DTECH
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Posts: 21
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Post by DTECH on Oct 6, 2021 9:09:15 GMT
SrCusEngr if we are discussing the loop coming from the RO to the dialysis machine, then yes, the home patients are 'meant' to do a heat disinfection once a week on the RO which will disinfect the loop of any contaminants. At the least we know its done atleast twice in 3 months, we can only see the last disinfection log on the gambro wro300H, and as techs we carry out a dialox every year when the annual service is due the flow at the property at my recollection was brilliant, 2.5 Bar pre filters and 2 bar post filters feeding the RO, with 1.5 Bar pressure at the loop with 1200ml/min flow The job got taken out of my hands as i had tried everything apart from changing the membranes on the balance chamber or personally myself i haven't checked the ferrite rods for any damage, that will be something i will check for at my next visit to the home patients when i carry put sampling, what i was advised by a superior tech was that DBK can also have an affect that if we turned the centre disc upside down, that will make a difference? have you heard anything like that? they do have the DF filter on the back but that was changed by myself on the day when i noticed alarm(we change DF filters every 6 months).
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btech
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Post by btech on Oct 6, 2021 10:13:44 GMT
This issue can be very complex and can have different reasons:
Particle inside the cartridge holder Check valve FBIC Filter blocked outlet tube kinked or restricted via a coupling (open the outlet) outlet tube to long or to high IV Pol adjustment, respective cartridge check valve not complete open (push the upper holder a bit more down after you connect the cartridge or simple put more wait (saline) at the IVpol). incorrect fixation of the IV Pol (at the close position you still see a distance) cartridge are simple to short, please check: see attachment
Or even a not openening VBCIP valve. all the uppon mentioned things are from my experience and shall give you helping hand to solve the issue
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DTECH
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Post by DTECH on Oct 6, 2021 11:55:39 GMT
btech thankyou for your reply all the above have been tried and tested to no avail, the above you mentioned normally are the most common reasons for the fault and have worked many of times for me in the past the one im unsure of is the cartidge being simple to short? i can not see the attachment provided. The home patient uses the 650g bicartidges so the smaller of the three which can be used but unsure how that will make a difference if other home patients arent having any problems?
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btech
New Member
Posts: 43
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Post by btech on Oct 7, 2021 15:07:44 GMT
Ok have you checked the DBk spring and the washer inside? It can be that the spring is worn out over time and thus not letting enough water through.
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Post by SrCusEngr on Oct 7, 2021 18:54:44 GMT
rhys: There was a bulletin submitted (either a tech or assembly, too long ago to remember) some time ago stating that the concave disc used in DBK must be installed flat side up. This will compress the spring slightly more than normal, but it should not have a drastic effect. We all know that a spring can only get weaker, but with only 2k hours, it should not be bad already.
Btech: I have seen this problem even with brand new machines from Germany (<100 WTC) IF, and only IF, the cartridge is installed at setup (prior to or just going into Preparation phase. Prior to 9.1B, if a cartridge was inserted at preparation, it would not start to fill until the time to "Connect Bicarb/Cartridge" message was due to appear. But 9.1B changed the procedure. If the cartridge was installed at startup, it would start to pre-fill but then be paused when the machine prepared to due its temperature testing. To prevent rapid degassing of the bicarb with hot water, flow to the cartridge was halted. I don't know for sure, but I think this pausing of the fill has something to due with the cartridge connected incorrectly alarms. I observed that it never actually opens VBICP/VBKO again, but it will flush for about 3 minutes and then start the A/B pumps to get into conductivity. However, if the same customer actually waited until the "Connect Bicarb/Cartridge" message appeared (which was after the temperature test) to install the cartridge, they would not have the "not connected properly" message appear.
So all the things you have mentioned should not be present on new machines. It is even more prevalent when using the large cartridge for a second patient (left on the machine). Again, removing the cartridge and waiting for the message to connect bicarb/cartridge produces no warning. However, nurses do not like removing and then reinstalling a fluid-filled cartridge.
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Post by SrCusEngr on Oct 8, 2021 0:03:40 GMT
rhys: I was referring to the flow in the machine, not what is coming into the property. Unfortunately, I have seen many portable ROs feeding a machine where the incoming water line to the machine is not properly disinfected at least monthly. So biofilm gets into the machine clogging the disposable filters causing a low flow which slows down the cycling of the balance chamber membranes. If your filters are clear, check the float sensor (NSVB) to see if it is ever reaching LOW while being fed water during operation. There may be insufficient water supply but not enough to trip a Water supply disturbed alarm. Just another thought.
