I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis - NxStage Users => Topic started by: Maggie and Jeff on March 19, 2014, 04:18:09 PM
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The last 8 pureflow Paks we have been shipped are to wide to easily fit in the pureflow chassis. NxStage has been wanting them back.
[EDIT] NxStage does not want them back anymore.
Here is a work around.
First here you can see the foam that makes the pak to wide.
(http://jtpotteryusa.com/GL1200I/100_6153.JPG)
Here is the pak
(http://jtpotteryusa.com/GL1200I/100_61551.JPG)
I peeled the tape back 6 black pieces and the top handle.
(http://jtpotteryusa.com/GL1200I/100_6156.JPG)
(http://jtpotteryusa.com/GL1200I/100_6157.JPG)
Opening the back flap
(http://jtpotteryusa.com/GL1200I/100_6158.JPG)
(http://jtpotteryusa.com/GL1200I/100_6159.JPG)
Flipped the pack over to peel back the rest of the tape.
(http://jtpotteryusa.com/GL1200I/100_6160.JPG)
(http://jtpotteryusa.com/GL1200I/100_6161.JPG)
(http://jtpotteryusa.com/GL1200I/100_6162.JPG)
(http://jtpotteryusa.com/GL1200I/100_6163.JPG)
When opening I found it helpful to press on the front near the label so it would stay open.
(http://jtpotteryusa.com/GL1200I/100_6164.JPG)
(http://jtpotteryusa.com/GL1200I/100_6165.JPG)
(http://jtpotteryusa.com/GL1200I/100_6166.JPG)
I found it easiest to grab the foam with both hands thumbs pointing away from each other and lift toward the top of the pak.
Watch the water lines you don't want to pull everything out.
Lift the foam and move it a few inches until the water lines are good and taught.
(http://jtpotteryusa.com/GL1200I/100_6168.JPG)
(http://jtpotteryusa.com/GL1200I/100_6167.JPG)
(http://jtpotteryusa.com/GL1200I/100_6170.JPG)
In the following pictures I moved the tube labeled MB first I found moving the tubes starting with tube AC is better because the water tubes have more room so the tubes move easier.
(http://jtpotteryusa.com/GL1200I/100_6169.JPG)
(http://jtpotteryusa.com/GL1200I/100_6171.JPG)
(http://jtpotteryusa.com/GL1200I/100_6172.JPG)
At this point I grabbed the foam and pulled it out sort of like pulling the table cloth off the table leaving the dishes behind only a lot slower and it was easier if I tilted the pak 45 deg.
(http://jtpotteryusa.com/GL1200I/100_6173.JPG)
(http://jtpotteryusa.com/GL1200I/100_6174.JPG)
Check the water lines to be sure they are not pinched.
(http://jtpotteryusa.com/GL1200I/100_6177.JPG)
Reattach the tape.
(http://jtpotteryusa.com/GL1200I/100_6179.JPG)
I put the pak back in the box.
(http://jtpotteryusa.com/GL1200I/100_6180.JPG)
I did all 10 I have on hand.
(http://jtpotteryusa.com/GL1200I/100_6182.JPG)
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Where did your Pureflow come from. Directly from NxStage or from DaVita? My chassis came from DaVita and had been dropped and never has been straight. When I first got it I also had to loosen the screws that hold the controller in and let it be loose. I then was able to slide a PAK in and then I tightened down the controller. It's still crooked, but most of the time I can get things to work.
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The pureflow chassis and supplies come from NxStage as we have been going through FMC (Fresenius Medical Care) for the last 4 years. Our chassis is in good shape. The Paks are just wider due to some change in assembly. They started using a different dividing system for the filters and didn't test them before they shipped them out. When I told the NxStage tech support guy the replacement pak has the same issue he said "Oh boy". I expect there will be many more of them before the issue is fixed. I opened one, removed the packing, and put it back together so we have a working pack the slides easily into the pureflow chassis.
It's just one of many issues over the last 8 years we've been using NxStage. NxStage always does there best to fix these things in a timely manner. We have very hard water so we go through paks.
Davita is not my favorite clinic and I'll leave it at that.
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Seems like love hate with this whole business. I just received 2 new pak's. I am not due to change one out for at least another month or so, but will keep this in mind.
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If you open the box there are 2 things to look for:
1) new lot# label wraps the pak to the right (instead of just on the front)
2) If you look on the left side (away from the tub when installed) there are slots in the plastic cardboard stuff. Look into the slots at a 45 deg angle a good pak has more black plastic. The new ones that don't fit have gray stuff (thin gray plastic covering foam)
These Paks are not bad/unsafe they just don't fit. I forced one in and called NxStage about it and found out all the ones I had were the same. I had to remove the pak after it was primed because the new control unit was bad. So when I took out the primed pak I had to sit on the floor one foot on the tub and the other on the edge of the door and my hand slid inside the pak (tape broke). I'm 34 year old male and I thought it was a bit difficult and my wife could not pull it out. Most probably would not be able to install to begin with.
With the pureflow off leaving the blue line connected you can clamp and disconnect the white line and unplug the inside connection then pull the pak out and set it by the tub. Just do not disconnect the blue line. One could then verify if the new paks fit. I would only do this with tech support on the line if I suspected the new paks would not fit. I tend to be proactive on these issues so they don't cause us to miss a treatment.
Over the 8 years we have missed treatments 3x due to equipment and 0x due to lack of supplies. Nearly 2,500 treatments to date with NxStage.
I've read you've had a hard time :stressed; :cuddle; hang in there it will get better.
When we were with Dah-vita they counted our gaze pads and wanted to know why we needed more than they thought we should. With FMC supplies are no issue but there tech support is lacking no 24 hour nurse on call yada-yada-yada
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Got 3 more delivered and picked up today. All 3 were to big.
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I just looed at my PAK's. I have 1 old style and the one I got last week is the new style. I asked my HHD nurse is she had heard anything and she hadn't. We'll see.
Yes, the whole idea of HH is great and wonderful, but the implementation stinks. I can't count the number of failures I've had. Right now I have a bad cycler and I emailed the senior tech at NxStage 2 days ago and I can't get in touch with him. I ended up calling to try and reach him today, but couldn't reach him. The person I got wanted me to give him the last 3 months worth of troubleshooting we have been through and I decided not to go through that.
I am also trying to get supplies and Sterling is just plain useless. I've been calling and on hold for 2 weeks getting no where. My nurse called them today and was shocked that the person she reached couldn't give her a straight answer on anything. She (Sterling rep) did suggest I not call on Monday or Tuesday or before 5 because, well...they're busy. Really??
My center and nurse are the best in the world. I couldn't do it without them. After that though it's a crap shoot.
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When you do need to change paks try the new style one first If/when it don't fit call tech support and tell them the pak will not fit. They'll ship a new one and may want the new style one back. I'm sure they'll issue a recall at some point.
