SMARTPHONE ENABLED DIGITAL OTOSCOPE INSTRUCTIONS FOR USE TABLE OF CONTENTS: Product Description All Users1-4 Intended Use All Users5 Storage and Handling All Users5 Maintenance All Users6 Cleaning Instructions All Users6 Set Up Instructions All Users7-9 Downloading and Preparing the CellScope Oto Mobile Application All Users 10 Launching the Mobile Application All Users10 Mobile App Operating Instructions Clinicians11 In-App Icon Glossary 11 Contraindications Clinicians12 General Safety Precautions Clinicians12 Conducting Ear Exam At Home-Users13-14 Mobile App Operating Instructions At Home-Users14 Contraindications At Home-Users15 General Safety Precautions Home-Users15 Troubleshooting All Users16 Symbol Glossary Clinicians17 Warranty All Users17 Technical Description All Users18 CellScope® Oto™ For support, please email [email protected] or visit www.cellscope.com. ALL USERS PRODUCT DESCRIPTION The CellScope Oto System consists of a smartphone case, optical otoscope attachment and CellScope mobile app. It enables users to perform and track otoscopic exams over time. Data (videos and images) collected using the Oto system is uploaded to CellScope’s HIPAAcompliant server, which is accessible from CellScope’s secure web app. THE CELLSCOPE OTO DEVICE USES THE FOLLOWING COMPONENTS: 1. A specially designed iPhone ® 5/5s case (for everyday use). 2. The optical otoscope attachment (Oto) that connects to the case. [Note: the Oto attachment is designed for use with usersupplied standard otoscope specula (tips) that are not provided] 3. A storage container for the Oto and tips. 4. A user-supplied iPhone 5/5s operating with iOS 7.0.4 or later. [Note: the iPhone 5 or 5s must be purchased separately. CellScope Oto device is not compatible with iPhone 5c, iPhone 4s, iPhone 4, iPhone 3GS or iPhone 3.] 1 ALL USERS 5. A mobile application (‘CellScope Oto mobile app’) used to collect, view, save and transmit otoscopic exam data to the secure CellScope web server. The CellScope Oto mobile app can be downloaded from the App Store (SM). Access via a username and password will be provided upon purchase of the CellScope Oto device. Contact CellScope support with questions. [Note: the CellScope Oto mobile app will not function correctly with any version of iOS prior to 7.0.4.] 6. The CellScope web app. Users can review ear exam and information logged on the mobile application by accessing the user portal at www.cellscope.com. [Note: the CellScope web app is supported on the following web browsers: Google Chrome on OS X and Windows 7, Internet Explorer 8 on Windows 7 and Firefox on OS X.] 2 ALL USERS Figure 1. CellScope Oto, connection to iPhone 5/5s, standard otoscope specula, with Mobile Application Otoscope attachment Tip* (not included) iPhone 5/5s* (not included) CellScope Oto mobile app (downloaded from the iTunes App Store) iPhone 5/5s compatible case * iPhone 5/5s and tips must be purchased separately 3 ALL USERS INCLUDED IN THIS PACKAGE • A CellScope iPhone 5/5s case • Optical otoscope attachment (Oto) • Storage container for optical attachment and tips • Lanyard to attach to the storage case • Instructions for Use ADDITIONAL ITEM FOR DOWNLOAD • CellScope Oto Mobile Application available in the App Store℠ (To find, search for “CellScope” within the App Store℠). ACCESSORIES REQUIRED BUT NOT SUPPLIED • iPhone 5 or 5s with iOS 7.0.4 or later (Available for purchase from Apple Retailers. See a list of authorized retailers at http://www.apple.com/buy/) • Disposable otoscope tips (KleenSpec® tips available for over the counter purchase online via Amazon.com). Consult a physician for specification on appropriately sized tips for each individual. 4 ALL USERS INTENDED USE The CellScope Oto is intended for inspection of the external ear canal and eardrum under magnification using an external illumination source (e.g. the iPhone 5 or 5s). For access to a CellScope Oto device or to the associated applications please contact [email protected] STORAGE AND HANDLING Store the device in the provided container at a temperature between -20º and 45º C (-4º to 113º F) and humidity between 5 and 95% (non-condensing). Avoid contact with dust during use or storage. 45º C (113º F) -20º C (-4º F) 95% 5% 5 ALL USERS MAINTENANCE No preventative maintenance is required. Use a new otoscope tip for each exam to prevent cross-contamination between patients. Any modification or repair of this device is strictly prohibited. CLEANING INSTRUCTIONS The Oto attachment can be cleaned with a non-scratching, lint-free microfiber cloth. The attachment and case can be disinfected with a cloth dampened with alcohol. Only use EPA-approved disinfectant. Use of improper cleaning solutions or methods may damage the device. The attachment is not watertight so it should not be submerged in liquid. Care should also be taken not to scratch the lens of the otoscope attachment. Failure to clean the device may cause blurry images. 