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124-513: An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities , such as hospitals . Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medical emergencies by emergency medical services (EMS), and can rapidly transport paramedics and other first responders , carry equipment for administering emergency care , and transport patients to hospital or other definitive care. Most ambulances use

248-508: A lightbar or in special flush-mount designs (as seen on the Danish ambulance to the right), or may be hidden in a host light (such as a headlamp ) by drilling a hole in the host light's reflector and inserting the emergency light. These hidden lights may not be apparent until they are activated. Additionally, some of the standard lights fitted to an ambulance (e.g. headlamps , tail lamps) may be programmed to flash. Flashing headlights (typically

372-409: A type of cake ), chevrons (arrowheads – often pointed towards the front of the vehicle if on the side, or pointing vertically upwards on the rear) or stripes along the side (these were the first type of retro-reflective device introduced, as the original reflective material, invented by 3M , only came in tape form). In addition to retro-reflective markings, some services now have the vehicles painted in

496-604: A 4.0-litre engine. Some models carry further designations indicating special features: Model designation badges can be removed at the request of the customer. Rationalisation of the model nomenclature was announced in November 2014 for future models. The changes consolidate many confusing nomenclature and their placements in the model range, for example—the CL-Class is now called the S-Class Coupé. The naming structure

620-817: A CA. In Italy it is the Ministero Salute (Ministry of Health) Medical devices must not be mistaken with medicinal products . In the EU, all medical devices must be identified with the CE mark . The conformity of a medium or high risk medical device with relevant regulations is also assessed by an external entity, the Notified Body , before it can be placed on the market. In September 2012, the European Commission proposed new legislation aimed at enhancing safety, traceability, and transparency. The regulation

744-410: A European Council Resolution of May 1985, represents an innovative way of technical harmonisation. It aims to remove technical barriers to trade and dispel the consequent uncertainty for economic operators, to facilitate free movement of goods inside the EU. The previous core legal framework consisted of three directives: They aim at ensuring a high level of protection of human health and safety and

868-488: A bright (sometimes fluorescent ) yellow or orange for maximum visual impact, though classic white or red are also common. Fire department-operated ambulances are often painted red to match the fire apparatuses. Another passive marking form is the word ambulance (or local language variant) spelled out in reverse on the front of the vehicle. This enables drivers of other vehicles to more easily identify an approaching ambulance in their rear view mirrors . Ambulances may display

992-406: A conformity test carried out by a European Notified Body. Class IIb Devices: Slightly more complex than IIa devices, class IIb devices are generally medium to high risk and will often be devices installed within the body for periods of 30 days or longer. Examples include ventilators and intensive care monitoring equipment. Identical compliance route to Class IIa devices with an added requirement of

1116-455: A design based on vans or pickup trucks , though others take the form of motorcycles , buses , hearses , aircraft and boats . Ambulances are generally considered emergency vehicles authorized to be equipped with emergency lights and sirens . Generally, vehicles count as an ambulance if they can transport patients. However, it varies by jurisdiction as to whether a non-emergency patient transport vehicle (also called an ambulette )

1240-411: A device type examination by a Notified Body. Class III Devices: Class III devices are strictly high risk devices. Examples include balloon catheters, prosthetic heart valves, pacemakers, etc. The steps to approval here include a full quality assurance system audit, along with examination of both the device's design and the device itself by a European Notified Body. The authorization of medical devices

1364-474: A diesel engine are no longer given a separate letter. The SLR and SLS supercars do not carry a numerical designation. Today, many numerical designations no longer reflect the engine's actual displacement, but more of the relative performance and marketing position. Despite its engine displacement in two litres, the powerplant in the A45 AMG produces 355 brake horsepower so the designation is higher as to indicate

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1488-704: A fully qualified doctor on board. Most ambulance services require at least two crew members to be on every ambulance (one to drive, and one to attend the patient). It may be the case that only the attendant need be qualified, and the driver might have no medical training. In some locations, an advanced life support ambulance may be crewed by one paramedic and one technician, or in countries like Australia advanced life support registered paramedics. Common ambulance crew qualifications are: Military ambulances have historically included vehicles based on civilian designs and at times also included armored, but unarmed, vehicle ambulances based upon armoured personnel carriers (APCs). In

1612-635: A function) can be marketed purely by self-certification. The European classification depends on rules that involve the medical device's duration of body contact, invasive character, use of an energy source, effect on the central circulation or nervous system, diagnostic impact, or incorporation of a medicinal product. Certified medical devices should have the CE mark on the packaging, insert leaflets, etc.. These packagings should also show harmonised pictograms and EN standardised logos to indicate essential features such as instructions for use, expiry date, manufacturer, sterile, do not reuse, etc. In November 2018,

1736-604: A gasoline engine in order to meet emissions requirements. In the United Kingdom, the National Health Service has set a target for all ambulances to be fully electric as part of the Net Zero campaign by 2045. Many regions have prescribed standards which ambulances should, or must, meet in order to be used for their role. These standards may have different levels which reflect the type of patient which

1860-704: A greater potential risk and are subject to in-depth scrutiny. A guidance document for device classification is published by Health Canada. Canadian classes of medical devices correspond to the European Council Directive 93/42/EEC (MDD) devices: Examples include surgical instruments (Class I), contact lenses and ultrasound scanners (Class II), orthopedic implants and hemodialysis machines (Class III), and cardiac pacemakers (Class IV). Medical devices in India are regulated by Central Drugs Standard Control Organisation ( CDSCO ). Medical devices under

1984-425: A human being; the restoration, correction or modification of a body function or the body structure of a human being; the diagnosis of pregnancy in a human being; or the care of a human being during pregnancy and at and after the birth of a child, including the care of the child. It also includes a contraceptive device but does not include a drug." The term covers a wide range of health or medical instruments used in

2108-457: A larger share, Japan has the second largest country market share. The largest market shares in Europe (in order of market share size) belong to Germany, Italy, France, and the United Kingdom. The rest of the world comprises regions like (in no particular order) Australia, Canada, China, India, and Iran. This article discusses what constitutes a medical device in these different regions and throughout

