i SENS PN200107 Users Manual

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© Copyright 2017, CoaguSense, Inc. All rights reserved.
No part of this publication may be reproduced, transmitted, transcribed, stored in a
retrieval system or translated into any language or computer language, in any form
or by any means, including, but not limited to, electronic, magnetic, optical,
chemical, manual, or otherwise without written permission of CoaguSense.
Coag-Sense is a registered trademark of CoaguSense, Inc.
Contacting CoaguSense
If you have any questions or concerns with the Coag-Sense® PT2 Professional Prothrombin Time (PT)/INR Monitoring System, please contact CoaguSense Technical Support at:
CoaguSense, Inc. 48377 Fremont Blvd., STE. 113 Fremont, CA 94538 Toll Free: 1-866-903-0890
E-Mail: techsupport@coagusense.com
Note : The Coag-Sense PT2 Professional Prothrombin Time
(PT)/INR Monitoring System meter is packaged in a special box. Do not discard this box. Re-use the package to transport the meter or, if directed by Technical Support, to return it for testing.
The Coag-Sense PT2 Professional PT/INR Monitoring System may be used for multiple-patient testing in a professional healthcare setting.
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The Coag-Sense® PT2 Prothrombin Time (PT)/INR Monitoring System
Intended Use
The Coag-Sense PT2 Prothrombin Time (PT)/INR Monitoring System is an in vitro diagnostic device that provides quantitative prothrombin time (PT) results, expressed in seconds and INR units. It uses fresh capillary whole blood. It is intended for use by health care professionals at the point of care to monitor patients who are on warfarin-type (coumarin) anticoagulation therapy. The device is not intended to be used for screening purposes.
The Coag-Sense PT2 Professional PT/INR Monitoring System may be used for multiple-patient testing in a professional healthcare setting.
Anticoagulation Medication
Oral anticoagulation medications, are typically prescribed to patients to avoid unwanted clots. The patient’s blood clotting time must be monitored to ensure that their dosage is correct.
Oral anti-coagulation medication is prescribed to patients with acute and chronic conditions including, but not limited to: congestive heart failure, atrial fibrillation, prosthetic heart valve, myocardial infarction, joint replacement, deep vein thrombosis, pulmonary embolism, thrombotic stroke, coronary artery disease, venous thromboembolism and cancer.
Blood-clotting Time
The rate at which blood clots is measured in units is called International Normalized Ratio (INR). It is very important for patients to stay within their individual target INR range. If the INR is too low, the risk of blood clots increases. If the INR is too high,
the risk of hemorrhaging increases. The patient’s physician will determine the most appropriate INR range for the patient, depending upon the patient’s indication and how they respond to the oral anticoagulant.
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Table of Contents
Contacting CoaguSense ...................................................... 3
Table of Contents ..................................................................... 6
1.About This Manual ........................................................ 7
2.System Description ....................................................... 8
3.Reordering Information ............................................ 1312
4.Warnings and Precautions ...................................... 1312
5.Hazards and Symbols ................................................. 18
Directions for Use .................................................................. 19
6.
Operating Conditions ................................................... 19
7.Power On and Off ........................................................ 20
8.Setting the Time and Date ........................................... 20
9.Performing a Control Test ........................................... 22
10.Performing a PT Test .................................................. 27
11.Collecting a Fingerstick Sample .................................. 33
12.Reviewing the Memory ................................................ 38
13.Printing ........................................................................ 39
14.Control Strips .............................................................. 41
15.Lithium Polymer Battery .............................................. 42
16.Cleaning and Disinfecting the Meter ............................ 44
17.Troubleshooting ........................................................... 46
18.Performance Characteristics ....................................... 53
19.Meter Specifications .................................................... 54
20.Warranty ...................................................................... 55
21.Index ........................................................................... 57
##. Connectivity (USB, Micro USB, Ethernet) ##
1. About This Manual
The purpose of the Coag-Sense PT2 Professional Prothrombin Time (PT)/INR Monitoring System User Manual is to help you understand your Coag-Sense PT/INR system, its parts, and its intended function. It provides you with the information you need to perform a PT test with the Coag-Sense PT/INR system.
You must complete proper training on the Coag-Sense PT2 Professional PT/INR system before you begin using the system. It is also important to read this entire User Manual and the inserts that come with the disposable Coag-Sense test strips. This User Manual has different formats and symbols to distinguish warnings, notes, and meter buttons.
