What Makes You Discard a PD Bag?

[drgirlfriend]

As many of you know, my boyfriend is extra persnickety about everything. As far as dialysis goes, I don't blame him. I can't say how I would act if I had to be responsible for putting stuff in my body like that on a daily basis.

There have always been a certain percentage of bags that didn't make the cut - too much liquid/condensation, dust, dirt, the ink being smeary or loose, etc. Since we moved to TX, there has been this rust colored/brownish liquid that has been showing up in the bags, especially around the threaded connector. It has been showing up pretty frequently and we asked our clinic if they knew what it was and if it was safe. They didn't know but said they would try to find out. I kinda doubt they'll get a straight answer even if they find someone to ask. Has anyone else seen this stuff? Do you know what it is? Do you discard many bags?

As always, thanks for your help!

[billybags]

drgirlfriend, I don't know if this helps but my husband gets this. He uses a  v iodine clamp when he does his dialysis. So he connects up, manual or machine, he does both and then he has to use a clamp that goes around the connection  that contains v iodine, when he opens his cath up he gets a little bit of brown v iodine  trickling into his bag. We are in the UK so I don't know if you use these in America. Its about keeping those nasty bugs out.

[Darthvadar]

Could the brownish colouring be an excess of iodine???.... Sometime there seem to be more of it than usual in the connection shields... We'd often get a good flush of brown colour on beginning a drain... Better too much iodine than too little in my opinion...

I'm paranoid about the bags being 'just right'... Any cloudiness, any suspected punctures in the outer packaging, or if I get the feeling it's just 'not right'...

Mum's Neph. tells me to trust my gut instinct, and 'if in doubt, leave it out'....

Darth....

[drgirlfriend]

I want to say that it's iodine, too, but the fact that is isn't in most of the bags makes me doubt that. He does use the caps with iodine in them - not clamps like billybags -  and sometimes it leaks out upon connection. If they want to put some in the bag on the port, that's cool, but they should make it known. Ya know, I would pay for a tour of where they make the bags and where they manufacture the cyclers. I'd really like to know how those things come together and how they THINK we're using them.

[Darthvadar]

As I said, there are varying amounts of iodine in the caps and shields... Some haven't a drop outside of the cap or shield, and some when you open the packet are virtually swimming in the stuff!...

Sometimes after doing Mum's D, I've so much of it on my hands, I look like a twenty a day smoker!....

Darth...

[jeannea]

Have you called the manufacturer? That could be worth your time. You may need to look online for a complaint line rather than your order line. Then they will have to look into it and give you a real answer.

[drgirlfriend]

Good point jeannea. The order people are not the most knowledgeable, I'm sorry to say.

[Joe]

Drgirlfriend, I think it's excess betadyne that is used to keep the end connectors sterile. I do like the Idea of calling your manufacturer, not the order folks but the tech side, and see if they have an answer for you. Of course the other thing you can do is return all the bags to your supplier as defective-I'd bet that gets a response fairly quickly 

Good luck!

[drgirlfriend]

You're a baaaad man, Joe. I like the cut of your jib.

[Annig83]

I agree with everyone who's posted.  I would as well call and see what they say.  I'm not "persnickey" as your boyfriend, but things to really look for:

- Cloudy fluid- Put a piece of paper with writing under the bag before usage.  If you can't see the writing, it's a no-go.
- Expired fluid- On the bags it should say something like December 13.
- Holes, or leakage.  Not the condensation on the outside of the bag.
- If you travel, or have a delivery, don't let the bags get overheated.
-Make sure the pins are intact in the bags before usage.   

"Runny ink" on the outside of the bag is most likely the condensation, or "misprinting" nothing to worry about.  There should never be any dust, dirt, or debris on the bags when delievered.  That is something that you need to call about.

[drgirlfriend]

Annig83 - the ink thing does bother me if it is able to come off on your hand. That's potential contamination unless you wash your hands yet again. One of the worst things about icky bags is the boyfriend washing his hands again in between each one. Makes for a long evening.

And speak of the devil he started getting ready over an hour ago and has discarded 4 bags. A new record, I'm sure. 

[highway61]

I agree with Joe, report this to the source. They do not want any bad bags out there and no one should take a chance with a questionable bag.

[bleija]

omg 4 bags in one night, wow that crazy, i maybe threw out 4 bags in a year, and half of those bc i cut bag myself when i opened the box, but ddnt take anychance thaqt it was there before
how many boxes does he order per delvery, he woulda destroyed my spare boxes in less than a week

[Annig83]

DrGirlFriend- I didn't realize the ink was literally wet!?  Then yes, I would discard it!!!  I thought you just meant it was smudged from the condensation (but dried). 