2232-428: A left -> right pattern for use when the ambulance is parked on the left hand side of the road, indicating to other road users that they should move to the right (away from the ambulance)). Incandescent and LED lights may also be programmed to burn steadily, without flashing, which is required in some provinces. Emergency lights may simply be mounted directly on the body, or may be housed in special fittings, such as in

2356-666: A medical device by modern standards dates as far back as c.  7000 BC in Baluchistan where Neolithic dentists used flint-tipped drills and bowstrings . Study of archeology and Roman medical literature also indicate that many types of medical devices were in widespread use during the time of ancient Rome. In the United States it was not until the Federal Food, Drug, and Cosmetic Act (FD&C Act) in 1938 that medical devices were regulated. Later in 1976,

2480-551: A number of its Merkava main battle tanks with ambulance features in order to allow rescue operations to take place under heavy fire in urban warfare . The modifications were made following a failed rescue attempt in which Palestinian gunmen killed two soldiers who were providing aid for a Palestinian woman in Rafah . Since M-113 armored personnel carriers and regular up-armored ambulances are not sufficiently protected against anti-tank weapons and improvised explosive devices , it

2604-458: A per-accident basis, ambulance collisions tend to involve more people, and result in more injuries. An 11-year retrospective study concluded in 2001 found that although most fatal ambulance crashes in the United States occurred during emergency runs, they typically occurred on improved, straight, dry roads, during clear weather. Furthermore, paramedics are also at risk in ambulances while helping patients, as 27 paramedics died during ambulance trips in

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2728-538: A perfectly serviceable body or vehicle (or both) separated from the other and reused. Toronto City Council operates a "Caravan of Hope" project to give retired Toronto ambulances a second life by donating them to the people of El Salvador . Since Ontario laws require ambulances to be retired after just four and a half years in service, the City of Toronto decommissions and auctions around 28 ambulances each year. Medical device Discovery of what would be considered

2852-1095: A potential, unreasonable risk of illness or injury and require premarket approval . Examples of Class III devices include implantable pacemakers, pulse generators, HIV diagnostic tests, automated external defibrillators, and endosseous implants. The classification of medical devices in the European Union is outlined in Article IX of the Council Directive 93/42/EEC and Annex VIII of the EU medical device regulation . There are basically four classes, ranging from low risk to high risk, Classes I, IIa, IIb, and III (this excludes in vitro diagnostics including software, which fall in four classes: from A (lowest risk) to D (highest risk)): Class I Devices: Non-invasive, everyday devices or equipment. Class I devices are generally low risk and can include bandages, compression hosiery, or walking aids. Such devices require only for

2976-641: A red traffic light or stop sign as a yield sign ('give way'), or be permitted to break the speed limit. Generally, the priority of the response to the call will be assigned by the dispatcher, but the priority of the return will be decided by the ambulance crew based on the severity of the patient's illness or injury. Patients in significant danger to life and limb (as determined by triage ) require urgent treatment by advanced medical personnel, and because of this need, emergency ambulances are often fitted with passive and active visual and/or audible warnings to alert road users. Passive visual warnings are usually part of

3100-417: A result, medics and other medical personnel attached to military ambulances are usually put through basic military training , on the assumption that they may have to use a weapon. The laws of war do allow non-combatant military personnel to carry individual weapons for protecting themselves and casualties. However, not all militaries exercise this right to their personnel. The Israeli Defense Forces modified

3224-549: A stopped ambulance in a dangerous position on the road. Common colours for ambulance warning beacons are blue, red, amber, and white (clear). However the colours may vary by country and sometimes by operator. There are several technologies in use to achieve the flashing effect. These include flashing a light bulb or LED , flashing or rotating halogen , and strobe lights , which are usually brighter than incandescent lights. Each of these can be programmed to flash singly or in groups, and can be programmed to flash in patterns (such as

3348-443: A strong reputation for quality and durability. Some objective measures looking at passenger vehicles, such as J. D. Power surveys, demonstrated a downturn in reputation in these criteria in the late 1990s and early 2000s. By mid-2005, Mercedes temporarily returned to the industry average for initial quality, a measure of problems after the first 90 days of ownership, according to J. D. Power. In J. D. Power's Initial Quality Study for

3472-537: Is "The Best or Nothing". Mercedes-Benz traces its origins to Karl Benz 's first internal combustion engine in a car, seen in the Benz Patent Motorwagen – financed by Bertha Benz 's dowry and patented in January 1886 – and Gottlieb Daimler and their engineer Wilhelm Maybach 's conversion of a stagecoach, with the addition of a petrol engine, introduced later that year. The Mercedes automobile

3596-698: Is a German luxury and commercial vehicle brand that was founded in 1926. Mercedes-Benz AG (a subsidiary of the Mercedes-Benz Group , established in 2019) is based in Stuttgart , Baden-Württemberg , Germany. Mercedes-Benz AG manufactures luxury vehicles and light commercial vehicles , all branded under the Mercedes-Benz name. From November 2019 onwards, the production of Mercedes-Benz-branded heavy commercial vehicles (trucks and buses) has been managed by Daimler Truck , which separated from

3720-615: Is a joint venture with Saigon Mechanical Engineering Corporation . In 2021-2022, Mercedes-Benz Vietnam invested approximately 33 million USD to upgrade 6 technologies at this factory in preparation for the assembly of AMG models. The 1996 Mercedes E230 was the first model produced by the Mercedes-Benz Vietnam assembly plant and was part of the initial batch assembled locally. Other than in its native birthplace, Germany, Mercedes-Benz vehicles are or have been partly manufactured or assembled in: Mercedes-Benz normally has

3844-528: Is a major factor in their effective use. When an ambulance is retired, it may be donated or sold to another EMS provider. Alternately, it may be adapted into a storage and transport vehicle for crime scene identification equipment, a command post at community events, or support vehicle, such as a logistics unit. Others are refurbished and resold, or may just have their emergency equipment removed to be sold to private businesses or individuals, who then can use them as small recreational vehicles . They may also have

