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Post by Chuck Weddle on Oct 20, 2021 17:12:20 GMT
I got a call from one of our clinics saying that when one of the patient's blood was rinsed back, the dialyzer had a bunch of little black specks all over it. I had them pull the machine and save the dialyzer (sorry, no picture of the dialyzer). When I arrived, I found that the machine had a LOT of black powder looking material almost everywhere above the sub-rack both pre and post dialyzer. That told me that the machine was the source and not the dialyzer.   Now a shocking discovery, when I looked at the repair history of this machine, I found that it has 23,000 hours and had NEVER been serviced other than its annual PM. You gotta love these Braun machines! With the number of hours, I was suspecting the source to be deteriorating BC membranes. I spoke to Adam in Tech Support and right away, without seeing any pictures he said it was a magnet in one of the gear pump. I was skeptical because after having 165 Dialog + machines for the last 15 years, I thought we had seen everything. But, sure enough, it was the magnet in the FPE pump.  Braun Tech Support can't be beat! Now a question...... We are already planning on replacing all of the filters. This stuff is visible in valves, tubing, and fittings. 1. Will it rinse out? 2. If not, is there something that will clean it out? |
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Post by SrCusEngr on Oct 23, 2021 16:32:48 GMT
The particles are the equivalent of carbon fines from activated charcoal. Even though they are magnetic (you can move them with a magnet), the finer particles will 'catch' in the irregularities of the inner walls of the tubing resulting in a discolored look. The larger particles can be flushed out, but if you want to remove that grey color, the only way is either replace the tubing or remove it, push (or pull) a cotton swab through it and reinstall it. It is ferrite material, an inert substance, so no harm to the patient but unnerving to say the least.
During the annual, did they not notice that to attain certain flow rates, the pump speeds were noted to be higher than usual? Especially at those high hours for original pumps?
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Post by Chuck Weddle on Oct 23, 2021 17:23:29 GMT
The machines at this clinic are actually being PM'd this month but that one had not been done yet. I don't have the previous years PM's here to see how its been. I do know though that I ran it for 30 minutes prior to anything being done to it and it passed test and sounded perfectly normal. The trends of the treatment that this was noticed on did not show any unusual alarms or fluctuations in pressures or flows.
I actually thought that you especially would have some kind of magic trick for cleaning this out.
Monday I will check it to make sure my team got it clean. Steve told me that a letter about this already exists but it needs to be updated. Once we have that my CMO will sign off on it going back in to service.
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btech
New Member
Posts: 43
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Post by btech on Oct 26, 2021 13:51:33 GMT
Hello Chuck, what you always should look for is the BC. If there are some particles left inside the tubings they will gather arround the new magnet of the pump. After 1h of rinsing and citric, you should open up the new pump and clean it again also look down into the upline tank and clean if neccessary. Thats how i got rid of these black particles.
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Post by Chuck Weddle on Oct 26, 2021 15:28:17 GMT
Hello Chuck, what you always should look for is the BC. If there are some particles left inside the tubings they will gather arround the new magnet of the pump. After 1h of rinsing and citric, you should open up the new pump and clean it again also look down into the upline tank and clean if neccessary. Thats how i got rid of these black particles. Thanks! Great advice! |
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Post by bcjammerx on Oct 31, 2021 15:17:18 GMT
So this was INSIDE the tubing as well as outside?
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Post by Chuck Weddle on Oct 31, 2021 16:29:37 GMT
So this was INSIDE the tubing as well as outside? Only what was in the dialyzer dialysate compartment was outside of the tubing. |
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Post by SrCusEngr on Oct 31, 2021 22:28:53 GMT
So this was INSIDE the tubing as well as outside? Technically, the magnet of a gear pump can be thought of as being surrounded by fluid because there is not a perfect waterproof seal between gears that move the fluid and the magnet, itself. Since the dialysate is not a neutral pH, it will have an affect on the magnet. After many years, particles from the magnet may make their way into the dialysate pathway. Depending on the amount of deterioration, this material can darken the interior walls of the tubing and discolors filters. Tubing walls are not perfectly smooth and the material is extremely fine; it just gets caught in the nooks and crannies of the tubing. |
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joey
Full Member
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Post by joey on Nov 2, 2021 16:13:43 GMT
So this was INSIDE the tubing as well as outside? Only what was in the dialyzer dialysate compartment was outside of the tubing. Chuck Did they get it cleaned out? I just had my first exposure to this. It's everywhere I just want to know if there was something that worked better than others in the advice so far. Thanks to you and everyone else who chimed in.
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Post by Chuck Weddle on Nov 2, 2021 16:56:05 GMT
Only what was in the dialyzer dialysate compartment was outside of the tubing. Chuck Did they get it cleaned out? I just had my first exposure to this. It's everywhere I just want to know if there was something that worked better than others in the advice so far. Thanks to you and everyone else who chimed in.
Joey, Right now it's about 99.5% clean. First, we did a citric/thermal disinfection 3 times. Then, we changed the dialysate lines, connectors, filter, and sample port, and acid wand on the outside. Internal all filters and a couple pieces of tubing. There was not any of the substance in any of the tubing in the sub-rack so we didn't open the upline tank like btech suggested. After all that was changed, 6 more citric/thermals were done and internal filters changed again. Tomorrow, more disinfections will be done to make sure everything stays clean. I'm sure it is safe even if some material is still there but, I need the document saying that it is before my CMO will sign off on it. That's the worst part, waiting for Germany to do something. |
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joey
Full Member
Posts: 227
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Post by joey on Nov 2, 2021 17:46:34 GMT
Chuck Did they get it cleaned out? I just had my first exposure to this. It's everywhere I just want to know if there was something that worked better than others in the advice so far. Thanks to you and everyone else who chimed in.
Joey, Right now it's about 99.5% clean. First, we did a citric/thermal disinfection 3 times. Then, we changed the dialysate lines, connectors, filter, and sample port, and acid wand on the outside. Internal all filters and a couple pieces of tubing. There was not any of the substance in any of the tubing in the sub-rack so we didn't open the upline tank like btech suggested. After all that was changed, 6 more citric/thermals were done and internal filters changed again. Tomorrow, more disinfections will be done to make sure everything stays clean. I'm sure it is safe even if some material is still there but, I need the document saying that it is before my CMO will sign off on it. That's the worst part, waiting for Germany to do something. Yeah and I am guessing we will need the same so there's that but at least I have time to kill by trying to clean this mess up. I'm going to check both FPE and FPA but which gear pump was it for you ? Thanks |
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Post by Admin on Nov 2, 2021 17:52:14 GMT
Joey, It was FPE.
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Post by Chuck Weddle on Nov 2, 2021 18:00:47 GMT
What Admin said!
How old was your pump? Ours was 10 years old. I think its noteworthy that bleach has never touched the inside of the machine.
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Post by bcjammerx on Nov 3, 2021 15:06:38 GMT
I'm a bit concerned because I have seen this carbon inside my older v8's (20k + hours) but never inside the tubing. As they are brush-less I "brushed" it off and since the machine wasn't giving me any errors...I still don't see how this could get inside the tubing given the motor construction but if that's what you folks are finding I take your word...good thing my machines are being replaced soon 0_o I'll be sure to put the ones with carbon inside on the list of those first to go!
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Post by Admin on Nov 3, 2021 15:47:51 GMT
I'm glad Chuck was able to get this straightened out though. It's a very odd situation but he got it narrowed down pretty quick. Big kudos to those tech support guys and the field service team. They know their stuff!
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