WARNING: This indicates a warning or precaution.
Please read and understand all warnings and precautions. They tell you about potential safety hazards and situations that may cause injury. If you have any questions, please contact CoaguSense Technical Support at 1-866-903-0890 (USA).
Note : Notes provide additional information that is useful or
important. All notes are displayed in italics. Words in BOLD ALL-CAPITALS refer to buttons on the Coag-Sense meter.
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2. System Description
The Coag-Sense PT2 Professional Prothrombin Time (PT)/INR System is used for quantitative measurement of Prothrombin Time (PT) in fresh, capillary whole blood. The Coag-Sense PT2 Professional PT/INR system is intended for use outside the body (in vitro diagnostic use) to test patients taking warfarin-type oral anticoagulant (blood thinning) therapy who need to monitor clotting time.
The meter performs a self-test when it is first turned on. If there are any problems with the meter, an error message is shown on the display. Refer to the “Troubleshooting” section of this manual or contact Technical Support.
A test strip is inserted and heated in the meter prior to sample application. The strip contains a tiny wheel with spokes that pull the sample into the reaction well. The spokes quickly and completely mix the sample with the clot initiating component of the test strip.
The PT time is determined from when (a) the sample is drawn into the reaction well of the test strip and detected by a beam of light until (b) a clot forms and interrupts the beam of light. The PT result is converted to an INR (International Normalized Ratio) using the calibration data stored in the meter. INR is a mathematical correction of the PT result that adjusts for sensitivity differences among different PT systems.
The meter continues to check every feature of its operation through a series of self-checks.
Your Coag-Sense PT2 Professional PT/INR Monitoring System
(Catalog number 03P70-01) comes supplied with:
Coag-Sense PT2 Professional PT/INR Meter
Coag-Sense PT2 Professional PT/INR System Monitoring
User’s Manual
Coag-Sense PT2 Professional PT/INR Monitoring System
Quick Reference Guide
Testing Tips Card
Rechargeable Lithium polymer battery (3.7V, 2350mAh)
(Factory installed)
AC Power Supply
Sample Transfer Tubes Capillary
Sample package of Single-use, Auto Sterile Lancets
Carrying Case
You will also need:
Coag-Sense Professional Test Strip Kit-50
(Catalog number 03P56-50), which includes:
50 Patient Test Strips
2 Low Control Strips
2 High Control Strips
1 Control Strip Activation Solution
54 Sample Transfer Tubes
Isopropyl alcohol or alcohol wipes
Gauze
Single-use Auto Lancets, 21 gauge - box of 100
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Puncture-resistant bio-hazard (SHARPS) container
The Coag-Sense PT2 Professional Meter: Top View
Meter Display
Placeholder
Power On/Off Button
ofPT2Top
View
Image
Menu Buttons
Strip Insertion
The Coag-Sense PT2 Professional Meter: Bottom View
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Connectivity *USB *Micro USB *Ethernet
Placeholder
ofPT2Bottom
View
Image
The Coag-Sense PT2 Professional Meter: Rear View
Data/Printer Port
Placeholder
ofPT2Rear
View
AC Adapter Jack
Image
The Coag-Sense Test Strip
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Sample Application Area
flashing when ready for sample)
Mixing Wheel and Reaction Well
(Green light
Bar Code
Handle
(Faces down when inserted into meter)
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Reordering Information
3. Reordering Information
For a description of the products listed below, please see the information above.
Product Catalog #
Coag-Sense PT2 PT/INR Professional System
Coag-Sense PT2 PT/INR Professional System
EU Version
Coag-Sense Test Strip Kit, Box of 50 03P56-50
Coag-Sense Control Strip Kit -10 03P69-10
Sample Transfer Tubes, Pack of 54 03P53-54
Lancets, Normal Depth (Box of 100) 03P58-03
AC Power Adapter – U.S. TBD
AC Power Adapter – EU Version TBD
03P70-01
TBD
4. Warnings and Precautions
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Test Site and Blood Sample
The Coag-Sense PT2 Professional PT/INR monitoring
system is for in vitro diagnostic use only.
The Coag-Sense meter will not produce a result if the test
strip is past its expiration date.
The quality of the blood sample can affect PT test results.
A blood sample of poor quality can produce unreliable results. Read the section on “Collecting a Fingerstick Sample” for more information.