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3968-724: Is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements. Ambulances ( ambulancias in Spanish) were first used for emergency transport in 1487 by the Spanish forces during the siege of Málaga by the Catholic Monarchs against the Emirate of Granada. During the American Civil War vehicles for conveying

4092-688: Is a van chassis-cab with a custom-made rear compartment, used for ALS and rescue. Type IV is for ad hoc patient transfer using smaller utility vehicles selected for maneuverability in special environments such as dense crowds at events; these are uncommon and are not subject to federal regulations in the United States. The move towards standardisation is now reaching countries without a history of prescriptive codes, such as India, which approved its first national standard for ambulance construction in 2013. Ambulances, like other emergency vehicles , are required to operate in most weather conditions, including those during which civilian drivers often elect to stay off

4216-530: Is based on a heavy truck chassis-cab with a custom rear compartment that is often referred to as a "box" or "module", primarily used for Advanced Life Support (ALS) or Mobile Intensive Care Unit (MICU), as well as rescue work. Type II is based on a commercial heavy-duty van with few modifications except for a raised roof and a secondary air conditioning unit for the rear of the vehicle, primarily used for Basic Life Support (BLS) and transfer of patients, though they are occasionally also used for ALS and rescue. Type III

4340-486: Is counted as an ambulance. These vehicles are not usually (although there are exceptions) equipped with life-support equipment, and are usually crewed by staff with fewer qualifications than the crew of emergency ambulances. Conversely, EMS agencies may also have nontransporting EMS vehicles that cannot transport patients. The term ambulance comes from the Latin word ambulare as meaning 'to walk or move about' which

4464-620: Is divided into four categories: core, off-road vehicle/SUV, 4-door coupé, and roadster. AMG GT and V-Class are unaffected by the change. In October 2016, Mercedes unveiled the X-Class; a pickup truck built on the Nissan Navara . At the 2016 Paris Motor Show , the company announced the EQ , a family of upcoming battery electric vehicles based on a modular platform , expected to represent up to 25% of its global sales by 2025. Note: The CLA

4588-493: Is essential for maintaining patient and staff safety while simultaneously facilitating the marketing of medical products. By establishing different risk classifications, lower risk devices, for example, a stethoscope or tongue depressor, are not required to undergo the same level of testing that higher risk devices such as artificial pacemakers undergo. Establishing a hierarchy of risk classification allows regulatory bodies to provide flexibility when reviewing medical devices. Under

4712-613: Is guaranteed by a Declaration of Conformity. This declaration is issued by the manufacturer itself, but for products in Class Is, Im, Ir, IIa, IIb or III, it must be verified by a Certificate of Conformity issued by a Notified Body . A Notified Body is a public or private organisation that has been accredited to validate the compliance of the device to the European Directive. Medical devices that pertain to class I (on condition they do not require sterilization or do not measure

4836-455: Is one of the best-known and longest-standing automotive brands in the world. The pontiff's Popemobile has often been sourced from Mercedes-Benz. In November 2019, Daimler AG announced that Mercedes-Benz, until that point a company marque, would be spun off into a separate, wholly-owned subsidiary called Mercedes-Benz AG. The new subsidiary would manage the Mercedes-Benz car and van business. Mercedes-Benz-badged trucks and buses would be part of

4960-612: Is positioned between the A- and B-Class models, while the CLE sits between the C- and E-Classes. In addition to the revised nomenclature, Mercedes-Benz has new suffix nomenclature for the drive systems. CDI GLA 200 d Electric Drive B 250 e BlueTEC HYBRID E 300 h The revised A45 AMG for the 2016 model year on has shifted the model designation to the right side while AMG is on the left side. This trend commenced with Mercedes-Maybach with MAYBACH on

5084-549: Is put on to the empty chassis of the ambulance, and then finished off. Modern ambulances are typically powered by internal combustion engines , which can be powered by any conventional fuel, including diesel , gasoline or liquefied petroleum gas , depending on the preference of the operator and the availability of different options. Colder regions often use gasoline-powered engines, as diesels can be difficult to start when they are cold. Warmer regions may favor diesel engines, as they are more efficient and more durable. Diesel power

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5208-821: Is risk-based and defines four levels: A - Low Risk, B - Low to Moderate Risk, C - Moderate – High Risk, and D - High Risk. The classification of medical devices in Australia is outlined in section 41BD of the Therapeutic Goods Act 1989 and Regulation 3.2 of the Therapeutic Goods Regulations 2002, under control of the Therapeutic Goods Administration . Similarly to the EU classification, they rank in several categories, by order of increasing risk and associated required level of control. Various rules identify

5332-533: Is similar to the KKK-A-1822F and NFPA 1917–2019 specifications. The decision on which of the current (3) standards to require is left up to each individual state legislature or EMS director. Some states have no specific requirement, while others specify which standard is acceptable. Others, yet, allow the end user to decide which standard to comply to. In the United States and Canada, there are four types of ambulances: Type I, Type II, Type III, and Type IV. Type I

5456-463: Is sometimes chosen due to safety concerns, after a series of fires involving gasoline-powered ambulances during the 1980s. These fires were ultimately attributed in part to gasoline's higher volatility in comparison to diesel fuel. The type of engine may be determined by the manufacturer: in the past two decades, Ford would only sell vehicles for ambulance conversion if they are diesel-powered. Beginning in 2010, Ford will sell its ambulance chassis with

5580-411: Is unable to alert pedestrians, those not using a compatible radio or even have it turned off. In the United States, the cost of an ambulance ride may be paid for from several sources, and this will depend on the local situation type of service being provided, by whom, and to whom. There are differing levels of qualification that the ambulance crew may hold, from holding no formal qualification to having

5704-575: Is usually sufficient. Since laws of war demand ambulances be marked with one of the Emblems of the Red Cross not to mount offensive weapons , military ambulances are often unarmed. It is a generally accepted practice in most countries to classify the personnel attached to military vehicles marked as ambulances as non-combatants ; however, this does not always exempt medical personnel from coming under fire – accidental or deliberate. As