I think the first 2-3 years of HH were the hardest.
I remember when it was not uncommon to get cartridges with kinks in the lines due to the way they were packed we had to make splints for them with plastic and paper tape.
The old cartridges 2006 & 2007 had a second hard plastic shell around the filter. The first time I got one of these newer style ones I cracked the filter open getting the air out.
Our first system one lasted until it had to go back for maintenance. Second one lasted a few days.
In the last 8+ years we've had about 12 cycler's and around 20 pureflow control units. But those are only a guess cause I can't remember exactly. I know we have shipped over 100 CAR, PAK, SAK back due to quality control issues.
We've had leaks - got a hole in the waste line on the pureflow soaked the floor and trashed the carpet.
- forgot to move the yellow line the saline bag held 7 liters before it exploded and killed the phone the pureflow the walke talkes and the fax machine. Salt water and electronics don't mix.
I hooked the venous and arterial lines up backward and it took over 30 min to figure out why we kept getting alarms.
We make pottery and go to craft shows. Maggie dialyzed in the middle of the street behind our booth at one of the shows. We got asked "Are ya'll doing permanent tattoos"
Wife accidentally pulled her venous needle - That was a bloody mess.
But I am really happy with NxStage all things considered. Most of tech support folks are very helpful. (you got to remember most of them live up north so they are a bit odd) I'm always kind to them (think: sugar/flies) I got a new cycler one time cause I thought the one we had was to loud.
Wife is able to live and have a somewhat normal life. And that is the whole point.
What is wrong with your cycler?
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Interesting.... Every time I call tech support (which I only do when I really hit a dead end) and explain a problem, they always say they've never heard of it. We know what each other is doing around me so I know when other patients are having the same problems. So I usually have to push and only then will I get an admission that maybe they've seen a problem or two. If I push a tad harder then I will get an admission that they do know about it, but they don't think it's a real problem.
I'd have to look at my other posts, but I think this will be my 6th cycler in just over 1 year. The current one has been getting noisier and noisier and now is shaking. I can tell it's a failing stepper motor. After working out settings for prime to minimize air, it's starting to creep back in. On a very noisy day there is a ton of air in the system.
I haven't sent nearly that many cartridges back, but again they have told me point blank that they never get cartridges sent back at all. Huh...? They've told me they haven't seen a cycler come back in some time, yet I know that I was the third locally to send one back in just one week. Plausible deniability.
We've all made bonehead mistakes. I just have to earn I can't try and hold a conversation while getting on of off. Been there done that.
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Next time you dialize call tech support with you phone on speaker phone set it on top of the system one. If they can't hear you you may have to move it until they can that way they can hear how loud the machine is. If the phone falls due to the shaking tell them the nxstage shook the phone off (It should not)
Use the 866NxStage # 1 wait wait 1 and be so sweet sugar wont melt in your mouth. explain your current issue. stay on topic. let them chose the best way to resolve the issue. and stay on the phone until the issue is resolved if possible. Every call is documented in your file. If at first you don't succeeded well call again later you'll get someone else stay on topic and with the current issue other wise you'll confuse them.
Every time I call it starts like this:
"NxStage tech support this is ------"
"Hi this is Jeff. How are you doing today"
3 to 5 seconds of silence
You see up north they don't do small talk and they've had so many patents go off on them.
I had a 601 on the system one today while I was on the phone about the paks. saline down. cartridge out machine off/on reload 601 He was going to send a new system one. I said "hold on let me try a new cartridge" This one worked. He stayed on the phone until we were sure it would go.
Give it a try "kill them with kindness" If your enemy is hungry, give him food! If he is thirsty, give him something to drink! This will make him feel ashamed of himself, and God will reward you.
Just to be clear I don't think being mean or yelling at them. I'm not even saying your telling them how to do there job. I just think your not realizing the sheer volume of calls they get from people who keep getting a red 21 because of needle placement and blame it on the machine. Or even a red 35 because the yellow clamp is clamped.
I never try to talk to anyone in particular but on the rare occasion the issue is not resolved I just call back later and start over.
Be kind
Stay on topic
leave the past in the past deal with the current issue
let me Know how it goes
If you want you can PM me and I'll give you my # and you can call me. I can't order you anything But I bet I've had almost every problem that can be had.
God Speed my friend.
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I am quite happy with Nxstage in general. I havent had an alarm in months. Our cycler is only our second in 2 years and we still have the original pureflow system. Dialysis runs like clockwork for us. I hardly notice the system is running for the 3 plus hours of dialysis. I go on my treadmill while my wife works on her com puter while being dialyzed. WE get an occasional bad sak or cartidge , but thats it.
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I do want to add that anyone who hasnt looked at their prescription for NxStage, particularly the volume of dialysate, should check on it.
I have an old calculator sheet from Nxstage from 2 years ago when my wife started and the numbers for dialysate volume are ridiculously low. On the sheet the maximum they recommended , even for a 140 kg male was 30 liters . Most of the recommendations were for 20 t0 25 liters which is very low. They started my wife on only 17 liters which is quite low and not very good for her. I have her up to 30 and she is only 53 kg.
Since Nxstage is totally volume based for the most part , it is important to get enough volume to get proper clearance. More is better, period.
Anyone using less than 30 liters now should rethink and talk to your team. The on line calculator shows much higher volume than the old sheet I have which is obsolete. So do some checking. Raise your volume as much as possible.
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Next time you dialize call tech support with you phone on speaker phone set it on top of the system one. If they can't hear you you may have to move it until they can that way they can hear how loud the machine is. If the phone falls due to the shaking tell them the nxstage shook the phone off (It should not)
Use the 866NxStage # 1 wait wait 1 and be so sweet sugar wont melt in your mouth. explain your current issue. stay on topic. let them chose the best way to resolve the issue. and stay on the phone until the issue is resolved if possible. Every call is documented in your file. If at first you don't succeeded well call again later you'll get someone else stay on topic and with the current issue other wise you'll confuse them.
Every time I call it starts like this:
"NxStage tech support this is ------"
"Hi this is Jeff. How are you doing today"
3 to 5 seconds of silence
You see up north they don't do small talk and they've had so many patents go off on them.
I had a 601 on the system one today while I was on the phone about the paks. saline down. cartridge out machine off/on reload 601 He was going to send a new system one. I said "hold on let me try a new cartridge" This one worked. He stayed on the phone until we were sure it would go.
Give it a try "kill them with kindness" If your enemy is hungry, give him food! If he is thirsty, give him something to drink! This will make him feel ashamed of himself, and God will reward you.
Just to be clear I don't think being mean or yelling at them. I'm not even saying your telling them how to do there job. I just think your not realizing the sheer volume of calls they get from people who keep getting a red 21 because of needle placement and blame it on the machine. Or even a red 35 because the yellow clamp is clamped.
I never try to talk to anyone in particular but on the rare occasion the issue is not resolved I just call back later and start over.