Blood samples must be applied to the test strip
immediately after collection or the blood begins to clot, causing unreliable results.
The blood sample transferred to the test strip must be a
minimum of 10 µL in volume. Low sample volume may cause an error message.
Use only fresh fingerstick capillary blood for testing. The
blood should only come in contact with the products provided with the Coag-Sense PT/INR system. Other products may have anti-coagulant agents on their surfaces and result in unreliable test results.
Squeezing the fingerstick site excessively (milking)
releases interstitial “tissue layer” fluid that can cause unreliable results.
The fingerstick site can be washed with warm water and
soap, and then completely dried. The site must be clean of all hand oils/lotions and foreign matter, which may cause unreliable results.
If Isopropyl Alcohol (IPA) wipes are used, wipe the
fingerstick site with a gauze pad and make sure the site is
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completely dry. If any alcohol remains (or is re-introduced) on the finger, it may cause unreliable results.
The quality of fingerstick and the sample delivery
technique are important to the test results. If there is a question about the sample or sample collection, obtain a new strip, repeat the fingerstick on a different finger, and test again.
If you need to repeat a test, use a different finger for the
fingerstick, since blood may have started to clot on the first finger, which may cause unreliable results.
If there is a bubble or an air pocket showing in the blood
sample in the collection tube, start the test over. Use a new fingerstick (using a different finger and collection tube) or results may be unreliable.
Refer to the package inserts provided with the Lancets
and Sample Transfer Tubes for more information.
Meter
The meter is designed with rechargeable lithium polymer
battery (3.7V, 2350mAh).
Use only the included Coag-Sense AC adapter with the
meter or damage to the meter may result.
The meter is a delicate instrument, and should be
handled with care. Dropping or other mishandling may cause damage to the meter. If this should occur, call Technical Support.
Do not allow any liquids to spill on the meter. If this should
occur, call Technical Support.
Do not put the meter in liquid. Do not allow liquids to get
into any of the connectors or plugs on the meter.
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Only use the method provided in this User Manual to
clean the Coag-Sense PT/INR meter.
Do not move or touch the meter while it is running a test.
Unreliable results may occur.
Store and use the Coag-Sense PT2 Professional PT/INR
monitoring system following the instructions in this manual.
This equipment is tested to meet the limits for medical
devices, which is designed to provide a reasonable protection against harmful interference when the equipment is operated in a clinical or home environment. If not installed and used in accordance with these instructions, it may cause harmful interference to other devices in the vicinity. If this equipment does cause harmful interference to other devices, which can be determined by turning the equipment on and off, the user is encouraged to try to correct the interference by one or more of the following measures:
Reorient or relocate the receiving device.
Increase the separation between the equipment.
Connect the equipment to an outlet on a circuit
different from that to which the other devices are connected.
Any equipment connected to the data port must be
certified to IEC 60601-1. If you connect any equipment that is not recommended by CoaguSense, you are responsible for meeting the requirements of this standard.
In the unlikely event of an electric power surge (i.e.,
severe static discharge during a thunderstorm), when using the AC power adapter, the display screen may go blank. If this occurs, unplug the power supply from the
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back of your meter, wait 5 seconds and plug it back in. Normal operation should return, but you may have to reset the time and date.
DO NOT OPEN THE METER. Do not attempt to repair or
modify this meter. The Coag-Sense meter does not require any periodic maintenance and there are no user serviceable parts inside. If you have problems, please contact Technical Support. The Coag-Sense PT2 Professional Prothrombin Time (PT)/INR Monitoring System needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in this manual.”
“Portable and mobile RF communications equipment can
affect Coag-Sense PT2 Professional Prothrombin Time (PT)/INR Monitoring System.”
“The use of accessories, transducers and cables other
than those specified by CoaguSense, may result in increased EMISSIONS or decreased IMMUNITY of the EQUIPMENT.”
“The Coag-Sense PT2 Professional Prothrombin Time
(PT)/INR Monitoring System should not be used adjacent to or stacked with other equipment and that if adjacent or stacked use is necessary, the Coag-Sense PT2 Professional Prothrombin Time (PT)/INR Monitoring System should be observed to verify normal operation in the configuration in which it will be used.”
Test Strips/ Control Strips/Control Strip Activating Solution
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The test strips are designed for single use only. Do not
reuse the test strips.