5828-468: The 190-class with the numeric designation of "190" as to denote its entry-level in the model along with the displacement label on the right side of the boot (190E 2.3 for 2.3-litre 4-cylinder petrol motor, 190D 2.5 for 2.5-litre 5-cylinder diesel motor, and so forth). Some older models (such as the SS and SSK) did not have a number as part of the designation at all. For the 1994 model year, Mercedes-Benz revised

5952-543: The DB601 aero engines. To build the latter, in 1936, it built a factory hidden in the forest at Genshagen around 10 km south of Berlin . By 1942, the company had mostly stopped producing cars, and was now devoted to war production. According to its own statement, in 1944, almost half of its 63,610 employees were forced labourers, prisoners of war, or concentration-camp detainees. Another source quotes this figure at 46,000. The company later paid $ 12 million in reparations to

6076-634: The F-Cell fuel cell vehicle. The current version, based on the B-Class, has a 250-mile range and is available for lease, with volume production scheduled to begin in 2014. Mercedes has also announced the SLS AMG E-Cell , a fully electric version of the SLS sports car, with deliveries expected in 2013. The Mercedes-Benz S400 BlueHYBRID was launched in 2009, and is the first production automotive hybrid in

6200-487: The Federal Administrative Court of Switzerland decided that the "Sympto" app, used to analyze a woman's menstrual cycle, was a medical device because it calculates a fertility window for each woman using personal data. The manufacturer, Sympto-Therm Foundation, argued that this was a didactic, not a medical process. the court laid down that an app is a medical device if it is to be used for any of

6324-495: The Federal Food Drug & Cosmetic (FD&C) Act defines a device as an "instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is: which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for

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6448-1265: The Food, Drug, and Cosmetic Act , the U.S. Food and Drug Administration recognizes three classes of medical devices, based on the level of control necessary to assure safety and effectiveness. The classification procedures are described in the Code of Federal Regulations , Title 21, part 860 (usually known as 21 CFR 860). Class I devices are subject to the least regulatory control and are not intended to help support or sustain life or be substantially important in preventing impairment to human health, and may not present an unreasonable risk of illness or injury. Examples of Class I devices include elastic bandages, examination gloves, and hand-held surgical instruments. Class II devices are subject to special labeling requirements, mandatory performance standards and postmarket surveillance . Examples of Class II devices include acupuncture needles, powered wheelchairs, infusion pumps, air purifiers, surgical drapes, stereotaxic navigation systems, and surgical robots. Class III devices are usually those that support or sustain human life, are of substantial importance in preventing impairment of human health, or present

6572-597: The Mercedes-Maybach name, with the models being luxury-focused, enhanced models of Mercedes-Benz cars, such as the 2016 Mercedes-Maybach S600 . The Mercedes-Maybach GLS 600 SUV debuted in November 2019. Daimler partnered with BYD Auto to make and sell a battery-electric car called Denza in China. However, after reducing its stake in 2021, the Stuttgart-based company has now exited Denza completely:

6696-641: The North American International Auto Show . Each car features a different powertrain – battery-electric, fuel-cell electric, and gasoline-electric hybrid. In the same year, Mercedes also showed the Vision S500 PHEV concept with a 19 miles (31 km) all-electric range and CO 2 emissions of 74 grams/km in the New European Driving Cycle . Since 2002, Mercedes-Benz has developed

6820-533: The Order of St John , the Order of Malta Ambulance Corps and Malteser International often use the Maltese cross to identify their ambulances. This is especially important in countries such as Australia, where St. John Ambulance operate one state and one territory ambulance service, and all of Australia's other ambulance services use variations on a red Maltese cross. Fire service operated ambulances may display

6944-602: The Second World War vehicles such as the Hanomag Sd Kfz 251 half-track were pressed into service as ad hoc ambulances, and in more recent times purpose-built AFVs such as the U.S. M1133 medical evacuation vehicle serve the exclusive purpose of armored medical vehicles. Civilian based designs may be painted in appropriate colors, depending on the operational requirements (i.e. camouflage for field use, white for United Nations peacekeeping , etc.). For example,

7068-947: The United States military currently employs the M113, the M577 , the M1133 Stryker medical evacuation vehicle (MEV), and the RG-33 heavily armored ground ambulance (HAGA) as treatment and evacuation vehicles, with contracts to incorporate the newly designed M2A0 armored medical evacuation vehicle (AMEV), a variant of the M2 Bradley fighting vehicle (formerly known as the ATTV). Some navies operate ocean-going hospital ships to lend medical assistance in high casualty situations such as wars or natural disasters. These hospital ships fulfill

7192-402: The 1950s also had lower-case letters (b, c, and d) to indicate specific trim levels. For other models, the numeric part of the designation does not match the engine displacement. This was done to show the model's position in the model range independent of displacement or in the price matrix. For these vehicles, the actual displacement in litres is suffixed to the model designation. An exception was

7316-533: The British Royal Army Medical Corps has a fleet of white ambulances, based on production trucks. Military helicopters have also served both as ad hoc and purpose-built air ambulances since they are extremely useful for MEDEVAC . In terms of equipment, military ambulances are barebones, often being nothing more than a box on wheels with racks to place manual stretchers, though for the operational conditions and level of care involved this

7440-451: The Cross of St. Florian (often incorrectly called a Maltese cross) as this cross is frequently used as a fire department logo (St. Florian being the patron saint of firefighters ). The active visual warnings are usually in the form of flashing lights. These flash in order to attract the attention of other road users as the ambulance approaches, or to provide warning to motorists approaching

7564-468: The Daimler Truck AG subsidiary. For information relating to the three-pointed star symbol of the brand, see under the title Daimler-Motoren-Gesellschaft , including the merger into Daimler-Benz. In May 2022, Mercedes-Benz announced that it has recently sold the most expensive car at the price of $ 142 million (€135 million). The car is a very rare 1955 Mercedes-Benz SLR that has been kept in