Be kind
Stay on topic
leave the past in the past deal with the current issue
let me Know how it goes
If you want you can PM me and I'll give you my # and you can call me. I can't order you anything But I bet I've had almost every problem that can be had.
God Speed my friend.
There is a difference between being rude or unkind and being direct. I have never been or will be rude, mean or disrespectful. However I do take exception when they tell me they have ever had a cartridge returned when I know myself how many I have sent in. When I "push", I mean I urge them to reconsider their answer. I was in customer service for over 20 years, I know how it is from both sides of the fence. I have a direct line to one of their senior tech's. I generally don't work with the tier one people unless it's something minor.
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Had another over sized Pak today. I even tried to slide it in the pureflow but it was to wide.
It still holds true.
The new ones that don't fit have gray stuff (thin gray plastic covering foam)
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I just checked on mine and one pak is the old and one is the new wider one . I called nxstage and they want the wide one back and will replace it.
This is weird and very poor . This kind of issue SHOULD NEVER HAPPEN with medical materials. I asked the tech support guy about ity and he knew nothing about what occurred or wouldnt admit he did. They did admit to taking quite a few back so far.
Everyone should check on theirs. Measure them. Measure the width of one in the machine that fits, it should be about 8.9 cm. . The wider one measures about 9.3 cm. wide so the extra 4 mm. is enough to not fit the tight metal chasis.
If you have a wide one , dont try to play with it to fit, CALL NXSTAGE and have them replace it. Dont take chances.
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If you have a wide one , dont try to play with it to fit, CALL NXSTAGE and have them replace it. Dont take chances.
+1
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This illustrates my concerns with NxStage. Lack of communication or plausible deniability. I've been working with one of their senior tech's since January on an on going problem,. When I called last week there was nothing in my record to indicate this. That's why the tech that day wanted me to give the entire history. My objection was that I shouldn't have to go through that...again. It seems pretty certain there is a flaw with the PAK's There should be or have been a notification sent out. I checked with my nurse and she hasn't heard anything from them about this.
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Yes the company is not perfect. But at least they make a product that works well and is a lot better than anything else we have currently in the US. for home dialysis. I look at the final results and they give what they claim. so all we can do is keep pushing them to continue to do their best to fix any problems. I have been known to email execs. there and voice my displeasure at times with issues that have arisen. They have listened and always tried to correct the problem.
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I contacted their head of customer relations a year ago.
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Soooo...the new cycler arrived today. It smelled a little odd, but OK. I plugged it in and reprogrammed it and let it go. The door was really rough to pull out and the handle latch was really tight. I turned it off and left it plugged in for about an hour. When I went back in the room the fan was very loud so I pulled the plug. Immediately it started to alarm and wouldn't stop. I called NxStage and couldn't get them to understand it was alarming while unplugged . I don't know how many times they told me to shut it off and unplug it. Finally it clicked and the only explanation I got was...that shouldn't happen. While standing over the machine I could smell burned electrical components, so I passed that along too. I am waiting for confirmation that will be sending yet another machine out.
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The tech from NxStage was supposed to call me back to confirm they had a cycler to send me. That way I knew whether I needed to make alternate plans for treatment. I also wanted to make sure to request a new jewel box since this one was questionable. I ended up getting a call late from National Logistics saying they wanted to schedule a delivery tomorrow. Bitter sweet. So I called NxStage to ask about the computer box and the tech I had been working with went home for the day. Good thing I wasn't holding my breath waiting for that call.
Supposedly a cylcer is coming from a center in LA. No computer box.
I am not holding my breath.
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Had another wide pak yesterday.
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So it sounds like that while they know about it, nothing is being done? Are they coming from a warehouse or from NxStage? I know some supplies are warehoused in remote areas accessible to National Logistics.
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So it sounds like that while they know about it, nothing is being done? Are they coming from a warehouse or from NxStage? I know some supplies are warehoused in remote areas accessible to National Logistics.
yep, National Logistics.
Got got another one today but I forgot to call it in I'll call tomorrow. UPS has been coming every weekday for 2 weeks. I really don't mind this is not much of an issue to me. They are the ones wasting money shipping those paks to me then shipping them back to themselves.
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I don't know about your schedule, but I don't have time to spend all my time on and off the machine with this stuff. I started this morning at 6:15, didn't get on till 10:30 due to a bad cartridge, didn't get done and off till 2. I felt like poop so the rest of the day was done. I didn't get any work done yet again today. Been trying to call Sterling for a week to get supplies and have to follow up with an email to NxStage about how the new (to me) machine is or isn't working. Then another call to find out why I didn't get the new computer box today. And then one more call to NxStage to report the bad cartridge.
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We also have had those bad days.
Well I just got told they don't want any more of the Paks back. Said they would send a replacement. I asked if they would send a thin one he said he hoped so.
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Well, The most recent to wide pak I called in I was told we can use or discard these paks. I was asked to continue reporting these paks and it is my choice to discard or open the pak and remove the foam. They will keep sending replacements or not it is my choice.
So for now I'll let them keep sending them.
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I'm on my last batch for this PAK so I'll use the new one that I just got to see what it's like.
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I chose the PAK with the newest lot number to see if it would fit. It didn't. It seemed to be the same in every respect to previous PAK's other than being a touch wider. The lot# was 41079023. I called NxStage and the rep said that they have seen 1 or 2 that have expanded and might be difficult to install. He was going to keep going, but I stopped him and told him I already knew about ALL the failures. At that point he said he'd send me out a new one, and some bags to replace what I needed to use till it came in.
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I doubt the new one will fit either.
I could post directions on how to remove the packing that makes the pak to wide.
Basically you cut the tape open the box and get the grey foam packing out then close it back up and use as normal just don't pinch the hoses.
I'm sure they will get it fixed eventually but I think they already have thousands of them produced like this.
I have received over 20 of them in the last 6 weeks.
They didn't want it back and said to discard the pak, right. Or if you want to you can remove the shipping foam and use the pak. at least that's what they told me pak before last.
Ooh Yah I got another to wide pak yesterday.
My lot #'s have been 41079xxx the last 3 #'s have been different. Although I have got some with the exact same lot #'s
When your new pak comes in check it to see if it will fit and call it in. You don't have to put it in the pureflow to check you can see the packing foam through the slit in the left side. Some of them have expanded my butt every single one with foam that I've tried will not fit unless forced in. And if you do force it in it's a real bear to get back out.
I'll keep posting if I keep getting wide paks.
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You guessed correctly, the new PAK didnt fit. I measured about 5mm difference from the old PAK and the two new ones. The new ones I received actually have white foam. I will hold onto them for now.
The lot#'s I have are 40179xxx and 40379xxx. You can decode the lot # to get an idea what you have. The first digit is the year 2014. The second two are the month and the fourth and fifth and likely a product code. Cartridges are 77, SAK's and PAK's are 79. The last three are the lot. I don't know this for fact, but it seems likely. It's almost identical to how we generated s#'s for our products. The only difference was we had a letter for country of origin code in the middle and since they were s#'s we used 5 unique digits for each unit at the end.