Patient samples, controls, used strips, transfer tubes and
lancets are potentially infectious. Discard used materials in a puncture resistant, biohazard waste container using universal precautions.
PT Test Strips, Control Strips, and Control Strip Activating
Solution are perishable goods with a limited shelf life. Do not use any of these items if the expiration date has passed.
Refer to the package insert that is supplied with each box
of test strips for more information.
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5. Hazards and Symbols
Warning. This indicates a warning or precaution,
requiring special attention.
Catalog Number / Model Number
Refer to Instructions for Use
Class II Equipment. The AC Adapter is double insulated.
Biological Risks: Disposable items pose biological risks. The strips and fingerstick materials should be disposed of in appropriate biohazard waste containers.
Electronic device. Dispose of unit and batteries properly.
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Use by/Expiration Date
Lot number
For In vitro diagnostic use
Storage temperature range
Manufacturer
Single Use Only – Do Not Reuse
This product meets the provisions of Council Directive 98/79/EC for In Vitro Diagnostic Devices.
Authorized/European Representative
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Directions for Use
Note : The Coag-Sense PT2 Professional PT/INR monitoring
system is packaged in a special box. Do not discard this box. Re-use the package to transport the meter or, if directed by Customer Service to return it for testing.
6. Operating Conditions
To ensure that your Coag-Sense PT2 Professional PT/INR monitoring system is working correctly, be sure the following conditions are met:
Be sure that the meter and strips are at room temperature
before use. Operating conditions are between 65ºF and 90ºF (18ºC and 32ºC). The meter will not allow a test to proceed until the meter is at room temperature.
Relative humidity should be between 10% and 85%,
without condensation, for testing.
Avoid dropping the meter or treating it roughly.
Use the meter only on a level, stable surface.
Do not move or touch the meter during testing.
Do not place the meter in direct sunlight or high
intensity light.
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7. Power On and Off
Place the meter on a flat, stable surface. To turn the
meter on. Press the (POWER) button, which is on the topside of the meter, beneath the display. To turn the meter off, press the same POWER button again.
8. Setting the Time and Date
Action Meter Display
1. If the date and time have not been set before on the meter or the setting has been lost, the display looks like this with blinking characters.
DONE NEXT
12:00PM
1/01/17
+ -
2. The blinking characters may be changed by pressing + to increase or – to decrease. When correct, press NEXT to advance to the next character.
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Press NEXT to advance to next character.
Action Meter Display
3. Once you have entered the correct date and time, press DONE to exit this function.
12:00PM
1/01/17
4. Once the date and time are set, the display looks like this.
5. If you need to change the date or time in the future, press SET. The meter display shows the set time and date.
6. Adjust the time and date by pressing + to increase or – to decrease. When the time and date are correct, press DONE when finished.
DONE NEXT
Press DONE when date and time are correct
+
READY
INSERT
STRIP
OFF
Press SET to adjust date and time again (if necessary)
SET MEM
8:00AM 3/07/17
DONE
NEXT
+
-
-
Press DONE when date and time are correct
Note : The clock time does not adjust for daylight savings time.
The date format is mm/dd/yy.
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9. Performing a Control Test
Control testing confirms the performance of both the meter and the test strips and should be completed for each new lot of test strips. Control testing can also be run whenever the PT results are unexpected to make sure that the system is working properly. There are 2 low control strips, 2 high control strips and a control strip activation solution shipped with each test strip kit. Extra controls may be ordered separately.
Follow these steps to perform a test on a low or high control.
Note : The following directions are for running a low control strip.
When this procedure is complete, run a high control strip. The controls may be run in any order. The meter will display and store the results in PT seconds only. The meter does not use or require results from the control strips prior to running a patient test strip. If multiple boxes of test strips are purchased at the same time and they have the same lot number, only one low and one high control from that lot needs to be tested.
Note : If an error message appears, consult the
“Troubleshooting” section of this manual.
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Action Meter Display
1. Make sure that the power is
on by pressing the (POWER) button on the top of the meter and the display looks like this.
READY
INSERT
STRIP
SET
MEMOFF
2. Open a low control package,
tearing at the notched end. Remove the strip. Set the package aside.
Note : Make sure that the
expiration date has not passed by checking the date on the front of the control package.
3. Holding the round end, gently push the strip completely into the
meter. The strip fits snuggly when pushed all the way toward the back wall of the strip insertion area.