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7688-845: The Drugs & Cosmetics Act. Section 3 (b) (iv) relating to definition of "drugs" holds that "Devices intended for internal or external use in the diagnosis, treatment, mitigation or prevention of disease or disorder in human beings or animals" are also drugs. As of April 2022, 14 classes of devices are classified as drugs. The regulatory authorities recognize different classes of medical devices based on their potential for harm if misused, design complexity, and their use characteristics. Each country or region defines these categories in different ways. The authorities also recognize that some devices are provided in combination with drugs, and regulation of these combination products takes this factor into consideration. Classifying medical devices based on their risk

7812-436: The Drugs and Cosmetics runs under 1945. CDSCO classification for medical devices has a set of risk classifications for numerous products planned for notification and guidelines as medical devices. Mercedes-Benz This is an accepted version of this page Mercedes-Benz ( German pronunciation: [mɛʁˌtseːdəs ˈbɛnts, -dɛs -] ), commonly referred to simply as Mercedes and occasionally as Benz ,

7936-685: The German automaker's collection and bought by a private owner. Mercedes in an announcement said that the sale will be used to establish the Mercedes-Benz Fund. In June 2022, Mercedes-Benz recalled almost one million vehicles built between 2004 and 2015, due to potential problems with their braking system, caused by possible "advanced corrosion". As of the Daimler AG company split, the Mercedes-Benz Cars division now handled

8060-1089: The Medical Device Amendments to the FD&;C Act established medical device regulation and oversight as we know it today in the United States. Medical device regulation in Europe as we know it today came into effect in 1993 by what is collectively known as the Medical Device Directive (MDD). On May 26, 2017, the Medical Device Regulation (MDR) replaced the MDD. Medical devices vary in both their intended use and indications for use. Examples range from simple, low-risk devices such as tongue depressors , medical thermometers , disposable gloves , and bedpans to complex, high-risk devices that are implanted and sustain life. One example of high-risk devices are those with embedded software such as pacemakers , and which assist in

8184-631: The Medical Devices Rules, 2017 are classified as per Global Harmonization Task Force (GHTF) based on associated risks. The CDSCO classifications of medical devices govern alongside the regulatory approval and registration by the CDSCO is under the DCGI. Every single medical device in India pursues a regulatory framework that depends on the drug guidelines under the Drug and Cosmetics Act (1940) and

8308-962: The Mercedes-Benz Group is no longer involved in the Chinese car brand Denza, as it sold its last ten per cent stake in Denza in July 2024. In 2016, Daimler announced plans to sell Mercedes-Benz-badged fully electric battery cars in China. Beijing Benz is a joint venture with the BAIC Group to produce the Mercedes-Benz branded cars in China. Established in 1995, Mercedes-Benz Vietnam is a joint venture between Saigon Mechanical Engineering Corporation (SAMCO) and Daimler AG . Daimler AG assembles various Mercedes-Benz models from CKD kits at its factory in Ho Chi Minh City . The factory

8432-460: The Mercedes-Benz Group to form an independent entity at the end of 2021. In 2018, Mercedes-Benz became the world’s largest premium vehicle brand, with a sales volume of 2.31 million passenger cars. The roots of the brand trace back to the 1901 Mercedes by Daimler-Motoren-Gesellschaft and the 1886 Benz Patent-Motorwagen by Carl Benz , which is widely recognized as the first automobile powered by an internal combustion engine. The brand’s slogan

8556-509: The Mercedes-Benz Trucks division is part of the Daimler Truck company and includes other sub-companies that were part of the DaimlerChrysler merger. Gottlieb Daimler sold the world's first truck in 1886. Their first factory to be built outside Germany after World War II was in Argentina . They originally built trucks, many of which were modified by third parties to be used as buses, popularly named Colectivo . Mercedes-Benz has been producing buses since 1895 in Mannheim , Germany. Since 1995,

8680-422: The Mercedes-Benz- and the Smart -branded cars' production. Mercedes-AMG became a majority-owned division of Mercedes-Benz in 1999. The company was integrated into DaimlerChrysler in 1999, and became Mercedes-Benz AMG on 1 January 1999. Daimler's ultraluxury Maybach brand was under the Mercedes-Benz Cars division until December 2012, when production was stopped due to decreased sales. It now exists under

8804-461: The Polytechnic School in Stuttgart from 1857 to 1859. After completing various technical activities in France and England, he started working as a draftsman in Geislingen in 1862. At the end of 1863, he was appointed workshop inspector at a machine-tool factory in Reutlingen, where he met Wilhelm Maybach in 1865. Throughout the 1930s, Mercedes-Benz produced the 770 model, a car that was notably popular throughout Germany's Nazi period. Adolf Hitler

8928-499: The Red Cross member organization use a red Star of David , but this does not have recognition beyond Israeli borders, where they must use the Red Crystal. The Star of Life is widely used, and was originally designed and governed by the U.S. National Highway Traffic Safety Administration , because the Red Cross symbol is legally protected by both National and international law. Ambulance services with historical origins such as

9052-755: The Spanish, and civilian variants were put into operation during the 1830s. Advances in technology throughout the 19th and 20th centuries led to modern self-powered ambulances. Ambulances can be grouped into types depending on whether or not they transport patients, and under what conditions. In some cases, ambulances may fulfill more than one function (such as combining emergency ambulance care with patient transport: Ambulances can be based on many types of vehicle although emergency and disaster conditions may lead to other vehicles serving as makeshift ambulances: Ambulance design must take into account local conditions and infrastructure. Maintained roads are necessary for road-going ambulances to arrive on scene and then transport

9176-530: The UK by Brighton-based Elektromotive , have been installed at seven locations as part of a pilot project, and further expansion of the initiative is planned later in 2010. In the United States, Mercedes-Benz was assessed a record US$ 30.66 million fine for their decision to not meet the federal corporate average fuel economy standard in 2009. Certain Mercedes-Benz cars, including the S550 and all AMG models sold in

9300-753: The US between 1991 and 2006. In addition to the equipment directly used for the treatment of patients, ambulances may be fitted with a range of additional equipment which is used in order to facilitate patient care. This could include: In parts of the world that lack a high level of infrastructure, ambulances are designed to meet local conditions, being built using intermediate technology . Ambulances can also be trailers, which are pulled by bicycles, motorcycles, tractors, or animals. Animal-powered ambulances can be particularly useful in regions that are subject to flooding. Motorcycles fitted with sidecars (or motorcycle ambulances ) are also used, though they are subject to some of

