Systems. Aftersuccessful completion of the initial pressure tests under 5.1.12.2.3,vacuum distribution piping shall be subjected to a standingvacuum test.

5.1.12.2.7.1 Tests shall be conducted after installation of allcomponents of the vacuum system.

5.1.12.2.7.2 The piping systems shall be subjected to a 24-hourstanding vacuum test.

5.1.12.2.7.3 Test pressure shall be not less than 300 mm (12 in.)gage HgV.

5.1.12.2.7.4 During the test, the source of test vacuum shall bedisconnected from the piping system.

5.1.12.2.7.5 At the conclusion of the test, there shall be no changein the vacuum other than that attributed to changes of ambienttemperature, as permitted under 5.1.12.2.7.6.

5.1.12.2.7.6 Test vacuum changes due to expansion or contractionshall be permitted to be determined by means of the followingpressure - temperature relationship:

(a) the calculated final absolute pressure equals the initialabsolute pressure times the final absolute temperature, divided bythe initial absolute temperature.

(b) absolute pressure is the gage pressure reading plus 101.4kPa (14.7 psi).

(c) absolute temperature is the temperature reading plus 238°C(460° F).

(d) the final allowable gage pressure reading equals the finalallowable absolute pressure minus 101.4 kPa (14.7 psi) gage.

5.1.12.2.7.7 Leaks, if any, shall be located, repaired (if permitted)or replaced (if required), and re-tested.

5.1.12.3 System Verification

5.1.12.3.1 General

5.1.12.3.1.1 Verification tests shall be performed only after all testsrequired in 5.1.12.2 Installer Performed Tests have been completed.

5.1.12.3.1.2 The test gas shall be oil free, dry Nitrogen NF or thesystem gas where permitted.

5.1.12.3.1.3 Testing shall be conducted by a party technicallycompetent and experienced in the field of medical gas and vacuumpipeline testing and meeting the requirements of ANSI/ASSEStandard 6030, Medical Gas Verifiers Professional QualificationsStandard.

5.1.12.3.1.4 Testing shall be performed by a party other than theinstalling contractor.

5.1.12.3.1.5 When systems have been installed by in-housepersonnel, testing shall be permitted by personnel of thatorganization who meet the requirements of 5.1.12.3.1.3.

5.1.12.3.1.6 All tests required under 5.1.12.3 shall be performedafter installation of any manufactured assemblies supplied throughflexible hoses or tubing.

5.1.12.3.1.7 Where there are multiple possible connection pointsfor terminals, each possible position shall be tested independently.

5.1.12.3.1.8 Where permitted by the authority having jurisdiction,for small projects affecting a limited number of areas where the useof nitrogen is impractical, the source gas shall be permitted to beused for the following tests:

(1) Standing pressure (5.1.12.3.2)(2) Cross-Connection (5.1.12.3.3)(3) Alarms (5.1.12.3.5)(4) Piping Purge (5.1.12.3.6)(5) Piping Particulates (5.1.12.3.7)(6) Piping Purity (5.1.12.3.8)(7) Operational Pressure (5.1.12.3.10)

5.1.12.3.2 Standing Pressure Test. Piping systems shall besubjected to a ten minute standing pressure test at operating linepressure using the following procedure:

(1) After the system is filled with nitrogen or source gas, thesource valve and all zone valves shall be closed.

(2) The piping system shall show no decrease in pressure after tenminutes.

(3) Any leaks found shall be located, repaired and re-tested per5.1.12.2.6 .

5.1.12.3.3 Cross-Connection Test. After closing of walls andcompletion of requirements of 5.1.12.2, Installer Performed Tests,it shall be determined that no cross-connection of piping systemsexists by either of the following methods:

5.1.12.3.3.1 Individual Pressurization(1) All medical gas and vacuum piping systems shall be

reduced to atmospheric pressure.(2) All sources of test gas from all of the medical gas and

vacuum systems, with the exception of the one system to bechecked, shall be disconnected.

(3) The system being checked shall be pressurized to 345 kPa(50 psi) gage.

(4) With adapters matching outlet labels, each individualstation outlet/inlet of all medical gas and vacuum systems installedshall be checked to determine that test gas is being dispensed onlyfrom the outlets/inlets of the piping system being tested.

(5) The source of test gas shall be disconnected and the systemtested reduced to atmospheric pressure.

(6) Proceed to test each additional piping system until allmedical gas and vacuum piping systems are free of cross-connections.

5.1.12.3.3.2 Pressure Differential(1) The pressure in all medical gas systems shall be reduced to

atmospheric.(2) The test gas pressure in all medical gas piping systems shall

be increased to the values indicated Table 5.1.12.3.3.2,simultaneously maintaining these nominal pressures throughoutthe test.

(3) Systems with nonstandard operating pressures shall betested at a pressure at least 70 kPa (10 psi) gage higher or lowerthan any other system being tested.

(4) Any vacuum systems shall be in operation so that thesevacuum systems are tested at the same time the medical gas systemsare tested.

(5 Following the adjustment of pressures in accordance with5.1.12.3.3.2 (2) and (3), each station outlet for each medical gassystem shall be tested using the gas-specific connection for each


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system with test gauge attached to verify that the correct testpressure/vacuum is present at each outlet/inlet of each system aslisted in Table 5.1.12.3.3.2.

(6) Each test gauge used in performing this test shall becalibrated with the pressure indicator used for the line pressureregulator used to provide the source pressure.

(7) Each station outlet shall be identified by label (and colormarking, if used), and the pressure indicated on the test gaugeshall be that listed in Table 5.1.12.3.3.2 for the system being tested.

Table 5.1.12.3.3.2 Alternate Test PressuresMedical Gas Pressure

Gas Mixtures 140 kPa (20 psi) gageNitrogen/Instrument Air 210 kPa (30 psi) gageNitrous Oxide 275 kPa (40 psi) gageOxygen 345 kPa (50 psi) gageMedical Air 415 kPa (60 psi) gageVacuum 510 mm (20 in.) gage HgVWAGD 380 mm (15 in.) gage HgV (if so

designed)Systems at nonstandardpressures

70 kPa (10 psi) greater or lessthan any other system

5.1.12.3.4 Valve Test. Valves installed in each medical gas andvacuum piping system shall be tested to verify proper operation androoms or areas of control.

5.1.12.3.4.1 Records shall be made listing the rooms or areascontrolled by each valve for each gas.

5.1.12.3.4.2 The information shall be utilized to assist and verifythe proper labeling of the valves.

5.1.12.3.5 Alarm Test

5.1.12.3.5.1 General(a) All warning systems for each medical gas and vacuum

system(s) shall be tested to ensure that all components functionproperly prior to placing the system in service.

(b) Permanent records of these tests shall be maintained.(c) Warning systems that are part of an addition to an existing

piping system shall be tested prior to the connection of the newpiping to the existing system.

(d) Tests of warning systems for new installations (initial tests)shall be performed after the cross-connection testing (5.1.12.3.3),but before purging the piping (5.1.12.3.6) and performing theremaining verification tests (5.1.12.3.7 through 5.1.12.3.14).

(e) Initial tests of warning systems that can be included in anaddition or extension to an existing piping system shall becompleted before connection of the addition to the existing system.

(f) Test gases for the initial tests shall be oil free, dry NitrogenNF, the gas of system designation, or operating vacuum.

5.1.12.3.5.2 Master Alarms(a) The master alarm system tests shall be performed for each

of the medical gas and vacuum piping systems.(b) Permanent records of these tests shall be maintained with

those required under 5.1.12.1.7.(c) The audible and non-cancellable visual signals of 5.1.9.1

shall indicate if the pressure in the main line increases or decreases20 percent from the normal operating pressure.

(d) The operation of all master alarm signals referenced in5.1.9.2.4 shall be verified.

5.1.12.3.5.3 Area Alarms . The warning signals for all medical gaspiping systems supplying anesthetizing locations and other vital life-support and critical care areas, such as post-anesthesia recovery,intensive care units, coronary care units, emergency suites andoperating rooms shall be tested to verify an alarm condition if thepressure in the piping system increases or decreases 20 percentfrom the normal operating pressure for positive pressure gases, orwhen the vacuum system(s) drop below 300 mm (12 in.) gageHgV.

5.1.12.3.6 Piping Purge Test. In order to remove any traces ofparticulate matter deposited in the pipelines as a result ofconstruction, a heavy, intermittent purging of the pipeline shall bedone.

5.1.12.3.6.1 The appropriate adapter shall be obtained from thefacility or manufacturer, and high purge rates of at least 225Nl/min (8 SCFM) shall be put on each outlet.

5.1.12.3.6.2 After the purge is started, it shall be rapidly interruptedseveral times until the purge produces no discoloration in a whitecloth loosely held over the adapter during the purge.

5.1.12.3.6.3 In order to avoid possible damage to the outlet and itscomponents, this test shall not be conducted using any implementother than the proper adapter.

5.1.12.3.7 Piping Particulate Test . For each positive-pressure gassystem, the cleanliness of the piping system shall be verified.

(a) A minimum of 1000 L (35 ft3) of gas shall be filteredthrough a clean, white 0.45-micron filter at a minimum flow rate of100 Nl/min (3.5 SCFM).

(b) Twenty-five percent of the zones shall be tested at the outletmost remote from the source.

(c) The filter shall accrue no more than .001 gram (1 mg) ofmatter from any outlet tested.

(d) If any outlet fails this test, the most remote outlet in everyzone shall be tested.

(e) The test shall be performed with the use of oil free, dryNitrogen NF.

5.1.12.3.8 Piping Purity Test . For each positive-pressure system,the purity of the piping system shall be verified.

(a) These tests shall be performed with oil free, dry NitrogenNF or the gas of system designation.

(b) The tests shall be for total hydrocarbons (as methane), andhalogenated hydrocarbons, and compared with the source gas.

(c) This test shall be performed at the outlet most remote fromthe source.

(d) The difference between the two tests shall in no caseexceed:

Total Hydrocarbons 1 ppmHalogenated Hydrocarbons 2 ppm

(e) A test for dew point shall be conducted at the outlet mostremote from the source and the dew point shall not exceed 500ppm (12°C).

5.1.12.3.9 Final Tie in Test

5.1.12.3.9.1 Prior to the connection of any work or any extensionor addition to an existing piping system, the tests in 5.1.12.3.1through 5.1.12.3.8 shall be successfully performed on the newwork.

5.1.12.3.9.2 Each joint in the final connection between the newwork and the existing system shall be leak-tested with the gas ofsystem designation at the normal operating pressure by means ofsoapy water or other means safe for use with oxygen.

5.1.12.3.9.3 For pressure gases, immediately after the finalconnection is made and leak tested, the specific altered zone andcomponents in the immediate zone or area that is downstreamfrom the point or area of intrusion shall be purged per 5.1.12.3.6.

5.1.12.3.9.4 Before the new work is used for patient care, positivepressure gases shall be tested for operational pressure, and gasconcentration in accordance with 5.1.12.3.10 and 5.1.12.3.11.

5.1.12.3.9.5 Permanent records of these tests shall be maintainedin accordance with 5.1.12.7.1.

5.1.12.3.10 Operational Pressure Test. Operational pressure testsshall be performed at each station outlet/inlet or terminal wherethe user makes connections and disconnections.

5.1.12.3.10.1 Tests shall be performed with oil free, dry NitrogenNF, the gas of system designation, or the operating vacuum.

5.1.12.3.10.2 All 345 kPa (50 psi) gage gas outlets including, butnot limited to oxygen, nitrous oxide, medical air, and carbondioxide, shall deliver 100 Nl/min (3.5 SCFM) with a pressure dropof no more than 35 kPa (5 psi), and static pressure of 345-380 kPa(50-55 psi) gage.

5.1.12.3.10.3 Nitrogen outlets shall deliver 140 Nl/min (5.0 SCFM)with a pressure drop of no more than 35 kPa (5 psi) gage and staticpressure of to 1275 kPa (160 to 185 psi) gage.


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5.1.12.3.10.4 Medical/surgical vacuum inlets shall draw 85 Nl/min(3 SCFM) without reducing the vacuum pressure below 300 mm(12 in) gage HgV at any adjacent station inlet.

5.1.12.3.10.5 Oxygen and air outlets serving critical care areas shallpermit a transient flow rate of 170 Nl/min (6 SCFM) for 3 seconds.

5.1.12.3.11 Medical Gas Concentration Test. After purging eachsystem with the gas of system designation, the following shall beperformed:

(1) Each pressure gas source and outlet shall be analyzed forconcentration of gas, by volume.

(2) Analysis shall be with instruments designed to measure thespecific gas dispensed.

(3) Allowable concentrations shall be as indicated in Table5.1.12.3.11.

Table 5.1.12.3.11 Gas ConcentrationsMedical Gas ConcentrationOxygen >99% OxygenNitrous Oxide >99% Nitrous OxideNitrogen <1% Oxygen or 99%

NitrogenMedical Air 19.5 – 23.5% OxygenOther Gases Concentration as specified

by their labelling ±1%unless otherwise specified.

5.1.12.3.12 Medical Air Purity Test (Compressor System).

Table 5.1.12.3.12 Contaminant Parameters for Medical Air

Parameter Limit ValueDew Point 4°C (39°F)Carbon Monoxide 10 ppmCarbon Dioxide 500 ppmGaseous Hydrocarbons 25 ppm (as methane)Halgonenated

Hydrocarbons2 ppm

5.1.12.3.12.1 The medical air source shall be analyzed forconcentration of contaminants by volume prior to the source valvebeing opened.

5.1.12.3.12.2 Sample(s) shall be taken for the air system test at thesystem sample port.

5.1.12.3.12.3 The test results shall not exceed the parameters inTable 5.1.12.3.12.

5.1.12.3.13 Labeling. The presence and correctness of labelingrequired by this standard for all components (e.g., stationoutlets/inlets, shutoff valves, and alarm panels) shall be verified.

5.1.12.3.14 Source Equipment Verification

5.1.12.3.14.1General. Source equipment verification shall beperformed following the installation of the interconnectingpipelines, accessories, and source equipment.

5.1.12.3.14.2 Gas Supply Sources(a) The system apparatus shall be tested for proper function,

including the changeover from primary to secondary supply (withits changeover signal) and the operation of the reserve (with itsreserve in use signal), before the system is put into service.

(b) If the system has an actuating switch and signal to monitorthe contents of the reserve, its function shall be tested before thesystem is put into service.

(c) If the system has an actuating switch and signal to monitorthe pressure of the reserve unit, its function shall be tested beforethe system is put into service.

(d) Testing of the bulk supply signal and the master signalpanel installations shall be arranged with the owner or theorganization responsible for the operation and maintenance of thesupply system for the testing of the bulk supply signals to ensureproper identification and activation of the master signal panels tobe sure the facility can monitor the status of that supply system.

(e) The tests required in 5.1.12.3.14.2 (d) shall also beconducted when the storage units are changed or replaced.

5.1.12.3.14.3 Medical Air Compressor Systems(a) Tests of the medical air compressor system shall include the

purity test for air quality, and the test of the alarm sensors aftercalibration and setup per the manufacturer’s instructions, as wellas lead-lag controls.

(b) Tests shall be conducted at the sample port of the medicalair system.

(c) The operation of the system control sensors, such as dewpoint, air temperature, and all other air-quality monitoring sensorsand controls, shall be checked for proper operation and functionbefore the system is put into service.

(d) The quality of medical air as delivered by the compressorair supply shall be verified after installation of new componentsprior to use by patients.

(e) The air quality tests in 5.1.12.3.14.3 (d) shall be performedafter a minimum of 24 hours of operation in accordance with5.1.12.3.14.3 (f) of the machinery.

(f) A demand of approximately 25 percent of the ratedcompressor capacity shall be created to cause the compressors tocycle on and off continuously and the dryers to operate for the 24-hour period.

5.1.12.3.14.4 Medical/Surgical Vacuum Systems. The properfunctioning of the medical/surgical vacuum source system(s) shallfor tested before it is put into service.

5.1.13 Level 1 Operation and Management

5.1.13.1 Administration. Administrative authorities of health careorganizations shall provide policies and procedures for safepractices.

5.1.13.1.1 Purchase specifications shall include:(1) specifications for cylinders,(2) marking of cylinders, regulators, and valves,(3) proper connection of cylinders supplied to the facility,

5.1.13.1.2 Training procedures shall include:(1) Maintenance programs in accordance with the

manufacturers’ recommendations for the piped gas system.(2) Use and transport of equipment and the proper handling of

cylinders, containers, hand trucks, supports, and valve protectioncaps.

(3) Proper uses of the medical/surgical vacuum system in orderto eliminate practices that reduce the system’s effectiveness, such asleaving suction tips and catheters open when not actuallyaspirating, and using equipment arrangements that are improperlytrapped or are untrapped.

5.1.13.1.3 Policies for enforcement shall include:(1) Regulations for the storage and handling of cylinders and

containers of oxygen and nitrous oxide.(2) Regulations for the safe handling of oxygen and nitrous

oxide in anesthetizing locations,(3) All signal warnings are promptly evaluated and all necessary

measures are taken to re-establish the proper functions of themedical gas and vacuum systems.

(4) The organization has the capability and resources to copewith a complete loss of any medical gas or vacuum system,

(5) Prior to the use of any medical gas or vacuum piping systemfor patient care all tests required in 5.1.12.3 have been successfullyconducted.

5.1.13.2* Special Precautions for Handling Oxygen Cylinders andManifolds . Handling of oxygen cylinders and manifolds shall bebased on CGA Pamphlet G-4, Oxygen .

5.1.13.2.1 Oxygen cylinders, containers and associated equipmentshall be protected from contact with oil or grease. Specificprecautions shall include:

(1) Oil, grease, or readily flammable materials shall never bepermitted to come in contact with oxygen cylinders, valves,regulators, gauges, or fittings.

(2) Regulators, fittings, or gauges shall never be lubricated withoil or any other flammable substance.

(3) Oxygen cylinders or apparatus shall never be handled withoily or greasy hands, gloves, or rags.


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5.1.13.2.2 Equipment associated with oxygen shall be protectedfrom contamination. Specific precautions shall include:

(1) Particles of dust and dirt shall be cleared from cylindervalve openings by slightly opening and closing the valve beforeapplying any fitting to the cylinder.

(2) The high-pressure valve on the oxygen cylinder shall beopened before bringing the apparatus to the patient or the patientto the apparatus.

(3) An oxygen cylinder shall never be draped with any materialssuch as hospital gowns, masks, or caps.

(4) Cylinder-valve protection caps, where provided, shall bekept in place and be hand tightened, except when cylinders are inuse or connected for use.

(5) Valves shall be closed on all empty cylinders in storage.

5.1.13.2.3 Cylinders shall be protected from damage. Specificprocedures shall include:

(1) Oxygen cylinders shall be protected from abnormalmechanical shock, which is liable to damage the cylinder, valve, orsafety device.

(2) Oxygen cylinders shall not be stored near elevators,gangways, or in locations where heavy moving objects will strikethem or fall on them.

(3) Cylinders shall be protected from the tampering ofunauthorized individuals.

(4) Cylinders or cylinder valves shall not be repaired, painted,or altered.

(5) Safety relief devices in valves or cylinders shall never betampered with.

(6) Valve outlets clogged with ice shall be thawed with warm —not boiling — water.

(7) A torch flame shall never be permitted under anycircumstances to come in contact with cylinder valves or safetydevices.

(8) Sparks and flame shall be kept away from cylinders.(9) Even if they are considered to be empty, cylinders shall

never be used as rollers, supports, or for any purpose other thanthat for which the supplier intended them.

(10) When small-size (A, B, D, or E) cylinders are in use, theyshall be attached to a cylinder stand or to therapy apparatus ofsufficient size to render the entire assembly stable.

(11) Large cylinders (exceeding size E) and containers largerthan 45 kg (100 lb) weight shall be transported on a proper handtruck or cart complying with 8-5.2.

(12) Freestanding cylinders shall be properly chained orsupported in a proper cylinder stand or cart.

(13) Cylinders shall not be chained to portable or movableapparatus such as beds and oxygen tents.

(14) Cylinders shall not be supported by radiators, steam pipes,or heat ducts.

5.1.13.2.4 Cylinders and their contents shall be handled with care.Specific procedures shall include:

(1) Oxygen fittings, valves, regulators, or gauges shall never beused for any service other than that of oxygen.

(2) Gases of any type shall never be mixed in an oxygen cylinderor any other cylinder.

(3) Oxygen shall always be dispensed from a cylinder through apressure regulator.

(4) The cylinder valve shall be opened slowly, with the face ofthe indicator on the regulator pointed away from all persons.

(5) Oxygen shall be referred to by its proper name, oxygen, notair and liquid oxygen referred to by its proper name, not liquid air.

(6) Oxygen shall never be used as a substitute for compressedair.

(7) The markings stamped on cylinders shall not be tamperedwith because it is against federal statutes to change these markingswithout written authority from the Bureau of Explosives.

(8) Markings used for the identification of contents of cylindersshall not be defaced or removed, including decals, tags, stenciledmarks, and upper half of shipping tag.

(9) The owner of the cylinder shall be notified if any conditionhas occurred that might permit any foreign substance to enter acylinder or valve, giving details and cylinder number.

(10) Neither cylinders nor containers shall be placed inproximity of radiators, steam pipes, heat ducts, or other sources ofheat.

(11) Very cold cylinders or containers shall be handled with careto avoid injury.

5.1.13.2.5 When individual small-size (A, B, D, or E) cylinders areused in association with patient care, the cylinders shall bepermitted to be placed and stored in open areas throughout thepatient care area.

5.1.13.2.6 Oxygen equipment that is defective shall not be useduntil either:

(1) it has been repaired by competent in-house personnel,(2) it has repaired by the manufacturer or his or her authorized

agent,(3) it has been replaced.

5.1.13.2.7 Regulators that are in need of repair or cylinders havingvalves that do not operate properly shall never be used.

5.1.13.3 Special Precautions for Making Cylinder and ContainerConnections

5.1.13.3.1* Wrenches and tools used to connect respiratory therapyequipment shall not be required to be non-sparking.

5.1.13.3.2 Cylinder valves shall be opened and connected inaccordance with the following procedure:

(1) Make certain that apparatus and cylinder valve connectionsand cylinder wrenches are free of foreign materials,

(2) Turn the cylinder valve outlet away from personnel. Stand tothe side — not in front and not in back. Before connecting theapparatus to cylinder valve, momentarily open cylinder valve toeliminate dust,

(3) Make connection of apparatus to cylinder valve. Tightenconnection nut securely with a wrench

(4) Release the low-pressure adjustment screw of the regulatorcompletely,

(5) Slowly open cylinder valve to full open position,(6) Slowly turn in the low-pressure adjustment screw on the

regulator until the proper working pressure is obtained, and(7) Open the valve to the utilization apparatus.

5.1.13.3.3. Connections for containers shall be made inaccordance with the container manufacturer’s operatinginstructions.

5.1.13.4 Special Precautions for the Care of Safety Mechanisms

5.1.13.4.1 Personnel using cylinders and containers and otherequipment covered in this chapter shall be familiar with the Pin-Index Safety System (see Chapter 9) and the Diameter-Index SafetySystem (see Chapter 9), both are designed to prevent utilization ofthe wrong gas.

5.1.13.4.2 Safety relief mechanisms, non-interchangeableconnectors, and other safety features shall not be removed, altered,or replaced.

5.1.13.5 Special Precautions - Storage of Cylinders and Containers

5.1.13.5.1 Storage shall be planned so that cylinders can be used inthe order in which they are received from the supplier.

5.1.13.5.2 If stored within the same enclosure, empty cylindersshall be segregated from full cylinders.

5.1.13.5.3 Empty cylinders shall be marked to avoid confusion anddelay if a full cylinder is needed in a rapid manner.

5.1.13.5.4 Cylinders stored in the open shall be protected asfollows:

(1) against extremes of weather and from the ground beneathto prevent rusting,

(2) during winter, against accumulations of ice or snow,(3) in summer, screened against continuous exposure to direct

rays of the sun in those localities where extreme temperaturesprevail.

5.1.13.5.5 No cylinders containing oxygen or nitrous oxide, otherthan those connected to anesthetic apparatus, shall be kept orstored in anesthetizing locations.

5.1.13.6 Special Precautions – Piped Patient Gas/Vacuum Systems

5.1.13.6.1* Piping systems shall not be used for the distribution offlammable anesthetic gases.

5.1.13.6.2 Nonflammable medical gas systems used to supply gasesfor respiratory therapy shall be installed in accordance with 5.1.1through 5.1.11 of this chapter.

5.1.13.6.3 Piping systems for gases shall not be used as a groundingelectrode.


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5.1.13.6.4 Liquid or debris shall not be introduced into themedical-surgical vacuum system for disposal.

5.1.13.6.5 The medical-surgical vacuum system shall not be usedfor vacuum steam condensate return or other non-medical or non-surgical applications.