6 ALL USERS SET UP INSTRUCTIONS Prepare to attach the Oto attachment to the phone by first placing the case on the phone (Figure 2). To attach, slide the case onto your iPhone 5/5s. Connect the attachment and slide into place (Figure 3). Attach a large or small tip (the CellScope Oto system is compatible with KleenSpec® tips) to the end of speculum cone (Figure 4). Begin use in conjunction with the application. When the exam is complete, discard the used tip and slide the Oto off the case (Figure 5). 7 ALL USERS Figure 2. Attach the case to the phone by sliding in the side with the volume control buttons first. Figure 3. Insert the Oto attachment into the case and slide left over the phone camera and flash. Figure 4. Once the Oto attachment is securely attached to the phone case, hold the end of the speculum tip gently between your pointer finger and thumb. Press the tip down lightly onto the speculum cone and twist clockwise until you feel resistance. The tip should be securely attached to the cone. Now you are ready to conduct an exam. 8 ALL USERS Figure 5. When exam is complete, discard the disposable tip and remove the Oto attachment from the case by sliding it back towards the right. Keep the Oto attachment in the storage case. Figure 6: The CellScope case is designed for everyday use, but it can be removed. Separate the case from the phone starting from the bottom right corner of the screen (the corner furthest from the volume buttons). Simultaneously, push on the phone through the cutout of the case (avoiding the phone’s camera and LED) to fully remove the phone from the case. Cutout 9 ALL USERS DOWNLOADING AND PREPARING THE CELLSCOPE OTO MOBILE APPLICATION The CellScope Oto mobile app may be downloaded to the phone from the App StoreSM. Search “CellScope” in the App Store or follow the link from the CellScope website. Create a username and password on the CellScope website or contact [email protected] to request an account. LAUNCHING THE MOBILE APPLICATION Before launching the application and recording, be sure that the device is firmly attached to your phone’s case and a tip has been securely attached to the speculum cone. 10 CLINICIAN USERS MOBILE APP OPERATING INSTRUCTIONS 1. Login using your email and password. 2. To begin recording an exam video or image, select L (left) or R (right) to indicate the ear that you will be recording first. 3. Tap on the record icon to begin. 4. Gently insert the tip into the patient’s ear. 5. Adjust the light source by swiping up or down on the screen. 6. Tap the record icon again to end the recording. Note: you can select the camera icon to capture a still image. 7. Repeat the process with the other ear. Once a video or image has been recorded, you can review by pressing the ‘Current Exam’ thumbnail in the bottom left which will take you to the Exam page. On the Exam page, you will have access to extract and save images from the video, annotate images, add the patient’s name, and add other information about the exam including reported symptoms, diagnosis and treatments. NOTE: A small info button on the bottom right of important screens will display a help overlay. For answers to Frequently Asked Questions, visit: http://www.cellscope.com/support IN-APP ICON GLOSSARY Exam library Help screen overlay Share or email Add a new patient to this exam Patient library Create a new exam 11 CLINICIAN USERS CONTRAINDICATIONS This device may only be used for inspection of the external ear canal and eardrum. Do not use for any purpose (such as ear wax or foreign body removal) other than an otoscopic exam to avoid injury or damage to the device. If you can see something stuck in the ear canal, do not insert the otoscope. GENERAL SAFETY PRECAUTIONS CAUTION: Proper care and handling is essential for satisfactory performance of the Oto device. Examine the device thoroughly before and after use. If any damage or irregularities are found, do not use the device. • To avoid injury, do not place objects or tissue directly against the Oto speculum cone. Light emitted from the Oto may be intense to enough increase surface temperature or cause damage to objects or living beings. • Use appropriate tips for the age and anatomy of the patient to avoid possible discomfort. • Do not use the same otoscope