quality control on NxStage cartridges

[NCspinner]

Just wondered if other users of the NxStage cycler, Pureflow  and associated equipment have had these issues. Recently we were forced to discard several cartridges because of severe kinks in the tubing (usually near the "line organizer"  inside the cartridge) or ... even more frustrating ... the plastic priming spike on the cartridge tubing deforms when inserted into the orifice in the saline bag. the spike bends over into a fish-hook shape and nothing more can be done except to throw out the cartridge and start over.

We also had a cartridge in which a major clamp on the patient line was so out of place that we had to substitute a hemostat to provide that function. Come on, guys!

So ... anyone else? Home hemo is demanding enough without these types of problems. If notified, NxStage will send a UPS shipment package ... taking more of your time trying to follow the ridiculous packaging instructions for a return to NxStage, in one case a single box and 3 sets of plastic envelopes, absorbent sheets etc  for cartridges that hadn't even been used. It's enough to give a person a bad attitude.

[cassandra]

I had quite a few cartridges where the connections were so loose that as soon as you spike the saline bag, the red, yellow or blue line would disconnect, one end spraying the machine, one end on the floor. New cartridge while checking every single connection, which I feel is not my job.


So yeah, I agree, it's time to change the holiday staff at Nxstage 

[rcjordan]

I had severe -but not debilitating- kinks in the lines on the last shipment. And just today I reported to my nurse that the caps were sometimes so loose they blew off.

Other than the above, we've only had two severely defective items since last May. One Pak and one cartridge had a leak.  In both cases, NxStage sent a shipping box and wanted it back to them asap.

[KatieV]

I had quite a few cartridges where the connections were so loose that as soon as you spike the saline bag, the red, yellow or blue line would disconnect, one end spraying the machine, one end on the floor. New cartridge while checking every single connection, which I feel is not my job.

Periodically, one of the lines will come loose on my husband.  When I set up the cartridge, I always check the connections before putting it into the cycler.

I have issues with the new style - it is very difficult for me to get the saline spike all the way into the bag.  I have to work it so that there isn't a 1/4 inch gap (which causes alarms during prime).

[NCspinner]

So good to know we're not alone with this chronic problem. When I open a new cartridge now, the first thing I do after taking off all the paper tape is check EVERY SINGLE CONNECTION to make sure they're all "finger tight."  Like, this should have been done way up the line from where we are but never mind. Then I look for bad crimps where we've found them before. Same deal when making a nerw batch. As soon as the SAK is in the tub I take off the tapes and keepers and check everything. SOme of the connections are so loose that the attachment is about to fall off.

Sure, if you call NxStage with the problem they're very sympathetic and then they want the problem cartridge back. (Can't help wondering what happens when they get it.) But as far as I'm concerned, that is just more and more of my time that is already eaten up with doing treatment, drawing & shipping labs (don't get me started on that one), ordering supplies, going to home hemo clinics etc etc ...

After Hurricane Maria we were suddenly unable to get 30-cc syringes, which we finally were told had been manufactured in Puerto Rico until the whole island was blacked out. Suddenly it was okay to just put the hemostat on the "pigtail" off the filter afdter bleeding the air out during Prime, and tape a 30-cc syringe to the pole in case we needed it in a hurry--fortunately, a rare occurrence.  We've continued with that arrangement even since the big syringes are once again available. Nice to save at least one piece of plastic out of the amount we throw out daily.

[rcjordan]

Today, we have a big, loose KNOT in the red line.  That's a new one, heh!

[rcjordan]

Just had a Sak with a very slow drip coming from the small, flat filter in the blue line.  We had to abort and switch that session to bags.  BTW, it takes forever to drain 60L with the pump.

[NCspinner]

I know it! My husband has figured out a way to manhandle the full 60L SAK out of the tub, drag it down the hall to the bathroom and somehow hoist it into the bathtub (no walk-in shower unfortunately). Fortunately that hasn't been necessary too often.
Meanwhile just this week while priming the cartridge I got a red 85 (I think it was)--"Cartridge incorrectly loaded." Yeah, right, as if I'd done anything differently than dozens of other times.  I went through the protocol to start it priming again and got the same alarm. Then I trashed the cartridge (obviously defective in some way I couldn't see) and saline bag, started over with new ones and everything went fine. When I told the home hemo nurse she was like, "You need to report that to NxStage. They may want the cartridge back." Well of course they will but to what purpose?