4. When the strip is correctly
inserted, the display looks like this
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LOW CONTROL
DETECTED
Action Meter Display
Note : If anything other than this is displayed, refer to the
“Troubleshooting” section.
5. The meter warms the strip.
The display looks like this. It shows a countdown of the time remaining during the warm-up cycle.
STOP
Note : Do not apply the control
activation solution until the warm-up is complete and the meter tells you to do so.
6. The meter beeps once when
it is ready for the control strip activation solution. The screen looks like this.
WARMING
PLEASE WAIT
24
Warming count down in seconds
APPLY
CONTROL
SOLUTION
STOP
Note : You now have up to 2 ½ minutes to apply the activation
solution to the control strip.
7. Open the control activation solution and hold at an angle to allow insertion of the transfer tube.
8. Holding the transfer tube below the bulb, insert into control activation solution.
Let capillary action fill glass portion of tube until flow stops.
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Action Meter Display
Note : DO NOT SQUEEZE THE BULB. Be careful to avoid
getting bubbles in the transfer tube.
9. Rest hand on instrument to steady. Move fingers to flat sides of bulb being sure to cover air holes. Insert tip into sample application well of test strip, touching tip down on strip at flashing green light. Slowly squeeze bulb until solution leaves tube.
Placeholder to insert tip into sample application well of test strip
10. When the control activation solution is properly applied and detected, the flashing green light will turn off, and the meter display looks like this.
TESTING
PLEASE WAIT
Note : If this screen is not displayed, either not enough solution was
applied or the solution had bubbles in it. Remove the strip. Retest with a new control strip. DO NOT attempt to add more solution to the strip.
11. When testing is complete, the display shows “OK” and looks similar to this.
LO CONTL OK
PT 22.5
10/18/17 8:01 AM
REMOVE STRIP
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Action Meter Display
Note : To avoid confusing control strip INR results with patient test
strip INR results, control test results will display in PT seconds only.
Note : The date and time shown in the display are examples only.
The date and time shown after actual testing is the current date and time.
Note : If anything other than this is displayed, refer to the
“Troubleshooting” section.
Note : Remember to repeat this entire procedure with a high
control strip.
12. When high control testing is complete, the display shows “OK” and looks similar to this.
HI CONTL OK
PT 42.1
10/18/17 8:05 AM
REMOVE STRIP
13. Once the controls have been successfully tested, remember to throw the control strips into a biohazard container. You can now proceed to testing patient blood samples. If you are not going to test, turn off the meter by pressing the POWER button. The opened control activation solution may be used until the expiration date.
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10. Performing a PT Test
WARNING:
surface for testing. Do not move the meter or allow it to vibrate during a test. Unreliable results may occur. Wear gloves and follow all applicable hygiene and safety procedures.
Action Meter Display
1. Make sure that the meter is
on by pressing the (POWER) button on the top of the meter.
Place the meter on a stationary, level
READY
INSERT
STRIP
Note : If an error message
OFF
appears, refer to the “Troubleshooting” section.
2. Open a PT test strip package, tearing at the notched end. Remove
the strip. Set the package aside.
Note : Make sure that the expiration date has not passed.
3. Holding the round end, gently push the strip completely into the
meter. The strip fits snuggly when pushed all the way toward the back wall of the strip holder.
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SET
MEM
Action Meter Display
4. When the patient test strip is
correctly inserted, the display looks like this.
PAT.
STRIP
DETECTED
5. The meter warms the strip.
The display looks like this. The meter counts down the time remaining during the warm-up cycle.
WARMING
PLEASE WAIT
24
Note : Do not apply any
sample until the warm-up is complete and the meter tells you do so.
STOP
Warming count down in seconds
While the meter is warming up, get ready to perform a fingerstick. See “Collecting a Fingerstick Sample” in this manual.
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Action Meter Display
6. When the warm-up is
complete, the meter beeps once. The screen looks like this.
APPLY
SAMPLE
Note : You now have up to 2
½ minutes to perform fingerstick and apply the sample to the test strip.
7. IMMEDIATELY after
collecting the patient sample, place the tip of the sample transfer tube at a 45º angle into the sample well on the test strip where you see the flashing green light. Gently touch the tip down onto the sample well.
8. Slowly squeeze the bulb
until the blood leaves the tube being careful not to introduce air bubbles into the sample. Keep pressure on bulb while you pull your hand away to avoid back suction of sample.