9424-520: The United States, also face an additional gas guzzler tax . However, newer AMG models fitted with the M157 engine will not be subject to the gas-guzzler tax, due to improved fuel economy, and newer models powered by the M276 and M278 engines will have better fuel economy. In 2008, Mercedes also had the worst CO 2 average of all major European manufacturers, ranking 14th out of 14 manufacturers. Mercedes

9548-674: The United States, standards for ambulance design have existed since 1976, where the standard is published by the General Services Administration and known as KKK-A-1822. This standard has been revised several times, and is currently in version 'F' change notice #13, known as KKK-A-1822F. The National Fire Protection Association has also published a design standard, NFPA 1917 , which offers an alternative to KKK-A-1822F. The Commission on Accreditation of Ambulance Services (CAAS) has published its Ground Vehicle Standard for Ambulances v2.0, effective July 2019. This standard

9672-509: The achievement of its primary intended purposes. The term 'device' does not include software functions excluded pursuant to section 520(o)." According to Article 1 of Council Directive 93/42/EEC, 'medical device' means any "instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, including the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic purposes and necessary for its proper application, intended by

9796-502: The ambulance is expected to transport (for instance specifying a different standard for routine patient transport than high dependency), or may base standards on the size of vehicle. For instance, in Europe, the European Committee for Standardization publishes the standard CEN 1789 , which specifies minimum compliance levels across the build of ambulance, including crash resistance, equipment levels, and exterior marking. In

9920-493: The ambulance that may interfere with patient care and radio communications. Ambulances can additionally be fitted with airhorn audible warnings to augment the effectiveness of the siren system, or may be fitted with extremely loud two-tone air horns as their primary siren. A recent development is the use of the RDS system of car radios . The ambulance is fitted with a short range FM transmitter, set to RDS code 31, which interrupts

10044-485: The appropriate hospital of the ambulance's pending arrival, or, in cases where physicians do not form part of the ambulance's crew, to confer with a physician for medical oversight. Ambulances often have two stages of manufacturing. The first is frequently the manufacture of light or medium truck chassis-cabs or full-size vans (or in some places, cars) such as Mercedes-Benz , Nissan , Toyota , or Ford . The second manufacturer (known as second stage manufacturer ) modifies

10168-409: The article these regions will be discussed in order of their global market share. A global definition for medical device is difficult to establish because there are numerous regulatory bodies worldwide overseeing the marketing of medical devices. Although these bodies often collaborate and discuss the definition in general, there are subtle differences in wording that prevent a global harmonization of

10292-617: The birth of Mercedes-Benz as a brand. In 1901, the name "Mercedes" was re-registered by DMG worldwide as a protected trademark. The first Mercedes-Benz branded vehicles were produced in 1926, following the merger of Karl Benz and Gottlieb Daimler's companies into the Daimler-Benz company on 28 June of the same year. Gottlieb Daimler was born on 17 March 1834 in Schorndorf. After training as a gunsmith and working in France, he attended

10416-495: The brands of Mercedes-Benz's buses and coaches are under the umbrella of EvoBus GmbH, since December 2021 belonging to Daimler Truck AG. EvoBus, through its regional subsidiaries, markets them in European countries, while in other regions of the world marketing and sales duties are passed to regional subsidiaries of Daimler Truck. Mercedes-Benz produces a wide range of buses and coaches, mainly for Europe and Asia. The first model

10540-418: The conduct of medical testing , implants , and prostheses . The design of medical devices constitutes a major segment of the field of biomedical engineering . The global medical device market was estimated to be between $ 220 and US$ 250 billion in 2013. The United States controls ≈40% of the global market followed by Europe (25%), Japan (15%), and the rest of the world (20%). Although collectively Europe has

10664-496: The criteria of an ambulance (transporting the sick or injured), although the capabilities of a hospital ship are more on par with a Mobile Army Surgical Hospital . In line with the laws of war , these ships can display a prominent Red Cross or Red Crescent to confer protection under the appropriate Geneva Convention . However, this designation has not always protected hospital ships from enemy fire. Ambulettes provide patient transport service for non-emergency situations. Scheduling

10788-445: The definition of a medical device, thus the appropriate definition of a medical device depends on the region. Often a portion of the definition of a medical device is intended to differentiate between medical devices and drugs , as the regulatory requirements of the two are different. Definitions also often recognize In vitro diagnostics as a subclass of medical devices and establish accessories as medical devices . Section 201(h) of

10912-557: The design becomes more important, as does the nature of the skills required to properly operate the vehicle. Cost-effectiveness can be a high priority. Emergency ambulances are highly likely to be involved in hazardous situations, including incidents such as a road traffic collision , as these emergencies create people who are likely to be in need of treatment. They are required to gain access to patients as quickly as possible, and in many countries, are given dispensation from obeying certain traffic laws. For instance, they may be able to treat

11036-416: The design of the vehicle, and involve the use of high contrast patterns. Older ambulances (and those in developing countries ) are more likely to have their pattern painted on, whereas modern ambulances generally carry retro-reflective designs, which reflects light from car headlights or torches. Popular patterns include 'checker board' (alternate coloured squares, sometimes called ' Battenburg ', named after

11160-420: The device's category The Medical Devices Bureau of Health Canada recognizes four classes of medical devices based on the level of control necessary to assure the safety and effectiveness of the device. Class I devices present the lowest potential risk and do not require a licence. Class II devices require the manufacturer's declaration of device safety and effectiveness, whereas Class III and IV devices present

11284-800: The first quarter of 2007, Mercedes showed dramatic improvement by climbing from 25th to 5th place and earning several awards for its newer models. For 2008, Mercedes-Benz's initial quality rating improved by yet another mark, to 4th place. On top of this accolade, it also received the Platinum Plant Quality Award for their Mercedes branded Sindelfingen, Germany body assembly plant. J. D. Power's 2011 US Initial Quality and Vehicle Dependability Studies both ranked Mercedes-Benz vehicles above average in build quality and reliability. In J. D. Power's United Kingdom Survey in 2011, Mercedes cars were rated above average. Additionally, iSeeCars.com study for Reuters in 2014 found Mercedes to have