5.1.13.7 Gas/ Vacuum Systems Information and Warning Signs

5.1.13.7.1 The gas content of medical gas and vacuum pipingsystems shall be labeled in accordance with 5.1.11.1.

5.1.13.7.2 Labels for shutoff valves shall be:(1) in accordance 5.1.11.2,(2) updated when modifications are made changing the areas

served.

5.1.13.8 Gas/ Vacuum Systems Maintenance and Record Keeping

5.1.13.8.1 Permanent records of all tests required by 5.1.11.3.1through 5.1.11.3.14 shall be maintained in the organization’s files.

5.1.13.8.2 A periodic testing procedure for nonflammable medicalgas/vacuum and related alarm systems shall be implemented.

5.1.13.8.3 Whenever modifications are made or maintenance isperformed that breaches the system the verification tests specifiedin 5.1.11.3 shall be conducted on the downstream portions of themedical gas piping system.

5.1.13.8.4 A maintenance program shall be established for thefollowing:

(1) the medical air compressor supply system in accordancewith the manufacturers’ recommendations,

(2) the facility shall establish a testing and calibrationprocedure which assures Carbon Monoxide monitors arecalibrated at least annually or more often if recommended by themanufacturer.

(3) both the medical/surgical vacuum piping system and to thesecondary equipment attached to medical/surgical vacuum stationinlets to ensure the continued good performance of the entiremedical/surgical vacuum system.

(4) the WAGD system to assure performance.

5.1.13.8.5* Audible and visual alarm indicators shall:(1) shall be periodically tested to determine that they are

functioning properly,(2) shall have the records of the test maintained until the next

test is performed.

5.1.13.8.6* Medical/surgical vacuum station inlet terminalperformance, as required in 5.1.11.3.10.4, shall be tested asfollows:

(1) on a regular preventive maintenance schedule asdetermined by the facility maintenance staff,

(2) based on flow of free air (Nl/min or SCFM) into a stationinlet while simultaneously checking the vacuum level.


5.2.1 Applicability. These requirements shall apply to health carefacilities which qualify for Level 2 systems as referenced in Chapters13 through 21.

5.2.2 Nature of Hazards of Gas and Vacuum Systems

5.2.3 Level 2 Sources

5.2.3.1 Central Supply System Identification and Labeling. Level 2Facilities shall comply with 5.1.3.1.

5.2.3.2 Central Supply Operations. Level 2 Facilities shall complywith 5.1.3.2.

5.2.3.3 Central Supply System Locations. Level 2 Facilities shallcomply with 5.1.3.3.

5.2.3.4 Central Supply Systems . Level 2 Facilities shall comply with5.1.3.4.

5.2.3.5 Level 2 Medical Air Supply Systems. Level 2 Facilities shallcomply with 5.1.3.5, except as follows:

(a) Medical air compressors, dryers, aftercoolers, filters andregulators shall be permitted to be simplex.

(b) The facility staff shall develop their emergency plan to dealwith the loss of medical air.

5.2.3.6 Level 2 Medical/Surgical Vacuum. Level 2 Facilities shallcomply with 5.1.3.6, except as follows:

(a) Medical/surgical vacuum systems shall be permitted to besimplex.

(b) The facility staff shall develop their emergency plan to dealwith the loss of medical/surgical vacuum.

5.2.3.7 Level 2 Waste Anesthetic Gas Disposal (WAGD) Level 2Facilities shall comply with 5.1.3.7, except as follows:

(a) Medical WAGD pumps shall be permitted to be simplex.(b) The facility staff shall develop their emergency plan to deal

with the loss WAGD.

5.2.3.8 Instrument Air Supply Systems. Level 2 Facilities shallcomply with 5.1.3.8.

5.2.4 Valves. Level 2 Facilities shall comply with 5.1.4.

5.2.5 Station Outlets/Inlets. Level 2 Facilities shall comply with5.1.5.

5.2.6 Manufactured Assemblies. Level 2 Facilities shall complywith 5.1.6.

5.2.7 Surface Mounted Medical Gas Rails. Level 2 Facilities shallcomply with 5.1.7.

5.2.8 Pressure and Vacuum Indicators. Level 2 Facilities shallcomply with 5.1.8.

5.2.9 Warning Systems (Level 2). Warning systems in Level 2facilities shall provide the master, area, and local alarm functionsof a Level 1 facility as required in 5.1.8, except as follows:

(a) Warning systems shall be permitted to be a single alarmpanel.

(b) The alarm panel shall be located in an area of continuoussurveillance while the facility is in operation.

(c) Pressure and vacuum switches/sensors shall be mounted atthe source equipment with a pressure indicator at the master alarmpanel.

5.2.10 Level 2 Distribution. Level 2 Facilities shall comply with5.1.10.

5.2.11 Labeling and Identification. Level 2 Facilities shall complywith 5.1.11.

5.2.12 Performance Criteria and Testing - Level 2 (Gas,Medical/Surgical Vacuum, and WAGD). Level 2 Facilities shallcomply with 5.1.12.

5.2.13 Level 2 Operation and Management. Level 2 Facilities shallcomply with 5.1.13.


5.3.1 Applicability

5.3.1.1 These requirements apply to health care facilities whichqualify to install Level 3 systems as referenced in Chapters 13through 21.

5.3.1.2 Wherever the term “medical gas” occurs, the provisionsshall apply to all piped systems for oxygen and nitrous oxide.

5.3.1.3 Wherever the term “vacuum” occurs the provisions shallapply to all piped systems for vacuum.

5.3.1.4 An existing Level 3 system that is not in strict compliancewith the provisions of this standard shall be permitted to becontinued in use as long as the authority having jurisdiction hasdetermined that such use does not constitute a distinct hazard tolife.

5.3.2 Nature of Hazards of Gas and Vacuum Systems. * Potentialfire and explosion hazards associated with medical gas systems andvacuum systems shall be considered in the design, installation,testing, operation and maintenance of these systems.

5.3.3 Level 3 Sources


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5.3.3.1 Medical Gas Supply System Identification and Labeling

5.3.3.1.1 Only cylinders and containers constructed, tested, andmaintained in accordance with U.S. Department of Transportationspecifications and regulations shall be permitted to be used.

5.3.3.1.2 Cylinder contents shall be identified by attached labelsor stencils naming the contents in accordance with CGA PamphletC-7, Guide to the Preparation of Precautionary Labeling and Marking ofCompressed Gas Containers.

5.3.3.1.3 Contents of cylinders and containers shall be verifiedprior to use.

5.3.3.1.4 Labels shall not be defaced, altered, or removed, andconnecting fittings shall not be modified.

5.3.3.1.5 Locations containing medical gases other than Oxygenshall have their door(s) labeled substantially as follows:


No Smoking or Open FlameRoom May have Insufficient Oxygen

Open Door and Allow Room to Ventilate before Entering

5.3.3.1.6 Locations containing only oxygen shall have theirdoor(s) labeled as follows:


NO Smoking or Open Flame

5.3.3.2 Supply System Operations

5.3.3.2.1 The use of adapters or conversion fittings to adapt onegas specific fitting to another shall be prohibited.

5.3.3.2.2 Only medical gas cylinders, reusable shipping containers,and their accessories shall be permitted to be stored in roomscontaining medical gas supply systems or medical gas cylinders.

5.3.3.2.3 No flammable materials, cylinders containingflammable gases or containers containing flammable liquids shallbe stored in rooms with medical gas cylinders.

5.3.3.2.4 Wooden racks for cylinder storage shall be permitted.

5.3.3.2.5 If cylinders are wrapped when received, the wrappersshall be removed prior to storage.

5.3.3.2.6 Cylinders not in use shall have their valve protection capssecured tightly in place.

5.3.3.2.7 Cylinders without correct markings or whose markingsand gas specific fittings do not match shall not be used.

5.3.3.2.8 Cryogenic liquid storage units intended to supply gas tothe facility shall not be used to transfill other liquid storage vessels.

5.3.3.2.9 Care shall be exercised when handling cylinders that havebeen exposed to freezing temperatures or containers that containcryogenic liquids to prevent injury to the skin.

5.3.3.2.10 Cylinders containing compressed gases and containersfor volatile liquids shall be kept away from radiators, steam piping,and like sources of heat.

5.3.3.2.11 When cylinder valve protection caps are supplied, theyshall be secured tightly in place unless the cylinder is connected foruse.

5.3.3.2.12 Containers shall not be stored in a tightly closed spacesuch as a closet.

5.3.3.3 Source Systems-Level 3

5.3.3.3.1 Cylinders in service and in storage shall be individuallysecured and located to prevent falling or being knocked over.

5.3.3.3.2 Locations for Medical Gas Supply Systems

5.3.3.3.2.1 Medical Gas Supply systems shall be permitted to belocated indoors or outdoors.

5.3.3.3.2.2 Air compressors and vacuum pumps shall be locatedseparately from other medical gas systems or cylinder storageenclosures.

5.3.3.3.2.3 Locations for supply systems shall not be used forstorage purposes other than for containers of nonflammable gasesexcept that storage of full or empty containers shall be permitted.

5.3.3.3.2.4 Other nonflammable medical gas supply systems orstorage locations shall be permitted to be in the same location withoxygen or nitrous oxide or both provided adequate ventilation toprevent the development of oxygen deficient atmospheres in theevent of functioning of cylinder or manifold pressure-relief devicesis provided.

5.3.3.3.2.5 Enclosures shall not be located in close proximity toopen electrical conductors and transformers.

5.3.3.3.2.6 Enclosures shall not be located adjacent to storagetanks for flammable or combustible liquids.

5.3.3.3.3 Indoor locations

5.3.3.3.3.1 Enclosures for medical gases shall serve no otherpurpose.

5.3.3.3.3.2 Enclosures shall be constructed of an assembly ofbuilding materials with a fire resistive rating of at least 1 hour.

5.3.3.3.3.3 Enclosures shall not communicate directly withanesthetizing or storage locations for flammable anesthetizingagents.

5.3.3.3.3.4 Other nonflammable (inert) medical gases shall bepermitted to be stored in the enclosure.

5.3.3.3.3.5 Flammable gases shall not be stored with oxidizingagents.

5.3.3.3.3.6 Storage of full and/or empty cylinders is permitted inthe same enclosure

5.3.3.3.4 Outdoor Locations

5.3.3.3.4.1 Storage facilities that are adjacent to a building wallshall be located such that the distance to any window of theadjacent building is greater than 7620 mm (25 ft.).

5.3.3.3.5 Doors and Gates . Enclosures for medical gas supplysystems shall be provided with doors or gates.

5.3.3.3.5.1 If the enclosure is outside and/or remote from thesingle treatment facility, it shall be kept locked.

5.3.3.3.5.2 If the storage area is within the single treatment facility(i.e., is not remote), it shall be permitted to be locked.

5.3.3.3.6 Ventilation. Enclosures for medical gas systems (e.g.oxygen and nitrous oxide) shall be ventilated.

5.3.3.3.6.1 Where the total volume of Level 3 medical gases (e.g.oxygen and nitrous oxide) connected and in storage is greater than84,950 L (3,000 ft 3) at STP, indoor supply locations shall beprovided with dedicated mechanical ventilation systems that drawair from within 300 mm (1 ft) of the floor and operatecontinuously.

5.3.3.3.6.2 The power supply for mechanical ventilation fans shallconform to the requirements of an essential electrical system asdescribed in Chapter 4 of this document.

5.3.3.3.6.3 Where the total volume of Level 3 medical gases (e.g.oxygen and nitrous oxide) connected and in storage is less than84,950 L (3,000 ft 3) at STP, natural ventilation shall be permitted tobe employed.

5.3.3.3.6.4 Where natural ventilation is permitted, it shall consist oftwo louvered openings, each having a minimum free area of 46,500mm2 (72 in. 2), with one located within 300 mm (1 ft) of the floorand one located within 300 mm (1 ft) of the ceiling.

5.3.3.3.6.5 Louvered natural ventilation openings shall not belocated in an exit access corridor.


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5.3.3.3.6.6 Mechanical ventilation shall be provided if therequirements of 5.3.3.3.6.5 cannot be met.

5.3.3.3.6.7 Heating (where required) shall be by steam, hot water,or other indirect means.

5.3.3.3.6.8 Where enclosures (interior or exterior) for medical gassupply systems are located near sources of heat, such as furnaces,incinerators, or boiler rooms, they shall be of construction thatprotects cylinders from reaching temperatures 54°C (130°F).

5.3.3.3.7 Locations for Air Compressors and Vacuum Pumps

5.3.3.3.7.1 Air compressors and vacuum pumps shall be installedin a designated mechanical equipment area, ventilated and withrequired utilities. (e.g. electricity, drains, lighting, etc.)

5.3.3.4 Medical Gas Supply Systems-Level 3

5.3.3.4.1 Mechanical means shall be provided to ensure theconnection of cylinders containing the correct gas to the pipingsystem.

5.3.3.4.1.1 Cylinder valve outlets for nonflammable gases and gasmixtures for medical purposes shall comply with CGA Pamphlet V-1, Standard far Compressed Gas Cylinder Valve Outlet and InletConnections (ANSI B57.1; CSA B96).

5.3.3.4.1.2 Threaded connections between the regulators and thepiping system shall comply with CGA Pamphlet V-5, Diameter-IndexSafety System.

5.3.3.4.2 Level 3 Medical Gas Supply Systems shall include thefollowing components:

5.3.3.4.2.1 A shutoff valve or check valve installed downstream ofeach pressure regulator.

5.3.3.4.2.2 A pressure relief valve set at 50 percent above normalline pressure installed downstream of the shutoff valve or checkvalve required in 5.3.3.4.2.1.

5.3.3.4.2.3 Pressure relief valves shall be of brass, bronze orstainless steel and designed for oxygen service.

5.3.3.4.3 Flexible connectors of other than all-metalconstruction used to connect outlets of pressure regulators to fixedpiping shall not exceed 1520 mm (5 ft) in length and shall notpenetrate walls, floors, ceilings, or partitions.

5.3.3.4.3.1 Flexible connectors shall comply with the provisions of5.3.3.4.1.2.

5.3.3.4.3.2 Flexible connectors shall have a pressure rating of atleast 6895 kPa (1000 psi) gage.

5.3.3.4.4 Supply systems supplying only a single treatment facilityshall contain the following:

5.3.3.4.4.1 Two banks of cylinders each containing the greater ofeither at least an average day's supply or:

(1) When storage is not remote, two cylinders of oxygen andone cylinder of nitrous oxide (if used).

(2) When storage is Remote, two cylinders of oxygen and twocylinders of nitrous oxide (if used).

5.3.3.4.4.2 The cylinders for each gas service shall be manifoldedso that the cylinders can alternately supply the piping system.

5.3.3.4.4.3 When the primary bank is unable to supply the system,the secondary bank shall be capable of being switched to supplythe system.

5.3.3.4.4.4 When storage is not remote, either manual or automaticswitchover shall be permitted to be used.

5.3.3.4.4.5 When the supply system is remote, automatic switchovershall be provided.

5.3.3.4.5 Supply systems supplying multiple treatment facilitiesshall contain the following:

5.3.3.4.5.1 Two banks of cylinders each containing at least thegreater of an average day's supply or two cylinders of oxygen andtwo cylinders of nitrous oxide (if used).

5.3.3.4.5.2 The cylinders for each gas service shall be manifoldedso that the cylinders can alternately supply the piping system.

5.3.3.4.5.3 When the primary bank is unable to supply the system,the secondary bank shall automatically operate to supply the pipingsystem.

5.3.3.5 Level 3 Gas Powered Devices Supply Systems

5.3.3.5.1 Level 3 Gas Powered Devices Supply Systems shall be usedwhere compressed air is required to drive dynamic devices used forpatient treatment.

5.3.3.5.1.1 A Gas Powered Devices Supply System shall bepermitted to be used to supply power to gas driven devices forscavenging but only where the exhaust of the scavenging device is aclosed vent to the outside of the building.

5.3.3.5.2 Level 3 Gas Powered Devices Supply Systems shall beobtained from and be installed under the supervision of amanufacturer(s) or supplier(s) familiar with proper practices forits construction and use.

5.3.3.5.3 Level 3 Gas Powered Devices Supply Systems shallinclude the following:

(1) Disconnect switch(es).(2) motor-starting device(s).(3) motor overload protection device(s).(4) One or more compressors.(5) For single, duplex, or multi- compressor systems, a means

for activation/deactivation of each individual compressor.(6) When multiple compressors are used, manual or automatic

means to alternate individual compressors.(7) When multiple compressors are used, manual or automatic

means to activate the additional unit(s). should the in-serviceunit(s) be incapable of maintaining adequate pressure.

(8) Intake filter-muffler(s) of the dry type.(9) receiver(s) with drain plug or a manual drain or an

automatic drain.(10) shutoff valves.(11) air dryer(s) that maintain 40 percent relative humidity at

operating pressure and temperature.(12) in-line final particulate filters rated at 5 microns, 98 percent

efficiency, with filter status indicator to ensure the delivery ofcompressed air with a maximum allowable 0.05 ppm liquid oil.

(13) pressure regulator(s).(14) pressure relief valve(15) pressure indicator.(16) moisture indicator.(17) oil indicator.(18) a reserve for cylinders shall be permitted to be used to

supplement or act as a reserve for the compressor source.

5.3.3.5.4 Receiver

5.3.3.5.4.1 Receiver(s) shall have the capacity to prevent shortcycling of the compressor(s).

5.3.3.5.4.2 Receiver(s) shall comply with Section VIII, UnfiredPressure Vessels, of the ASME Boiler and Pressure Vessel Code .

5.3.3.5.5 Moisture Indicator

5.3.3.5.5.1 The Moisture Indicator shall be located in the activeair stream prior to or after the receiver and upstream of any systempressure regulators.

5.3.3.5.5.2 The Moisture Indicator shall indicate (by colorchange, digital readout, or other method understood by the user)when the relative humidity of the compressed air exceeds 40percent at line pressure and temperature.


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5.3.3.5.6 Oil Indicator

5.3.3.5.6.1 The Oil Indicator shall be located downstream of thereceiver.

5.3.3.5.6.2 The Oil Indicator shall measure (by color change,digital readout, or other method understood by the user) an oilconcentration of 0.05 ppm +/- 0.03 ppm in air at 550 to 690 kPa (80to 100 psi) gage.

5.3.3.5.7 Source of Intake Air

5.3.3.5.7.1 Air sources for a compressor(s) located inside thebuilding shall:

(1) be located within a room where no chemical- basedmaterial is stored or used and which is not an operatory.

(2) not be taken from a room or space in which there is anopen or semi-open discharge from a Level 3 vacuum or scavengingsystem.

5.3.3.5.7.2 Air sources for a compressor(s) located outside thebuilding shall be drawn from locations where no contaminationfrom vacuum or scavenging system discharges or particulate matteris anticipated.

5.3.3.5.8 Cylinder Gas Reserves/Supplements to CompressorSources .

5.3.3.5.8.1 When used, Cylinder Reserves/Supplements forCompressor sources shall be a system of cylinders and necessarysupply equipment which will permit supplying the required supplygas as an alternative to the compressor supplied air.

5.3.3.5.8.2 When the content of one primary cylinder is unable tosupply the normal operating pressures, the secondary cylinder(s)shall be activated manually or automatically.

5.3.3.5.8.3 When used, Cylinder Gas Reserves/Supplements toCompressor Sources shall be piped into the system through acheck valve and shutoff valve located in each supply line prior tothe tee connection to the main line.

5.3.3.5.8.4 The designed operating pressure shall be below kPa(160 psi) gage.

5.3.3.5.8.5 Reserves/supplements to compressor source systemsshall either have regulator(s) mounted on the individualcylinder(s) or the cylinder(s) may be connected to a manifold viapigtail with pressure regulated at the manifold.

5.3.3.5.8.6 When Nitrogen is used as the gas in aReserves/Supplement to a Compressor Source, the following shallbe permitted to apply:

(1) The volume of nitrogen connected and in storage shall notbe considered in the limit of 84,950 L (3000 ft 3) of medical gases(e.g. oxygen and nitrous oxide) for classification as Level 3 and theventilation of enclosures.

(2) nitrogen gas cylinders shall be permitted to be stored incompressor rooms.

(3) the gas used shall be oil free, dry Nitrogen NF.

5.3.3.6 Level 3 Vacuum Sources (See Figure A.5.3.3.6.3.2 andA.5.3.3.6.3.3.)

5.3.3.6.1 Level 3 vacuum sources shall be obtained from and beinstalled under the supervision of a manufacturer(s) or supplier(s)familiar with it’s installation and use.

5.3.3.6.2 Level 3 vacuum sources shall include the following:(1) Pump or pumps suited for wet or dry service as intended in

the design.(2) If intended for wet service, a liquid/air separator.

5.3.3.6.3 Drains (See Fig A-5.3.3.6.3.)

5.3.3.6.3.1 Liquids drained from a Level 3 Vacuum source shallbe directly connected to a sanitary drainage system through atrapped and vented drain.

5.3.3.6.3.2 Where the drainage is from a waste holding tank on thesuction side of the vacuum source:

(1) a check valve shall be installed in the drain line from theholding tank.

(2) the trap in the building drainage system shall be the deep-seal type that is conventionally vented within the plumbing system.

(3) an additional vent shall be installed between the hold ingtank drain check valve and the drain trap, on the inlet side of thetrap, to close and seal the check valve while the holding tank isoperating under vacuum and collecting waste.

(4) this additional vent shall be permitted to be connected tothe plumbing system vents.

(5) both vents shall extend vertically to not less than six inchesabove the top of the holding tank before turning horizontal.

(6) the trap and drain branch shall be not less than two pipesizes larger than the waste pipe from the separator, but not lessthan DN50 (NPS 2).

(7) The trap seal shall be not less than 100 mm (4 in.) deep.(8) The vent for the vacuum check valve shall be not less than

the size of the check valve.(9) The vent for the trap shall be not less than one-half the size

of the trap and drain branch.

5.3.3.6.3.3 Where the drainage is at a positive pressure from anair/waste separator on the discharge side of the vacuum source:

(1) the trap in the building drainage system shall be the deep-seal type that is conventionally vented within the plumbing system.

(2) the trap vent shall extend vertically to not less than sixinches above the top of the separator before turning horizontal.

(3) the trap and drain branch shall be not less than two pipesizes larger than the waste pipe from the separator, but not lessthan DN40 (NPS 1-1/2).

(4) the vent shall be the full size of the trap and drain.(5) the trap seal shall be at least two times the exhaust back

pressure in the separator, but not less than 100 mm (4 in.) deep.

5.3.3.6.4 Exhausts.

5.3.3.6.4.1 The gas discharge from a Level 3 vacuum source shallbe piped to the outside.

5.3.3.6.4.2 The discharge point shall be chosen to minimize thehazards of noise.

5.3.3.6.4.3 The discharge point shall be located remote from anydoor, window or other opening in the building.

5.3.3.6.4.4 The discharge point shall be located at a different levelthan air intakes.

5.3.3.6.4.5 The discharge point shall not be located whereeffected by prevailing winds, adjacent buildings, topography orother obstacles to the rapid dispersion of the exhaust gases.

5.3.3.6.4.6 The discharge point shall be protected against the entryof insects, vermin, debris, and precipitation.

5.3.3.6.4.7 The discharge piping shall be sized to prevent backpressure greater than the pump manufacturer’s recommendations.

5.3.3.6.4.8 Where multiple pumps discharge through a commonpipe, each pump shall be fitted with a check valve, a manualisolation valve or arranged to permit capping the individual pumpexhausts when a pump is removed for service.

5.3.3.6.4.9 Where multiple pumps discharge through a commonpipe, piping shall be arranged following the pump manufacturer’srecommendations.

5.3.4 Level 3 Valves (Reserved)

5.3.5 Service Inlets and Outlets

5.3.5.1 The service outlet for Level 3 Gas Powered Devices shallnot be interchangeable with a medical air station outlet.

5.3.5.2 The service Inlet for Level 3 Vacuum shall be permitted tobe either a shutoff valve with a threaded female pipe connector or aquick connect fitting with a single check valve.

5.3.6 Level 3 Manufactured Assemblies (reserved)

5.3.7 Level 3 Surface Mounted Medical Gas Rails (reserved)

5.3.8 Level 3 Pressure and Vacuum Indicators (reserved)

5.3.9 Level 3 Warning Systems


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5.3.9.1 Warning systems for medical gases (e.g. oxygen and nitrousoxide) in Level 3 facilities shall provide the alarm functions of aLevel 1 facility as required in 5.1.9, except as follows:

(a) Area and local alarms shall not be required.(b) Warning systems shall be permitted to have a single alarm

panel.(c) The alarm panel shall be located in an area of continuous

surveillance while the facility is in operation.(d) Pressure switches/sensors that monitor main line pressure

shall be mounted at the source equipment with a pressureindicator at the alarm panel.