Oh and NxStage was also supposed to send me bags to replenish my supply while waiting for the new PAK. I told them I use 30L which would be 6 bags per treatment. They sent me 4. So now they are overnighting another PAK and 6 bags and another 3 by ground.
Someone needs to walk down to the warehouse and yank the bad PAK's. Maybe they can somehow rework them. But at least they aren't sending them out and at a high cost only to fail again.
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I had another one today 40379xxx. No replacement sent out cause I will use the ones I have and there are 3 more on there way. The guy I spoke with today is one of the higher up's great guy anyway sounds like the ones being made now are not the same as what we have been getting but they are not pulling the wide ones. I guess it is like when a child eats dirt "This to shall pass".
You are allowed at the least a 2 week supply of hanging bags and I suggest you have that on hand during the winter this year our supplies got delayed 2 weeks and our pureflow was down and back ordered for 3 week these events overlapped. We have a 4 week supply cause we travel a lot for 3-4 days at a time. Customer service says we have a warehouse. I say it's just 2 skids worth.
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The one I got yesterday is too wide again. Lot# 4037xxxx The tech I spoke to today said they are aware a "few" bad PAK's did get shipped out. I had to inform him I got 3 this week and you got over 20. I think he was truly surprised. He also told me they aren't shipping any more bad ones out. So I had to again inform him they still are, since I just got one yesterday. Clueless, absolutely clueless. He was encouraging though when he told me he "hoped" the next one I get will be good. OMG!
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NxStage is brilliant.
So for the last two weeks they have been sending me defective PAK's, and then bag's to tideme over. Every time I tell them I use 30L per treatment and they send me 20L. Then the next day I get 2 or 3 more cases. Sigh. So Saturday I was expecting a PAK, and not surprisingly....nothing. I figured it would be here this morning then, and nothing. So I call and all I got was, the person must have forgotten it was Friday and it would be here today. I tell them it wasn't here today and no response other than sorry. Then I was told the bags were coming ground and I say when am I supposed to do a treatment, a week from now and....sorry, but nothing more. Amazing.
So I am reviewing my inventory to see how many bags I have to get me through and I notice they are all wet. I open 3 boxes and they're leaking. Wonderful! So I painfully call back and try to explain why I need more bags and the person in ordering/customer support just isn't getting it. Finally she says she will and them out. I ask for tomorrow right? And she says no, ground of course, so again I have to explain I NEED them because I have no good PAK's. So then she finally says, so I should send them out overnight?
But to take the cake I ask her what they are doing about all the bad PAK's and she had no idea what I was talking about. There is some serious lack of communication going on there.
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:rofl; :rofl;
I suspect this is going on all over the county. PITA is what it is for those who don't just fix their own paks and we shouldn't have to.
I got another one this weekend it probably came Friday but I've been out of town.
I could post pictures on how to fix your pak if you want just say so.
I plain on fixing all the ones I have after the next 2 come tomorrow. Probably take me and hour or so to do all 10 of them.
Let me Know if I should take pictures. I wouldn't mind and may do it anyway.
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So the order came today 2 more wide paks. I called and reported all 3 I tried to tell him I'll fix and use the 10 I already have but he said he has an email saying to ship replacements. 3 more on the way :yahoo;
They must be trying to purge the system.
:cheer: :cheer: Go NxStage :cheer: You Can Do it. :cheer: :cheer:
:urcrazy; :urcrazy; :urcrazy; :urcrazy; :urcrazy; :urcrazy; :urcrazy; :urcrazy;:urcrazy; :urcrazy; :urcrazy; :urcrazy;
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I will break my silence for this.
The problem occurred when they tried this new foam to protect the PAKs in shipping from damage. Unfortunatly the foam manufacturer gave them bad info on how the foam would expand in shipping. It expanded more than they expected causing the extra wide PAKS. I talked directly to my contact way up in the company whom I wont out. . I got the truth about 10 days ago.
I was told to try and use the PAKs if possible. I was told it is hard to damage them and it is ok to force them or play with them to get them to fit. it wont damage the inner workings. Eventually the defective ones will be gone. So try to work through this until it smooths out.
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I will break my silence for this.
The problem occurred when they tried this new foam to protect the PAKs in shipping from damage. Unfortunatly the foam manufacturer gave them bad info on how the foam would expand in shipping. It expanded more than they expected causing the extra wide PAKS. I talked directly to my contact way up in the company whom I wont out. . I got the truth about 10 days ago.
I was told to try and use the PAKs if possible. I was told it is hard to damage them and it is ok to force them or play with them to get them to fit. it wont damage the inner workings. Eventually the defective ones will be gone. So try to work through this until it smooths out.
That is completely unprofessional to say the least. NxStage should recall all of these if nothing more from a business point of view in the extra costs of shipping. Unreal that a top level NxStage person would make that comment. They are now a for-profit dialysis company. Many of their latest actions are granting me no peace on how they will act as they continue to grow.
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I see several issues.
One is that they screwed up and made bad PAK's. OK, it happens. Should it, no. I guess if it were my company and I was changing something I would want to make sure and QC the change before releasing product. But that's the engineer in me. Measure twice, cut once.
Two is that there has been no communication to anyone on this. My nurse hasn't heard a word. That is unacceptable. Not everyone is resourceful to modify a PAK. It could lead to critical situations where a good replacement PAK is unavailable and a patient needing treatment. Sending out bad PAK after bad PAK is also not fiscally responsible. I can't imagine what they have spent just on me with 6 PAK's shipping overnight and all the cases of bags too.
But he latest lack of communication got me. Where one hand doesn't know what the other is doing. There is no excuse that half of their company doesn't know what the heck is going on.
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I see several issues.
One is that they screwed up and made bad PAK's. OK, it happens. Should it, no. I guess if it were my company and I was changing something I would want to make sure and QC the change before releasing product. But that's the engineer in me. Measure twice, cut once.
Two is that there has been no communication to anyone on this. My nurse hasn't heard a word. That is unacceptable. Not everyone is resourceful to modify a PAK. It could lead to critical situations where a good replacement PAK is unavailable and a patient needing treatment. Sending out bad PAK after bad PAK is also not fiscally responsible. I can't imagine what they have spent just on me with 6 PAK's shipping overnight and all the cases of bags too.
But he latest lack of communication got me. Where one hand doesn't know what the other is doing. There is no excuse that half of their company doesn't know what the heck is going on.
Well stated.
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First here you can see the foam that makes the pak to wide.
(http://jtpotteryusa.com/GL1200I/100_6153.JPG)
Here is the pak
(http://jtpotteryusa.com/GL1200I/100_61551.JPG)
I peeled the tape back 6 black pieces and the top handle.