tip between patients or between examinations. Always use a new tip for each examination. Dispose of tips after use. • Do not use the device with any objects plugged into the iPhone 5 or 5s Lightning® connector, the headphone jack or other non-standard areas of the iPhone 5 or 5s. • Do not use in the presence of flammable anesthetics, drugs or pressurized oxygen (such as in a hyperbaric chamber, ultraviolet sterilizer or oxygen tent). • Do not place other equipment adjacent to the device during use. • Keep out of reach of infants, small children, or anyone incapable of using the device properly. • Do not use the device anywhere where usage of the iPhone 5/5s is not permitted. The Oto was not tested for immunity to electromagnetic disturbances and may not function correctly in an environment where electromagnetic disturbances generated by other equipment are present. • Do not use the device in conjunction with water, or in a wet environment 12 AT-HOME USERS EAR ANATOMY CONDUCTING EAR EXAM The following instructions are guidelines. If one method does not work with your child, try one of the other two methods. Before trying this on your child, try on an adult for practice. You will then get a feel for how far the device needs to be inserted into the canal in order to correctly capture the eardrum. SUGGESTED METHODS FOR BABIES UNDER 1 YEAR OF AGE: 1. Lay the child on his or her back on a bed or on a blanket on the floor. 2. It may be helpful to have a second adult hold the child’s legs or body to prevent sudden movement during the exam. 3. Gently press the child’s head to the one side. 4. Gently pull the pinna (or outer flap of the ear) DOWNWARD and BACKWARD to straighten the ear canal. FOR CHILDREN AGES 1 TO 3: 1. Distract the child with a toy or game. 2. It may be helpful to have a second adult hold the child’s head in an upright position during the exam to prevent them from moving suddenly. 3. Gently pull the pinna (or outer flap of the ear) of the affected ear DOWNWARD and BACKWARD to straighten the ear canal. 13 AT-HOME USERS FOR ADULTS AND CHILDREN OVER AGE 3: 1. Sit your child in a comfortable place and ask your child to stay as still as possible. 2. It’s helpful for the child to be in an upright position during the exam. 3. Gently pull the pinna (or outer flap of the ear) of the affected ear UPWARD and BACKWARD to straighten the ear canal. Video tutorials (which include sample images of the eardrum) are available for viewing within the mobile app and on the web at www.cellscope.com/support/videos MOBILE APP OPERATING INSTRUCTIONS 1. Login using your email and password. 2. Select a Patient Profile to begin. 3. Start a new ear exam and select the appropriate ear. 4. Position the patient according to the suggested methods on page 13. 5. Tap the camera button to begin the recording. 6. Gently insert the appropriately-sized tip into the patient’s ear canal and find the eardrum. 7. Depending on the size of the tips used, you may need to adjust the brightness by swiping up on the recording screen. 8. Once you have been able to visualize the eardrum on the iPhone screen, tap the camera button again to end the recording (there is no required video length). 9. Select the other ear and repeat steps 4–8. 10. Once you have captured a video for each ear, the mobile app will ask you to note the child’s symptoms, and any additional information that a doctor would find helpful to assess your child’s health. 11. Submit the exam for review by following the steps within the mobile app. NOTE: A small info button on the bottom right of the recording screen will guide you along. 14 AT-HOME USERS CONTRAINDICATIONS This device may only be used for inspection of the external ear canal and eardrum. Do not use for any purpose (such as ear wax or foreign body removal) other than an otoscopic exam to avoid injury or damage to the device. If you can see something stuck in the ear canal, do not insert the otoscope. GENERAL SAFETY PRECAUTIONS CAUTION: This device is not designed or intended to provide a diagnosis of ear infections or other ailments of the ear. This device should not be used as a basis for starting or modifying treatment without independent confirmation by medical examination. Do not attempt self-diagnosis or self-treatment based on the recording results and analysis. Self-diagnosis or self-treatment may lead to deterioration of your health. CAUTION: Proper care and handling is essential for satisfactory performance of the Oto device. Examine the device thoroughly before and after use. If any damage or irregularities are found, do not use the device • To