DF or DP ERRORS Check for the following: 1. Level detector connection to back of analyzer are tight. 2. Leakage under instrument. 3. Level detector inserted correctly into box. 4. No pinch or kink in level detector Perform a Prime, then a background count DONE All highlighted areas of flowchart are to be performed by trained in-house technician ONLY. Remove back, right YES cover see instruction in manual NO Check that lower and upper tubing is connected to measuring pipettes by tightening tubing onto ends. Perform a background count and watch liquid in measuring chambers. 1. Perform Valve Check YES 2. Contact Service and give DF/DP flag? Valve Check results NO NO NO DF/DP flag? Re-analyze DF/DP flag? sample YES YES Perform Level Detector Test. in Service Menu. Were all values 2 (2 = liquid)? Did liquid YES Did liquid stop at move up and down upper detector? in pipette? NO YES NO Is there YES any liquid in air Contact Service Representative bin? NO Check and tighten Perform a tubing on waste background count bin DONE 87
Discordant Results Questions to ask: 1. Was sample collected and handled properly? 2. Was the same sample used for both in-house and outside lab analysis? 3. Different blood draw and/or different tube? 4. Could the sample have been switched with another patient? 5. Could discordance be due to age changes during shipping or time periods between blood draw and analysis (RBC swelling, platelet clumping, deterioration of WBC for differential)? Check that sample is mixed correctly and no YES hemolysis or lipemia is present. Perform HGB YES blank. 1. Verify by looking at blood film. YES 2. Check sample for clots. 3. Review PLT histogram. (verify bell-shaped curve) Verify that sample is mixed correctly and tube YES has correct ratio of blood to anticoagulant. 1. Check reagent level. 2. Run Orifice Clean cycle from Service Menu (possible blockage of aperture) 3. Check if monthly or 6- month Maintenance is due? Contact Service Representative Are controls NO Go to control out of range Troubleshooting Repeat using correct Is MCHC within range? protocol procedure out-of-range? YES NO NO NO Are all parameters YES Was calibration YES Was calibration Is HGB discordant? recently protocol followed out-of-range? performed? correctly? NO NO YES Is PLT out-of-range? Change out NO Are reagent NO Were all reagent and levels ok? parameters re-run sample. low? NO YES YES Perform Is HCT low Maintenance compared to Review differences that can Is monthly or 6- YES spun PCV? be expected when comparing month Maintenance results from same system, due? NO from different systems, etc. Are NO RBC Examine blood film Perform Clot and PLT both Prevention procedure high or both YES low? and rerun sample. NO YES Is sample Are results still YES Are pathological? discordant? WBC and HGB both high or both low? NO NO YES NO DONE Are RBC and HGB both low? Contact Service NO Representative YES 1. Verify by looking at blood film. Rerun and/or Is WBC 2. Check sample for clots. redraw sample. out-of-range? 3. Remix and check correct sample handling followed. 88
Display Issues Usual Cause: 1. Keypad flex-cable loose 2. Static electricity 3. Power Outage/Lightening Verify/record with clinic if power surge was noted Turn off analyzer with On/Off switch and All highlighted areas of flowchart then turn back on. are to be performed by trained inhouse technician ONLY. Is green power NO Contact Service light on front of Representative analyzer lit? YES Contact Service Touch screen and Representative wait one minute. YES Is beep NO Is display YES heard when screen DONE visible? is touched? NO Turn off analyzer with On/Off switch. Remove front cover, see instruction in manual. YES Check that keypad flexcable, behind top of Turn on analyzer with Is display NO Press screen, is firmly On/Off switch. visible? start lever. Is beep heard? pressed into connector. YES NO Contact Service Representative 89
HIGH BACKGROUND COUNTS Initial Procedure: 1. Check Diluent Lot Number and expiration date. 2. Check age of Diluent (i.e. when was it opened?) 3. Check that level sensors are pushed all the way to the bottom of the reagent containers and firmly tightened on back of analyzer. 4. Check that level sensors are in correct reagent containers (red=diluent, yellow = lyse) 5. Check reagent level. 6. Check environmental condition (i.e. extreme temperature fluctuations?) Run total of 3 backgrounds to See Clot Removal verify procedure YES DONE YES Did NO Are clots NO Perform Orifice Clean NO Did background visible ? in Maintenance menu background pass? pass? YES Did YES background DONE Repeat procedure NO Was procedure YES pass? using correct protocol followed correctly? NO YES Was Monthly or YES Were all Check Noise Test 6-Month Maintenance values '0'? under Service Run 2 Prime just performed? Menu cycles followed by a background NO cycle. NO See Noise Issue Flowchart YES Did DONE background Is maintenance YES Perform scheduled pass? procedure scheduled to maintenance and rebe performed? analyze background. NO Run 3 NO backgrounds. Try another box of NO Did background diluent. pass? YES Did NO Did YES YES DONE background pass? background DONE pass? NO Perform heated detergent procedure, using detergent from 6-month cleaning kit Contact Service NO Did YES Run 2 Prime cycles Representative background followed by a pass? background count 90
Noise Issues Usual Cause: 1. Bad electrical outlet in clinic 2. Power Outage/Lightening Is SE flag YES See SE flag present? troubleshooting protocol NO Perform Noise Ask customer to Test, under tighten screws on Service Menu cable YES Are the YES Are any cables loose values for the Noise on back of as follows? analyzer? Values should be: NO RBC Amph = 0 WBC Amph = 0 RBC Discr = 100 filter = 80 WBC Discr = 50 filter = 80 NO Try plugging analyzer into different outlet Is Noise test NO positive? YES Check for noisy Done equipment and /or try another room YES Is Noise test YES Recommend trying Did line conditioner positive? line conditioner work? NO NO Contact Service Representative 91
TU or TL ERRORS Re-analyze sample (system cleans and rinses the orifice automatically when error is generated) All highlighted areas of flowchart TU/TL flag? NO DONE are to be performed by trained inhouse technician ONLY. YES Perform a Prime, then a background count TU/TL flag? Re-analyze NO sample YES Perform Orifice Clean in Maintenance menu Perform NO background count Check tubing to MPA, re- Remove front cover, YES NO attach if necessary see instruction in TU/TL flag? DONE manual Check NO Perform heated for blockage in detergent procedure, Run 2 Prime cycles MPA. Is there a using detergent from followed by a background count blockage? 6-month cleaning kit DONE NO TU/TL flag? YES YES Perform MPA blockage removal procedure YES Remove right-side Check tubing to TU/TL flag? cover see instruction measuring chambers, in manual. re-attach if necessary. NO Is DONE NO liquid level above orifice in measuring chambers? YES 1. Perform Valve Check NO Is there Check tubing to metering 2. Contact Service and give any liquid in help columns, re-attach if Valve Check results pump? necessary. YES Contact Service Representative 92
Art no 1504154 Apr 2006