Did you ever get a hold of the company that sends them?

[tito]

I continue to have defective bags from Baxter that I must discard. Had one last night. When you break the frangible, the hole is insufficiently big for fluid to pass through. The first clue is repeated errors on the machine during priming. I must discard the bag and get a new one on line under clean conditions. Then throw the defective bag out. What a pain. i have complained repeatedly to Baxter but still the problem is there.

[drgirlfriend]

tito: that sucks! Sometimes the boyfriend stands there shaking the bag trying to get the cone away from the hole. Those bags are too heavy to be shaking around!

Annig83 - I haven't gotten on the phone yet. That's on the schedule for either tomorrow or Tuesday. The boyfriend has taken example bags to the clinic and they have sent them back but there hasn't been any news yet. The clinic says that often no news is good news, but frankly that's just lazy and stupid on Fresenius' part. While we wait, bag after bag gets tossed out. Not a good policy if true.

We have managed to toss out so many bags over the last 6 days that we're having extra boxes sent to us this coming week. Terrible.

[bleija]

ohhh its freseneus i had baxter and loved them, rarely had to throw out bags

[fearless]

I'm a bit confused because I don't think there should be any brownish liquid in any dialysate bags.  i understand that the caps for the catheter have iodine in them, but I never had anything attached to a bag that would have had iodine.  Am I just not remembering this right?  That is: when you take the bag out of the protective plastic it's shipped in, the liquid should be clear, with no color of any kind - right?

[Joe]

And drgirlfriend, you're sending all the defective bags back for credit, right? This stuff is way too expensive to just suck up bad bags.

[drgirlfriend]

fearless: You're remembering right. That's why this has been so freaky.

Joe: No one has suggested or asked us to send them back. I'd feel terrible for the delivery guy if we tried to foist them on him. I have been told that there isn't a credit situation to be taken. The insurance pays the clinic a flat fee per patient.

So I called Fresenius yesterday and spoke to someone in the training/tech support area. Told him everything I knew - including the catalog and lot numbers. He typed it into his system and said he would pass it on to the quality control people. He suggested I make sure that the customer service people knew what was up. I called them and they are in the loop with the clinic and know about the sample bag getting sent back. No answers, but they knew. So, in my mind, this is all I can do for now. I can only hope they take this seriously and communicate with us.

Additional: Just got a call from Fresenius complaint department asking to verify what we reported and asked if we still had some of the offending bags. Told him we gave them to the clinic and he said he had just spoken to them so that's cool. I told him I wanted to be sure we would get something telling us what was in the bags and he said we would get a letter of their findings. Hope it doesn't take too long.

[Joe]

Ok, now I understand. I didn't realize it was a flat fee per day. In that case, you are accomplishing what I was getting at anyway, you are asking for replacement fluid for the defective bags and that is costing them $$$. That alone should get their attention and, hopefully, some action from their end.

Good luck!

[JLM]

To remove the cone from the bag, try setting it on the lap, grab the top of the tube and rotate the tube, then pinching further down the tube  repeat, then with the bag  still laying on the lap shake the bag by holding on the tube.  Hope this helps

[drgirlfriend]

JLM: I will suggest that to the boyfriend.

Well, I had been dreading today's delivery all week. I did not want to be the one to discover that, despite knowing that there are notes to their warehouse to the contrary, we were getting another shipment of the same lot of bags. I hate trying to be the hardass with people who are not directly part of the problem. The boyfriend has no problem bitching people out, regardless.

Happy to report that the shipment is not part of the evil lot! Whew! I just hope that the mystery substance doesn't show up in these!

[drgirlfriend]

Another update!

The new lot of bags has the same stupid problems the previous lot had.  We are at a ratio of 4:1 potentially contaminated bags to useable ones. This is wearing on our nerves something terrible. We get to bed pretty late as you can imagine. There are both full and empty boxes everywhere it seems since they have been sending us extra to cover the ones we throw out. FYI: UPS is not great at delivering bag boxes. Several of them have arrived open (!) or beat up to the point we can't use them. It's a miracle they haven't burst the bags.

Fresenius says that they have had many of the same complaints and they are all in the southern United States. (Can I please go back to California now?) The also said that it can take up to a month to test the bags and let us know if they're safe. A month of this? Yay.   

[billybags]

That sounds so bad!