(e) Changeover alarms to suit the arrangement of the sourceequipment shall be provided.

5.3.9.2 Systems for gases such as compressed air or nitrogen usedto power devices, as well as Level 3 vacuum systems, shall not berequired to have warning systems.

5.3.10 Level 3 Distribution

5.3.10.1 Piping Materials for Field-Installed Level 3 Positive-Pressure Gas Systems

5.3.10.1.1 Piping for Medical Gases. Piping for Level 3 positive-pressure nonf lammable medical gases (e.g. oxygen and nitrousoxide) shall meet the following requirements:

5.3.10.1.1.1 Tubes, valves, fittings, station outlets, and other pipingcomponents in medical gas systems shall have been cleaned foroxygen service by the manufacturer prior to installation inaccordance with CGA 4.1 Cleaning Equipment for Oxygen Service.

5.3.10.1.1.2 Each length of tube shall be delivered plugged orcapped by the manufacturer and kept sealed until prepared forinstallation.

5.3.10.1.1.3 Fittings, valves, and other components shall bedelivered sealed and labeled by the manufacturer and kept sealeduntil prepared for installation.

5.3.10.1.1.4 Tubes shall be hard drawn seamless copper ASTM B819 medical gas tube, Type L or K.

5.3.10.1.1.5 ASTM B 819 medical gas tube shall be identified by themanufacturer's markings "OXY", "MED", "OXY/MED","OXY/ACR", or "ACR/MED" in blue (Type L) or green (Type K).

5.3.10.1.2 Piping for Level 3 Gas-Powered Devices. Tubes shall behard drawn seamless copper; either ASTM B 819 medical gas tube(Type K or L), ASTM B 88 water tube (Type K or L), or ASTM B280 ACR tube (O.D. size), except that tube installed undergroundor within floor slabs shall be permitted to be soft annealed temper.

5.3.10.2 Piping Materials for Field-Installed Level 3 VacuumSystems

5.3.10.2.1 In copper piping systems, the tubes shall be harddrawn seamless copper, either ASTM B 819 medical gas tube (TypeK or L), ASTM B 88 water tube (Type K, L, or M), or ASTM B 280ACR tube (O.D. size).

5.3.10.2.2 Copper tube installed underground or within floor slabsshall be permitted to be soft annealed temper.

5.3.10.2.3 In plastic piping systems, the pipe shall bepolyvinylchoride (PVC) plastic, schedule 40 minimum.

5.3.10.3 Fittings

5.3.10.3.1 Turns, offsets, and other changes in direction in medicalgas piping, copper level 3 vacuum piping and piping for gas-powered devices shall be made with brazed wrought coppercapillary fittings complying with ANSI B16.22, Wrought Copper andCopper Alloy Solder-Joint Fittings , or brazing fittings complying withMSS SP-73, Brazed Joints for Wrought and Cast Copper Alloy Solder JointPressure Fittings .

5.3.10.3.2 Cast copper alloy fittings shall not be used where jointsare brazed.

5.3.10.3.3 Branch connections in copper vacuum piping systemsshall be permitted to be made using mechanically-formed, drilled,and extruded tee-branch connections that are formed inaccordance with the tool manufacturer's instructions, and brazed.

5.3.10.3.4 Turns, off sets, and other changes in direction in plasticLevel 3 vacuum piping shall be made with solvent-cemented PVCplastic pressure fittings, schedule 40 minimum.

5.3.10.4 Threaded Joints. Threaded joints in Level 3 gas andvacuum distribution piping shall be:

(a) limited to connections to pressure/vacuum indicators,alarm devices, and source equipment.

(b) tapered pipe threads complying with ANSI B1.20.1, PipeThreads, General Purpose.

(c) made up with polytetraflouroethylene (such as Teflon ™)tape or other thread sealant recommended for oxygen service, withthe sealant applied to the male threads only.

5.3.10.5 Soldered Joints. Soldered joints in copper Level 3vacuum piping shall be made in accordance with ASTM B 828,Making Capillary Joints by Soldering of Copper and Copper Alloy Tubeand Fittings, using a "lead-free" solder filler metal containing notmore than 0.2% lead by volume.

5.3.10.6 Solvent-Cemented Joints. Solvent-cemented joints inplastic Level 3 vacuum piping shall be in accordance with ASTM D2855, Practice for Making Solvent-Cemented Joints in PolyVinyl Chloride(PVC) Pipe and Fittings.

5.3.10.7 Brazed Joints

5.3.10.7.1 General Requirements

5.3.10.7.1.1 Brazed joints shall be made using a brazing alloy thatexhibits a melting temperature in excess of 538°C (1000°F) toretain the integrity of the piping system in the event of fireexposure.

5.3.10.7.1.2 Brazed tube joints shall be the socket type.

5.3.10.7.1.3 Filler metals shall bond with and be metallurgicallycompatible with the base metals being joined.

5.3.10.7.1.4 Filler metals shall comply with ANSI/AWS A.5.8,Specification for Brazing Filler Metal.

5.3.10.7.1.5 Copper-to-copper joints shall be brazed using acopper-phosphorus or copper-phosphorous-silver brazing fillermetal (BCuP series) without flux.

5.3.10.7.1.6 Joints to be brazed in place shall be accessible fornecessary preparation, assembly, heating, filler application,cooling, cleaning, and inspection.

5.3.10.7.2 Cutting Tube Ends

5.3.10.7.2.1 Tube ends shall be cut square using a sharp tubingcutter to avoid deforming the tube.

5.3.10.7.2.2 The cutting wheels on tubing cutters shall be free fromgrease, oil, or other lubricant not recommended for oxygenservice.

5.3.10.7.2.3 The cut ends of the tube shall be deburred with asharp, clean deburring tool, taking care to prevent chips fromentering the tube.

5.3.10.7.3 Cleaning Joints for Brazing

5.3.10.7.3.1 The interior surfaces of tubes, fittings and othercomponents that are cleaned for oxygen service shall be stored andhandled to avoid contamination prior to assembly and brazing.

5.3.10.7.3.2 The exterior surfaces of tube ends shall be cleanedprior to brazing to remove any oxides and surface dirt and toroughen the surfaces to prepare them for brazing.

5.3.10.7.3.3 If the interior surfaces of fitting sockets that werecleaned for oxygen become contaminated prior to brazing, theyshall be re-cleaned for oxygen in accordance with 5.3.10.7.3.9 andbe cleaned for brazing with a clean, oil-free wire brush.


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5.3.10.7.3.4 Non-abrasive pads (such as Scotchbrite™) shall beused to clean the exterior surfaces of tube ends.

5.3.10.7.3.5 The use of steel wool or sand cloth shall beprohibited.

5.3.10.7.3.6 The cleaning process shall not result in grooving of thesurfaces to be joined.

5.3.10.7.3.7 After being abraded, the surfaces shall be wiped usinga clean, lint-free white cloth.

5.3.10.7.3.8 Tubes, fittings, valves, and other components shall bevisually examined internally before being joined to verify that theyhave not become contaminated for oxygen service (if so required)and that they are free of obstructions or debris.

5.3.10.7.3.9 The interior surfaces of tube ends, fittings, and othercomponents that were cleaned for oxygen service by themanufacturer, but become contaminated prior to being installed,shall be permitted to be re-cleaned on-site by the installer bythoroughly scrubbing the interior surfaces with a clean, hotwater/alkaline solution, such as sodium carbonate or trisodiumphosphate, mixed 450 g to 11 liters (1 lb to 3 gal) of potable waterand thoroughly rinsing them with clean, hot potable water.

5.3.10.7.3.10Other aqueous cleaning solutions shall be permitted tobe used for on-site re-cleaning permitted in 5.3.10.7.3.9 providedthat they are as recommended in CGA Pamphlet G-4.1, CleaningEquipment for Oxygen Service, and are listed in CGA Pamphlet O2-DIR, Directory of Cleaning Agents for Oxygen Service.

5.3.10.7.3.11Material that has become contaminated internally andis not clean for oxygen service (if so required) shall not beinstalled.

5.3.10.7.3.12 Joints shall be brazed within one hour after thesurfaces are cleaned for brazing.

5.3.10.7.4 Brazing Dissimilar Metals

5.3.10.7.4.1 Flux shall only be used when brazing dissimilar metalssuch as copper and bronze or brass, using a silver (BAg series)brazing filler metal.

5.3.10.7.4.2 Surfaces shall be cleaned for brazing in accordancewith 5.3.10.7.3.

5.3.10.7.4.3 Flux shall be applied sparingly to minimizecontamination of the inside of the tube with flux.

5.3.10.7.4.4 The flux shall be applied and worked over the cleanedsurfaces to be brazed using a stiff stainless steel bristle brush toensure complete coverage and wetting of the surfaces with flux.

5.3.10.7.4.5 Where possible, short sections of copper tube shall bebrazed on to the non-copper component and the interior of thesubassembly shall be cleaned of flux prior to installation in thepiping system.

5.3.10.7.4.6 On joints DN20 (NPS 3/4) (7/8 in. O.D.) size andsmaller, flux-coated brazing rods shall be permitted to be used inlieu of applying flux to the surfaces being joined.

5.3.10.7.5 Nitrogen Purge

5.3.10.7.5.1 While being brazed, joints shall be continuouslypurged with oil free, dry Nitrogen NF to prevent the formation ofcopper oxide on the inside surfaces of the joint.

5.3.10.7.5.2 The source of the purge gas shall be monitored andthe installer shall be audibly alerted when the content is low.

5.3.10.7.5.3 The purge gas flow rate shall not produce a positivepressure in the piping system.

5.3.10.7.5.4 The purge gas flow rate shall be controlled by the useof a pressure regulator and flow meter, or combination thereof.

5.3.10.7.5.5 Pressure regulators alone shall not be used to controlpurge gas flow rates.

5.3.10.7.5.6 During and after installation, openings in the pipingsystem shall be kept capped or plugged to maintain a nitrogenatmosphere within the piping and to prevent debris or othercontaminants from entering the system.

5.3.10.7.5.7 While a joint is being brazed, a discharge opening shallbe provided on the opposite side of the joint from where the purgegas is being introduced.

5.3.10.7.5.8 The flow of purge gas shall be maintained until thejoint is cool to the touch.

5.3.10.7.5.9 After the joint has cooled, the purge discharge openingshall be plugged or capped to prevent contamination of the insideof the tube and maintain the nitrogen atmosphere within thepiping system.

5.3.10.7.5.10 The final connection of new piping to an existingin-use pipeline shall be permitted to be made without the use of anitrogen purge.

5.3.10.7.5.11 After a final connection in a Level 3 positive-pressure gas pipeline is made without a nitrogen purge, an outletin the immediate downstream zone of the affected portion(s) ofboth the new and existing in-use piping shall be tested inaccordance with 5.3.12.3.9 Final Tie-in Test .

5.3.10.7.6 Assembling and Heating Joints

5.3.10.7.6.1 Tube ends shall be inserted fully into the socket of thefitting.

5.3.10.7.6.2 Where flux is permitted, the joint shall be heatedslowly until the flux has liquefied.

5.3.10.7.6.3 After flux is liquefied, or where flux is not permitted tobe used, the joint shall be heated quickly to the brazingtemperature, taking care not to overheat the joint.

5.3.10.7.6.4 Techniques for heating the joint, applying the brazingfiller metal, and making horizontal, vertical, and large-diameterjoints shall be as stated in sections on "Applying Heat and Brazing"and "Horizontal and Vertical Joints" in Chapter VII - "Brazed Joints"in the CDA Copper Tube Handbook .

5.3.10.7.7 Inspection of Brazed or Soldered Joints

5.3.10.7.7.1 After brazing or soldering, the outside of all joints shallbe cleaned by washing with water and a wire brush to remove anyresidue and permit clear visual inspection of the joint.

5.3.10.7.7.2 Where flux has been used, the wash water shall be hot.

5.3.10.7.7.3 Each joint shall be visually inspected after cleaning theoutside surfaces.

5.3.10.7.7.4 Joints exhibiting the following conditions shall not bepermitted:

(1) Flux or flux residue (when flux or flux coated BAg rods areused with dissimilar metals).

(2) Base metal melting or erosion.(3) Unmelted filler metal.(4) Failure of the filler metal to be clearly visible all the way

around the joint at the interface between the socket and the tube.(5) Cracks in the tube or component.(6) Cracks in the braze or solder filler metal.(7) Failure of the joint to hold the test pressure or vacuum

under the installer-performed initial pressure or vacuum test(5.3.12.2.3 or 5.3.2.12.2.4) and standing pressure or vacuum test(5.3.12.2.7 or 5.3.12.2.8).

5.3.10.7.7.5 Joints that are identified as defective under 5.3.10.7.7.4,conditions (2 ) or (5) shall be replaced.

5.3.10.7.7.6 Joints that are found to be defective under 5.3.10.7.7.4,conditions (1), (3), (4), (6) or (7) shall be permitted to berepaired, except that no joint shall be reheated more than oncebefore being replaced.

5.3.10.8 Spec ial Joints

5.3.10.8.1 The following joints shall be prohibited throughout Level3 medical gas (e.g. oxygen and nitrous oxide) pipeline systems:


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(1) flared and compression connections, including connectionsto station outlets and inlets, alarm devices, and other components.

(2) other straight-threaded connections, including unions.5.3.10.8.2 Flared and compression connections shall bepermitted in piping for Level 3 gas-powered devices and Level 3vacuum in junction boxes, and where exposed at stationoutlets/inlets and source equipment.

5.3.10.9 Special Fittings. The following special fittings shall bepermitted to be used in lieu of brazed joints:

(1) memory-metal couplings having temperature and pressureratings joints not less than that of a brazed joint.

(2) listed or approved metallic gas tube fittings that, when madeup, provide a permanent joint having the mechanical, thermal, andsealing integrity of a brazed joint.

5.3.10.10 Installation of Level 3 Piping and Equipment

5.3.10.10.1 Qualification of Installers

5.3.10.10.1.1The installation of Level 3 gas and vacuum systemsshall be made by qualified, competent technicians who areexperienced in making such installations.

5.3.10.10.1.2The installers of Level 3 medical gas systems (e.g.oxygen and nitrous oxide) shall be qualified under therequirements of ASSE 6010 - Medical Gas Systems InstallersProfessional Qualifications Standard.

5.3.10.10.1.3Brazing shall be performed by individuals who arequalified under the provisions of 5.3.10.10.15.

5.3.10.10.1.4 Prior to any installation work involving brazing,the installer of Level 3 medical gas piping shall providedocumentation for the qualification of brazing procedures andindividual brazers that is required under 5.3.10.10.15.

5.3.10.10.2 Pipe Sizing. Piping systems shall be designed and sizedto deliver the required flow rates at the utilization pressures.

5.3.10.10.3 Minimum Pipe Sizes

5.3.10.10.3.1Mains, branches, and drops to individual serviceoutlets in Level 3 oxygen piping systems shall be not less than DN10(NPS 3/8) (1/2 in. O.D.) size.

5.3.10.10.3.2Mains, branches, and drops to individual serviceoutlets and inlets in the following piping systems shall be not lessthan DN8 (NPS 1/4) (3/8 in. O.D.) size:

(1) Level 3 medical gases other than oxygen (e.g. nitrous oxide)(2) gas-powered devices(3) Level 3 vacuum

5.3.10.10.3.3Runouts to alarm panels and connecting tubing forpressure/vacuum indicators and alarm devices shall be permittedto be DN8 (NPS 1/4) (3/8 in. O.D.) size.

5.3.10.10.4 Protection of Piping. Piping shall be protectedagainst freezing, corrosion, and physical damage.

5.3.10.10.4.1Piping exposed in corridors and other areas wheresubject to physical damage from the movement of carts, stretchers,portable equipment, or vehicles shall be protected.

5.3.10.10.4.2Piping underground within buildings or embedded inconcrete floors or walls shall be installed in a continuous conduit.

5.3.10.10.5 Location of Piping. Piping for Level 3 medicalgases, Level 3 gas-powered devices, and Level 3 vacuum systemsshall be located as follows:

5.3.10.10.5.1Piping shall be installed overhead wherever possible.

5.3.10.10.5.2 Piping shall not be installed in electricalswitchgear rooms, elevator shafts, and areas having open flames.

5.3.10.10.5.3 Medical gas piping (e.g. oxygen and nitrousoxide) shall not be located where subject to contact with oil.

5.3.10.10.6 Pipe Support

5.3.10.10.6.1Piping shall be supported from the building structurein accordance with MSS Standard Practice SP-69, Piping Hangersand Supports - Selection and Application.

5.3.10.10.6.2Hangers and supports shall comply with MSS StandardPractice SP-58 - Pipe Hangers and Supports - Materials, Design, andManufacture.

5.3.10.10.6.3Hangers for copper tube shall be sized for copper tubeand have a copper finish.

5.3.10.10.6.4 In potentially damp locations, copper tube hangersand supports that are in contact with the tube shall be plastic-coated or otherwise be electrically insulated from the tube.

5.3.10.10.6.5Maximum support spacing for copper tubing shall bein accordance with Table 5.3.10.10.6.5.

Table 5.3.10.10.6.5Maximum Pipe Support SpacingPipe Size Hanger Spacing

DN8 (NPS 1/4) (3/8 in.O.D.)

1520 mm (5 ft)

DN10 (NPS 3/8) (1/2 in.O.D.)

1830 mm (6 ft)

DN15 (NPS 1/2) (5/8 inO.D.)

1830 mm (6 ft)

DN20 (NPS 3/4) 7/8 in.O.D.)

2130 mm (7 ft)

DN25 (NPS 1) 1-1/8 in.O.D.)

2440 mm (8 ft)

DN 32 (NPS 1-1/4)(1-3/8 in. O.D.) 2740 mm (9ft)

DN40 (NPS 1-1/2) (1-5/8 in. O.D.) and larger 3050 mm (10 ft)

Vertical risers, all sizes Every floor, but notto exceed 4570 mm

(15 ft)

5.3.10.10.6.6 PVC plastic piping for Level 3 vacuum systems shallbe supported at a maximum spacing of 1220 mm (4 ft), except thatvertical piping shall be supported at every floor and with mid-storyguides.

5.3.10.10.6.7 Where required, Level 3 gas and vacuum piping shallbe seismically restrained against earthquakes in accordance withthe applicable building code.

5.3.10.10.7 Piping Within Floor Slabs and Underground WithinBuildings. The following conditions shall be permitted only whenpiping must be installed within a floor slab or underground withina building in order to reach the service outlets or inlets served.

5.3.10.10.7.1 Tubes shall be permitted to be annealed soft temperseamless copper tube up to DN10 (NPS 3/8) (1/2 in. O.D.)maximum size.

5.3.10.10.7.2 Tubes shall have been cleaned for oxygen service inaccordance with CGA Pamphlet G-4.1, Cleaning Equipment for OxygenService.

5.3.10.10.7.3 The tube(s) shall be installed in one (or more)continuous conduits that are of sufficient size to permit subsequentinstallation, removal, and replacement of the gas and/or vacuumlines.

5.3.10.10.7.4 Each tube pulled into the conduit shall be acontinuous length having no joints within the conduit.

5.3.10.10.8 Underground Piping Outside of Buildings

5.3.10.10.8.1 Underground piping outside of buildings shall beinstalled below the local level of frost penetration.

5.3.10.10.8.2 Underground piping shall be installed in a continuosenclosure to protect the pipe during backfilling.

5.3.10.10.8.3 The continuous enclosure shall be split or otherwiseprovide access at the joints during visual inspection and leaktesting.


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5.3.10.10.8.4 Underground piping that will be subject to surfaceloads shall be buried at a depth that will protect the piping and itsenclosure from excessive stresses.5.3.10.10.8.5 The minimum backfilled cover above the top of theenclosure for underground piping outside of buildings shall be 920mm (36 in.), except that the minimum cover shall be permitted tobe reduced to 460 mm (18 in.) where the pipeline is not subject tophysical damage.

5.3.10.10.8.6 Trenches shall be excavated so that the pipeenclosure has firm, substantially continuous bearing on the bottomof the trench.

5.3.10.10.8.7 Backfill shall be clean and compacted so as to protectand uniformly support the pipe enclosure.

5.3.10.10.8.8 A continuous tape or marker placed immediatelyabove the enclosure shall clearly identify the pipeline by specificname.

5.3.10.10.8.9 A continuous warning means shall also be providedabove the pipeline enclosure at approximately one-half the depthof bury.

5.3.10.10.8.10 Where underground piping is installed through awall sleeve, the ends of the sleeve shall be sealed to prevent theentrance of ground water into the building.

5.3.10.10.9 Branch Takeoffs. Runouts from horizontal pipingshall be taken off above the centerline of the main or branch pipeand rise vertically or at an angle of not less than 45 degrees fromvertical.

5.3.10.10.10 Special Requirements for Level 3 Vacuum Piping

5.3.10.10.10.1 Horizontal piping in Level 3 vacuum systemsshall be sloped a minimum of 7 mm per 3050 mm (1/4 in. per 10ft) toward the vacuum source equipment.

5.3.10.10.10.2 Horizontal piping shall include no sags or lowpoints that will permit fluids or debris to accumulate.

5.3.10.10.10.3 Accessible clean outs shall be provided wherenecessary to clear the piping of obstructions.

5.3.10.10.11 Hoses and Flexible Connectors

5.3.10.10.11.1 Hose and flexible connectors, both metallic andnon-metallic, shall be no longer than necessary and shall notpenetrate or be concealed in walls, floors, ceilings, or partitions.

5.3.10.10.11.2 Flexible connectors, metallic or non-metallic, shallhave a minimum burst pressure of 6895 kPa (1000 psi) gage.

5.3.10.10.12 Prohibited System Interconnections

5.3.10.10.12.1 Two or more piping systems for medical gases, gas-powered devices, and Level 3 vacuum shall not be interconnectedfor testing or any other reason.

5.3.10.10.12.2 Leak testing shall be accomplished by separatelycharging and testing each individual piping system.

5.3.10.10.13 System Manufacturer's Instructions

5.3.10.10.13.1 The installation of individual components shall bemade in accordance with the instructions of the systemmanufacturer.

5.3.10.10.13.2 Such instructions shall include directions andinformation deemed by the system manufacturer to be necessaryfor attaining proper operation, testing, and maintenance of thesystem.

5.3.10.10.13.3 Copies of system manufacturer's instructions shall beleft with the system owner.

5.3.10.10.14 Changes in System Use

5.3.10.10.14.1 Where a Level 3 positive pressure gas pipingdistribution system originally used or constructed for use at onepressure or for one gas is converted for operation at anotherpressure or for another gas, all provisions of 5.3.10 shall apply as ifthe system were new.

5.3.10.10.14.2 Piping for Level 3 gas-powered devices or Level 3vacuum shall not be permitted to be converted for use as a medicalgas piping system (e.g. oxygen or nitrous oxide).

5.3.10.10.15 Qualification of Brazing Procedures and Brazing

5.3.10.10.15.1 Brazing procedures and brazer performance for theinstallation of Level 3 brazed piping shall be qualified the same asfor Level 1 piping, in accordance with either Section IX, Weldingand Brazing Qualifications, of the ASME Boiler and Pressure VesselCode, or AWS B2.2, Standard for Brazing Procedure and PerformanceQualifications, both as modified below.

5.3.10.10.15.2 Brazers shall be qualified by visual examination ofthe test coupon followed by sectioning.

5.3.10.10.15.3 The Brazing Procedure Specification shall addresscleaning, joint clearance, overlap, internal purge gas, purge gasflow rate, and filler metal.

5.3.10.10.15.4 The Brazing Procedure Specification and the Recordof Brazer Performance Qualification shall document filler metalused, cleaning, joint clearance, overlap, internal purge gas andflow rate during brazing of coupon, and the absence of internaloxidation in the completed coupon.

5.3.10.10.15.5 Brazing procedures qualified by a technicallycompetent group or agency shall be permi tted under the followingconditions:

(1) The Brazing Procedure Specification and the ProcedureQualification Record meets the requirements of this standard.

(2) The employer obtains a copy of both the Brazing ProcedureSpecification and the supporting qualification records from thegroup or agency and signs and dates these records, therebyaccepting responsibility for the qualifications that were performedby the group or agency.

(3) The employer qualifies at least one brazer following eachBrazing Procedure Specification used.

5.3.10.10.15.6 An employer shall be permitted to accept BrazerQualification Records of a previous employer under the followingconditions:

(1) The brazer has been qualified following the same or anequivalent procedure that the new employer uses.

(2) The new employer obtains a copy of the record of BrazerPerformance Qualification tests from the previous employer andsigns and dates these records, thereby accepting responsibility forthe qualifications performed by the previous employer.