STOP
Placeholdertoshowtip ofthesampletransfer tubeintothesample wellontheteststrip
9. Discard the sample transfer
tube in a biohazard waste container.
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Action Meter Display
10. When the sample is
detected, the meter display looks like this.
Note : If this screen is not displayed, either not enough blood
sample was applied or the sample had air bubbles in it. Remove the strip and retest with a new strip.
PLEASE WAIT
TESTING
11. When testing is complete,
the meter beeps once. The results (INR and PT in seconds) are shown on the screen.
INR 2.2
PT 22.2
10/18/17 8:50 AM
REMOVE STRIP
Note : If any display other than the one shown is visible (such as
CLOT TIME TOO SHORT or NO CLOT DETECTED), refer
to the “Troubleshooting” section.
12. Record the results. Then remove the test strip. Throw it away in a
biohazard collection container.
Note : Repeat the test if the results seem unusually low or high.
If the results still seem unusual after a second test, contact Technical Support.
Turn the meter off by pressing the
POWER
button when you are finished testing. If left unattended, the meter automatically turns off in a few minutes.
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The last 100 test results are stored in memory with the time and date. Refer to “Reviewing the Memory” in this manual for more information.
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WARNING: Unexpected results
An unexpected result may include any result that falls outside the patient’s therapeutic target range, or a result that falls inside the target range but is not consistent with the patient’s current health status (e.g., patient is experiencing bleeding or bruising).
What can cause unexpected results:
Certain prescription drugs (for example, heparin) and certain over-the-counter medications (for example, antibiotics) can affect the action of oral blood thinners and the INR value.
Changes in diet, lifestyle, or taking nutritional supplements such as ginkgo biloba can affect the action of oral blood thinners and the INR value. Liver diseases, congestive heart failure, thyroid dysfunction, Lupus, antiphospholipid antibody syndrome (APS) and other diseases or conditions can affect the action of oral blood thinners and the INR value.
Be sure to confirm whether the patient has any of these conditions before you begin testing, and any time there are changes in health patient status or medications after you have begun testing.
What to do when you get an unexpected result:
Follow instructions for re-testing on the Coag-Sense PT/INR meter. For unexpected results, contact Technical Support at
1-866-903-0890
. Consider re-testing using an alternative method prior to adjusting the patient’s dose of anticoagulant medication, or any other corrective actions.
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11. Collecting a Fingerstick Sample
Tips for a Successful Fingerstick
Make sure that you have all the supplies needed before
you start.
21g Lancet device (Single use, auto disabling)
Sample Transfer Tubes
Sterile alcohol prep pads
Gauze square
Band-Aids
Biohazard waste container (SHARPS)
For fingerstick blood testing, increasing the flow of blood
in the finger will help you capture a good drop of blood. Before you prick the finger, have the patient warm their hand by washing it in warm water, holding it under their armpit, or by using a hand warmer. Ensure that the patient’s hand is dry prior to testing.
Do not use fingers with tight rings, scars, calluses, or
other features that prevent getting good access to the blood.
One of the middle or index fingers on either hand
is recommended.
Gently squeeze or massage the finger to be lanced, near
the tip. Good circulation can be seen if the patient’s fingertip changes to a pinkish shade.
Use a 21g 1.8 mm depth single-use auto-disabling lancet.
Smaller gauge/shallow depth lancets (i.e. diabetes
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23g lancets) should not be used.
Refer to the Lancet
device instructions for more information on use.
Lance the fleshy part of the fingertip just slightly left or
right of the center.
Press lancet firmly against finger.
For better blood flow, you may have the patient hold their
hand below their heart.
Squeeze the finger from the sides to open up the wound for proper blood flow if necessary to produce pea sized drop.
The best test sample is when:
The blood is collected right after the fingerstick and put
into the sample well without delay. If there is any delay in sample collection or application, repeat with a fresh fingerstick and a new strip.
There are no bubbles or air pockets in the tube or sample.
WARNING:
Patient samples, controls, used test strips, transfer tubes and lancets are potentially infectious. Dispose of strips and collection devices using universal precautions.
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Action Meter Display
1. Have patient wash hands with soap and warm water. Dry completely.
2. Choose a site near the top of one of the middle fingers to lance.
Note : Avoid the more
sensitive area in the center. Avoid any calluses or scars.