(http://jtpotteryusa.com/GL1200I/100_6156.JPG)
(http://jtpotteryusa.com/GL1200I/100_6157.JPG)
Opening the back flap
(http://jtpotteryusa.com/GL1200I/100_6158.JPG)
(http://jtpotteryusa.com/GL1200I/100_6159.JPG)
Flipped the pack over to peel back the rest of the tape.
(http://jtpotteryusa.com/GL1200I/100_6160.JPG)
(http://jtpotteryusa.com/GL1200I/100_6161.JPG)
(http://jtpotteryusa.com/GL1200I/100_6162.JPG)
(http://jtpotteryusa.com/GL1200I/100_6163.JPG)
When opening I found it helpful to press on the front near the label so it would stay open.
(http://jtpotteryusa.com/GL1200I/100_6164.JPG)
(http://jtpotteryusa.com/GL1200I/100_6165.JPG)
(http://jtpotteryusa.com/GL1200I/100_6166.JPG)
I found it easiest to grab the foam with both hands thumbs pointing away from each other and lift toward the top of the pak.
Watch the water lines you don't want to pull everything out.
Lift the foam and move it a few inches until the water lines are good and taught.
(http://jtpotteryusa.com/GL1200I/100_6168.JPG)
(http://jtpotteryusa.com/GL1200I/100_6167.JPG)
(http://jtpotteryusa.com/GL1200I/100_6170.JPG)
In the following pictures I moved the tube labeled MB first I found moving the tubes starting with tube AC is better because the water tubes have more room so the tubes move easier.
(http://jtpotteryusa.com/GL1200I/100_6169.JPG)
(http://jtpotteryusa.com/GL1200I/100_6171.JPG)
(http://jtpotteryusa.com/GL1200I/100_6172.JPG)
At this point I grabbed the foam and pulled it out sort of like pulling the table cloth off the table leaving the dishes behind only a lot slower and it was easier if I tilted the pak 45 deg.
(http://jtpotteryusa.com/GL1200I/100_6173.JPG)
(http://jtpotteryusa.com/GL1200I/100_6174.JPG)
Check the water lines to be sure they are not pinched.
(http://jtpotteryusa.com/GL1200I/100_6177.JPG)
Reattach the tape.
(http://jtpotteryusa.com/GL1200I/100_6179.JPG)
I put the pak back in the box.
(http://jtpotteryusa.com/GL1200I/100_6180.JPG)
I did all 10 I have on hand.
(http://jtpotteryusa.com/GL1200I/100_6182.JPG)
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I will break my silence for this.
The problem occurred when they tried this new foam to protect the PAKs in shipping from damage. Unfortunatly the foam manufacturer gave them bad info on how the foam would expand in shipping. It expanded more than they expected causing the extra wide PAKS. I talked directly to my contact way up in the company whom I wont out. . I got the truth about 10 days ago.
I was told to try and use the PAKs if possible. I was told it is hard to damage them and it is ok to force them or play with them to get them to fit. it wont damage the inner workings. Eventually the defective ones will be gone. So try to work through this until it smooths out.
That is completely unprofessional to say the least. NxStage should recall all of these if nothing more from a business point of view in the extra costs of shipping. Unreal that a top level NxStage person would make that comment. They are now a for-profit dialysis company. Many of their latest actions are granting me no peace on how they will act as they continue to grow.
I remember when we had a similar issue with the cartages years ago. Most of them had blood lines pinched so bad they would only work after splints were taped on the lines. They would send replacements with the same problem for over 6 months. Some were so bad they wouldn't even run with splints.
The pak issue is easier to deal with IMO.
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I received another PAK, another too wide PAK. When I call tomorrow I am going to escalate this. What is the point? They obviously don't have a clue as to what is being shipped out and I really don't feel like getting another 5 or 10 or even 20 bad PAK's.
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My advise is to fix the one you have that should get you by 6 or more weeks.
If/When you report the pak tell them you fixed it and do not want a replacement.
Or use the big stick on them :Kit n Stik;
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Thanks for the very detailed writeup!
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If the write up helps someone then it was worth the time and effort.
Your welcome.
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Thanks for the excellant pictures.
This doesnt absolve Nxstage at all but I do want to point out other medical products and conpanies that worse things happen and they dont seem to care much either.
My wife has to use a feeding tube into her intestine to eat and drink. Without it she would be dead in a very few days. It is a life sustaining product. We use a MIC-KEY Button which is a contraption that connects to the food line . it ebters her stoma(hole) into her abdomen and down into her intestine. It has a water filled balloon to lock it in place. Without the balloon it falls right out and then her intestines leak out. so you can see it is critical it work correctly.
The other night we woke up at 1:30 AM to find it had come out and we had a bed full of her food and her inner fluids(yuk). But worst of all the hole ha dstarted to close quickly in the 3 or 4 hours at had been out. When we looked at it , it was apparant the balloon had failed and deflated. This button had just been put in a week earlier by me . i change them every 2 months. It took me a half hour of very stressful work to get it back in as the hole had tried to seal shut . Thankfully I had some medical instrumentsat home and could dilate it and work it in carefully. Otherwise we would have had to go to the ER in the middle of the night. It was a somewhat dangerous situation created by a defective poduct.
Well , I put a new one in and guess what!!!!. Three days later my wife was sitting at her desk at our office and suddenly let out a "oh SH---t!!. I looked up from my desk where i was doing patient notes and saw her holding the new Mic-key button in her hand while her addomen was leaking fluid ,--AGAIN! For the second time in a week the balloon holding the button in had deflated on its own and out it popped. Two defective buttons in a row.
I called the company that provides it for us from the manufacturer and they so far are claiming there are no reports of this happening in others . Does that sound familiar??? Hear no evil, speak no evil, see no evil??
So here is a very dangerous situation with a defective medical product and so far no admission of anything from the manufacturer.
In my office we use a lot of medical products. A few years ago a product I use for fractured bones to immonilize them was suddenly not working correctly. My patients were calling me telling me the air cells that keep compression on the fractured bone were losing air and deflating. Not good at all!!! Tjis was a product I had used for 15 years and was the best available . After several went bad and after numerous calls to the manufacturer asking them what was going on I kept being told nothing had changed and they didnt know why this occurred. I had my suspicions as the product was still manufactured in th U.S. which is rare . They lied at first but when it kept happening and I kept calling they finally admitted they had moved the manufacturing facility form Indiana to MEXICO. This was after they had lied and told me they hadnt moved it. Then they tried to claim that there were no differences between the old plant in Indiana and the new plant in Mexico. "everything the same.!!" Ah ha. It took several months and a lot of defective units before things improved.
So bottom line , I can go on with stories of defective medical products (like the syringes that leaked back onto me when I injected medications) by numerous companies and the lies they told about it. Nxstage is no worse. Its just like all the other compnies out there. Yes they should have been more forthcoming. But some of that is typical corporate behavior. No corporation likes to admit it screwed up. Coverups are common as are lies and lack of information.