5.3.10.10.15.7 Performance qualifications of brazers shall remainin effect indefinitely unless the brazer does not braze with thequalified procedure for a period exceeding 6 months, or there is aspecific reason to question the ability of the brazer.

5.3.11 Labeling and Identification

5.3.11.1 Pipe Labeling

5.3.11.1.1 Piping shall be labeled by stenciling or adhesive markersthat identify the system.

5.3.11.1.2 Pipe labels shall show the name of the gas/vacuumsystem or the chemical symbol.

5.3.11.1.3 Where positive pressure gas piping systems operate atpressures other than the standard 345 to 380 kPA (50 to 55 psi)gage or to 1275 kPa (160 to 185 psi) gage for nitrogen, the pipelabels shall include the nonstandard operating pressure in additionto the name or symbol of the gas.

5.3.11.1.4 Pipe labels shall be located as follows:(1) At intervals of not more than 6100 mm (20 ft)(2) At least once in or above every room(3) On both sides of walls or partitions penetrated by the

piping(4) At least once in every story height traversed by risers

5.3.11.2 Shutoff Valves

5.3.11.2.1 Shutoff valves shall be identified as to the following:(1) The name or chemical symbol for the specific system(2) The name of the room(s) or area(s) served.(3) A caution to not close (or open) the valve except in an

emergency.


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5.3.11.2.2 Where positive pressure gas systems operate at pressuresother than the standard 345 to 380 kPA (50 to 55 psi) gage or to1275 kPa (160 to 185 psi) gage for nitrogen, the valve identificationshall also include the nonstandard operating pressure.

5.3.11.3 Service Outlets and Inlets

5.3.11.3.1 Service outlets and inlets shall be identified as to thename or chemical symbol for the specific gas or vacuum provided.

5.3.11.3.2 Where positive pressure gas systems operate at pressuresother than the standard 345 to 380 kPa (50 to 55 psi) gage or to1275 kPa (160 to 185 psi) gage for nitrogen, the station outletidentification shall include the nonstandard operating pressure.

5.3.12 Performance Criteria and Testing--Level 3 (Medical Gas,Gas-Powered Devices, Vacuum)

5.3.12.1 General

5.3.12.1.1 Inspection and testing shall be performed on all newpiped gas systems, additions, renovations, temporary installations,or repaired systems, to assure the facility, by a documentedprocedure, that all applicable provisions of this document havebeen adhered to and system integrity has been achieved ormaintained.

5.3.12.1.2 Inspection and testing shall include all components ofthe system or portions thereof including, but not limited to,medical gas source(s), compressed air source systems (e.g.,compressors, dryers, filters, regulators), alarms and monitoringsafeguards, pipelines, isolation valves, and service outlets andinlets.

5.3.12.1.3 All systems that are breached and components that aresubjected to additions, renovations, or replacement (e.g., newmedical gas sources, compressors, dryers, alarms) shall beinspected and tested.

5.3.12.1.4 Systems shall be deemed breached at the point ofpipeline intrusion by physical separation or by system componentremoval, replacement, or addition.

5.3.12.1.5 Breached portions of the systems subject to inspectionand testing shall be confined to only the specific altered zone andcomponents in the immediate zone or area that is locatedupstream for vacuum systems and downstream for pressure gases atthe point or area of intrusion.

5.3.12.1.6 The inspection and testing reports shall be submitteddirectly to the party that contracted for the testing, who shallsubmit the report through channels to the responsible authorityand any others that are required.

5.3.12.1.7 Reports shall contain detailed listings of all findings andresults.

5.3.12.1.8 The responsible facility authority shall review theseinspection and testing records prior to the use of any systems toassure that all findings and results of the inspection and testinghave been successfully completed.

5.3.12.1.9 All documentation pertaining to inspections and testingshall be maintained on-site within the facility.

5.3.12.1.10 Before piping systems are initially put into use, theLevel 3 health care facility authority shall be responsible forascertaining that the gas/vacuum delivered at each outlet/inlet isthat shown on the outlet/inlet label and that the proper connectingfittings are installed for the specific gas/vacuum. See 5.3.12.1.11.

5.3.12.1.11 Acceptance of the Verifier’s reports required under5.3.12.3.1.8 under 5.3.12.3 -System Verification shall be permittedto satisfy the requirements of 5.3.12.1.10.

5.3.12.2 Initial Tests

5.3.12.2.1 General

5.3.12.2.1.1 The tests required by this section shall be performedprior to the tests listed in 5.3.12.3 System Verification by one ormore of the following:

(1) the installer.(2) a representative of the system supplier.

(3) a representative of the system manufacturer.5.3.12.2.1.2 The test gas for positive-pressure gas systems shall beoil free, dry Nitrogen NF.

5.3.12.2.1.3 Where manufactured assemblies are to be installed,the tests required under 5.3.12.2 shall be performed:

(1) After completion of the distribution piping(2) Prior to installation or connection of manufactured

assemblies supplied through flexible hoses or flexible tubing(3) At all station outlets/inlets on manufactured assemblies

supplied through copper tubing

5.3.12.2.2 Initial Blow Down. Piping in Level 3 positive-pressuregas distribution systems shall be blown clear by means of oil free,dry Nitrogen NF as follows:

(1) After installation of the distribution piping(2) Before installation of station outlets and other system

component (e.g., pressure alarm devices, pressure indicators,pressure relief valves, manifolds, source equipment).

5.3.12.2.3 Initial Pressure Test for Positive-Pressure Gas Systemsand Copper Level 3 Vacuum Piping

5.3.12.2.3.1 Each section of the piping in Level 3 positive-pressuregas piping systems and copper Level 3 vacuum systems shall bepressure tested using oil free, dry Nitrogen NF.

5.3.12.2.3.2 Initial pressure tests shall be conducted as follows:(1) After installation of station outlets/inlets rough-in

assemblies. Test caps shall be permitted to be used.(2) Prior to the installation of components of the distribution

piping system that would be damaged by the test pressure (e.g.pressure/ vacuum alarm devices, pressure/ vacuum indicators, linepressure relief valves).

5.3.12.2.3.3 Where Level 3 vacuum piping systems include plasticpiping, they shall be inspected to assure that there are no visiblecross-connections to positive-pressure gas piping systems prior toapplying test pressures to the positive-pressure systems.

5.3.12.2.3.4 The source shutoff valves for all piping systems shallremain closed during these tests.

5.3.12.2.3.5 The test pressure for positive pressure gas piping shallbe 1.5 times the system working pressure but not less than 1035 kPa(150 psi) gage.

5.3.12.2.3.6 The test pressure for copper Level 3 vacuum pipingshall be 105 kPa (15 psi) gage.

5.3.12.2.3.7 The test pressure shall be maintained until each jointhas been examined for leakage by means of soapy water or otherequally effective means of leak detection.

5.3.12.2.3.8 Leaks, if any, shall be located, replaced (if permitted)or repaired (if required) and retested.

5.3.12.2.4 Initial Leak Tests - PVC Level 3 Vacuum Piping. PlasticLevel 3 vacuum piping shall be leak-tested under vacuumconditions.

5.3.12.2.4.1 Plastic Level 3 vacuum piping shall not be tested withcompressed gas.

5.3.12.2.4.2 Leak tests shall be conducted after installation ofstation inlets.

5.3.12.2.4.3 The piping being tested shall be subjected to a vacuumof not less than 485 mm (19 in.) gage HgV, using either thevacuum source equipment or a vacuum test pump.

5.3.12.2.4.4 The test vacuum shall be maintained until each jointhas been examined for leakage.

5.3.12.2.5 Initial Cross-Connection Test. The installer shalldetermine that no cross connections exist between the variousLevel 3 gas and vacuum piping systems.

5.3.12.2.5.1 All level 3 gas and vacuum piping systems shall be atatmospheric pressure.

5.1.12.2.5.2 Face plates for outlets/inlets shall be installed.


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5.3.12.2.5.3 Level 3 vacuum piping systems shall be subjected to avacuum of not less than 485 mm (19 in.) gage HgV, using eitherthe vacuum source equipment or a test pump.

5.3.12.2.5.4 Each individual system gas outlet and vacuum inlet ineach piping system shall be checked to determine that the vacuumis present only at the inlets for the vacuum system being tested.

5.3.12.2.5.5 The vacuum piping system shall be relieved toatmospheric pressure.

5.3.12.2.5.6 The test gas for all positive-pressure gas piping systemsshall be oil free, dry Nitrogen NF.

5.3.12.2.5.7 Sources of test gas and vacuum shall be disconnectedfrom all piping systems except for the one system being tested.

5.3.12.2.5.8 The positive-pressure gas system being tested shall bepressurized to 345 kPa (50 psi) gage with oil free, dry Nitrogen NF.

5.3.12.2.5.9 Each individual system gas outlet and vacuum inlet ineach installed piping system shall be checked to determine that thetest gas is being dispensed only from the outlets in the pipingsystem being tested.

5.3.12.2.5.10 The cross–connection test shall be repeated for eachinstalled positive-pressure gas piping system.

5.3.12.2.5.11 The proper labeling and identification of systemoutlets/inlets shall be confirmed during these tests.

5.3.12.2.6 Initial Piping Purge Test. The outlets in each Level 3positive-pressure gas piping system shall be purged to remove anyparticulate matter from the distribution piping.

5.3.12.2.6.1 The test gas shall be oil free, dry Nitrogen NF.

5.3.12.2.6.2 Using appropriate adapters, each outlet shall bepurged with an intermittent high-volume flow of test gas until thepurge produces no discoloration in a clean white cloth.

5.3.12.2.6.3 The purging shall be started at the furthest outlet inthe system and proceed towards the source equipment.

5.3.12.2.7 Initial Standing Pressure Test for Positive Pressure GasPiping. After successful completion of the initial pressure testsunder 5.3.12.2.3, Level 3 positive-pressure gas distribution pipingshall be subjected to a standing pressure test.

5.3.12.2.7.1 Tests shall be conducted after the installation ofstation outlet valve bodies and face plates, and other distributionsystem components (e.g. pressure alarm devices, pressureindicators, and line pressure relief valves).

5.3.12.2.7.2 The source valve shall be closed during this test.

5.3.12.2.7.3 The piping systems shall be subjected to a 24-hourstanding pressure test using oil free, dry Nitrogen NF.

5.3.12.2.7.4 Test pressures shall be 20 percent above the normalsystem operating line pressure.

5.3.12.2.7.5 At the conclusion of the tests, there shall be no changein the test pressure greater than 35 kPa (5 psi) gage.

5.3.12.2.7.6 Leaks, if any, shall be located, repaired (if permitted),replaced (if required) and retested.

5.3.12.2.8 Initial Standing Vacuum Test for Vacuum Systems.Level 3 vacuum systems, with either plastic or copper piping, shallbe subjected to a standing vacuum test.

5.3.12.2.8.1 The piping system shall be subjected to a vacuum ofnot less than 485 mm (19 in.) HgV gage for 24 hours, using eitherthe vacuum source equipment or a test source.

5.3.12.2.8.2 During the test, the source of test vacuum shall bedisconnected from the piping system.

5.3.12.2.8.3 At the conclusion of the test, the vacuum shall nothave reduced to less the 300 mm (12 in.) HgV.

5.3.12.2.8.4 Leaks, if any, shall be located, repaired (if permitted),replaced (if required) and retested.

5.3.12.3 System Verification

5.3.12.3.1 General

5.3.12.3.1.1 Verification tests shall be performed only after all testsrequired in 5.3.12.2 - Initial Tests have been completed.

5.3.12.3.1.2 The test gas shall be oil free, dry Nitrogen NF or thesystem gas where permitted.

5.3.12.3.1.3 Testing shall be conducted by a party technicallycompetent and experienced in the field of Level 3 gas and vacuumsystem verification and meeting the requirements of ANSI/ASSEStandard 6030, Medical Gas Verifiers Professional QualificationsStandard.

5.3.12.3.1.4 Testing shall be performed by a party other than theinstalling contractor.

5.3.12.3.1.5 All tests required under 5.3.12.3 shall be performedafter installation of any manufactured assemblies supplied throughflexible hoses or tubing.

5.3.12.3.1.6 Where manufactured assemblies include multiplepossible connection points for terminals, each possible positionshall be tested independently.

5.3.12.3.1.7 For small projects affecting a limited number of areaswhere the use of nitrogen is impractical, the system gas shall bepermitted to be used for the following tests:

(1) Standing Pressure (5.3.12.3.2)(2) Cross-Connection (5.3.12.3.4)(3) Warning Systems (5.3.12.3.5)(4) Piping Purge (5.3.12.3.6)(5) Piping Particulates (5.3.12.3.7)(6) Piping Purity (5.3.12.3.8)(7) Operational Pressure (5.3.12.3.10)

5.3.12.3.1.8 All verification test results shall be reported as requiredin 5.3.12.1.

5.3.12.3.2 Verifier Standing Pressure Test. Each positive-pressuregas piping system shall be subjected to a ten minute standingpressure test at operating line pressure using the followingprocedures:

(1) After the system is filled with oil free, dry Nitrogen NF orthe system gas, the source valve and any zone valves shall be closed.

(2) The piping system downstream of the valves shall show nodecrease in pressure after ten minutes.

(3) Any leaks found shall be located, repaired (if permitted),replaced (if required) and retested.

5.3.12.3.3 Verifier Standing Vacuum Test. Each Level 3 vacuumpiping system shall be subjected to a ten minute standing vacuumtest at operating line vacuum using the following procedures:

(1) After the system has stabilized at the operating line vacuum,the source valve and any zone valves shall be closed.

(2) The piping system upstream of the valves shall show nodecrease in vacuum after ten minutes.

(3) Leaks, if any, shall be located, repaired (if permitted),replaced (if required) and retested.

5.3.12.3.4 Verifier Cross-Connection Test . After closing of wallsand completion of the requirements of 5.3.12.2, Installer-PerformedTests , it shall be determined that no cross-connections of thepiping systems exist by the following method:

(1) Shutoff the source of test gas for all positive-pressure gaspiping systems and reduce them to atmospheric.pressure.

(2) Operate Level 3 vacuum systems at the normal systemvacuum, using the source equipment.

(3) Each positive-pressure gas outlet and Level 3 vacuum inletshall be tested with appropriate adapters to verify that vacuum ispresent only at the vacuum inlets in the system being tested and notat any positive-pressure gas outlets.

(4) Shutdown the vacuum source equipment and slowly breakthe vacuum in the Level 3 vacuum piping system, increasing itspressure to atmospheric.

(5) Using oil free, dry Nitrogen NF or the system gas, pressurizeone of the positive-pressure gas piping systems to 345 kPa (50 psi)gage.

(6) Test each positive-pressure gas outlet and Level 3 vacuuminlet using appropriate adapters to verify that the test gas pressure ispresent only at the outlets in the piping system being tested.


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(7) After it has been verified that a piping system is free ofcross-connections, disconnect the source of test gas and reduce thepiping to atmospheric pressure.

(8) Proceed to test each positive-pressure gas piping systemuntil all gas and vacuum systems are verified to be free of cross-connections.

5.3.12.3.5 Verifier Level 3 Warning System Tests

5.3.12.3.5.1 All warning systems required by 5.3.9 shall be tested toensure that all components function correctly prior to placing thesystem into service.

5.3.12.3.5.2 Permanent records of these tests shall be maintained.

5.3.12.3.5.3 Warning systems that are part of an addition to anexisting piping system shall be tested prior to connection of thenew piping to the existing system.

5.3.12.3.5.4 Tests of warning systems for new installations (initialtests) shall be performed after the verifier's cross-connection testing(5.3.12.3.4), but before purging the piping (5.3.12.3.6) andperforming the remaining verification tests (5.3.12.3.7 through5.3.12.3.13).

5.3.12.3.5.5 Test gases for the initial tests shall be either oil free,dry Nitrogen NF, the gas of system designation, or the operatingvacuum source.

5.3.12.3.5.6 The audible and non-cancellable alarm signals in eachsingle treatment facility shall be checked to verify that they are in alocation that will be continuously attended while the facility is inoperation.

5.3.12.3.5.7 The operation of the Level 3 line pressure alarmsrequired by 5.3.9.1(d) shall be verified.

5.3.12.3.5.8 Audible and non-cancellable visual signals in eachsingle treatment facility shall indicate if the pressure in the mainline being monitored increases or decreases 20 percent from thenormal operating pressure.

5.3.12.3.5.9 The operation of the Level 3 changeover alarmsrequired by 5.3.9.1(e) shall be verified.

5.3.12.3.5.10 Audible and non-cancellable visual signals shallindicate whenever automatic changeover occurs or is about tooccur.

5.3.12.3.5.11 Where Level 3 gas and vacuum systems include otheralarm features that are not mandatory under 5.3.9, they shall befunctionally tested in accordance with their intended purpose andthe equipment manufacturer's recommendations.

5.3.12.3.6 Verifier Piping Purge Test. In order to remove any tracesof particulate matter deposited in the pipelines as a result ofconstruction, a heavy, intermittent purging of each medical gas(e,g, oxygen and nitrous oxide) pipeline shall be done.

5.3.12.3.6.1 The appropriate adapter shall be obtained from thefacility or manufacturer, and high purge rates of at least 230Nl/min (8 SCFM) shall be put on each outlet.

5.3.12.3.6.2 After the purge is started, it shall be rapidlyinterrupted several times until the purge produces no discolorationin a white cloth loosely held over the adapter during the purge.

5.3.12.3.6.3 In order to avoid possible damage to the outlet and itscomponents, this test shall not be conducted using any implementother than the correct adapter.

5.3.12.3.7 Verifier Piping Particulate Test. The cleanliness of thepiping in each medical gas (e,g, oxygen and nitrous oxide) systemshall be verified as follows:

(a) The test shall be performed using oil free, dry Nitrogen NFor the system gas.

(b) A minimum of 1000 L (35 ft 3) of gas shall be filteredthrough a clean, white 0.45-micron filter at a minimum flow rate of100 Nl/min (3.5 SCFM).

(c) Each zone shall be tested at the outlet most remote from thesource.

(d) The filter shall accrue no more than .001 gram (1 mg) ofmatter from any outlet tested.

5.3.12.3.8 Verifier Piping Purity Test . For each medical gas (e,g,oxygen and nitrous oxide) system, the purity of the piping systemshall be verified as follows:

(a) These tests shall be performed with oil free, dry NitrogenNF or the system gas.

(b) The tests shall be for total hydrocarbons (as methane) andhalogenated hydrocarbons, and compared with the source gas.

(c) This test shall be performed at the outlet most remote fromthe source.

(d) The difference between the two tests shall in no caseexceed:

Total Hydrocarbons 1 ppmHalogenated Hydrocarbons 2 ppm

(e) A test for dew point shall be conducted at the outlet mostremote from the source and the dew point shall not exceed 500ppm (12°C).

5.3.12.3.9 Verifier Final Tie-in Test

5.3.12.3.9.1 Prior to the connection of any new piping to its sourceof supply, including extensions or additions to an existing pipingsystem, the verification tests in 5.3.12.3.1 through 5.3.12.3.8 shall besuccessfully performed on the new work.

5.3.12.3.9.2 Each joint in the final connection between the newwork and the existing system shall be leak-tested with the gas ofsystem designation or vacuum at the normal operating pressure bymeans of soapy water or other means effective for use with oxygen.

5.3.12.3.9.3 For positive-pressure gases, immediately after the finalconnection is made and leak tested, the specific altered zone andcomponents in the immediate zone or area that is downstreamfrom the point or area of intrusion shall be purged per 5.3.12.3.6.

5.3.12.3.9.4 Before the new work is used for patient care, thefollowing tests shall be performed for all medical gas (e,g, oxygenand nitrous oxide) systems:

(1) Operational pressure (5.3.12.3.10).(2) Gas concentration (5.3.12.3.11).

5.3.12.3.9.5 Permanent records of these tests shall be maintainedin accordance with 5.3.12.8.1

5.3.12.3.10 Verifier Operational Pressure Test. Operationalpressure tests shall be performed at each station outlet in Level 3medical gas piping systems (e.g. oxygen and nitrous oxide) wherethe user makes connections and disconnections.

5.3.12.3.10.1 Tests shall be performed using either oil free, dryNitrogen NF or the gas of system designation.

5.3.12.3.10.2 Medical gas outlets (e.g. oxygen and nitrous oxide)shall deliver 100 Nl/min (3.5 SCFM) with a pressure drop of nomore than 35 kPa (5 psi) gage, and static pressure of 345-380 kPa(50-55 psi) gage.

5.3.12.3.11 Verifier Gas Concentration Test. After purging eachpiping system with the gas of system designation, the following shallbe performed:

(1) Each medical gas outlet (e.g. oxygen and nitrous oxide)shall be analyzed for concentration of gas, by volume.

(2) Analysis shall be with instruments designed to measure thespecific gas dispensed.

(3) Allowable concentrations shall be as follows:Oxygen > 99% oxygenNitrous oxide > 99% nitrous oxide

5.3.12.3.12 Labeling. The presence and correctness of labelingrequired by this standard for all components (e.g., stationoutlets/inlets, shutoff valves, and alarm panels) shall be verified.

5.3.12.3.13 Source Equipment Verification

5.3.12.3.13.1 General. Source equipment verification shall beperformed following the installation of the interconnectingpipelines, accessories, and source equipment.

5.3.12.3.13.2 Use of Source Equipment for PipelineVerification Tests. Where the source equipment and system gas orvacuum is used for verification testing of the distribution piping,the source equipment shall be verified prior to verification of thedistribution piping.


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5.3.12.3.13.3 Level 3 Source Equipment for Positive-PressureGases

5.3.12.3.13.4 Level 3 Vacuum Source Equipment. The functioningof the Level 3 vacuum source system(s) shall be tested and verifiedbefore it is put into service.

5.3.13 Level 3 Operat ion and Management

5.3.13.1 Administration. Administrative authorities of health careorganizations shall provide policies and procedures for safepractices.

5.3.13.1.1 Purchase specifications shall include:(1) specifications for cylinders.(2) marking of cylinders, regulators, and valves.(3) proper connection of cylinders supplied to the facility.

5.3.13.1.2 Training procedures shall include:(1) Maintenance programs in accordance with the manufacturers’

recommendations for the piped gas system.(2) Use and transport of equipment and the proper handling of

cylinders, containers, hand trucks, supports, and valve protectioncaps.

(3) Proper uses of the Medical/Surgical vacuum system in orderto eliminate practices that reduce the system’s effectiveness, such asleaving suction tips and catheters open when not actuallyaspirating, and using equipment arrangements that are improperlytrapped or are untrapped.

5.3.13.1.3 Policies for enforcement shall include:(1) Regulations for the storage and handling of cylinders and

containers of oxygen and nitrous oxide.(2) Regulations for the safe handling of oxygen and nitrous

oxide in anesthetizing locations,(3) All signal warnings are promptly evaluated and all necessary

measures are taken to reestablish the proper functions of themedical gas system.

(4) The organization has the capability and resources to copewith a complete loss of any medical gas system,

(5) Prior to the use of any medical gas piping system for patientcare all tests required in 5.3.11 have been successfully conducted.

5.3.13.2 Special Precautions for Handling Oxygen Cylindersand Manifolds . Handling of oxygen cylinders and manifolds shallbe based on CGA Pamphlet G-4, Oxygen .

5.3.13.2.1 Oxygen cylinders, containers and associated equipmentshall be protected from contact with oil or grease. Specificprecautions shall include:

(1) Oil, grease, or readily flammable materials shall never bepermitted to come in contact with oxygen cylinders, valves,regulators, gauges, or fittings.

(2) Regulators, fittings, or gauges shall never be lubricated withoil or any other flammable substance.

(3) Oxygen cylinders or apparatus shall never be handled withoily or greasy hands, gloves, or rags.

5.3.13.2.2 Equipment associated with Oxygen shall be protectedfrom contamination. Specific precautions shall include:

(1) Particles of dust and dirt shall be cleared from cylindervalve openings by slightly opening and closing the valve beforeapplying any fitting to the cylinder.

(2) The high-pressure valve on the oxygen cylinder shall beopened before bringing the apparatus to the patient or the patientto the apparatus.

(3) An oxygen cylinder shall never be draped with any materialssuch as hospital gowns, masks, or caps.

(4) Cylinder-valve protection caps, where provided, shall bekept in place and be hand tightened, except when cylinders are inuse or connected for use.

(5) Valves shall be closed on all empty cylinders in storage.

5.3.13.2.3 Cylinders shall be protected from damage. Specificprocedures shall include:

(1) Oxygen cylinders shall be protected from abnormalmechanical shock, which is liable to damage the cylinder, valve, orsafety device.

(2) Oxygen cylinders shall not be stored near elevators,gangways, or in locations where heavy moving objects will strikethem or fall on them.

(3) Cylinders shall be protected from the tampering ofunauthorized individuals.

(4) Cylinders or cylinder valves shall not be repaired, painted,or altered.