11408-467: The front are often fitted as well to increase visibility for the driver. In order to increase safety, it is best practice to have 360° coverage with the active warnings, improving the chance of the vehicle being seen from all sides. In some countries, such as the United States, this may be mandatory. The roof, front grille, sides and rear of the body, and front fenders are common places to mount emergency lights. A certain balance must be made when deciding on

11532-420: The front or roof of the ambulance. Most modern ambulances are now fitted with electronic sirens, producing a range of different noises which ambulance operators can use to attract more attention to themselves, particularly when proceeding through an intersection or in heavy traffic. The speakers for modern sirens can be integral to the lightbar, or they may be hidden in or flush to the grill to reduce noise inside

11656-479: The good functioning of the Single Market. These three main directives have been supplemented over time by several modifying and implementing directives, including the last technical revision brought about by Directive 2007/47 EC. The government of each Member State must appoint a competent authority responsible for medical devices. The competent authority (CA) is a body with authority to act on behalf of

11780-535: The greater performance. Another example is the E250 CGI having greater performance than the E200 CGI due to the different engine tuning even though both have 1.8-litre engines. From the marketing perspective, E200 seems more "upscale" than E180. Recent AMG models use the "63" designation (in honor of the 1960s 6.3-litre M100 engine) despite being equipped with either a 6.2-litre ( M156 ), a 5.5-litre ( M157 ) or even

11904-401: The high beams, flashed alternately) are known as a wig-wag . Additional white lights may be placed strategically around the vehicle to illuminate the area around it when it is dark, almost always at the rear for loading and unloading stretchers and often at the sides as well. In areas very far North or South where there are times of year with long periods of darkness, additional driving lights at

12028-453: The labourers' families. In 1958, the two companies began a partnership to sell their cars in the United States with Studebaker . A few American-based Daimler Benz dealerships were converted into Mercedes-Benz dealerships when Daimler's non-Mercedes-partnered company closed in 1966. Over the decades, Mercedes-Benz has introduced many electronic and mechanical innovations and safety features that later became common. Currently, Mercedes-Benz

12152-541: The left and S500/S600 on the right. Mercedes-Benz has developed multi- concept cars with alternative propulsion, such as hybrid-electric, fully electric, and fuel-cell powertrains . At the 2007 Frankfurt motor show , Mercedes-Benz showed seven hybrid models, including the F700 concept car , powered by a hybrid-electric drivetrain featuring the DiesOtto engine. In 2009, Mercedes-Benz displayed three BlueZERO concepts at

12276-445: The lowest vehicle recall rate out of competitors. Mercedes-Benz offers a versatile range of consumer-passenger, light commercial and heavy commercial equipment. These vehicles are manufactured in multiple countries worldwide. The Smart marque of city cars are also produced by Daimler AG. Mercedes-Benz currently offers three types of vans; Citan , Vito , and Sprinter . They are all produced by Daimler AG. Since December 2021,

12400-524: The manufacturer must provide a technical file and be certified by a European Notified Body for manufacturing in accordance with metrology regulations. Class IIa Devices: Class IIa devices generally constitute low to medium risk and pertain mainly to devices installed within the body in the short term. Class IIa devices are those which are installed within the body for only between 60 minutes and 30 days. Examples include hearing-aids, blood transfusion tubes, and catheters. Requirements include technical files and

12524-486: The manufacturer to be used for human beings for the purpose of: and which does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means;" Based on the New Approach , rules that relate to safety and performance of medical devices were harmonised in the EU in the 1990s. The New Approach , defined in

12648-678: The manufacturer to complete a Technical File. Class Is Devices: Class Is devices are similarly non-invasive devices, however this sub-group extends to include sterile devices. Examples of Class Is devices include stethoscopes, examination gloves, colostomy bags, or oxygen masks. These devices also require a technical file, with the added requirement of an application to a European Notified Body for certification of manufacturing in conjunction with sterility standards. Class Im Devices: This refers chiefly to similarly low-risk measuring devices. Included in this category are: thermometers, droppers, and non-invasive blood pressure measuring devices. Once again

12772-575: The medical purposes provided by law, and creates or modifies health information by calculations or comparison, providing information about an individual patient. Medical devices (excluding in vitro diagnostics) in Japan are classified into four classes based on risk: Classes I and II distinguish between extremely low and low risk devices. Classes III and IV, moderate and high risk respectively, are highly and specially controlled medical devices. In vitro diagnostics have three risk classifications. For

12896-499: The member state to ensure that member state government transposes requirements of medical device directives into national law and applies them. The CA reports to the minister of health in the member state. The CA in one Member State has no jurisdiction in any other member state, but exchanges information and tries to reach common positions. In the UK, for example, the Medicines and Healthcare products Regulatory Agency (MHRA) acted as

13020-585: The name of their owner or operator, and an emergency telephone number for the ambulance service. Ambulances may also carry an emblem (either as part of the passive warning markings or not), such as a Red Cross, Red Crescent or Red Crystal (collective known as the Protective Symbols ). These are symbols laid down by the Geneva Convention , and all countries signatory to it agree to restrict their use to either (1) Military Ambulances or (2)

13144-401: The naming system. Models were divided into "classes" denoted by an arrangement of up to three letters (see "Current model range" above), followed by a three-digit (or two-digit for AMG models, with the number approximately equal to the displacement in litres multiplied by 10) number related to the engine displacement as before. Variants of the same model such as an estate version or a vehicle with

13268-433: The national Red Cross or Red Crescent society. Use by any other person, organization or agency is in breach of international law. The protective symbols are designed to indicate to all people (especially combatants in the case of war) that the vehicle is neutral and is not to be fired upon, hence giving protection to the medics and their casualties, although this has not always been adhered to. In Israel, Magen David Adom ,