I still beleive in nxstage and hope they fix this problem.
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nteresting and scary reading.I guess we take for granted how we think things should work, rather than how they actually do. It's somewhat prophetic but I had an interesting talk with my son last night. He's of course an amazing kid but our talk caught me by surprise. He's 20 and in most ways a typical college aged kid. But, we were talking about life and such and he was seriously worried about the future. He told me how little faith he had in his generation and where that might lead. The gist of it was that none of his friends give a d@#m about anything. It's all party and move on. We've all had similar thoughts, but to hear it from someone his age and in the context of our discussion was an eye opener.
In speaking with NxStage I am left with the impression that they don't care and they don't really grasp the impact of this problem. Tell the patient what the script says and move on to the next caller. I called today to try and escalate my problem with the PAK's and didn't get anywhere. The tech tried to go through the whole script story about the one or two units that may have slipped through the cracks before I stopped him. I told him I was well aware since I have a stockpile of bad ones here,and that it was making the internet rounds. It almost sounds like he was annoyed that he couldn't finish his speach. But he then what on to say that the problem had been fixed an no bad PAK's were going out. I informed him I just got another bad one, so maybe they still are going out. To which he admitted that there may be a "few" bad ones still in the warehouse. Sigh.
What I don't understand is that they know the bad lot numbers, so why not take a cart down to the warehouse and pull them? All they are doing Is shipping them to us to dispose of them. Fiscally that makes no sense. I am expecting another PAK tomorrow. I half want it to be bad so I can call back and hopefully get the same tech and say TOLD YA! I don't want it to be bad for one because my family room has turned into a warehouse. Secondly because I want to be done with this.
We'll see...
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Another day another bad PAK. My garage and family room look like a warehouse. I think I am close to ten bad ones over the last three weeks. Going through ton's of bag's and the empties are piling up. That and the leaky ones too.
I called NxStage and requested it be escalated and they refused. Yet again they started to give me the scripted spiel so I stopped them and told them I've been dealing with this for weeks, no need to repeat the talk. They really do get a bit upset when you don't let them finish. I was told it didn't need to be escalated because they have identified the problem. I told them bad PAK's are still being shipped, so the problem isn't solved. the answer to that was they have identified the problem and they aren't making any bad PAK's. I told them that's what I've been told for the last three weeks. The response was "I'm truly sorry". I couldn't make any headway, that's their story and they're sticking to it.
So, the action plan was to send me yet another PAK and more bag's. No guarantee's if would be god or not. They again "hoped" it would be good.
About 15 minutes later they called me back. The new plan is to not send ME another PAK till Monday. Hopefully by then I would get a good one. In the meantime EVERYONE ELSE will be getting them. They're going to send me a bunch of bags till then. I think I'm going to need to rent a storage unit.
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Another day and 3 more wide paks.
They called me and seeing as I am fixing the paks they would rather not send me any more which is fine with me seeing as I have 13. 12 cause I used one today. I may not even call these 3 new ones in.
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Please call it in. Unless they hear from patients, nothing will change because everything is fine.
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I totality agree they need to hear from patients.
When they called they told me if they could they would stop the shipment of these 3 paks I just got because I made the ones I already have usable.
I'll call them in just to see what they say....
I have 16 months worth of paks they expire in 15 months I don't need any more.
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I spoke to them today on another matter. I had a bag leak on the warmer and, well hopefully the cycler dries out. But apparently an internal email informed the techs that new PAK's are supposed to be shipping. They will be or have sent me one that is supposed to be good.
I did find out something else today too.if you are with DaVita there is a contact who deals with NxStage issues. My nurse called NxStage and tried to escalate this is got the same story we all have. She was annoyed so she called her management team and found out there was someone at DaVita she could have handle NxStage issues. So let your nurses know for any issues so it can go up the ladder and they can get a handle on what kinds of troubles patients are having. Let them get frustrated with NxStage.
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Let us know if you really get one that fits.
Have you tried to fix one yet?
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I just did one. I actually just opened up one end to expose the foam when it stood up and then pulled it straight up an out . I didnt have to expose the wiring at the end that way. I will try it out for use on Monday or possibly tomorrow eve. to see if it works. Thanks for the visual as it made figuring it out easier.
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I asked phone support about this when I was calling on another issue. The tech support person (Dan) told me that the foam insert is additional protection for the PAK in shipping, and that a supplier made it a bit too big. He told me the foam is still in new PAKs, but that the dimensional problem has been corrected.
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That's pretty much the story. Depending on the particular tech you talk to will yield a similar story. I heard weeks ago that the problem was identified and no chubby PAK's were shipping. Meanwhile 10 bad PAK's later.I lost count how many Jeff had.
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I am now using the Pak I took out the foam on . It seems to be working ok. It was pretty easy to slip out the foam . Then it fit well.
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you got to remember most of them live up north so they are a bit odd
Us Yankees think people from down south at a bit odd.
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you got to remember most of them live up north so they are a bit odd
Us Yankees think people from down south at a bit odd.
Coverups are common as are lies and lack of information.
A RN explained to me that medication errors are not recorded in your chart in the hospital - only the MDs orders of what you were supposed to get. So, if you are given a dangerous drug by mistake - there is no record of it in the paperwork, and no legal requirement that the patient be told they were given a non-ordered medication, or incorrect dose, by mistake - basically a system of "automatic cover up" to keep plaintiff's counsel at bay.
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you got to remember most of them live up north so they are a bit odd
Us Yankees think people from down south at a bit odd.
Coverups are common as are lies and lack of information.
A RN explained to me that medication errors are not recorded in your chart in the hospital - only the MDs orders of what you were supposed to get. So, if you are given a dangerous drug by mistake - there is no record of it in the paperwork, and no legal requirement that the patient be told they were given a non-ordered medication, or incorrect dose, by mistake - basically a system of "automatic cover up" to keep plaintiff's counsel at bay.
Well, with over 20 years in the medical field before I retired, you are supposed to record all adverse drug reactions including mistakes. That is the law. If it is not recorded, that is an actionable event and people can and have lost jobs and more.
That being said, I am under the belief that my father suffered an adverse drug reaction that was not recorded in his chart while being treated in the ER. He ended up in the ICU on a ventilator. I arrived 2 about 36 hours later from the other side of the country and when I reviewed the chart, I asked the nurse why he had dropped his blood pressure so dramatically in the ER. The nurse gave me an honest answer that when she took report from the ER, the nurse there stated they gave him an IV BP med. However, when my dad arrived on the floor at the ICU, she didn't find that drug recorded. I wasn't able to take it any further, but that is exactly what the nurse reported to my question. Funny, I didn't see her again in the week I was there. My dad survived but never really recovered and died a year later at the age of 82.