(5) Safety relief devices in valves or cylinders shall never betampered with.

(6) Valve outlets clogged with ice shall be thawed with warm —not boiling — water.

(7) A torch flame shall never be permitted under anycircumstances to come in contact with cylinder valves or safetydevices.

(8) Sparks and flame shall be kept away from cylinders.(9) Even if they are considered to be empty, cylinders shall

never be used as rollers, supports, or for any purpose other thanthat for which the supplier intended them.

(10) When small-size (A, B, D, or E) cylinders are in use, theyshall be attached to a cylinder stand or to therapy apparatus ofsufficient size to render the entire assembly stable.

(11) Large cylinders (exceeding size E) and containers largerthan 45 kg (100 lb) weight shall be transported on a proper handtruck or cart complying with Chapter 9.

(12) Freestanding cylinders shall be properly chained orsupported in a proper cylinder stand or cart.

(13) Cylinders shall not be chained to portable or movableapparatus such as beds and oxygen tents.

(14) Cylinders shall not be supported by radiators, steam pipes,or heat ducts.

5.3.13.2.4 Cylinders and their contents shall be handled with care.Specific procedures shall include:

(1) Oxygen fittings, valves, regulators, or gauges shall never beused for any service other than that of oxygen.

(2) Gases of any type shall never be mixed in an oxygen cylinderor any other cylinder.

(3) Oxygen shall always be dispensed from a cylinder through apressure regulator.

(4) The cylinder valve shall be opened slowly, with the face ofthe gauge on the regulator pointed away from all persons.

(5) Oxygen shall be referred to by its proper name, oxygen, notair and liquid oxygen referred to by its proper name, not liquid air.

(6) Oxygen shall never be used as a substi tute for compressedair.

(7) The markings stamped on cylinders shall not be tamperedwith because it is against federal statutes to change these markingswithout written authority from the Bureau of Explosives.

(8) Markings used for the identification of contents of cylindersshall not be defaced or removed, including decals, tags, stenciledmarks, and upper half of shipping tag.

(9) The owner of the cylinder shall be notified if any conditionhas occurred that might permit any foreign substance to enter acylinder or valve, giving details and cylinder number.

(10) Neither cylinders nor containers shall be placed inproximity of radiators, steam pipes, heat ducts, or other sources ofheat.

(11) Very cold cylinders or containers shall be handled with careto avoid injury.

5.3.13.2.5 When individual small-size (A, B, D, or E) cylinders areused in association with patient care, the cylinders shall bepermitted to be placed and stored in open areas throughout thepatient care area.

5.3.13.2.6 Oxygen equipment that is defective shall not be useduntil:

(1) it has been repaired by competent in-house personnel,(2) it has repaired by the manufacturer or his or her authorized

agent,(3) it has been replaced.

5.3.13.2.7 Regulators that are in need of repair or cylinders havingvalves that do not operate properly shall never be used.

5.3.13.3 Special Precautions for Making Cylinder and ContainerConnections

5.3.13.3.1* Wrenches and tools used to connect equipment shall bemanufactured of material of adequate strength.

5.3.13.3.2 Cylinder valves shall be opened and connected inaccordance with the following procedure:

(1) Make certain that apparatus and cylinder valve connectionsand cylinder wrenches are free of foreign materials,

(2) Turn the cylinder valve outlet away from personnel. Stand tothe side — not in front and not in back. Before connecting theapparatus to cylinder valve, momentarily open cylinder valve toeliminate dust,


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(3) Make connection of apparatus to cylinder valve. Tightenconnection nut securely with a wrench

(4) Release the low-pressure adjustment screw of the regulatorcompletely,

(5) Slowly open cylinder valve to full open position,(6) Slowly turn in the low-pressure adjustment screw on the

regulator until the proper working pressure is obtained, and(7) Open the valve to the utilization apparatus.

5.3.13.3.3 Connections for containers shall be made in accordancewith the container manufacturer’s operating instructions.

5.3.13.4 Special Precautions for the Care of Safety Mechanisms

5.3.13.4.1 Personnel using cylinders and containers and otherequipment covered in this chapter shall be familiar with the Pin-Index Safety System (see Chapter 9) and the Diameter-Index SafetySystem (see Chapter 9), both are designed to prevent utilization ofthe wrong gas.

5.3.13.4.2 Safety relief mechanisms, non-interchangeableconnectors, and other safety features shall not be removed oraltered.

5.3.13.5 Special Precautions - Storage of Cylinders and Containers

5.3.13.5.1 Storage shall be planned so that cylinders can be used inthe order in which they are received from the supplier.

5.3.13.5.2 If stored within the same enclosure, empty cylindersshall be segregated from full cylinders.

5.3.13.5.3 Empty cylinders shall be marked to avoid confusion anddelay if a full cylinder is needed in a rapid manner.

5.1.13.5.4 Cylinders stored in the open shall be protected asfollows:

(1) against extremes of weather and from the ground beneathto prevent rusting,

(2) during winter, against accumulat ions of ice or snow,(3) in summer, screened against continuous exposure to direct

rays of the sun in those localities where extreme temperaturesprevail.

5.3.13.6 Special Precautions – Piped Patient Gas/Vacuum Systems

5.3.13.6.1* Piping systems shall not be used for the distribution offlammable anesthetic gases.

5.3.13.6.2 Piping systems for gases shall not be used as a groundingelectrode.

5.3.13.6.3 The vacuum system shall not be used for vacuum steamcondensate return or other non-medical applications.

5.3.13.7 Gas/Vacuum Systems Information and Warning Signs

5.3.13.7.1 The gas content of medical gas piping systems shall belabelled according to 5.3.11.1.

5.3.13.8* Gas/Vacuum Systems Maintenance and Record Keeping

5.3.13.8.1 Permanent records of all tests required by 5.3 shall bemaintained in the organization’s files.

5.3.13.8.2 A periodic testing procedure for nonflammable medicalgas/vacuum and related alarm systems shall be implemented.

5.3.13.8.3 Whenever modifications are made or maintenance isperformed that breaches the system the tests specified in 5.3.12shall be conducted on the downstream portions of the medical gaspiping system.

5.3.13.8.4 A maintenance program shall be established for thefollowing:

(1) the medical air compressor supply system in accordancewith the manufacturers’ recommendations.

(2) the vacuum source and accessories in accordance with themanufacturers’ recommendations.

(3) * both the vacuum piping system and to the secondaryequipment attached to vacuum station inlets to ensure thecontinued good performance of the entire vacuum system.

(4) the scavenger system to assure performance.

5.3.13.8.5* Audible and visual alarm indicator(s):(a) shall be periodically tested to determine that they are

functioning properly,(b) shall have the records of the test maintained until the next

test is performed.

Annex Materials

A-5.1.2 Nature of Hazards of Gas and Vacuum Systems

Gas Systems. Oxygen and nitrous oxide, the gases normally usedfor relative analgesia and as components of general anesthesia, arestrong oxidizing gases and individually or as a mixture supportcombustion quite readily.

Inhalation gases or vapors introduce fire, chemical, mechanical,and electrical hazards that are all interrelated. Any mixture ofinhalation gases will support combustion. In an oxygen-enrichedatmosphere, materials that are flammable and combustible in airignite more easily and burn more vigorously. Combustiblematerials that could be found near patients who are to receiverespiratory therapy include hair oils, oil-based lubricants, skinlotions, facial tissues, clothing, bed linen, tent canopies, rubberand plastic articles, gas supply and suction tubing, ether, alcohols,and acetone.

A particular hazard exists when oxygen or nitrous oxide equipmentbecomes contaminated with oil, grease, or other combustiblematerials. Such contaminants will ignite readily and burn morerapidly in the presence of high oxygen concentrations and make iteasier to ignite less combustible materials with which they come incontact.

Any mixture of breathing gases used in respiratory therapy willsupport combustion. In an oxygen-enriched atmosphere, materialsthat are combustible and flammable in air ignite more easily andburn more vigorously. Materials not normally considered to becombustible may be so in an oxygen-enriched atmosphere.

An oxygen-enriched atmosphere normally exists in an oxygen tent,croup tent, incubator, and similar devices when supplementaloxygen is being employed in them. These devices are designed tomaintain a concentration of oxygen higher than that found in theatmosphere.

A hazard exists if either oxygen or nitrous oxide leaks into a closedspace, creating an oxygen-enriched atmosphere.

Oxygen-enriched atmospheres can exist in the immediate vicinity ofall oxygen administration equipment. (See definition of Site ofIntentional Expulsion).

The transfer of liquid oxygen from one container to anothercontainer can create an oxygen-enriched atmosphere within thevicinity of the containers.If oxygen is supplied by a container that stores the oxygen as aliquid, there will be a small amount of oxygen vented into thevicinity of the container after a period of nonuse of the equipment.Larger amounts of oxygen will be vented if the container isaccidentally tipped over or placed on its side. This venting maycreate an oxygen-enriched atmosphere if the container is stored ina confined space.

A hazard exists if improper components are employed to connectequipment containing pressurized oxygen or nitrous oxide duringrespiratory therapy administration.

The occurrence of a fire requires the presence of combustible orflammable materials, an atmosphere of oxygen or other oxidizingagents, and a source of ignition. Combustible materials can beunavoidably present when oxygen is being administered, butflammable liquids and gases and ignition sources are avoidable.

Sources of ignition include not only the usual ones in ordinaryatmospheres, but others that become significant hazards in oxygen-enriched atmospheres such as the following:

(a) Open flames, burning tobacco, and electric radiant heatersare sources of ignition.

(b) The discharge of a cardiac defibrillator can serve as asource of ignition.

(c) Arcing and excessive temperatures in electrical equipmentare sources of ignition. Electrically powered oxygen apparatus and


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electrical equipment intended for use in an oxygen-enrichedatmosphere are sources of ignition if electrical defects are present.

(d) Electrical equipment not conforming to the requirements of7-6.2.4.1, which can include, but is not limited to, electric razors,electric bed controls, hair dryers, remote television controls, andtelephone handsets, can create a source of ignition if introducedinto an oxygen-enriched atmosphere.

(e) A static discharge having an energy content that can begenerated under normal conditions in respiratory therapy will notconstitute an ignition source as long as easily ignited substances(such as alcohols, acetone, oils, greases, or lotions) are notpresent.

(f) Rapid opening of cylinder valves can cause sudden increasein downstream gas pressure and temperature caused by theadiabatic heat of recompression with consequent ignition ofcombustible materials in contact with the hot gas downstream,including the valve seat. Sudden compression or recompression ofa gas to high pressure can generate large increase in temperature[up to 2000°F (1093°C)] that can ignite any organic materialpresent, including grease. (See also NFPA 53, RecommendedPractice on Materials, Equipment, and Systems Used in Oxygen-Enriched Atmospheres.)

Medical/Surgical Vacuum Systems. There are potential fire andexplosion hazards associated with medical gas central pipingsystems and medical-surgical vacuum systems. The variouscomponents are usually not independent isolated components, butare parts of a larger system dedicated to total patient care andsafety.

Many of these components are covered by existing standards tominimize the fire, explosive, and patient safety hazard. Thepotential for mistaken interconnection with oxidizing gases and forunder-capacity requiring extended overheated operation all presentpotential hazards or compound other hazardous conditions thatshould be properly addressed. While the potential for theseproblems exists, the Piping Committee on Medical Gas andVacuum Systems is unaware of the actual occurrence of anysignificant fire-related hazards with Medical/Surgical vacuumsystems.

There are also potential hazards to patients in the unplannedshutdown or failure of the systems secondary to a fire and/or theinability of the system to provide adequate levels of performanceunder normal or emergency situations. There is also the potentialfor mistaken interconnection with pressurized nonflammablemedical gas systems.

Waste Anethetic Gas Disposal. There are potential fire andexplosion hazards associated with the gases that are removed fromthe anesthesia machine by the WAGD system. These gases typicallyinclude oxygen, nitrous oxide, and halogenated anesthetics. Thereare also potential hazards to patients and staff resulting fromexposure to these gases or from improper interface between thevery low pressures in the breathing circuit and the high vacuumpresent in some WAGD systems. There is also the hazard ofinterconnection between the WAGD system and the other medicalgas systems, and especially the medical surgical vacuum system.

Any mixture of breathing gases used in respiratory therapy willsupport combustion. In an oxygen-enriched atmosphere, materialsthat are combustible and flammable in air ignite more easily andburn more vigorously. Materials not normally considered to becombustible may be so in an oxygen-enriched atmosphere.

Toxicity during Respiratory Therapy Administration.

Chemical hazards can be associated with the presence of residualsterilant in high-pressure equipment.

Some breathing mixtures can decompose in contact with hotsurfaces and produce toxic or flammable substances.

Smoldering combustion of flammable substances can occur withthe production of significant amounts of toxic gases and fumes.

Safety (Mechanical Injury; Cross-Connection, and So Forth).

A large amount of energy is stored in a cylinder of compressed gas.If the valve of a cylinder is struck (or strikes something else) hardenough to break off the valve, the contents of the cylinder could bedischarged with sufficient force to impart dangerous reactivemovement to the cylinder.

Mechanical Hazards during Respiratory Therapy Administration.

Cylinders and containers can be heavy and bulky and can causepersonal injury or property damage (including to the cylinder orcontainer) if improperly handled. In cold climates, cylinders orcontainers stored outdoors or in unheated ventilated rooms canbecome extremely cold. A hazardous situation could develop ifthese cylinders or containers are heated

Improper maintenance, handling, or assembly of equipment canresult in personal injury, property damage, or fire.

A hazardous condition exists if cylinders or containers areimproperly located so that they can become overheated or tippedover. If a container is tipped over or placed on its side, liquidoxygen could be spilled. The liquid can cause frostbite on contactwith skin.

A hazardous condition exists if there is improper labeling ofcylinders or containers or inattention to the manufacturer’s labelor instructions.

A hazardous condition exists if care is not exercised in making slip-on and other interchangeable connections when setting upequipment.

Safety features, including relief devices, valves, and connections, areprovided in equipment and gas supply systems. Altering orcircumventing these safety features by means of adapters creates ahazardous condition.

Extreme danger to life and property can result when compressedgases are mixed or transferred from one cylinder to another.A hazardous condition exists if devices, such as fixed or adjustableorifices and metering valves, are directly connected to cylinders orsystems without a pressure-reducing regulator.

Hazardous conditions are created when pressure-reducingregulators or gauges are defective.

Manufactured Assemblies. Specific hazards associated withmanufactured assemblies are the same as those listed above as wellas additional hazards resulting from improper assembly, separationand leakage resulting from hidden semipermanent connections,improper connection resulting in cross connection, and blockageand flow problems resulting from damage to hoses, etc.

A.5.1.3 (See Figure A.1.3 on page 260.)

A.5.1.3.1.1 Regulations of the U.S. Department of Transportation(formerly U.S. Interstate Commerce Commission) outlinespecifications for transportation of explosives and dangerousarticles (Code of Federal Regulations, Title 49, Parts 171-190). InCanada, the regulations of the Canadian Transport Commission,Union Station, Ottawa, Ontario, apply.

A.5.1.3.3 The bulk supply system should be installed on a site thathas been prepared to meet the requirements of NFPA 50, Standardfor Bulk Oxygen Systems at Consumer Sites, or CGA Pamphlet G-8.1, Standard for the Installation of Nitrous Oxide Systems atConsumer Sites. Storage unit(s), reserve, pressure regulation, andsignal actuating switch(es) are components of the supply system.Shutoff valves, piping from the site, and electric wiring from asignal switch(es) to the master signal panels are components of thepiping system.The bulk supply system is normally installed on the site by theowner of this equipment. It is the responsibility of the owner or theorganization responsible for the operation and maintenance of thebulk supply system to ensure that all components of the supplysystem — main supply, reserve supply, supply system signalactuating switch(es), and delivery pressure regulation equipment— function properly before the system is put in service.

A.5.1.3.4 (See Figure A.5.1.3.4 on page 261.)


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Either of two valve types: a ball valve or a check valve.

A union or other means to disassemble components. (Note: These are not illustrated in every location where they may be required.)

Either

A pressure regulator.

A quarter turn ball valve. The type shown is used for ease of recognition, but other configurations may be permissible.

Items shown in dashed format indicate alternative arrangements or components required only conditionally.

A relief valve.

The wall of the source enclosure.

The point at which the diagramtransitions to the next portion of the system.

A switch or sensor connected to the alarm panel(s).

A relief valve vent piped to outside.V

A pressure indicator. A gauge typeis shown, but other types may be permitted.

A demand check to allow disconnection of the device without shutting down of the system.

D.C.A check valve. The valve flows in the direction of the point.

A high-pressure valve. The technology of the valve is not specified.

A liquid vessel for containing cryogenic liquified gas.

A vaporizer for converting cryogenic liquified gas from liquid to gas state.

A "pigtail" for connecting cylinders to the header. May be rigid or flexible, depending on the gas and pressure

A filter.

Figure A.5.1.3 Legend for the Typical Drawings


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Source Valve5.1.4.4

Main Line Shutoff Valve(Not required in some cases)

5.1.4.5.4

Line Pressure Alarm Switch/Sensor

Line PressureIndicator

Isolating Valve

PressureIndicator

Isolation Valve

Pressure Relief Valve(s)

Line PressureRegulators

V

V

V

dc dc

A four-valve bypass arrangement is illustrated. Three-way valves are permitted in lieu of the four valves shown.

Wall of Source Enclosure (Note: Location of items downstream of the source valve may vary. Refer to the text.)

Either

Figure A.5.1.3.4 Typical Arrangement for Line Controls at Pressure Sources


262

A.5.1.3.4.2 Prohibited uses of medical gases include fuelingtorches, blowing down or drying any equipment such as labequipment, endoscopy or other scopes, or any other purposes.Also prohibited is using the oxygen or medical air to raise, lower,or otherwise operate booms or other devices in ORs or otherareas.

A.5.1.3.4.3 Components include but are not limited to containers,valves, valve seats, lubricants, fittings, gaskets, and interconnectingequipment including hoses. Easily ignitable materials should beavoided.

Compatibility involves both combustibility and ease of ignition.Materials that burn in air will burn violently in pure oxygen atnormal pressure and explosively in pressurized oxygen. Also, manymaterials that do not burn in air will do so in pure oxygen,particularly under pressure. Metals for containers and piping mustbe carefully selected, depending on service conditions. The varioussteels are acceptable for many applications, but some serviceconditions can call for other materials (usually copper or itsalloys) because of their greater resistance to ignition and lower rateof combustion.Similarly, materials that can be ignited in air have lower ignitionenergies in oxygen. Many such materials can be ignited by frictionat a valve seat or stem packing or by adiabatic compressionproduced when oxygen at high pressure is rapidly introduced intoa system initially at low pressure.

A.5.1.3.4.8 (See Figures A.5.1.3.4.8 Part 1 and Figure A.5.1.3.4.8Part 2 on pages 263-264.)

A-5.1.3.4.8 (1) The appropriate number of cylinders should bedetermined after consideration of delivery schedules, proximity ofthe facility to alternate supplies, and the emergency plan.

A.5.1.3.4.9 (See Figure A.5.1.3.4.9 on page 265.)


A.5.1.3.4.11 For bulk oxygen systems, see NFPA 50 , Standard forBulk Oxygen Systems at Consumer Sites. (See Figure A.5.1.3.4.11 onpage 267.)

A-5.1.3.4.11.2 Consideration should be given to the consequencesof a large spillage of liquid on the vehicle pad in terms of wherethe liquid would run and where the very cold gas would travel as itboiled off the liquid.


A.5.1.3.5 Medical Air. Air supplied from on-site compressor andassociated air treatment systems (as opposed to medical air USPsupplied in cylinders) that complies with the specified limits isconsidered medical air. Hydrocarbon carryover from thecompressor into the pipeline distribution system could bedetrimental to the safety of the end user and to the integrity of thepiping system. Mixing of air and oxygen is a common clinicalpractice, and the hazards of fire are increased if the air iscontaminated. Compliance with these limits is thus consideredimportant to fire and patient safety. The quality of local ambient airshould be determined prior to its selection for compressors and airtreatment equipment. (See Figure A.5.1.3.5 on page 269.)

A-5.1.3.5.1 Supply systems for medical air using compressors drawair of the best available quality from a source of clean localambient air, add no contaminants in the form of particulatematter, odor, or other gases, dry, filter, regulate and supply that aironly via the Medical Air piping distribution system for useexclusively in the application of human respiration.

A.5.1.3.5.2 It is the intent that the medical air piping distributionsystem support only the intended need for breathable air for suchitems as IPPB and long-term respiratory assistance needs,anesthesia machines, and so forth. The system is not intended tobe used to provide engineering, maintenance, and equipmentneeds for general hospital support use. It is the intent that the lifesafety nature of the medical air be protected by a system dedicatedsolely for its specific use.As a compressed air supply source, a medical air compressorshould not be used to supply air for other purposes because suchuse could increase service interruptions, reduce service life, andintroduce additional opportunities for contamination.

A.5.1.3.5.4 Examples of 5.1.3.5.4.1 (1) are liquid ring andpermanently sealed bearing compressors.An example of 5.1.3.5.4.1 (2) is an extended head compressor withan atmospheric vent between the compression chamber and thecrankcase.

A.5.1.3.5.10 Other functions can be added at the request of thefacility, such as low water pressure, etc.

A.5.1.3.5.11.6 The two configurations are equally acceptable. Thecomponents may be arranged in two parallel branches ofcomponents as follows:

(1) Individual components consisting of a tee + inlet valve - dryer- outlet valve + tee + inlet valve - filter - outlet valve + tee + inlet valve- regulator - outlet valve + tee

(2) Grouped components consisting of a tee + inlet valve - dryer -filter - regulator - outlet valve + tee. (See Figure A.5.1.3.5.11.6 onpage 270.)

A.5.1.3.5.15 The utilization of an air-treatment system is the jointresponsibility of the system designer, hospital clinical andengineering staffs, and the authority having jurisdiction. Differenttypes of compressors have characteristics that affect the selection ofthe type of air-treatment system. Some air-treatment systems imposean additional load upon the compressors that must be accountedfor in the sizing of the system (usable capacity). The compressorduty cycle must be chosen in accordance with the manufacturer’srecommendation.The type of air compressor and air condition at the intake willgovern the type of filter provided for the air compressor supplysystem. All filters should be examined quarterly for the presence ofliquids or excessive particulates and replaced according to themanufacturer’s instructions.One method for a decision on the quality of the medical air is thefollowing:

(1) Test at the intake and at the sample connection valve.(2) If the two purities agree within the limits of accuracy of the

test, the compressor system can be accepted.(3) If the air is found to exceed the values for Medical

Compressed Air in 5.1.3.5.1, the facility can elect to installpurification apparatus for the contaminants in question.


A.5.1.3.7 A functioning WAGD system will permit the facility tocomply with occupational safety requirements by preventing theaccumulation of waste anesthetic gases in the work environment.WAGD using an HVAC (heating, ventilation, and air conditioning)system are not within the scope of this chapter.

Flammable and nonflammable gases are known to be incompatiblewith some seals and piping used in medical-surgical vacuumsystems. If waste anesthetic gas disposal is to be included as part ofthe medical-surgical vacuum system, it should be recognized thatthis activity might cause deterioration of the vacuum system. Thestation inlet performance tests outlined in 5.1.12.3.10 are extremelyimportant in maintaining the integrity of the medical-surgicalvacuum system, and they should be made at more frequentintervals if waste anesthetic gas disposal is included in the vacuumsystem.

A.5.1.3.7.1 WAGD Interface. Interfaces are provided withoverpressure, underpressure, overflow, and underflowcompensation to ensure the breathing circuit is isolated from theWAGD system.


A-5.1.3.8.5 Drawing intake air from outside in compliance with5.1.3.5.13 is recommended.

A.5.1.4 (See Figure A.5.1.4 on page 273.)

A-5.1.5 Station outlets/inlets should be located at an appropriateheight above the floor to prevent physical damage to equipmentattached to the outlet.

A.5.1.6 Manufactured Assembly. Examples are headwalls,columns, ceiling columns, ceiling hung pendants, movable tracksystems, and so on. (See Figure A.5.1.6 on page 274.)


263

Header Pressure Regulator

Header Check Valve

Header Contents Indicator

Intermediate Pressure Gauge

Header Valve

Filter

Cylinders

Gas SpecificCylinder Lead ConnectorContains a Check Valve

Cylinder Valve Cylinder Lead Connection(CGA Fitting per CGA V-1)

Cylinder Leads

Cylinder Pressure Relief

Figure A.5.1.3.4.8 Part 1 Header for Gas in Cylinders


264

Gas Specific Cylinder Connection

Cylinders

Cylinder Leads

Header Pressure Indicator

Header Pressure Relief

Header ValveFilter

Header Check Valve

Connection to the gas outlet connection is illustrated. If the liquid outlet connection were used, an external vaporizer may be required.