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Post by kolev77 on Oct 26, 2021 12:35:16 GMT
Hello guys. I has a problem like that. 4 or 5 machines SW 9.1A with cartridge module and aroun 2000-2200 working hours. I just replace FBIC with old one, and the problem is gone.
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DTECH
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Posts: 21
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Post by DTECH on Dec 10, 2021 11:59:13 GMT
SrCusEngrThanks for the information and we have tried now absolutely everything, we have gone to bbraun for more information but they are just coming up with the same fixes now which we have already tried, we are looking at a possibly a faulty valve or one of the blocks such as the DF block having a manufacturing issue, when we finally get the center of this fault, I will update the thread in what has caused this problem, it may be a 1/10000 but could save someone else months of hair pulling(im bald now)
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Post by SrCusEngr on Dec 11, 2021 19:20:33 GMT
You could do a pressure test of the DF block but I honestly do not think you are going to find a problem. Like I had said previously, this started occurring when they introduced the Temperature plausibility and certification check in the software in 9.1B. If you put the cartridge in right at the beginning of preparation, it starts to fill with warmed (37 deg. C) water. But when the temperature tests begin, the water temperature is raised to >50 deg C. 2(NaHCO3) begins to decompose at room temperature into Na2CO3 + CO2 + H2O. The Na2CO3 is more stable at room temperature but is still capable of breaking down at higher temperatures. So this is why you will see some 'bubbles' as the cartridge fills. But when that water goes above 45 deg. C, the reaction will become more aggressive, especially for the NaHCO3 molecules. This is why the filling process is halted (VBKO stays closed) at high water temperatures. Once it returns to a more normal value, the fill process starts again. But some of that bicarbonate has already been raised significantly above the decomposition point of the sodium bicarbonate, and the fresh side of the balance chamber does not have an air separator chamber. So, and this is my guess, if the fresh side 'sees' an increase of 'air [CO2]', it would cause the membranes to not function properly (remember that the flushing of the cartridge requires two complete cycles of the balance chamber membranes within a fixed period of time; air is compressible and allows membranes to continue movement when they should be stopped). The error message produced is your "Cartridge is not connected properly" because it is waiting for a satisfactory completion of that test.
Lastly, as you have found, installing the cartridge when the machine displays the "Connect bicarbonate cartridge" alert, the system works fine. So it is probably advisable to just follow the machine prompts to reduce annoyance warnings. People like shortcuts, but perhaps this is one (cartridge installed at start of prep) that needs to be set aside. And it will save you hours of attempting to troubleshoot a problem that doesn't really exist.
There is a reason why the "Connect bicarbonate cartridge" alert occurs WHEN it does!
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Post by Chuck Weddle on Dec 11, 2021 19:41:35 GMT
You could do a pressure test of the DF block but I honestly do not think you are going to find a problem. Like I had said previously, this started occurring when they introduced the Temperature plausibility and certification check in the software in 9.1B. If you put the cartridge in right at the beginning of preparation, it starts to fill with warmed (37 deg. C) water. But when the temperature tests begin, the water temperature is raised to >50 deg C. 2(NaHCO3) begins to decompose at room temperature into Na2CO3 + CO2 + H2O. The Na2CO3 is more stable at room temperature but is still capable of breaking down at higher temperatures. So this is why you will see some 'bubbles' as the cartridge fills. But when that water goes above 45 deg. C, the reaction will become more aggressive, especially for the NaHCO3 molecules. This is why the filling process is halted (VBKO stays closed) at high water temperatures. Once it returns to a more normal value, the fill process starts again. But some of that bicarbonate has already been raised significantly above the decomposition point of the sodium bicarbonate, and the fresh side of the balance chamber does not have an air separator chamber. So, and this is my guess, if the fresh side 'sees' an increase of 'air [CO2]', it would cause the membranes to not function properly (remember that the flushing of the cartridge requires two complete cycles of the balance chamber membranes within a fixed period of time; air is compressible and allows membranes to continue movement when they should be stopped). The error message produced is your "Cartridge is not connected properly" because it is waiting for a satisfactory completion of that test.
Lastly, as you have found, installing the cartridge when the machine displays the "Connect bicarbonate cartridge" alert, the system works fine. So it is probably advisable to just follow the machine prompts to reduce annoyance warnings. People like shortcuts, but perhaps this is one (cartridge installed at start of prep) that needs to be set aside. And it will save you hours of attempting to troubleshoot a problem that doesn't really exist.
There is a reason why the "Connect bicarbonate cartridge" alert occurs WHEN it does!
I follow what you're saying and it makes perfect sense except for one thing.....I have 100 machines that we upgraded to 9.1B and 40 more that had it original and we don't have this issue. I've always thought of those connect alert messages saying "HEY DUMMY YOU FORGOT SOMETHING" more than WHEN to do a step.
