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Author Topic: Poor quality control with Fresenius tubing  (Read 1834 times)
RightSide
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« on: November 02, 2010, 08:28:45 PM »

On October 29, I had posted a rant about how air bubbles in the dialysis lines had caused clotting of those lines and the needles during my dialysis treatment. And that this seemed to be on the verge of damaging my fistula and causing other problems.

I see now that I should NOT have been so quick to accuse the dialysis staff at my center of doing anything wrong.  They didn't.

The head nurse at my dialysis center has since learned that the air bubbles in the dialysis lines were caused by faulty tubing.  Our Fresenius sales representative visited her today, and admitted that they've been shipping faulty tubing due to poor quality control at their factory.   These tubing connectors are prone to loosening during use.  I do not know how many other dialysis centers, if any, have received faulty tubing.  But evidently this has been going on for at least a month, since a number of other patients at our center have experienced similar problems (air bubbles causing clotting) over the past month.

If your dialysis center uses tubing (hemodialysis lines) produced by Fresenius, you might want to inform your head nurse or center manager that Fresenius has admitted to having a quality control problem with their tubing, and they should discuss this with their own Fresenius sales reps.

In the meanwhile, the head nurse at my center has issued a directive calling for repeated checks of the tubing connections throughout the dialysis session.  We can no longer assume that the tubing will work just because it appears to be secure at the start of the session.

And I'm glad to report that the dialysis staff at my center has been exonerated!
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Bruno
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« Reply #1 on: November 04, 2010, 02:38:39 AM »

We always tighten the the connectors on our Fresenius lines before use. Some of the connectors are loose some are disconnected.
Because we know this and check beforehand, I (and the centre too, I suppose) have never had the problem you describe.
Your centre sounds a bit slack, RightSide, I wouldn't be heaping it all on Fresenius. It's pretty basic IMHO to check your equipment before you use it.
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RightSide
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« Reply #2 on: November 04, 2010, 06:28:38 AM »

Maybe I didn't make myself clear.

Our staff always check the tightness of the connections before starting the dialysis session.

But these defective tubes may loosen up again, at any point during the dialysis session.  There may be other defects that cause air leaks too.

So we're going to have to keep tightening the connections over and over through the dialysis session until it's over.

I've volunteered to do this for my own treatment.  The machine will be moved close to me, so I can deal with it myself when the staff are busy.
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greg10
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« Reply #3 on: November 04, 2010, 07:28:16 AM »

Sorry to hear about your problem with the Fresenius tubing.  A decade ago, there was a recall of Baxter tubing that caused hemolysis due to a narrowing of the defective tubing.  We have not hear any more details about this problem you described with the Fresenius but it sounds dangerous as well.  Usually the connectors you described are the Luer syringe type connectors and they can be either too tight or too loose.  If they are loose on the low side, air can get in and if loose on the high side, it may leak.  On the other hand, if they are too tight, they may break when you attempt to loosen it, so you have to be careful as well not to over-tighten the connectors.

http://en.wikipedia.org/wiki/Luer
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Newbie caretaker, so I may not know what I am talking about :)
Caretaker for my elderly father who has his first and current graft in March, 2010.
Previously in-center hemodialysis in national chain, now doing NxStage home dialysis training.
End of September 2010: after twelve days of training, we were asked to start dialyzing on our own at home, reluctantly, we agreed.
If you are on HD, did you know that Rapid fluid removal (UF = ultrafiltration) during dialysis is associated with cardiovascular morbidity?  http://ihatedialysis.com/forum/index.php?topic=20596
We follow a modified version: UF limit = (weight in kg)  *  10 ml/kg/hr * (130 - age)/100

How do you know you are getting sufficient hemodialysis?  Know your HDP!  Scribner, B. H. and D. G. Oreopoulos (2002). "The Hemodialysis Product (HDP): A Better Index of Dialysis Adequacy than Kt/V." Dialysis & Transplantation 31(1).   http://www.therenalnetwork.org/qi/resources/HDP.pdf
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