V

Figure A.5.1.3.4.8 Part 2 Header for Cryogenic Gas in Containers


265

Changeover Alarm Switch/Sensor AutomatingControl(s)

IntermediateRelief Valve

Primary/Secondary Headers

V V

Final Line Controls5.1.3.4

Header 5.1.3.4.8 Header 5.1.3.4.8

V

V

V

Figure A.5.1.3.4.9 Manifold for Gas Cylinders


266

Reserve in UseAlarm Switch/Sensor

Changeover AlarmSwitch/Sensor

Primary/Secondary Headers

Reserve Header


V

Alternating Control(s)

Header 5.1.3.4.8

Header 5.1.3.4.8 Header 5.1.3.4.8


V

V

V

Figure A.5.1.3.4.10 Typical Source of Supply for Cryogenic Gas inContainers


267


V

Reserve in Use AlarmSwitch/Sensor


Main Vaporizer

Economizer

Reserve Tank Pressure Switch/Sensor

Either

Bulk Liquid Reserve5.1.3.4.11.4

Gas Cylinder Reserve5.1.3.4.11.4

Reserve Contents Indicator and Switch/Sensor

Main Contents Indicator and

Switch/Sensor

Primary/Secondary Supplies

ReserveVaporizer

Check Valve

Two possible choices of reserves are illustrated. Both are not required.

Check Valve

Header 5.1.3.4.8

V

V

V

Figure A.5.1.3.4.11 Typical Source of Supply for Cryogenic Gas in Bulk


268

Line Pressure Alarm Switch/Sensor

Relief Valve and Vent

Check Valves

Main Line Valve

Inlet Isolation Valve

Connection Point


dc dc

V

Note: If the relief valve on the emergency oxygen connection is moved to downstream from the check valve in the emergency oxygen line, connect it to the system with a demand check fitting.

Figure A.5.1.3.4.12 Emergency Oxygen Supply Connection


269

A Compressor that adds no oil to the Air

Ball ValveAutomaticTrap and Drain

Legend

Check Valve

PressureIndicator

PressureReliefValve

Demand Check

Pressure Regulator

Filter with Change Indicator

DemandCheck

SourceValve

ReliefValve

PressureIndicator

CharcoalAdsorber

Filter

Regulator

InletIsolationValves

OutletIsolation

Valve or Check

ChangeIndicators

SightGlass

AutomaticTrap and Drain

PressureRelief

Gauge

ManualDrain

ASME

OR

Turned downand screened

Duct

Note: An intake filteris required (not shown)

Intake(s)

Compressors

Monitoring

SourceValve

Receiver

AirTreatment& ControlAftercooler/

Air Dryer

Compressors

IsolationValve

CheckValve

ReliefValve

InletIsolationMeans

(valve shown)

AutomaticTrap and Drain

OutletIsolationValve(s)

InletIsolationValve(s)

Aftercooler(s)



Dryer(s)

D.P.

CO ppm

Carbon Monoxideand

Dew PointMonitors

DemandCheck(s)

1/4 NPTSample Port

Note 1: See also Figure A.5.1.3.5.11.6 for arrangement of control components.

Note 2: Unions or other disconnect means may berequired for maintenance and/or replacement ofeach component.

SystemPressure

Switch/Sensor

Figure A.5.1.3.5 Elements of a Typical Duplex Medical Aire Compressor Source System (Level 1 Gas Systems


270

Either

Either

Either

Either

Either

Either

Either

Either

Dryers Filters Regulators

Dryers Filters Regulators

Figure A.5.1.3.5.11.6 Alternate Valving Sequences for Line Controls in Medical Air


271

Ball Valve

Legend

VacuumIndicaror

Demand Check

Note: Unions or other disconnect means may berequired for maintenance and/or replacement of each component.

SourceValve

5.1.4.1.4

VacuumIndicator System

VacuumSwitch/Sensor

SightGlass

Indicator

EitherBypass

Arrangement5.1.3.6.5.2

Vacuumreceivers5.1.3.6.3

VacuumLine5.1.3.6.55.1.9.2

Vibration Isolation5.1.3.6.2.4

ManualValve

Turned downand screened

Note: A drip leg and muffler may be required (not shown)

Discharge(s)

Pump(s)

SourceValve

Receiver

Pumps

IsolationValve

OutletIsolationMeans

(valve shown)

Check Valve(point in direction of flow)

CheckValve

VacuumExhausts5.1.3.6.7

ASME

VacuumPumps5.1.3.6.2

Figure A.5.1.3.6 Elements of a Typical Duplex Vacuum Source System (Level 1 Vacuum Systems)


272

AutomaticTrap & Drain

D.P.

Dew PointMonitor

DemandCheck

Ball ValveAutomaticTrap and Drain

Legend

Check Valve

PressureIndicator

PressureReliefValve

Demand Check

Pressure Regulator

Filter withChangeIndicator

SightGlass

AutomaticDrain

PressureRelief Valve

Gauge

ManualDrain

ASME

Cylinder ReserveHeader

5.1.3.4.8

ReserveSource

Intake(s)

Compressor(s)

Monitoring

SourceValve

ReceiverAir

Treatment& ControlAftercooler/

Air Dryer

Compressor(s)

IsolationValve




CheckValve

ReliefValve

Aftercoolers

Dryer(s)

DemandCheck

SourceValve

ReliefValve

PressureIndicator

SystemPressure

Switch/Sensor

CharcoalAdsorber

Filter

Regulator

InletIsolationValves

OutletIsolation

Valve or Check

ChangeIndicators

InletIsolationMeans

(valve shown)

Note: Unions or other disconnect means may berequired for maintenance and or replacement ofeach component.


Figure A.5.1.3.8 Elements of Typical Instrument Air Source


273

Riser Valve(s)5.1.4.6

Service Valve5.1.4.7


Note: Single service valves are shown, but multiple zones may branch off a single service valve.

Outlet(s)/Inlet(s)Outlet(s)/Inlet(s)

Outlet(s)/Inlet(s)


Future Valve5.1.4.10

ZoneValve5.1.4.10

ZoneValve

5.1.4.10

Zone Valve5.1.4.10

Indicates a valve that must be secured

Noncritical areas, such as general patient rooms

Anesthetizing areas

Critical areas, such as Intensive Care


5.1.8

Source orMain Valve

5.1.4.45.1.4.5

dc

Master Alarm Switch/Sensor5.1.9.2

dc

Area Alarm Switch/Sensor(1)

5.1.9.2

dc

Area Alarm Switch/Sensor(1)5.1.9.2

dc

Main Line

Ris

er

Note: Area alarms are required in critical care locations (examples include intensive care units, coronary care units, angiography laboratories, cardiac catherization laboratories, postanesthesia recovery rooms, and emergency rooms) and anesthetizing locations (examples include operating rooms, delivery rooms). Refer to definitions for these areas.

Figure A.5.1.4 Arrangement of Pipeline Components


274

Standard Terminal Terminals in Manufactured Assemblies

Flexible Hose Assembly

Inte

rior o

f Manufa

cture

d A

ssem

bly

Inte

rior o

f Manufa

cture

d A

ssem

bly

Copper Pipe

SecondaryCheck

PrimaryCheck

PrimaryCheck

{User}Gas Specific

Adapter

{User}Gas Specific

Adapter

{User}Gas Specific

Adapter

SecondaryCheck

PrimaryCheck

DISS PrimaryCheck

Braze Coupling

Figure A.5.1.6 Terminals in Manufactured Assemblies.


275

A.5.1.7 Surface-Mounted Medical Gas Rail Systems. It is theintent that surface-mounted medical gas rail systems would bepermitted in individual patient rooms but would not be allowed togo directly through room walls to adjacent patient rooms.However, it is the intent to allow surface-mounted medical gas railsto be used in a given critical care area where there can be apartition separating certain patient care functions, essentiallyleaving the system within the given critical care area. As anexample, two adjacent patient rooms outside of a critical care unitwould not be permitted to have a surface-mounted medical gas railinterconnect between the two rooms through the wall. However, ina nursery where there might be one or two segregated areas forisolation, a medical gas rail system supplying more than oneisolation room, but within the nursery area, would be permitted tobe interconnected with the nursery system.

A.5.1.7.9 Typical plating would be nickel plating over copper orbrass per Federal Specification QQ-N290, Class I, Type 7.

A.5.1.9.2 See Table A.5.1.9.2 on next page.

A.5.1.9.3

Table A.5.1.9.3 Requirements for Level 1 Area Alarms

Alarm Condition Requirement

High Line pressure (for each gas piped tothe area)

5.1.9.35.1.9.3.15.1.9.3.25.1.9.3.4

Low line pressure (for each gas piped to thearea)

5.1.9.35.1.9.3.15.1.9.3.25.1.9.3.4

Low medical/surgical vacuum (if piped tothe area)

5.1.9.35.1.9.3.15.1.9.3.35.1.9.3.4

Low WAGD vacuum (if piped to the area) 5.1.9.35.1.9.3.15.1.9.3.35.1.9.3.4

A.5.1.9.3.4 (a) This signal is intended to provide immediatewarning for loss of, or increase in, system pressure for eachindividual vital life support and critical care area.

A.5.1.9.3.4 (b) This signal is intended to provide immediatewarning for loss of, or increase in, system pressure for allanesthetizing locations supplied from a single branch line — notfor each individual operating or delivery room.

A.5.1.10.1.4 Operation of piped medical gas systems at pressuresin excess of 1280 kPa (185 psi) gage involves certain restrictionsbecause of the limitations in materials.

A.5.1.10.3.1 A distinction is made between deep-socket solder-jointfittings (ANSI B16.22) and those having shallow sockets for brazing(MSS SP-73). The use of shallow-socket brazing fittings improvesthe quality of the brazement without decreasing its strength,particularly in larger sizes which are difficult to heat. See Table A-4-3.1.2.7(e) for socket depths conforming to MSS SP-73. The installercan use MSS SP-73 fittings (if available) or have the sockets onANSI B16.22 fittings cut down to MSS depths. Where shallow-socketfittings are used for the medical gas piping, care should be taken toavoid their use in other piping systems where joints may besoldered instead of brazed.

Table A.5.1.10.3.1Socket depths for MSS Sp-73 Brazing Fittings

Tube Size Socket Depth1/4 inch (3/8” OD) 0.17 inch

3/8 inch (1/2” OD) 0.2 inch

1/2 inch (5/8” OD) 0.22 inch

3/4 inch (7/8” OD) 0.25 inch

1 inch (1 1/8” OD) 0.28 inch

1 1/4 inch (1 3/8” OD) 0.31 inch

1 1/2 inch (1 5/8” OD) 0.34 inch

2 inch (2 1/8” OD) 0.40 inch

2 1/2 inch (2 5/8” OD) 0.47 inch

3 inch (3 1/8” OD) 0.53 inch

4 inch (4 1/8” OD) 0.64 inch

5 inch 5 1/8” oD) 0.73 inch

6 inch ( 6 1/8” OD) 0.83 inch

A.5.1.10.5.5 The intent is to provide an oxygen-free atmospherewithin the tubing and to prevent the formation of copper oxidescale during brazing. This is accomplished by filling the pipingwith a low-volume flow of low-pressure inert gas.

A.5.1.12.3.2 This is the final pressure test of the completelyinstalled system and is intended to locate any leaks that would bemore likely to occur at lower pressure, for example, leaks in stationoutlet valve seals.

A.5.3.3.5 Level 3 Compressed Air System. The system does notproduce air to meet the medical requirements of medical air and isnot intended to be used for air life support devices.

A.5.3.3.4 Remote. A gas storage supply system can be remotefrom the single treatment facility, but all use points must becontiguous within the facility. [See Figure A-2-2(b).]Figure A-2-2(b) Examples of treatment facilities.

A.5.3.3.4 Single Treatment Facility. The definition of singletreatment facility was established to take into considerationprincipally single-level installations or those of a practice that couldbe two-level, but are reached by open stairs within the confines ofthe single treatment facility.

A.5.3.5 Utility Center (J box). Typically includes electricalreceptacle(s), compressed air, nitrogen, vacuum, and water.

A.5.3.3.6 Vacuum System — Level 3. The system is notintended for Level 1 vacuum applications. A wet piping system isdesigned to accommodate liquid, air-gas, and solids through theservice inlet. A dry piping system is designed to accommodate air-gas only through the service inlet. [Liquid(s) and solid(s) aretrapped before entering the service inlet.]

A-5.1.14 Safe Practice for Cylinders Containing CompressedGases. Specifications for Cylinders. All cylinders containingcompressed gases, such as anesthetic gases, oxygen, or other gasesused for medicinal purposes, whether these gases are flammable ornot, should comply with the specifications and be maintained inaccordance with regulations of the U.S. Department ofTransportation.

Cylinder and container temperatures greater than 125°F (52°C) canresult in excessive pressure increase. Pressure-relief devices aresensitive to temperature and pressure. When relief devices actuate,contents are discharged.

Table A.5.1.9.2 Requirements for Level 1 Master AlarmsMaster Alarms for Level 1 Gas and Vacuum Systems

Alarm Condition Manifold forGas Cylindersw/o Reserve(5.1.3.4.9)

Manifold forCryogenic

LiquidCylinders

w/ Reserve(5.1.3.4.10)

Cryogenic Bulkw/Cryogenic

Reserve(5.1.3.4.11)

Cryogenic Bulkw/Cylinder

Reserve(5.1.3.4.11)

Medical AirCompressors

(5.1.3.5)

Instrument AirCompressors

(5.1.3.8)

MedicalSurgicalVacuumPumps

(5.1.3.6)

WAGDProcedures

(5.1.3.7)

Nitrogen main line pressure high 5.1.9.2.4(6)Nitrogen main line pressure low 5.1.9.2.4(6)Nitrogen changeover to secondary supply 5.1.3.4.9.6

5.1.9.2.4(1)Carbon dioxide main line pressure high 5.1.9.2.4(6)Carbon dioxide main line pressure low 5.1.9.2.4(6)Carbon dioxide changeover to secondary supply 5.1.3.4.9.6

5.1.9.2.4(1)Medical air main line pressure high 5.1.9.2.4(6) 5.1.9.2.4(6)Medical air main line pressure low 5.1.9.2.4(6) 5.1.9.2.4(6)Medical air changeover to secondary supply 5.1.3.4.9.6

5.1.9.2.4(1)Medical air dew point high 5.1.3.5.15(1)

5.1.9.2.4(9)Oxygen main line pressure high 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6)Oxygen main line pressure low 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6)Oxygen changeover to secondary supply 5.1.3.4.9.6

5.1.9.2.4(1)5.1.3.4.10.9(1)

5.1.9.2.4(1)5.1.3.4.11.6(5)

5.1.9.2.4(1)5.1.3.4.11.6(1)

5.1.9.2.4(1)Oxygen main supply less than one day (low contents) 5.1.3.4.11.6(1)

5.1.9.2.4(2)5.1.3.4.11.6(1)

5.1.9.2.4(2)Oxygen reserve in use 5.1.3.4.10.9(2)

5.1.3.4.13.55.1.9.2.4(3)

5.1.3.4.11.6(2)

5.19.2.4(3)

5.1.3.4.11.6(2)5.1.3.4.13.55.1.9.2.4(3)

Oxygen reserve supply less than one day (low contents) 5.1.3.4.10.9(3)5.1.9.2.4(4)

5.1.3.4.11.6(3)5.1.9.2.4(4)

Oxygen reserve pressure low (not functional) 5.1.3.4.11.6(4)5.1.9.2.4(5)

Nitrous oxide main line pressure high 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6)Nitrous oxide main line pressure low 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6) 5.1.9.2.4(6)Nitrous oxide changeover to secondary supply 5.1.3.4.9.6

5.1.9.2.4(1)5.1.3.4.10.9(1)

5.1.9.2.4(1)5.1.3.4.11.6(5)

5.1.9.2.4(1)5.1.3.4.11.6(5)

5.1.9.2.4(1)Nitrous oxide main supply less than one day (low contents) 5.1.3.4.11.6(1)

5.1.9.2.4(2)5.1.3.4.11.6(1)

5.1.9.2.4(2)Nitrous oxide reserve in use 5.1.3.4.10.9(2)

5.1.3.4.13.55.1.9.2.4(3)

5.1.3.4.11.6(2)

5.1.9.2.4(3)

5.1.3.4.11.6(2)5.1.3.4.13.55.1.9.2.4(3)

Nitrous oxide reserve supply less than one day (low contents) 5.1.3.4.10.9(3)5.1.9.2.4(4)

5.1.3.4.11.6(3)5.1.9.2.4(4)

Nitrous oxide reserve pressure low (not functional) 5.1.3.4.11.6(4)5.1.9.2.4(5)

Medical/surgical main line vacuum low 5.1.9.4.2(7)WAGD main line vacuum low 5.1.9.4.2(7)Local alarm 5.1.3.5.14

5.1.9.2.4(8)5.1.9.4.2

5.1.3.8.105.1.9.2.4(8)

5.1.9.4.2

5.1.3.6.85.1.9.2.4(8)

5.1.9.4.2

5.1.3.7.35.1.9.2.4(8)

5.1.9.4.2

Instrument air main line pressure high 5.1.9.2.4(6)Instrument air main line pressure low 5.1.9.2.4(6)Instrument air dew point high 5.1.3.8.10.1

5.1.9.2.4(11)Instrument air cylinder reserve in use (if provided) 5.1.3.8.9.2(3) 5.1.3.8.10.2(1)Instrument air cylinder reserve less than one hour supply 5.1.3.8.9.2(4) 5.1.3.8.10.2(2)


277

A-5.1.14.3.1 Use of so-called nonsparking wrenches and tools isnot necessary.

A-5.1.3.2 Handling of Gas Containers. The precautions outlinedin CGA Pamphlet P-1, Safe Handling of Compressed Gases, andPamphlet P-2, Characteristics and Safe Handling of Medical Gases,should be observed. (See Appendix B.) These publications coversuch items as moving and storage of cylinders, labeling,withdrawing of cylinder contents, and handling of leakingcylinders. Cryogenic fluids are to be used only in containersdesigned for the purpose, such as a double-walled thermos bottle.Caps are to be replaced promptly after each use to prevent thesolidification of atmospheric water vapor in the pouring neck,which otherwise could convert a safe cylinder into a potentialbomb.Protective clothing and eye shields should be used to prevent burnsfrom issuing gases or spilled liquids. Effects of flammable andoxidizing properties are intense and demand special fire protectionmeasures and handling. Inadvertent saturation of clothing byoxygen or spills on asphalt flooring, for example, require promptand accurate corrective measures. Ample ventilation is needed toprevent hazardous concentrations, for example, of nitrogen, whichcould cause asphyxiation. For routine cooling operations, liquidair or oxygen should never be used as substitutes for liquidnitrogen.

A-5.1.3.3.2 Electric wiring and equipment in storage rooms foroxygen and nitrous oxide are not required to be explosion proof.

A-5.1.1.2 These requirements do not restrict the distribution ofother inert gases through piping systems.

A-5.1.9.4 Activation of any of the warning signals shouldimmediately be reported to the department of the facilityresponsible for the medical gas piping system involved. If themedical gas is supplied from a bulk supply system, the owner orthe organization responsible for the operation and maintenance ofthat system, usually the supplier, should also be notified. As muchdetail as possible should be provided.

A-5.1.12 All testing should be completed before putting a newpiping system, or an addition to an existing system, into service.Test procedures and the results of all tests should be made part ofthe permanent records of the facility of which the piping systemforms a part. They should show the room and area designations,dates of the tests, and name(s) of persons conducting the tests.

A-5.1.1 Section 5.1 covers requirements for Level 1 piped gas andvacuum systems; Section 5.2 covers Level 2 piped gas and vacuumsystems; Section 5.3 covers Level 3 piped gas and vacuum systems.Laboratory systems are no longer (2002) covered by Chapter 5.

A-5.1.15.7.4 Vacuum systems from station inlets to the exhaustdischarge should be considered contaminated unless provenotherwise. Methods exist to disinfect the system or portions thereof.Clogging of regulators, for example, with lint, debris, or dried bodyfluids, reduces vacuum system performance.

A- 5.1.15.7.6 The test can be conducted using (1) a rotometer orother flow-measuring device and (2) a vacuum gauge, both devicesbeing fitted with the appropriate station inlet connector.The test procedure will be to measure the flow with the stationinlet wide open while simultaneously measuring the vacuum levelat an adjacent wall station inlet or other station inlet on the samebranch line.It is recognized that this criterion might not be met by someexisting systems. It is the responsibility of facility personnel, basedon past experience and use, to determine the acceptable alternateperformance criterion for their system(s).

A-5.1.15.7.4 Suction collection bottles that are used as part ofpatient treatment equipment should be equipped with an overflowshutoff device to prevent carryover of fluids into equipment of thepiping system. It is recommended that a separate vacuum trap withshutoff be used between the suction collection bottle and thevacuum system station inlet.

A-5.3.3.2 When the storage/supply enclosure is remote from thesingle treatment facility, it should be locked for security reasons toprevent tampering. Access should be only via authorized staff orfire department. When the enclosure is within the single treatmentfacility, it is left to the discretion of the single treatment facilitymanagement as to whether greater benefit is achieved by immediateaccess or by security. An enclosure with direct access from a publichallway should be locked. If the door to the enclosure opens ontoan exit access corridor, see 4-5.1.1.2.

A-5.3.3.5 Level 3 compressed air and nitrogen gas systems are usedprimarily to drive gas-powered power devices. Similar applicationsare in podiatry and plastic surgery. Examples of these are air usedto drive turbine-powered drills and air used to dry teeth and gums.Some dental hand pieces have an internal self-contained air returnsystem, while other hand pieces discharge air into the atmosphere.Some discharge a mixture of air and water. Nitrogen is often pipedas an alternate or reserve supply to the compressor system.The application of dental compressed air is not used for life-support purposes such as respirators, IPPB machines, analgesia,anesthesia, and so forth. Air discharged into the oral cavity isincidental and not a primary source of air to sustain life. However,if there is a coincident use of dental air for providing respiratorysupport, the requirements of dental air will be superseded by thoseof the respiratory support, and the compressed air system mustproduce the higher-quality medical compressed air as defined inChapter 2. This could affect the selection of a compressor.A dental compressed air system should not be used to providepower for an air-powered evacuation system without specificattention paid to the discharge of the evacuated gases and liquids.An open discharge of evacuated gases into the general environmentof an operatory could compromise the quality of breathing air inthe treatment facility. Air discharge should be vented to the outsideof the building through a dedicated vent.An air power evacuation system might require significant quantitiesof air to operate. Manufacturers’ recommendations should befollowed regarding proper sizing of the air compressor. Inadequatesizing can result in overheating, premature compressor failures,and inadequate operating pressures and flows.

A-5.3.3.5.2 Compressed-air quality can be compromised andexpected life of system components can be shortened if anundersized system is installed. Manufacturers’ recommendationsshould be followed regarding proper sizing of the aircompressor(s).

A-5.3.3.5.7 The environmental air source for the compressor inletshould take into consideration possible contamination byparticulates, concentrations of biological waste contaminants,ozone from nearby brush-type electric motors, and exhaust fumesfrom engines.Air taken from an outside atmosphere could cause harmfulcondensation problems in the compressor. Long runs of inlet tubeshould also be avoided as it will degrade compressor performance.The compressor manufacturer’s recommendations should befollowed regarding appropriate pipe size to prevent possibledegradation of system performance.A dental air compressor and dental vacuum system can be in thesame equipment room as long as the inlet for the dental aircompressor does not draw air from a room or space containing anopen discharge for the dental vacuum system.Atmospheric air in an operatory can have traces of mercury vaporand other contaminants. A compressor inlet location that woulddraw its supply directly from an operatory should be avoided.

A-5.3.3.5.5 A color dew point monitor downstream of the receiverindicating the quality of air coming into the receiver is desirable.A color dew point monitor in the main treatment facility isappropriate to help the staff promptly identify when the system isbeing degraded with air of dew point higher than is acceptable.The design of the color monitor should be such that the normaltolerance of variations will limit the maximum moisture at 39°F at100 psig (3.9°C at 690 kPa) at activation.

A-5.3.3.5.8 If nitrogen is used as a backup supply to a compressedgas system, the nitrogen operating pressure should be regulated soas not to exceed the operating pressure of the Level III compressedair system.

A-5.3.3.5.8.6 The ft3 (or m3 ) of stored nitrogen gas is notrestricted.


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A-5.3.3.4.2 If the supply system is within the confines of a singletreatment facility, a simple manual transfer is permissible. Onlyhigh/low pressure alarms are required. The gases are to bemanifolded so a quick manual transfer is possible without life-threatening consequences.However, if the supply system is remote, a prompt transfer of gasesbecomes more difficult. It could require transcending one or moreflights of stairs and/or going to a remote location on the samefloor. Under these situations an automatic system is required.