13392-493: The number and location of lights: too few and the ambulance may not be noticed easily, too many and it becomes a massive distraction for other road users more than it is already, increasing the risk of local accidents. In addition to visual warnings, ambulances can be fitted with audible warnings , sometimes known as sirens , which can alert people and vehicles to the presence of an ambulance before they can be seen. The first audible warnings were mechanical bells, mounted to either

13516-499: The patient to a hospital, though in rugged areas four-wheel drive or all-terrain vehicles can be used. Fuel must be available and service facilities are necessary to maintain the vehicle . Methods of summoning (e.g. telephone) and dispatching ambulances usually rely on electronic equipment, which itself often relies on an intact power grid . Similarly, modern ambulances are equipped with two-way radios or cellular telephones to enable them to contact hospitals, either to notify

13640-478: The radio of all cars within range, in the manner of a traffic broadcast, but in such a way that the user of the receiving radio is unable to opt-out of the message (as with traffic broadcasts). This feature is built into every RDS radio for use in national emergency broadcast systems, but short-range units on emergency vehicles can prove an effective means of alerting traffic to their presence. It is, however, unlikely that this system could replace audible warnings, as it

13764-481: The remaining regions in the world, the risk classifications are generally similar to the United States, European Union, and Japan or are a variant combining two or more of the three countries' risk classifications. The ASEAN Medical Device Directive (AMDD) has been adopted by several southeast Asian countries. The nations are at varying stages of adopting and implementing the Directive. The AMDD classification

13888-492: The road. Also, the ambulance crew's responsibilities to their patient often preclude their use of safety devices such as seat belts . Research has shown that ambulances are more likely to be involved in motor vehicle collisions resulting in injury or death than either fire trucks or police cars . Unrestrained occupants, particularly those riding in the patient-care compartment, are particularly vulnerable. When compared to civilian vehicles of similar size, one study found that on

14012-414: The same limitations as more traditional over-the-road ambulances. The level of care provided by these ambulances varies between merely providing transport to a medical clinic to providing on-scene and continuing care during transport. The design of intermediate technology ambulances must take into account not only the operation and maintenance of the ambulance, but its construction as well. The robustness of

14136-406: The structure or functions of the body of man or other animals." The term medical device, as defined in the Food and Drugs Act , is "any article, instrument, apparatus or contrivance, including any component, part or accessory thereof, manufactured, sold or represented for use in: the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, in

14260-552: The time, it was a meeting place for the haute volée of France and Europe, especially in winter. His customers included the Rothschild family and other wealthy clients, but as early as 1901, he was selling Mercedes cars in the " New World " as well, including to billionaires Rockefeller , Astor , Morgan , and Taylor. At the Nice race he attended in 1899, Jellinek drove under the pseudonym "Monsieur Mercédès". Many consider that race

14384-568: The treatment, mitigation, diagnosis or prevention of a disease or abnormal physical condition. Health Canada reviews medical devices to assess their safety, effectiveness, and quality before authorizing their sale in Canada. According to the Act, medical device does not include any device that is intended for use in relation to animals. India has introduced National Medical Device Policy 2023. However, certain medical devices are notified as DRUGS under

14508-403: The vehicle (which is sometimes purchased incomplete, having no body or interior behind the driver's seat ) and turns it into an ambulance by adding bodywork, emergency vehicle equipment , and interior fittings. This is done by one of two methods – either coachbuilding , where the modifications are started from scratch and built on to the vehicle, or using a modular system, where a pre-built 'box'

14632-538: The world to use a lithium-ion battery . In mid-2010, production commenced on the Vito E-Cell all-electric van. In 2008, Mercedes-Benz announced that it would have a demonstration fleet of small electric cars in two to three years. Mercedes-Benz and Smart are preparing for the widespread uptake of electric vehicles (EVs) in the UK by beginning the installation of recharging points across their dealer networks. So far 20 Elektrobay recharging units, produced in

14756-665: The wounded off the field of battle were called ambulance wagons. Field hospitals were still called ambulances during the Franco-Prussian War of 1870 and in the Serbo-Turkish war of 1876 even though the wagons were first referred to as ambulances about 1854 during the Crimean War . The history of the ambulance begins in ancient times , with the use of carts to transport incurable patients by force. Ambulances were first used for emergency transport in 1487 by

14880-648: Was adopted in 2017. The currct core legal framework consists of two regulations, replacing the previous three directives: The two regulations are supplemented by several guidances developed by the Medical Devices Coordination Group (MDCG). Article 2, Paragraph 4, of the Pharmaceutical Affairs Law (PAL) defines medical devices as "instruments and apparatus intended for use in diagnosis, cure or prevention of diseases in humans or other animals; intended to affect

15004-463: Was decided to use the heavily armored Merkava tank. Its rear door enables the evacuation of critically wounded soldiers. Israel did not remove the Merkava's weaponry, claiming that weapons were more effective protection than emblems since Palestinian militants would disregard any symbols of protection and fire at ambulances anyway. For use as ground ambulances and treatment & evacuation vehicles,

15128-400: Was first marketed in 1901 by Daimler Motoren Gesellschaft (DMG). Emil Jellinek-Mercedes , an Austrian automobile entrepreneur who worked with DMG, registered the trademark in 1902, naming the 1901 Mercedes 35 hp after his daughter Mercedes Jellinek . Jellinek was a businessman and marketing strategist who promoted "horseless" Daimler automobiles among the highest circles of society. At

15252-625: Was known to have driven in a model of this car during his time in power, with modified custom bulletproof windshields. Most of the currently surviving 770 models were sold at auctions to private buyers. One of the cars is currently on display at the War Museum in Ottawa, Ontario . From 1937 onward, Daimler Benz focused increasingly on military products such as the LG3000 lorry and the DB600 and

15376-487: Was produced by Karl Benz in 1895. The Mercedes-Benz 600 or 600S Pullman Guard limousines offer the option of armour-plating and have been used by diplomats worldwide. Until 1994, Mercedes-Benz utilized an alphanumeric system for categorizing their vehicles, consisting of a number sequence approximately equal to the engine's displacement in liters multiplied by 100, followed by an arrangement of alphabetical suffixes, indicating body style and engine type. Some models in

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