All actions whether favorable or unfavorable are legally mandated items for the medical record. It is much easier to get fired and lose a medical license for fabricating medical records than for a patient dying. In fact, Paul Newman had a movie based on just that event. When he proved that the nurse changed the record at the doctors direction, they won the case. I hope American medicine is not slipping to the point where this type of fabrication is widespread, but that may just be wishful thinking.
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Well, with over 20 years in the medical field before I retired, you are supposed to record all adverse drug reactions including mistakes. That is the law. If it is not recorded, that is an actionable event and people can and have lost jobs and more
I live in Massachusetts. A very experienced RN (who has worked in several of the big name Boston hospitals) I know tells me that if a nurse makes a med error, it is reported internally and may be recorded on a safety report (which by MA law is excluded from civil discovery) but is not entered into the patient's chart, and there is no requirement that the patient be notified. She also told me that if an another drug is ordered to counteract the erroneously administered drug, that drug will be in the chart as it was an "ordered administration".
Are you saying that this is incorrect?
If I am in the hospital and given 120mg of a drug when the order is written for 12mg, will I be formally notified? Will it be entered into my medical chart? Will it be on any written record I can obtain from the hospital? I have been told by those "in the trenches" executing, rather than writing, the orders that the answer is "no", although depending on the situation, the patient is sometimes told.
the nurse there stated they gave him an IV BP med. However, when my dad arrived on the floor at the ICU, she didn't find that drug recorded.
In the hospitals I am familiar with, that drug would be in the chart if it was ordered by an MD, even if the MD was mistaken in his/her choice of that drug, or ordered it for the wrong patient. It would not be in the chart if administered as the result of a nursing error. (record of "what is ordered" vs. "what is given")
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I ALWAYS stay in the room when my wife has been hospitalized. I will not allow her to be left at the mercy of the system EVER. We always get a private room with an extra bed for me and I bunk in for the whole time (they even feed me). I do some of the nursing care myself to pay them back. WE have had aroound 6 hospitalizations in the past 10 years. I have seen all kinds of potential MISTAKES that thankfully I caught before they injured or killed her. Its scary to see what I caught.
Examples: wrong medication doses, overflooding with fluids causing pulmanary edema to the point that if I werent sleeping in the room she would have died from choking on her own fluids (that was a very long night) , stopping a nurse by grabbing her hand when she tried to give a medication IV that was ordered IM and can severly injure or worse when given IV, stopping a doctor who ordered a medicine that was contrindicated strongly with the meds my wife is on whe the idiot doctor never bothered to stop and look first at what she was taking (and said "well we would have taken care of any adverse reaction anyway"), constantly had to check every medication order as the doctors would leave out crucial meds or the nurses didnt check for the correct meds, and on and on it goes.
It shocked the hell out of me. I wont ever let her alone in the hospital. I feel bad for patients who dont have someone there to watch out for them. Hospitals are VERY dangerous places.
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Well, with over 20 years in the medical field before I retired, you are supposed to record all adverse drug reactions including mistakes. That is the law. If it is not recorded, that is an actionable event and people can and have lost jobs and more
I live in Massachusetts. A very experienced RN (who has worked in several of the big name Boston hospitals) I know tells me that if a nurse makes a med error, it is reported internally and may be recorded on a safety report (which by MA law is excluded from civil discovery) but is not entered into the patient's chart, and there is no requirement that the patient be notified. She also told me that if an another drug is ordered to counteract the erroneously administered drug, that drug will be in the chart as it was an "ordered administration".
Are you saying that this is incorrect?
If I am in the hospital and given 120mg of a drug when the order is written for 12mg, will I be formally notified? Will it be entered into my medical chart? Will it be on any written record I can obtain from the hospital? I have been told by those "in the trenches" executing, rather than writing, the orders that the answer is "no", although depending on the situation, the patient is sometimes told.
the nurse there stated they gave him an IV BP med. However, when my dad arrived on the floor at the ICU, she didn't find that drug recorded.
In the hospitals I am familiar with, that drug would be in the chart if it was ordered by an MD, even if the MD was mistaken in his/her choice of that drug, or ordered it for the wrong patient. It would not be in the chart if administered as the result of a nursing error. (record of "what is ordered" vs. "what is given")
I retired from practice in 2007. During my entire time in the medical field which started when I was 19 years old working as an orderly in the same hospital that my mother worked as an RN, I have never heard or seen anything as you are describing. If the hospital tries to hide something from discovery, it is first of all very unlikely it won't come out somewhere which compounds the degree of guilt not only of the providers but also of the entire system.
The medical record is a legal document where every single medication, procedure and observation MUST be recorded.
What is not subject to discovery is QA inquiries into adverse events. That is not documented in the chart, but the event itself is. In fact, medical errors are much more common than we would like and it is often not the adverse event itself that is at issue, but how the event was addressed. If you do enough procedures complications will occur. If you give enough medications, adverse events will occur. Providers that try to hide these events are subject to robust sanctions above and beyond litigation. That is the easiest way to lose your medical license. So, QA proceedings are not discoverable but the adverse event is to be documented not only for good medical care to correct any complications, but yes, for the legal documentation that is open to discovery not only to the patients representatives, but to state and county and federal officials.
What you are describing I would hope is absolutely not true since that would end any semblance of oversight and transparency that medical records are supposed to represent. In fact, the nurses document when you come to the patient's room, any orders you give and, when they carried out those orders and how the patient reacts. That is why a single hospitalization can generate hundreds of pages of documentation. I have seen and documented medical errors, adverse events and the steps taken to correct these actions. That is the nature of practicing medicine literally in a fishbowl where all of our actions are open to 20-20 review which can be quite brutal for sure.
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I am curious what is entered into record. I was the victim of a screw up that could have been averted. I was trying to advocate for myself but was ignored. When the surgeon came in he knew exactly what was wrong and I was rushed into surgery. If it had been left to the ICU Dr and substitute nurse I would have died. Not my own exageratin, but that of the anesthisiologist who visited me a couple days later once I woke up. It was a nurse who did not follow written orders.
However when I spoke of the incident months and even years later, the staff looked at me like I was crazy and in a dismissive way. If I had to guess,I bet there is no record of the mistake. I wonder how the emergency surgery is written up.
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That's pretty much the story. Depending on the particular tech you talk to will yield a similar story. I heard weeks ago that the problem was identified and no chubby PAK's were shipping. Meanwhile 10 bad PAK's later.I lost count how many Jeff had.
Have you mentioned these issues on the Home Dialyzors United (NxStage Users) FB page?
https://www.facebook.com/groups/nxstageusers/
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That's pretty much the story. Depending on the particular tech you talk to will yield a similar story. I heard weeks ago that the problem was identified and no chubby PAK's were shipping. Meanwhile 10 bad PAK's later.I lost count how many Jeff had.
Have you mentioned these issues on the Home Dialyzors United (NxStage Users) FB page?
https://www.facebook.com/groups/nxstageusers/
I have not.