A-5.3.3.5.3 The installation of a supply serving more than onesingle treatment facility creates by its very nature a remote locationrelative to the other facility. Because more than one practice couldbe involved, the transfer of oxygen and nitrous oxide gases is to beautomatically achieved.

A-5.3.10.10.2 One of the major concerns is the cross-connection ofpiping systems of different gases. The problem of cross-connectionof oxygen and other gases such as nitrous oxide, air, and nitrogencan readily be recognized/prevented by the use of different sizes oftubing. It is recommended that piping and manifolds for oxygenservice be of a different size than the piping intended for other gasservices. The piping for other than oxygen can be of a smaller size.Generally, oxygen is installed in 1/2 in. O.D. tube size and othergases with 3/8 in. O.D. tube size.

A-5.3.10.7.5 The intent is to provide an oxygen-free atmospherewithin the tubing and to prevent the formation of copper oxidescale during brazing. This is accomplished by filling the pipingwith a low-volume flow of low-pressure inert gas.

A-5.3.4 Should a fire occur at night or when the facility is not inuse, fire fighters should not be confronted with a potentialpressurized gas source that could feed the fire and cause extensivedamage and risk of life. Good economics also dictate that when thesystem is not in use, the leakage of gas through hoses, couplings,etc., can be minimized if the system is shut off and portableequipment disconnected.

A-5.3.5 Service outlets can be recessed or otherwise protected fromdamage.

A-5.3.3.6.3 Improper design will permit gas pressure to build up inthe ventilation system and might blow the trap liquid seals.

A-5.3.3.6.4.8 Care should be taken to ensure the dual exhaustsystems do not develop excessive back pressure when using acommon exhaust line.

A-5.3.5.2 This will ensure that the required pressure and flow meetthe secondary equipment manufacturer’s requirements.

A.5.3 Level 3 Vacuum System. The system is not intended forLevel 1 medical/surgical vacuum applications. A Level 3 wet pipingsystem is designed to accommodate liquid, air-gas, and solidsthrough the service inlet. A Level 3 dry piping system is designed toaccommodate air-gas only through the service inlet, with liquidsand solids being trapped before entering the system.

Note:This belongs as an appendix item for the Occupancy Chapterswhere the 3,000 ft3 limit now resides.

It is the intent to provide a simple, safe piping system for smallfacilities. Although the number of use points could be aconsideration, it was felt that actual gas use is a more accurateindicator of complexity. Applications involving a storage in excessof 3000 ft3 (85 m3) would have a complexity warranting installationin accordance with the provisions of Level I patient gas distributionsystems.Although the principal intent is to provide simple installations forsingle treatment facilities, numerous applications exist where aremote use point creates essentially a second treatment facility orwhere the supply system might be shared by another health careprofessional such as another dentist, podiatrist, oral surgeon, orgeneral medicine practioner. The addition of another treatmentfacility requires incremental safety precautions.A maximum of two single treatment facilities also approximates thelimit with which a 3000 ft3 (85 m3) supply system can provide[5000 ft3 (143 m3) when liquid oxygen is used].It is acknowledged that older user analgesia equipment has offereda nitrous oxide lockout device that requires a minimum of 3 L/minoxygen flow. However, a reasonable percentage of older equipmentwithout this safety feature is in daily use. The storage and piping

system is based upon the potential use, either initially orsubsequently, of one of the older style analgesia equipment in oneof the single treatment facilities.The quantity of 3000 ft3 (85 m3), or 5000 ft3 (143 m3) if liquidoxygen storage, is to be taken as the total combined storage ofgases if there is more than one supply system in the singletreatment facility.C-5 Additional Information on Chapter 5.

C-5.1 Initial Testing of Nonflammable Medical Piped Gas Systems(Level 1 Systems).

NOTE: Numbers in brackets refer to paragraphs in Chapter 5 oftext.

C-5.1.1 [5.1.3.4.5.1]The pressure relief valve, set at 50 percent above normal linepressure, should be tested to assure proper function prior to use ofthe system for patient care.

C-5.1.2 [5.1.3.5.2] The proper functioning of the safety valve,automatic drain, pressure gauge, and high-water-level sensorshould be verified before the system is put into service.

C-5.1.3 [5.1.9.2.4] Changeover Warning Signal — 5.1.3.4.9,5.1.3.4.10, and 5.1.3.4.11.

(1) Start a flow of gas from an outlet of the piping system.(2) Close the shutoff valve or cylinder valves on the primary

supply of the manifold (Figure 5.1.3.4.8), or the primary unit of thealternating bulk supply to simulate its depletion (Figure 5.1.3.4.11).Changeover should be made to the secondary supply or thealternate bulk unit.

(3) Check main-line pressure gauge to ensure maintenance ofthe desired pressure.

(4) Check signal panels for activation of the proper changeoversignal.

(5) Silence the audible signal; visual signal should remain.(6) Open the valves closed in Step 2. Close the valve on the

secondary supply or alternate bulk unit. When changeover back tooriginal primary supply has occurred, reopen the valve. This willreinstate system to its original status.

(7) Check signal panels for deactivation of warning signals.(8) Stop flow of gas from the piping system.

C-5.1.4 [5.1.9.2.4] Reserve-In-Use Warning Signal — 5.1.3.4.9,5.1.3.4.10, and 5.1.3.4.11.

(1) Start a flow of gas from the piping system.(2) Close the proper shutoff valves to simulate depletion of the

operating supply. Reserve should begin to supply the piping system.(3) Check the main-line pressure gauge. Pressure should

remain at the desired level.(4) Check the master signal panels to determine that the

reserve-in-use signals have been activated.(5) Silence the audible signal. Visual signal should remain.(6) Open the shutoff valves closed in Step 2.(7) Check master signal panels for deactivation of the warning

signals.(8) Stop the flow of gas from the piping system.

C-5.1.5 [5.1.9.2.4] Reserve Supply Low — 5.1.3.4.10, 5.1.3.4.11,5.1.3.4.13., and 5.1.3.8.2.3.

1. Start a flow of gas from the piping system.2. Close all operating supply shutoff valves (to use pressure

from the reserve).3. Close the reserve supply shutoff valve or, if necessary, the

reserve cylinder valves, depending on the exact location of theactuating switch (to reduce pressure on the actuating switch,simulating loss of reserve).

4. Open the operating supply valves closed in Step 2 (so thatonly the “reserve low” signal should be activated).

5. Check the master signal panels for activation of the propersignal.

6. Silence the audible signal. Visual signal should remain.7. Open reserve supply valve or cylinder valves closed in Step

3.8. Check master signal panels for deactivation of the warning

signals.9. Stop flow of gas from the piping system.

Note on Liquid Bulk Reserves.This type of reserve requires an actuating switch on the contentsgauge and another actuating switch for the gas pressure beingmaintained in the reserve unit. Reduced contents or gas pressure inthe reserve unit would indicate less than a day’s supply in reserve.


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Simulation of these conditions requires the assistance of the owneror the organization responsible for the operation and maintenanceof the supply system as it will vary for different styles of storageunits.

C-5.1.6 [5.1.9.2.4] High or Low Pressure in Piping System.Initial test of the area alarms covered in 5.1.9.3 can be done at thesame time.

(1) Increase the pressure in the piping system to the high-pressure signal point (20 percent above normal pressure).

(2) Check all master signal panels (and area signals) to ensurethat the properly labeled warning signal is activated; also checkmain-line pressure gauge and area gauges to ensure their function.

(3) Silence the audible signal. Visual signal should remain.(4) Reduce piping system pressure to the normal. A flow from

the system is required to lower the pressure and permitreadjustment of the line regulator.

(5) Check all signal panels for deactivation of the signals.(6) Close main-line shutoff valve.(7) Continue the flow from the system until pressure is reduced

to the low-pressure signal point (20 percent below normal).(8) Check all signal panels for activation of the properly labeled

warning signal; also check main-line gauge and area pressuregauges to ensure their function.

(9) Silence the audible signa l. Visual signal should remain.(10) Open main-line shutoff valve.(11) Check main-line gauge for proper line pressure.(12) Check all signal panels for deactivation of warning signals.

C-5.1.7 [5.1.9.3] This signal should be initially tested at the timethe tests of C-5.1.6 are performed.

C-5.2 Retesting and Maintenance of Nonflammable Medical PipedGas Systems (Level 1 Systems).NOTE: Numbers in brackets refer to paragraphs in Chapter 4 oftext.

C-5.2.1 [5.1.3.4.9] These systems should be checked daily to assurethat proper pressure is maintained and that the changeover signalhas not malfunctioned. Periodic retesting of the routinechangeover signal is not necessary as it will normally be activatedon a regular basis.

C-5.2.2 [5.1.3.4.10] These systems should be checked daily toassure that proper pressure is maintained and that the changeoversignal has not malfunctioned. Periodic retesting of the routinechangeover signal is not required. Annual retesting of theoperation of the reserve and activation of the reserve-in-use signalshould be performed.

C-5.2.3 [5.1.3.4.10] If the system has an actuating switch and signalto monitor the contents of the reserve, it should be retestedannually.

C-5.2.4 [5.1.3.4.11] Maintenance and periodic testing of the bulksystem is the responsibility of the owner or the organizationresponsible for the operation and maintenance of that system.

The staff of the facility should check the supply system daily toensure that medical gas is ordered when the contents gauge dropsto the reorder level designated by the supplier. Piping systempressure gauges and other gauges designated by the suppliershould be checked regularly, and gradual variation, either increasesor decreases, from the normal range should be reported to thesupplier. These variations might indicate the need for correctiveaction.

Periodic testing of the master signal panel system, other than theroutine changeover signal, should be performed. Requestassistance from the supplier or detailed instruction if readjustmentof bulk supply controls is necessary to complete these tests.

C-5.2.5 [5.1.8.8] The main-line pressure gauge should be checkeddaily to ensure the continued presence of the desired pressure.Variation, either increases or decreases, should be investigated andcorrected.

C-5.2.6 [5.1.3.5.13] Quarterly rechecking of the location of the airintake should be made to ensure that it continues to be asatisfactory source for medical compressed air.

C-5.2.7 [5.1.3.5.14] Proper functioning of the pressure gauge andhigh-water-level sensor should be checked at least annually. Check

the receiver drain daily to determine if an excessive quantity ofcondensed water has accumulated in the receiver.

C-5.2.8 [5.1.3.5] An important item required for operation of anymedical compressed air supply system is a comprehensivepreventive maintenance program. Worn parts on reciprocatingcompressors can cause high discharge temperatures resulting in anincrease of contaminants in the discharge gas. Adsorber beds, ifnot changed at specified time intervals, can become saturated andlose their effectiveness. It is important that all components of thesystem be maintained in accordance with the manufacturers’recommendations. It is important that any instrumentation,including analytical equipment, be calibrated routinely andmaintained in operating order. Proper functioning of the dewpoint sensor should be checked at least annually.

C-5.2.9 [5.1.9] When test buttons are provided with signal panels,activation of the audible and visual signals should be performed ona regular basis (monthly).

C-5.2.10 [5.1.9.2.4] Changeover Warning Signals As these areroutine signals that are activated and deactivated at frequentintervals, there is no need for retesting UNLESS they fail. If thereserve-in-use signal is activated because both units of the operatingsupply are depleted without the prior activation of the changeoversignal, it should be repaired and retested.

C-5.2.11 [5.1.9.2.4] Reserve-In-Use Warning Signal All componentsof this warning signal system should be retested annually inaccordance with Steps 2 through 7 of the procedure given in C-5.1.4. Audible and visual signals should be tested periodicallyduring the year (monthly).

C-5.2.12 [5.1.9.2.4] Reserve Supply Low (Down to an average one-day supply)High-Pressure Cylinder or Liquid Reserve.All components of these signal warning systems should be retestedannually in accordance with Steps 2 through 8 of the proceduregiven in C-5.1.5. If test buttons are provided, audible and visualsignals should be periodically tested throughout the year(monthly).

C-5.2.13 [5.1.9.2.4] The medical compressed air system alarms in5.1.3.5.14 should be checked at least annually.

C-5.2.14 [5.1.8.8 (1)] This pressure gauge should be checked on adaily basis to ensure proper piping system pressure. A change,increase or decrease, if noted, can give evidence that maintenanceis required on the line pressure regulator and could thus avoid aproblem.

C-5.2.15 [5.1.9] Annual retesting of all components of warningsystems, if it can be done without changing piping system linepressure, should be performed.

C-5.2.16 [5.1.9] If test buttons are provided, the retesting of audibleand visual alarm indicators should be performed monthly.

C-5.2.17 [5.1.4] Shutoff valves should be periodically checked forexternal leakage by means of a test solution or other equallyeffective means of leak detection safe for use with oxygen.

C-5.2.18 [5.1.5] Station outlets should be periodically checked forleakage and flow. Instructions of the manufacturer should befollowed in making this examination.

C-5.7 Oxygen Service Related Documents.The following publications may be used for technical reference:ASTM G63, Guide for Evaluating Nonmetallic Materials for OxygenService.ASTM G88, Guide for Designing Systems for Oxygen Service.ASTM G93, Practice for Cleaning Methods for Material andEquipment Used in Oxygen-Enriched Environments.ASTM G94, Guide for Evaluating Metals for Oxygen Service.SUBSTANTIATION: Editorial restructuring, to conform with the2000 edition of the NFPA Manual of Style.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker


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COMMENT ON AFFIRMATIVE: ERICKSON: I want everyone to know how long and hard theManual of Style Task Group worked on this task. The original taskgroup was made up of Dick Wagner, David Mohile, DanielShoemaker, Mark Allen and myself. Along the way we includedDale Dumbleton and Michael Frankel to assist us in reviewing thedocument. NFPA staff, at times as many as three, were also at ourmeetings and involved with the review of proposed material. If Ihad to calculate the professional hours and fees associated withthis volunteer effort it would be in the hundreds of thousands ofdollars not counting the out of pocket expenses to attend the MOSmeetings. The NFPA and the using public needs to extend a hugethanks to the volunteers who made this happen. It was amonumental undertaking that has produced a much more userfriendly document, the goal of the NFPA. For those of you familiarwith the older version of Chapter 4 when you read the new Chapter5 it is going to be totally different in appearance and format. Inour efforts to comply with the NFPA's Manual of Style the entirechapter needed to be reformatted and paragraphs broken downinto individual requirements. The MOS task group did its absolutebest at only making style changes and not to modify the text so thatthe requirements changed in meaning. In some cases this was verychallenging and needed the consensus of the task group to make ithappen. In closing, I especially want to thank the three people that withouttheir dedication and countless hours of work this task would neverhave happened: Dick Wagner, Mark Allen, and David Mohile. ESHERICK: I agree with the new Chapter 5 as long as thecommittee's and my comments are incorporated therein.

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99- 188 - (5-2.4.4.5): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-152RECOMMENDATION: Add new subsections to 5.2.4.4.5 asfollows: 5.2.4.4.5.1 WAGD line pressure low signal shall be alarmed atboth master signal alarm panels when a central dedicated pump isprovided per XXXX. 5.2.4.4.5.2 WAGD Lag in use shall be alarmed on the local alarmpanel if WAGD is provided by a central pump. 5.2.4.4.5.3 WAGD shall be alarmed at the anesthetizinglocation(s) area alarm panel.SUBSTANTIATION: These requirements bring WAGD systemsinto compliance with other medical gas and vacuum systems.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 189 - (8-1.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Replace dangerous with potentiallyharmful. 8.1.1 (7.1.2) Although An appliance that yields erroneous data orfunctions poorly can be is potentially harmful dangerous . ,q Q ualityand assurance of full appliance performance is not covered exceptas it relates to direct electrical or fire injury to patients orpersonnel.SUBSTANTIATION: Editorial.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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(Log #CC200)Committee: HEA-GAS

99- 190 - (8-3.1.11.1, 8-3.1.11.2): AcceptSUBMITTER: Technical Committee on LaboratoriesCOMMENT ON PROPOSAL NO: 99-320RECOMMENDATION: Revise the technical committee's actionsin Proposal #99-320 (Log #CP302): Storage for nonflammable gases equal to or greater than 85 m3

(3000 ft3) uncompressed shall comply with 4-3.1.1.2 and 4-3.5.2.2. 8.4.2 8.3.1.11.2 Storage for nonflammable gases greater than8.5m 3 (300 ft 33 ) but less than 85 m3 (3000 ft 3 ), uncompressed . to read as follows: Storage for nonflammable gases equal to or greater than 85 m 3

(3000 ft3 ) uncompressed compressed shall comply with 4-3.1.1.2and 4-3.5.2.2. 8.4.2 8.3.1.11.2 Storage for nonflammable gases greater than8.5m 3 (300 ft 3 ) but less than 85 m3 (3000 ft3), uncompressedcompressed .SUBSTANTIATION: The committee reconsidered the use ofcommonly used compressed gas industry designations.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 ABSTENTION: 1 NOT RETURNED: 1 CrowleyEXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 191 - (8-3.11.3): Accept in PrincipleSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-324RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor further consideration. The Technical Committee Statement didnot address the submitter’s substantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept in Principle.Insert a new section 8-4.3, renumbering the existing 8-4.3, asfollows: 8-4.3 Storage for nonflammable gases with a total volumecompressed equal to or less than 8.5 m 3 (300 ft 3 ). (a) Individual cylinder storage associated with patient care areas,not to exceed 2100 m 2 (22,500 ft 2 ) , are not required to be stored in enclosures. (b) Precautions in handling these cylinders shall be inaccordance with 4-3.5.2.1.COMMITTEE STATEMENT: The Committee's Action addressesthe submitter’s substantiated concerns.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 ABSTENTION: 1 NOT RETURNED: 1 CrowleyCOMMENT ON AFFIRMATIVE: LIPSCHULTZ: Please enter a comment for next cycle that newpart 8-4.3.a should not just be restricted to individual cylinders.EXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 192 - (8-4.1.2.1.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Revise text to read as follows: 8.4.1.2.1.1 All cord-connected electrically powered appliancesthat are not double insulated and are used in the patient carevicinity shall be provided with a three-wire power cord and a three-pin grounding-type plug.SUBSTANTIATION: Editorial to avoid a conflict with 8.4.1.2.1.2.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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NOTE: Since the ballot on this Comment did not confirm theCommittee Action, the comment is being rejected.


99- 193 - (8-4.1.2.4.1):SUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Change (e)'s (a) and (b) to (e)'s (1) and(2). 8.4.1.2.4.1 Exception No. 1: Foot-treadle-operated controllers areshall be permitted in any anesthetizing location if appended toportable electric appliances in an approved manner. Foot-treadle-operated controllers and their connector shall be splashproof. Exception No. 2: Two or more power receptacles supplied by aflexible cord are shall be permitted to be used to supply power toplug-connected components of a movable equipment assembly thatis rack-, table-, or pedestal-mounted provided all of the followingconditions are met : (a) The receptacles are an integral part of the equipmentassembly, permanently attached; and(b) The sum of the ampacity of all appliances connected tothe receptacles shall not exceed 75 percent of the ampacity of theflexible cord supplying the receptacles; and (c) The ampacity of the flexible cord is suitable and shall be inaccordance with the current edition of NFPA 70, NationalElectrical Code; and (d) The electrical and mechanical integrity of the assembly isregularly verified and documented through an ongoingmaintenance program. (e) Exception No. 3: Overhead power receptacles are shall be permitted to be supplied by a flexible cord with strain relief (ceiling drop) that is connected at a ceiling-mounted junction boxand either of the following ways : (a) (1) Permanently; or (b) (2) Utilizing a locking-type attachment plug cap andreceptacle combination, or other method of retention. In eitherconnection made, suitable strain relief shall be provided

SUBSTANTIATION: Editorial, paragraph numbering.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 5 NEGATIVE: 3 NOT RETURNED: 2 Carlson, WilleyEXPLANATION OF NEGATIVE: DAVID: (1) "Exception No. 2 should now read Exception No. 1. (2) the exception belongs to 8.4.1.2.1.1 and not to 8.4.1.2.4.1. LIPSCHULTZ: I strongly ask that any other committee memberswho may have voted for this proposal reconsider their vote as themeaning is totally changed in spite of the substantiation readingthat the change was meant to be editorial. I also ask that theCorrelating Committee read the changes carefully before acceptingthem. Exception No. 2 is not an exception to what was Exception No. 1(now the main 8.4.2.4.1). This wording has nothing to do with"foot treadle operated controllers." Part (e) (Old Exception No. 3) doesn’t make any sense as part ofException No. 2. It was better as a freestanding exception. This isespecially true since the revised wording to Exception No. 2 hasnow added the words "provided that all of the following conditionsare met:" This wording now requires all auxiliary power

receptacles to be overhead from the ceiling. This conflicts directlywith condition (a) that requires that "The receptacles are anintegral part of the equipment assembly." There are two extraneous words (In either) stuck on the end of(e) (2). MURNANE: I believe that the intent of the Technical Committeewas to make only editorial changes involving paragraph numberingand mandated editorial text changes. These type changes can beaccepted, however the resulting text is not consistent with this. TheCorrelating Committee needs to view this change with respect tothe intended purpose as stated in the substantiation. Twoadditional comments, the "are" in the first sentence of 8.4.1.2.4.1should be lined out and shouldn’t "exception 2" be lined out as theexceptions were to be formatted out. The committee can thenclean up the text to reflect the intent as noted above. The proposalshould not go to print as is.

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99- 194 - (8-4.2.2.1.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Revise to read as follows: 8.4.2.2.1.1 The leakage current for facility-owned appliances (e.g.,housekeeping or maintenance appliances) shall not exceed 500microamperes when: a. they are used in a patient care vicinity and, b. will, in normal, use contact patients Tests shall be made with Switch A in Figure 8.4.1.3.5 7-5.1.3.5 inthe open position for two-wire equipment that is not double-insulated.SUBSTANTIATION: Editorial clarification.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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99- 195 - (8-4.2.2.2): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Revise text to read as follows: 8.4.2.2.2* 7-5.2.2.2* Laboratory. 8.4.2.2.2.1 (a) Portable equipment intended for laboratory useshall be grounded or otherwise arranged provided with anapproved method to protect personnel against shock.SUBSTANTIATION: Corrects an editorial error made during theproposal process that resulted in limiting the methods to protectagainst shock.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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99- 196 - (8-5.2.1.5.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Restore existing text deleted in the ROP,as follows: 8.5.2.1.5.1 Only equipment that is specifically designed to beconnected directly to electrically conductive pathways to a patient’sheart (e.g., intracardiac electrodes such as implanted pacemakerleads and guide wires) shall be provided with isolated patient leadsor connections. Only equipment that is specifically designed forthe purpose, that is, provided with suitable isolated patient leads orconnections (see 9-2.1.12, Direct Electrical Pathways to the Heart),shall be connected directly to electrically conductive pathways to apatient’s heart. Such electrically conductive pathways include


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intracardiac electrodes such as implanted pacemaker leads andguide wires.SUBSTANTIATION: The original editorial change inadvertentlychanged the standard's intent and meaning.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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99- 197 - (8-5.2.4.6): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Add the word "that" and delete "they". 8.5.2.4.6* 7-6.2.4.3 When h H igh-energy-delivering probes (such asdefibrillator paddles) or other electrical devices that do not complywith 8.5.2.4.1 and 8.5.2.1.4.2 7-6.2.4.1 that are deemed essential tothecare of an individual patient and must be used within a site ofadministration or within oxygen delivery equipment, they shall bepermitted . used with extreme caution.SUBSTANTIATION: Editorial.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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99- 198 - (8-5.5.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Revise text to read as follows: 8.5.5.1 7-6.5.1 Personnel concerned with the application andmaintenance of electric appliances, including physicians, nurses,nurse ing aids assistants engineers, and technicians, and orderlies,shall be cognizant of the risks associated with their use.SUBSTANTIATION: Editorial.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

___________________(Log #179)

Committee: HEA-LAB99- 199 - (Chapter 10): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-330RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that a portion of this proposal beeditorially corrected. In new paragraph 11.5.4, insert "be" between"would" and "classified by the authority... " and insert "as" between"... jurisdiction" and "severe."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 200 - (10-7.1 & A-10.7.1): RejectSUBMITTER: Jon NisjaCOMMENT ON PROPOSAL NO: 99-330RECOMMENDATION: Revise 10.7.1 to read: 10.7.1* General.

