Manufacturer
|
(0008,0070)
|
Acme Corp.
|
Manufacturer's Model Name
|
(0008,1090)
|
Primo Protocol Management Workstation Plus
|
Device Serial Number
|
(0018,1000)
|
A59848573
|
Software Versions
|
(0018,1020)
|
V2.3
|
SOP Class UID
|
(0008,0016)
|
1.2.840.10008.5.1.4.1.1.200.3 (Protocol Approval)
|
SOP Instance UID
|
(0008,0018)
|
1.33.9.876.1.1.1
|
Approval Subject Sequence
|
(0044,0109)
|
|
Item #1
|
>Referenced SOP Class UID
|
(0008,1150)
|
1.2.840.10008.5.1.4.1.1.200.1 (CT Defined Procedure Protocol)
|
>Referenced SOP Instance UID
|
(0008,1155)
|
1.2.3.456.7.7
|
Item #2
|
>Referenced SOP Class UID
|
(0008,1150)
|
1.2.840.10008.5.1.4.1.1.200.1 (CT Defined Procedure Protocol)
|
>Referenced SOP Instance UID
|
(0008,1155)
|
1.2.3.456.7.8
|
Approval Sequence
|
(0044,0100)
|
|
Item #1
|
>Assertion Code Sequence
|
(0044,0101)
|
(128603, DCM, "Approved for use at the institution")
|
>Assertion UID
|
(0044,0102)
|
1.2.33.9.876.5.5.5.5.21
|
>Asserter Identification Sequence
|
(0044,0103)
|
|
>>Observer Type
|
(0040,A084)
|
PSN
|
>>Person Name
|
(0040,A123)
|
"Welby^Marcus^^Dr.^MD"
|
>>Person Identification Code Sequence
|
(0040,1101)
|
(12345, 99NPI, "Welby^Marcus^^Dr.^MD")
|
>>Organizational Role Code Sequence
|
(0044,010A)
|
(128670, DCM, "Head of Radiology")
|
>>Institution Name
|
(0008,0080)
|
Mercy Hospital, Centerville
|
>>Institution Code Sequence
|
(0008,0082)
|
(000011113, 99NPI, "Mercy Hospital, Centerville")
|
>Assertion DateTime
|
(0044,0104)
|
20150601145327
|
>Assertion Expiration DateTime
|
(0044,0105)
|
20200601000000 (based on a 5 yearly review plan)
|
>Institution Code Sequence
|
(0008,0082)
|
(000011113, 99NPI, "Mercy Hospital, Centerville")
|
Item #2
|
>Assertion Code Sequence
|
(0044,0101)
|
(128605, DCM, "Approved for use on pregnant patients")
|
>Assertion UID
|
(0044,0102)
|
1.2.33.9.876.5.5.5.5.22
|
>Asserter Identification Sequence
|
(0044,0103)
|
|
>>Observer Type
|
(0040,A084)
|
PSN
|
>>Person Name
|
(0040,A123)
|
"Welby^Marcus^^Dr.^MD"
|
>>Person Identification Code Sequence
|
(0040,1101)
|
(12345, 99NPI, "Welby^Marcus^^Dr.^MD")
|
>>Organizational Role Code Sequence
|
(0044,010A)
|
(128670, DCM, "Head of Radiology")
|
>>Institution Name
|
(0008,0080)
|
Mercy Hospital, Centerville
|
>>Institution Code Sequence
|
(0008,0082)
|
(000011113, 99NPI, "Mercy Hospital, Centerville")
|
>Assertion DateTime
|
(0044,0104)
|
20150601145327
|
>Assertion Expiration DateTime
|
(0044,0105)
|
20200601000000 (based on a 5 yearly review plan)
|
>Assertion Comments
|
(0044,0106)
|
"Limited scan range and proper use of abdominal shielding result in negligible dose to the fetus."
|