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According to my contact way up in company , the PAK problem is over and all new shipments should be ok now.
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No they are not.
I was supposed to get on of the new PAK's last Monday. By Friday I hadn't received anything so I called. I think I caught them by surprise and after a little backpedalling they said they would send me two of the new good lot's to arrive today. Fail. I did get two PAK's but they are a very old lot number which were still the chubby PAK's. Lot# 40379004. I had received weeks ago PAK's with lot number 403791xx so these were certainly not new production units. I measured them to be sure and indeed they were too wide.
I called NxStage and was told that indeed new ones were shipping and the good lot's were from 40379136 and up. I looked and saw I had one of those in my stack, so I pulled it out and it is a chubby PAK. Internally they think 40379136 and up are good but they apparently aren't. I was told this would get escalated to a supervisor and I have two more PAK's coming on Monday.
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No they are not.
I was supposed to get on of the new PAK's last Monday. By Friday I hadn't received anything so I called. I think I caught them by surprise and after a little backpedalling they said they would send me two of the new good lot's to arrive today. Fail. I did get two PAK's but they are a very old lot number which were still the chubby PAK's. Lot# 40379004. I had received weeks ago PAK's with lot number 403791xx so these were certainly not new production units. I measured them to be sure and indeed they were too wide.
I called NxStage and was told that indeed new ones were shipping and the good lot's were from 40379136 and up. I looked and saw I had one of those in my stack, so I pulled it out and it is a chubby PAK. Internally they think 40379136 and up are good but they apparently aren't. I was told this would get escalated to a supervisor and I have two more PAK's coming on Monday.
I think they have a picture of you at Nxstage and use it for dart practice. (this is a joke so dont get too excited) . You do seem to have more bad luck then most. Maybe its where you live? Arent you in Buffalo , former home of OJ Simpson?
I just figured it out, if you are in Buffalo. NxStage is in Massachusets and of course this is the home of the Patriots. The Buffalo Bills are a long term foe of the Patriots . Maybe Tom brady is behind this . Or Bill Belichick. "SPYGATE"
Sorry for the humor but I do like to laugh at things.
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I expect it will be months before the paks being shipped fit in the pureflow. That is what my experience tells me.
:Kit n Stik; :oops; :Kit n Stik;
I'm cool with that.
:beer1;
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Twenty years ago I would have defended what were MY Bills. Now they are someone else's Bills. I had season tickets for a long time but just couldn't justify spending that kind of or any money for that matter on such a bad team. I got tired of decades of rebuilding. I no longer hold my breath. As far as OJ goes, we aren't missing him. We are also very proud of our last place Sabres too. Cuz they're...rebuilding.
I'm sure they dread when I call, but that's OK. I'm keeping them honest. I'm not vulgar or mean when I call, but please one of these days get it right. And if you promise to and me a PAK on Monday, do it. If they were to simply say, you know what, we can't send you a good PAK till a particular day, so be it. But don't make a promise then break it. They've been promising me good PAK's for almost 4 weeks now.
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I went to home depot to get the rubber part of a french door threshold. All they had was 36" ones I asked about 72" one so I could put a solid piece in without a seam. The guy called the supplier they said they would ship me one free .............. never came.....I wanted to buy it not get it free. :cuddle;
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Apparently I set off something at NxStage. I've gotten several calls this morning about the supposed good PAK I got. They believe lot 34079136 is good but the one I got was the worst of the bunch. Almost 98 mm. They are issuing a call tag to get it. Oopsie!
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I got two more PAK's today. Without opening the boxes I know they will fit. Guess how I know? They are old PAK's, the lot numbers are from last year.
I had a clinic visit today and spoke with my nurse about this. All she could do is shake her head. She was getting the same responses I was. Gee, we're sorry, but we have identified the problem.... She was told however that the chubby PAK's will still work. Just shove them in the chassis and force them in. She laughed.
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After having shoved a pak in and priming then finding out the control unit was new to me but broken all the same I had one heck of a time getting that pak back out. Better to pull the foam out if you use one of these "chubby paks".
So you can use your pureflow again :bandance;
One of my last calls tech said "So your saying you can't force the pak in"
Me "No, I can't force the pak in but I can take it apart and remove the foam"
tech " I'll send you 3 more I can't advise you to take apart the pak"
me "What ever you want to do. I call you back when they don't fix."
Next day I get a call and am told it is OK to pull the foam out and since I did that they don't want to send me any more replacement paks.
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In my conversation on the phone with management I explained how some of us had been taking the Paks apart and pulling out the foam. I think that made them realize it was something we could do fairly easily. So you can blame me for the change in tactics.
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In my conversation on the phone with management I explained how some of us had been taking the Paks apart and pulling out the foam. I think that made them realize it was something we could do fairly easily. So you can blame me for the change in tactics.
If anyone blames you they can blame me to cause I also told them.
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No need to blame any of the many messengers. Another way to look at it is to wonder why we on this side of the equation are the ones telling them what the problem is and how to fix it.
Now to fix the next problem. How to stop them from sending me cases of bags. At first I was running short, now I am running out of room to stack them.
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Make the madness stop!
So we couldn't get PAK's no matter how hard we tried, now I have them out the wazoo. They did send me two old ones and that was dandy. I didn't measure them, but why were old, so they should be fine. We'll, I just got another two. These are lot 4047, so completely new. I will measure them to be sure. But I have 4 PAK's which should last me till next year.
So if that weren't enough, almost every day I am getting eight to 10 cases of bags too. The UPS driver just shook his head today. He asked if this was normal, and I had no reply.
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So if that weren't enough, almost every day I am getting eight to 10 cases of bags too. The UPS driver just shook his head today. He asked if this was normal, and I had no reply.
Maybe you can go on a nice Alaskan Cruise:
http://www.youtube.com/watch?v=4khIMLaN9xQ#t=28
8)
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Make the madness stop!
So we couldn't get PAK's no matter how hard we tried, now I have them out the wazoo. They did send me two old ones and that was dandy. I didn't measure them, but why were old, so they should be fine. We'll, I just got another two. These are lot 4047, so completely new. I will measure them to be sure. But I have 4 PAK's which should last me till next year.
So if that weren't enough, almost every day I am getting eight to 10 cases of bags too. The UPS driver just shook his head today. He asked if this was normal, and I had no reply.
You can use them for fertilizer. Green up the planet with Nxstage.
I am back to using the used dialysate for my fruit trees. I had my best crop ever last year with the dialysate for fertilizer.
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Seriously?
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It does make good fertilizer my tomatoes love it. Just don't over do it.
We use a gray water line for the used dialysate and the grass grows really fast all around it but theres a strip of dirt were the main flow is.
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I posted all about it last summer. I had incredible amounts of peaches (our nephrologist calls them pee-ches) and apples las summer. I have 19 fruit trees.
I dump buckets of dialysate around the trees all summer . It is full of nitrogen and other goodies.