Flammable and combustible liquids shall be stored , handled andused in accordance with NFPA 30. with care and with knowledge oftheir hazardous properties, both individually and in combinationwith other materials with which they can come in contact. A.10.7.1 The storage, handling, and use of flammable liquidsshould be with care and with knowledge of their hazardousproperties, both individually and in combination with othermaterials with which they can come in contact. SUBSTANTIATION: NFPA 99 should be referencing the standardthat has the scope and responsibility for flammable andcombustible liquids. The last sentence is appendix material andshould be moved to the appendix to comply with the manual ofstyle.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: Storage of flammable andcombustible liquids is addressed in paragraph 10-7.2. Thecommittee's intent is that 10-7.1 provides an overall mandate forstaff knowledge to ensure safe handling.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 201 - (10-7.1.1): RejectSUBMITTER: Jon NisjaCOMMENT ON PROPOSAL NO: 99-335RECOMMENDATION: Reconsider the original proposal andaccept.SUBSTANTIATION: We do not agree with the committeestatement on the rejection of this proposal. The scope of NFPA 30does not discriminate on the amount of flammable liquid. Also wedo not believe that the technical committee has the authority tochange requirements that another standard, in this case 30, hascontrol of. NFPA 30 in 4.4.3.5 does not permit any quantity in anyoccupancy. Our concern is that in any occupancy, even industrial(a low life safety hazard occupancy) they are not permitted to storeClass 1 liquids but a heath care facility (a high life safety hazardoccupancy) can. This does not make sense. NFPA 99 should haveto follow the same rules as other occupancies and comply with thescopes of those codes and standards that have control of particularhazards.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The existing restrictions concerningClass I liquids in 10-7.2.1 limits the quantities of Class I liquids inhospital laboratories, and fire protection requirements areprovided for within chapter 10 and in NFPA 101.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

___________________(Log #180)

Committee: HEA-LAB99- 202 - (10-8.1.5): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-340RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned tocommittee. The proposed new wording needs to provide concise,specific, and enforceable language.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Replace the existing text, and that of Proposal 99-340 with thefollowing: There shall be a written procedure for the disposal of hazardouswaste in accordance with local, state and federal hazardousmaterial and waste regulations. NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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283

(Log #181)Committee: HEA-HCE

99- 203 - (11-1): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-343RECOMMENDATION: It was the action of the TechnicalCorrelating Committee to correct a typographical error. In the lastline, insert "mitigation" between "...preparedness," and "recovery."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 10 NOT RETURNED: 9 Gulinello, Jarrett, Phillips, Salamone,Sinsigalli, Spahr, Stone, Svetlik, Woodfin

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99- 204 - (12-2.8, 13-2.1, 16-2.1, 17-2.1 (New 13.2.8, 14.2.1, 17.2.1,18.2.1)): AcceptSUBMITTER: Technical Committee on AdministrationCOMMENT ON PROPOSAL NO: 99-356RECOMMENDATION: Revise the following: "Laboratories. The governing boards.." " Responsibilities. The governing body ..."SUBSTANTIATION: Editorial continuity.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 205 - (12-3.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-348RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The Technical Committee on Pipingmaintains all the requirements except for part (d).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 206 - (12-3.4): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-348RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.

COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: 12.3.4.1(b) and (c) apply only in thesituations where patients are served by the system. These sectionsare not specific to laboratories for that reason.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 207 - (13-2 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-350RECOMMENDATION: The Technical Correlating Committeedirects that this proposal be returned to Committee; the action andaccomplishment are not clear.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The Committee accepts theCorrelating Committee’s direction to review and comment. The Committee Accepted in Principle Proposal 99-350(Log #325). The Committee does not want to use Table 15-3.4, ascontained in Proposal 99-350, to define gas and vacuum systemlevels. Since definitions for gas and vacuum system levels did not exist inthe chapter of definitions within NFPA 99, the Committee drafteddefinitions. As noted in the Committee Statement of Proposal 99-350, the committee’s definitions are contained within Proposal 99-20 (Log #CP710. Providing written definitions achieves the intentof Proposal 99-350 (Log #325) in principle. Proposal 99-20 (Log #CP710) was referred to the TechnicalCommittee on Administration by the Technical CorrelatingCommittee on Health Care Facilities, as the Technical Committeeon Administration is responsible for definitions.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 209 - (13-3.4): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-352RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.


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SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement on 99-206(Log #182a).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 210 - (13-3.4.2): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-354RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement. TheCommittee Statement does not address the submitter’srecommendation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The statement being proposed to berevised no longer exists.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 211 - (13-3.4.7): AcceptSUBMITTER: Burton R. Klein , Burton Klein Associates

COMMENT ON PROPOSAL NO: 99-355RECOMMENDATION: Reconsider and accept proposal 99-355.SUBSTANTIATION: 1. T/C reason for rejection is not related torecommendation. If inhalation anesthetics are administered in"other health care facilities", T/C needs to document why a WAGDsystem is not required in "other health care facilities" since aWAGD system is required for hospitals that administer inhalationanesthetics. 2. Reasons provided in proposal 99-355 are still considered valid.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 212 - (13-3.4.7): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-355RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement as theCommittee Statement does not address the submitter’ssubstantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The committee reversed the actionon Proposal 99-355.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 213 - (13-4 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-356RECOMMENDATION: It was the action of the TechnicalCorrelating Committee to accept the Technical Committee’s actionand further propose that the Technical Committee consider that13-2.1 be revised to read: "Laboratories. Responsibilities. Thegoverning boards ..." Substantiation: Paragraph 13-2.1 concerns responsibilities and isnot limited to laboratories. Of all of the occupancies withinChapter 13, laboratories are a special area that need to beaddressed.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 ABSTENTION: 1 NOT RETURNED: 1 CrowleyEXPLANATION OF ABSTENTION: BRANCROFT: Have not been able to follow committee processsecondary to extensive hospitalization.

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99- 214 - (13-4 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-357RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that the submitter’s substantiation wastechnically correct. Paragraph 13-4.2 is appropriate. See TechnicalCommittee on Gas Delivery Equipment Proposal 99-356(Log #112).SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 215 - (Chapter 15): AcceptSUBMITTER: Technical Committee on Piping SystemsCOMMENT ON PROPOSAL NO: 99-80RECOMMENDATION: Add new Chapter 15 as follows: Chapter 15 Veterinary Facilities 15.1 Applicability. This chapter applies to veterinary facilities. 15.3.5 Gas and vacuum systems requirements. Gas and vacuumsystems used in veterinary facilities shall conform to Level 3 pipedgas systems of Chapter 5.SUBSTANTIATION: This committee comment was toaccomplish the directive of 99-9 (Log #301) of the TechnicalCommittee on Administration.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 216 - (Chapter 15): Accept TCC NOTE: See Technical Correlating Committee Note onComment 99- (Log #32).SUBMITTER: Technical Committee on AdministrationCOMMENT ON PROPOSAL NO: 99-9RECOMMENDATION: Create a new Chapter 15, VeterinaryFacilities. The committee directs the Technical Committee onPiping Systems to write sections 15-1 Applicability, and 15-3.4 Gasand Vacuum System Requirements. The remaining sectionheadings remain reserved.SUBSTANTIATION: The committee is creating a new chapter 15in response to the modifications made to the scope by acceptingComment 99-3 (Log #32) . The new chapter is created to separatethe medical missions of health care and veterinary facilities, whileprotecting their respective staffs.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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99- 217 - (15-3.4.8 and 15-3.4.9): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-358RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 219 - (16-3.4.2): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-360RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement. TheCommittee Statement does not address the submitter’ssubstantiation.

SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The statement being proposed to berevised no longer exists.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 221 - (17-3.4): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-361RECOMMENDATION: The Technical Correlating Committeerefers this proposal to the Technical Committee on Laboratoriesfor review, comment and correlation with the TechnicalCommittee on Piping Systems.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: See Committee Statement on 99-206(Log #182a).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 8VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 7 NOT RETURNED: 1 Linder

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99- 222 - (17-3.4.2): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-362RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement. TheCommittee Statement does not address the submitter’ssubstantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.COMMITTEE STATEMENT: The statement being proposed to berevised no longer exists.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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286

(Log #194)Committee: HEA-HYP

99- 223 - (Chapter 19): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-363RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that a portion of this proposal (19-2.5.5) bereturned to committee to clarify their intentions. The strikethrough and underscore in 19-2.5.5 should have been moreexplicit, making it consistent with the reorientation of theparagraph.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.19-2.5.5 Testing Requirements. The deluge and handline systemsshall be functionally tested at least semiannually per 19-2.5.2.3 fordeluge systems and 19-2.5.3.4 for handline systems. 19.2.5.5.1 If a bypass system is used, it shall not remain in the testmode after completion of the test. 19.2.5.5.2 During initial construction, or whenever changes aremade to the installed deluge system which will affect the spraypattern, testing of spray coverage to demonstrate conformance tothe requirements of 19-2.5.2.3 shall be performed at surfacepressure,and at maximum operating pressure. The requirements of 19-2.5.2.3 shall be satisfied under both conditions. 19.2.5.5.3 A detailed record of the test results shall be supplied tothe authority having jurisdiction and the hyperbaric facility safetydirector.COMMITTEE STATEMENT: Paragraph numbers provided toclarify committee's intent.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 224 - (Chapter 19): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-366RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be editorially corrected.In the existing paragraph 19-2.1.1, Exception No. 2, the term "2-hour fire resistive-rated" precedes perimeter, barrier, andconstruction. Replace "resistive" with "resistant " for continuitywith NFPA 101. In the existing paragraph 19-2.7.3.1, Exception No.1, replace "classified as flame resistant" with "classified as flameretardant."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 225 - (Chapter 19): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-367RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned tocommittee. The paragraph is difficult to read, should not be in alist format and delete "its" in paragraph 19-3.1.4.3(a). Betweenparagraphs 19-3.2.2 and 19-3.5.1.1 there is a directive to relocatetext; the meaning is unclear whether it pertains to the paragraphabove or below. The intent of "See also A-19.3.2.2" is unclear.

SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.19-3.1.4.3 All personnel, including those involved in maintenanceand repair of the hyperbaric facility shall be trained on thepurpose, application, operation, and limitations of emergencyequipment. Revise the following ROP text following 19-3.2.4 ...."Relocate thefollowing text to Annex for 19-3.2.4-"(see also A-19-3.2.2.)", asfollows: Add an asterisk as indicated in the ROP, and an appendix note A- 19.3.2.4 See also A-19.3.2.2 COMMITTEE STATEMENT: Revised to eliminate the list andclarify intent. A-19.3.2.4 clarifies the committee's original intent.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 226 - (Chapter 19): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-369RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be editorially corrected.In new paragraph 19-2.4.1.3.3 delete the word "A", beginning thesentence with "Breathing."SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.The proposal number is 99-371 in the ROP, not 99-369. Revise: (New) 19-2.4.1.3.3 Such A breathing apparatus shall function atall pressures....source so as to prevent excessive current draw onthe system during As follows: (New) 19-2.4.1.3.3 Such A Breathing apparatus shall function atall pressures....source so as to prevent excessive current draw onthe system duringNUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 227 - (Chapter 19): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-372RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor editorial correction. Rewrite existing paragraph 19-1.1.1 tosuccinctly convey the Technical Committee’s intended messageSUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise: 19-1.1.1* The purpose of this chapter is to set forth minimumsafeguards for the protection of patients or other subjects of, andpersonnel administering, hyperbaric therapy and experimentalprocedures. Its purpose is also to offer some guidance for rescuepersonnel who are not ordinarily involved in hyperbaric chamberoperation, but who could become so involved in an emergency. As follows: 19-1.1.1* The purpose of this chapter is to set forth minimumsafeguards for the protection of patients or other subjects of, andpersonnel administering, hyperbaric therapy and experimental


287

procedures. Its purpose is also to offer some guidance for rescuepersonnel who are not ordinarily involved in hyperbaric chamberoperation, but who could become so involved in an emergency.19-1.1.2 Requirements cited in this section are minimum ones.Discretion on the part of chamber operators and others mightdictate the establishment of more stringent regulations.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 228 - (19-2.1.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-377RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. In the Committee Statement, expand uponthe reason for rejection; address the submitter’s substantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Change Committee Action to Proposal 99-377 (Log #296) fromReject to Accept.COMMITTEE STATEMENT: The committee reconsidered themerits of the proposal.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 229 - (19-2.2.1): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-378RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. In the Committee Statement, expand uponthe reason for rejection; address the submitter’s substantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise the substantiation to read as follows: Committee believes current wording is adequate. As proposed the wording was ambiguous and unenforceable.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 230 - (19-2.4.5 (New) ): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-382RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. The Technical Committee did notsubstantiate why it is beyond the scope of the committee. TheTechnical Correlating Committee believes it is part of theTechnical Committee’s scope, and that the proposal bereconsidered.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordance

with 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise the proposed new text in Proposal #99-382 (Log #229): 19-2.4.5 Emergency Depressurization Capability. All chambersshall be provided with an emergency depressurization mechanismcapable of depressurizing the chamber from 3 ATA to surfacepressure in less than 120 seconds. Operation of this mechanismshall be possible only by direct operator action. A lock-outcapability shall be permitted for use when chamber occupants haveincurred a decompression obligation. As follows: 1. Change Committee Action of Reject to Accept in Principle. 19-2.4.5 Emergency Depressurization Capability. 19-2.4.5.1 All Class A chambers shall be provided with anemergency depressurization mechanism capable of depressurizingthe chamber from 3 atm abs (304.0 kPa) to surface ambient pressure in less no more than 6 minutes 120 seconds. Operationof this mechanism shall be possible only by direct operator action.A lock-out capability shall be permitted for use when chamberoccupants have incurred a decompression obligation. 19-2.4.5.2 Class B chambers shall be capable of depressurizingfrom 3 atm abs (304.0 kPa) to ambient pressure in no more than2 minutes. COMMITTEE STATEMENT: 1. The committee reconsidered theProposal 99-382 (Log #299). 2. The proposed value was modified to reflect current design andoperating standards in both Class A and Class B chambers.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 231 - (19-2.5): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-383RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. The Technical Committee stated theprocedures are essential. The Technical Correlating Committeedirects the Technical Committee to develop the language toimplement the procedures.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: 1. The committee rejects thecorrelating committee's direction to develop language for theimplementation of the submitter’s procedures. 2. The procedures listed in the submission are addressed in thefollowing sections: 19-3.1.5.4; 19-3.1.5.1; 19-2.9.1; 19-2.7.4.1; 19-3.1.5.6, A-19-3.1.5.6; 19-2.8.5, 19-2.8.5; 19-2.2.1; 19-2.4.1.1; 19-1.4.1.4; 19-2.7.3.10; 19-2.7.3.2; and 19-2.7.6.1. 3. Compliance with these sections does not eliminate the needfor a deluge system. The only documented Class A Chamber firein a United States health care facility with known survivors wasextinguished by a deluge system activated by staff from outside ofthe chamber.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 232 - (19-2.5.1.1, 19-2.5.1.2,19-2.5.3.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-385RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. For Committee Statement No. 2, address thesubstantiation made by the submitter.


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SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise the Action and Recommendation of 99-385 (Log #121): "(1) Revise 19-2.5.1.1 to read: "A fire suppression system consisting of an independentlysupplied and operating handline system and deluge system shall beinstalled in all Class A chambers." (2) Revise 19-2.5.1.2 to read:"Design of the fire suppression system shall be such that failure ofcomponents or water supply in either the handline system ordeluge system will not render the other system inoperative. Thehandline and deluge systems shall be permitted to be suppliedfrom a common water source only if one or both of them containsa holding tank of sufficient size to meet the requirement of thisstandard without refilling." (3) Revise last sentence of 19-2.5.3.4 to read: "The system shall be capable of supplying a minimum of 5 gpm(18.8 L/min) simultaneously to each of any two of the handlines atthe maximum chamber pressure for a period of not less than fourminutes." As follows: 1. Change the Committee Action of 99-385 (Log #121) fromReject to Accept in Principle in Part. 2. Item No.1: (The action was to Accept in Principle andreferred to 99-384 (Log #278). The committee is further modifyingthe text of 99-384 as follows: ) "A fire suppression systemconsisting of an independently supplied and operating handlinesystem and deluge type water spray systems shall be installed in allClass A chambers." 3. Item No. 2: Reject the submitter's proposed text revision. 4. Item No. 3: Accept the proposed revision of 19-2.5.3.4 to read: The system shall be capable of supplying a minimum of 5 gpm(18.8 L/min) simultaneously to each of any two of the handlines atthe maximum chamber pressure for a period of not less than fourminutes."COMMITTEE STATEMENT: 1.The committee reconsidered 99-385 (Log #121) 2. Item No. 1: Was addressed by 99-384 [Log #278] (Add theword "system" following the word "handline." Revise text asfollows:"A fire suppression system consisting of an independentlysupplied and operating handline system and deluge type waterspray system shall be installed in all Class A chambers.) as noted inthe substantiation; however, during the reconsideration of thecommittee's action on 99-385, the committee provided furthereditorial clarification. 3 .Item No. 2: The existing requirement conveys the committee'sintentions. The requirements for independence for deluge andhandlines, 19-2.5.1.1 and 19-2.5.1.2 are considered to provide anacceptable level of safety. 4. Item No. 3: During reconsideration the committee reversedthe earlier decision and accepts the revision of the last sentence of19-2.5.3.4.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 233 - (19-2.5.2.5): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-390RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. The subject is within the scope of theTechnical Committee. Cite the other NFPA documents.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.1. Change committee action from Reject to Accept in Principle. 2. Insert as paragraph 19.3.1.4.7 as follows: "When an inspection, test, or maintenance procedure of the firesuppression system results in the system being placed "OUT OFSERVICE," a protocol should shall be followed which notifies

appropriate personnel and agencies of the planned or emergencyIMPAIRMENT. A sign indicating the fire suppression system is"OUT OF SERVICE" should shall be conspicuously placed on theoperating console until the fire suppression system is restored toservice."COMMITTEE STATEMENT: 1. Editorial replacing should withshall. 2. Located requirement under appropriate heading.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 234 - (19-2.5.3.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-391RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. The Committee Statement should qualify theiraction since they believe that there is no specific substantiation thatthere is a problem.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.1. The committee reconsidered Proposal 99-391 (Log #205) andthe basis for the Committee Action. 2. Replace the committee statement: "The existing text is acceptable." as follows: The current design, capabilities, and actual testing experience inthe hyperbaric industry has proven existing standards to beacceptable. COMMITTEE STATEMENT:NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 235 - (19-3.1.5.5): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-400RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor reconsideration. The Committee Statement should cite specificparagraphs.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise the Committee's Action from Reject to Accept.COMMITTEE STATEMENT: The committee reconsideredProposal 99-400 (Log #319).NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 236 - (19-3.6.4): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-404RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committee


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for reconsideration. The Committee Statement needs to citespecific paragraphs.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.The committee reconsidered Proposal 99-404 (Log #207), andretained the Committee Action of Reject.COMMITTEE STATEMENT: Electrical switches and electricalmonitoring equipment testing before each pressurization isoverbroad, undefined and presents an impractical operatingburden. Automatic fire detection and suppression equipment,and functional testing are covered in paragraphs 19.2.5.5 and19.3.6.4.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 16 NOT RETURNED: 3 Beeson, Newton, Sheffield

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99- 237 - (21-1.2.1): RejectSUBMITTER: Peter Esherick, Patient Instrumentation Corp.COMMENT ON PROPOSAL NO: 99-405RECOMMENDATION: Do not add the recommended additionaltext.SUBSTANTIATION: See my comments on Proposal 99-191 (pg.694) (Log #190) and 99-234 (pg. 724) (Log #28).COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The committee did not reverse theaction on Proposals 99-191 or 99-234, therefore therecommendation is not valid. The reference will appear in the newChapter 2, Mandatory References.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: The comments to Proposal 191 and 234 are valid.Putting ANSI/ASSE Series 6000 into NPFA 99 is beyond the scopeof NFPA 99.

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99- 238 - (21-1.2.1): RejectSUBMITTER: Corky J. Bishop, Medical Gas Management, Inc.COMMENT ON PROPOSAL NO: 99-405RECOMMENDATION: Relocate to Appendix B Referenced andInformatory Publications: ANSI/ASSE Series 6000 Professional Qualifications Standard forMedical Gas Systems Installers, Inspectors, and Verifiers. SUBSTANTIATION: If the comments to Proposal 99-191 and 99-234 result in a reversal of the committee’s position, Appendix Bwill be a more appropriate location to reference this standard andto increase the awareness of it to designers for inclusion in theirspecifications.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The committee did not reverse theaction on Proposals 99-191 or 99-234, therefore therecommendation is not valid. The reference will appear in the newChapter 2, Mandatory References.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 20 NEGATIVE: 1 NOT RETURNED: 3 Bancroft, Lynam, ShoemakerEXPLANATION OF NEGATIVE: ESHERICK: See my Explanation of Negative on Comment 99-237(Log #50).

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99- 239 - (A-2-2): RejectSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-408RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor a more expansive substantiation and definitive action, or updatethe appendix information.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: The definition in Chapter 2adequately addresses the use of the term in this standard.Additional appendix material is not needed.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 5VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 4 NOT RETURNED: 1 Davidson

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(Log #209)Committee: HEA-HCE

99- 240 - (A-11-5.3.2): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-411RECOMMENDATION: It was the action of the TechnicalCorrelating Committee that this proposal be returned to committeefor an insufficient committee statement. Identify the otherregulatory agencies or standards.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.Revise Committee Statement on Proposal 99-411 (Log #205 ) toread as follows: "The material suggested by the proposal has been covered by otherregulatory agencies or standards the Joint Commission onAccreditation of Healthcare Organizations [JCAHO]Comprehensive Accreditation Manual for Hospitals [CAMH]standard E.C. 1.6 Emergency Management[New 2001 E.C. 1.4 (l)],E.C. 1.9 Utility Management [New 2001 E.C. 1.7 (p)(2)], E.C. 2.14Maintenance, Testing and Inspection of Utility Systems [New 2001E.C. 2.10.4 and New 2001 E.C. 2.10.4.1 Emergency Power SystewmTesting and Inspection], and NFPA 99 Standard for Health CareFacilities chapter 3, Electrical Systems. Note: Proposal 99-411 was rejected. This action on theTechnical Correlating Committee’s comment clarifies theTechnical Committee’s substantiation for rejection.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 19VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 10 NOT RETURNED: 9 Gulinello, Jarrett, Phillips, Salamone,Sinsigalli, Spahr, Stone, Svetlik, Woodfin

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99- 241 - (Table C-4-3.4 and C-4-8): AcceptSUBMITTER: Technical Correlating Committee on Health CareFacilitiesCOMMENT ON PROPOSAL NO: 99-416RECOMMENDATION: The Technical Correlating Committeedirects the Committee to review the Committee Statement as theCommittee Statement does not address the submitter’ssubstantiation.SUBSTANTIATION: This is a direction from the TechnicalCorrelating Committee on Health Care Facilities in accordancewith 3-4.2 and 3-4.3 of the Regulations Governing CommitteeProjects.COMMITTEE ACTION: Accept.


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COMMITTEE STATEMENT: This information is over 20 years oldand contains many inaccuracies. Some of the information is over36 years old. As an instance, the lead and lag vacuum settings aretoo low for today's machinery. There are many technicaldocuments used by professional designers that have much more upto date information and are relied upon. Although a notation at the beginning of this section indicates thatit has not been updated since it's initial publication in 1980, it isstill used in many cases. We need to take this information out ofNFPA 99.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 242 - (Table C-4-3.4 and C-4.8): RejectSUBMITTER: Burton R. Klein , Burton Klein Associates

COMMENT ON PROPOSAL NO: 99-416RECOMMENDATION: Reconsider and accept proposal 99-416.SUBSTANTIATION: 1. Reasons provided in T/C substantiationare not related to issue raised in proposal. 2. Reasons listed in substantiation of proposal 99-416 are stillconsidered valid.COMMITTEE ACTION: Reject.COMMITTEE STATEMENT: This information is over 20 years oldand contains many inaccuracies. Some of the information is over36 years old. As an instance, the lead and lag vacuum settings aretoo low for today's machinery. There are many technicaldocuments used by professional designers that have much more upto date information and are relied upon. Although a notation at the beginning of this section indicates thatit has not been updated since it's initial publication in 1980, it isstill used in many cases. We need to take this information out ofNFPA 99.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 24VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 21 NOT RETURNED: 3 Bancroft, Lynam, Shoemaker

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99- 243 - (C-8-2.3.1): AcceptSUBMITTER: Technical Committee on Electrical EquipmentCOMMENT ON PROPOSAL NO: 99-313RECOMMENDATION: Revise text to read as follows: C.8.2.3.1 Sustained skin contact with surfaces of equipment thathave temperatures in excess of 42°C (107°F) can cause burns.Additional C c aution is required advised when exposing susceptable patients are exposed to warmed surfaces. , particularly when theyare helpless.SUBSTANTIATION: Editorial.COMMITTEE ACTION: Accept.NUMBER OF COMMITTEE MEMBERS ELIGIBLE TO VOTE: 10VOTE ON COMMITTEE ACTION: AFFIRMATIVE: 8 NOT RETURNED: 2 Carlson, Willey

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