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Post by SrCusEngr on Dec 11, 2021 20:23:08 GMT
And I installed 10 brand new 9.1B's some months ago, and each one failed (gave the message) if they kept the cartridge on the machine for the next patient, installed a new cartridge at the start of Prep, or put a used cartridge on at the start of Prep. But no messages were generated if they waited until the machine told them to connect the cartridge, new or used. What can I say? I do know (from going bug-eyed watching the Service Overview screen and making timing measurements) that once the message is issued, the cartridge is NOT flushed any more (VBICP opens which indicates it is repeating the test)! So after about 95-115 seconds, the acid [KP] and bicarb [BICP] pumps start and attempt to go into conductivity without any intervention by the operator. So while this seems to be a one and done test, the result is only a short delay to coming up into conductivity, not a complete stoppage and then repeat the test attempt.
Except for aged equipment with mechanical problems, I have not seen any machine give that warning message after the prompt "Connect bicarbonate cartridge".
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DTECH
New Member
Posts: 21
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Post by DTECH on Dec 13, 2021 14:54:12 GMT
You could do a pressure test of the DF block but I honestly do not think you are going to find a problem. Like I had said previously, this started occurring when they introduced the Temperature plausibility and certification check in the software in 9.1B. If you put the cartridge in right at the beginning of preparation, it starts to fill with warmed (37 deg. C) water. But when the temperature tests begin, the water temperature is raised to >50 deg C. 2(NaHCO3) begins to decompose at room temperature into Na2CO3 + CO2 + H2O. The Na2CO3 is more stable at room temperature but is still capable of breaking down at higher temperatures. So this is why you will see some 'bubbles' as the cartridge fills. But when that water goes above 45 deg. C, the reaction will become more aggressive, especially for the NaHCO3 molecules. This is why the filling process is halted (VBKO stays closed) at high water temperatures. Once it returns to a more normal value, the fill process starts again. But some of that bicarbonate has already been raised significantly above the decomposition point of the sodium bicarbonate, and the fresh side of the balance chamber does not have an air separator chamber. So, and this is my guess, if the fresh side 'sees' an increase of 'air [CO2]', it would cause the membranes to not function properly (remember that the flushing of the cartridge requires two complete cycles of the balance chamber membranes within a fixed period of time; air is compressible and allows membranes to continue movement when they should be stopped). The error message produced is your "Cartridge is not connected properly" because it is waiting for a satisfactory completion of that test.
Lastly, as you have found, installing the cartridge when the machine displays the "Connect bicarbonate cartridge" alert, the system works fine. So it is probably advisable to just follow the machine prompts to reduce annoyance warnings. People like shortcuts, but perhaps this is one (cartridge installed at start of prep) that needs to be set aside. And it will save you hours of attempting to troubleshoot a problem that doesn't really exist.
There is a reason why the "Connect bicarbonate cartridge" alert occurs WHEN it does!
Great bit of information, its at our home patients who like to set the machine up from the get go as it was the way they were taught with the home dialysis nurses. This is the first we have come across on the 9.1b, our other tech had a crack at it, replacing the MSBK1&2 sensors and also the membranes. We know there is something which is causing it, we sent the trends over to Germany and we can see a malfunction of the balance chamber when it does its test the second time round when the prompt would originally be there to connect the bicarbonate cartridge, we have the issue where the DF block valves start acting erratically open and closing crazy quick during the movement of the membranes, it fails on the last cycle.
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Post by SrCusEngr on Dec 14, 2021 20:50:13 GMT
9.1B software changed several things and it is possible that there is a timing glitch that is throwing things off. I can't say because I didn't write it or proof it. That is for the experts. But when changes are made to software, stuff can happen. It sounds like that machine is getting the valves out of sync. There may be one that is slow to close or it is not being seen by the valve board correctly. Anyway, please post what the find.
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DTECH
New Member
Posts: 21
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Post by DTECH on Jul 19, 2022 13:46:33 GMT
A quick little update with this fault.. nearly a year on and we have changed quite a lot and still seeing error message
every single valve from the balance chamber has been changed Analog board Digital Board Power board for the valves MSBK1/2 and membranes Y connector O-rings in bicart holder and replaced Bicart holder & Spikes for new FBIC BICP Both Dialyser couplings RVFPE and DDE DF manifold DBK and Spring
Replaced Power board for motors, error occurred still after running with new board
We are in liaison with Bbraun and have sent trends off but Bbraun dont have anything to add on what could be the cause of the fault. JIRA ticket created
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