avoid injury, do not place objects or tissue directly against the Oto speculum cone. Light emitted from the Oto may be intense to enough increase surface temperature or cause damage to objects or living beings. • Use appropriate tips for the age and anatomy of the patient to avoid possible discomfort. • Patients should always consult their physician if they notice changes in their health, regardless of ear exam results. • Do not use the same otoscope tip between patients or between examinations. Always use a new tip for each examination. Dispose of tips after use. • Do not use the device with any objects plugged into the iPhone 5/5s Lightning® connector, the headphone jack or other non-standard areas of the iPhone 5/5s. • Do not use in the presence of flammable anesthetics, drugs or pressurized oxygen (such as in a hyperbaric chamber, ultraviolet sterilizer or oxygen tent). • Do not place other equipment adjacent to the device during use. • Keep out of reach of infants, small children, or anyone incapable of using the device properly. • Do not use the device anywhere where usage of the iPhone 5/5s is not permitted. The Oto was not tested for immunity to electromagnetic disturbances and may not function correctly in an environment where electromagnetic disturbances generated by other equipment are present. • Do not use the device in conjunction with water, or in a wet environment. 15 ALL USERS TROUBLESHOOTING PROBLEM SOLUTION The CellScope case doesn’t fit on my phone. The CellScope case is designed to fit over the standard iPhone 5 or 5s. No other case can be used simultaneously. I cannot login to my account The first time you login to the CellScope Oto app, make sure you are connected to the Internet. If you don’t have a data plan available, connect to Wifi. If you cannot remember your password, press the Forgot Password link and you will be prompted to reset your password. The tips fall off the Oto. Make sure to use appropriate sized tips (as instructed by your physician) and twist onto the Oto module in the clockwise direction until fully engaged. I see the image upside down. Only use the Oto module with the CellScope Oto mobile application. I am experiencing poor image quality or am unable to view an image on the screen Attach the Oto modular attachment properly by sliding it into the CellScope case from right to left until you hear it click. Use device with the appropriate tip (as instructed by your physician). Make sure to clean the device as instructed to avoid debris from blocking the light source or optical path. If all of the above have been determined, your device may be broken. Contact CellScope Support for additional assistance. An error message is shown when I try to record an exam Make sure your phone has enough free space available by viewing available Storage from the phone’s Settings < General < Usage menu. If less than 120 MB of space is available, a CellScope error will be displayed. I accidently recorded the right ear in the space for the left ear exam (Clinicians Only) You can move any video or image to the correct ear by pressing and holding the thumbnail of the video or image on the Exam screen. The app will give you the option to switch the association. 16 ALL USERS SYMBOL GLOSSARY Review instructions for use. The CellScope Oto is a type BF applied part. Batch Code Catalog Number Caution 95% 5% 45º C (113º F) -20º C (-4º F) WARRANTY CellScope, Inc. provides a limited warranty for the CellScope Oto product. Please visit http://www.cellscope.com/warranty for a full description of the warranty. Important: Report any injury or adverse event to your physician immediately. For general or product related comments, questions, concerns or experiences, please contact CellScope directly. 17 CellScope, Inc. 530 Howard St. Suite 300, San Francisco, CA 94104 [email protected] (866) 930-6490 CellScope is a registered trademark owned by CellScope, Inc. Other parties’ trademarks or registered trademarks are the property of their respective owners and should be treated as such. U.S. and Foreign Patents Pending. www.cellscope.com facebook.com/cellscope @cellscope CELLSCOPE OTO MODEL NUMBER: FG1103 Technical Description Optical Oto Attachment Dimensions: 1.5” x 0.8” x 1.0” (36.8mm x 19.2mm x 24.8mm) Weight: 0.25oz (7g) Magnification Factor: 3.5x CellScope Case Dimensions: 5.0” x 2.4” x 0.4” (127.2mm x 61.8mm x 11.1mm) Weight: 0.55oz (15g) Storage Container with Specula Attachment Dimensions: 1.2” x 1.1” x 4.1” (30.7mm x 27.7mm x 104.6mm) Weight: 1.15oz (32g) LB068 B January, 2014 18
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