3. Clean the fingertip with an alcohol wipe using one side for the first cleaning. Use the second side for a final wipe.
4. Dry the fingertip with gauze to remove any excess alcohol.
5. Place the patient’s hand on a solid surface with the palm of the hand facing up.
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Action Meter Display
6. Remove the cap from the
single use lancet. Place it against the skin. Holding the body of the lancet, push down firmly against the finger to lance the surface of the skin. Do not lance
finger until meter displays “APPLY SAMPLE”. A minimum of
10µl of collected blood sample is required.
Note : The blood should flow
freely. If it doesn’t, gently squeeze the finger to get it started. Lowering the patient’s hand and arm so that the fingertip is below the heart helps the blood drop form.
WARNING:
Squeezing the fingerstick site excessively (milking) releases interstitial “tissue layer” fluid that can cause unreliable results.
Page 38 For In Vitro Diagnostic Use CoaguSense, Inc.
Action Meter Display
7. When ready to collect the drop of blood, hold the Sample Transfer Tube between your thumb and forefinger below the bulb, being sure not to cover the air hole in bulb. DO NOT SQUEEZE THE BULB.
8. With tube horizontal touch tip to bead of blood. Let capillary action fill the glass portion of tube until the blood flow stops at the black line. Squeeze finger to produce additional blood if required to completely fill glass portion of tube.
9. Once you have collected the sample, put it into the sample well on the test strip. See
“Performing a PT Test” section of this manual.
IMMEDIATELY
WARNING:
If there is a bubble or an air pocket showing in the blood sample in the transfer tube, start the test over with a fresh fingerstick on a different finger.
CoaguSense, Inc. For In Vitro Diagnostic Use Page 39
12. Reviewing the Memory
The Coag-Sense PT2 Professional meter stores up to 100 results, along with the date and time in its memory. When the 100th result is reached, the first result 1 is replaced (written over) with test results for test number 101. This continues with the oldest result being replaced with the most recent. Memory is not lost if there is a break in power for any length of time. Memory cannot be erased.
Action Meter Display
The memory can be accessed from any mode that displays a MEM button.
1. Press MEM. The meter
displays the last two records.
2. Press PREV or NEXT to
scroll through the result records.
3. Press DONE when finished.
Example of display with two most recent records:
2/07/17 12:56 PM INR 5.2 PT 49.1
2/06/17 12:56 PM INR 2.9 PT 28.8
NEXT PREVDONE
Page 40 For In Vitro Diagnostic Use CoaguSense, Inc.
13. Printing
With the optional portable printer and cable, results from the Coag-Sense meter memory can be printed on either thermal paper or other media such as thermal labels for applying to patient charts.
What you’ll need:
Coag-Sense meter
running software version 3.94 or greater
Pocket Printer,
Catalog # TBD thermal portable printer
Thermal Paper,
Catalog # PD99906-OM or 2” wide thermal labels
Printing Test Results:
CoaguSense, Inc. For In Vitro Diagnostic Use Page 41
1. Refer to the User Manual provided with the printer for general operation.
2. Connect the cable to the back side of the Coag-Sense meter, and the other connector to the printer.
3. When printing is required, turn on the printer after the Coag-Sense meter has finished testing.
4. Press MEM. The two most recent results in memory will be shown. If you wish to go further back into the meter’s memory to print a result press NEXT. Continue to press NEXT until the desired result(s) are visible in the display. Press PREV if you need to scroll back to more recent results.
5. Once you have the result(s) you wish to print displayed, press PRINT then press PRN1 to print the top result displayed or PRN2 to print the bottom result displayed.
If the results fail to print, confirm that the printer is on as it automatically turns off after a few minutes. If the printer turns off after attempting to print, then the batteries in the printer are too weak and should be replaced.
For assistance with the printing function call Technical Support at 1-866-903-0890.
Page 42 For In Vitro Diagnostic Use CoaguSense, Inc.
14. Control Strips
Quality control is an important part of PT testing to verify the integrity of the performance characteristics of the testing system. The Coag-Sense Meter has been designed with multiple internal systems to ensure proper system function. When turned on, the meter runs an extensive self-check protocol to assure, for example, that room temperature, timing functions, optical and mechanical functions are within specification. There are 2 low control strips, 2 high control strips and a control strip activation solution shipped with each test strip kit. Each control strip contains plasma of known INR. Real plasma allows for a fully functional liquid quality control test of both the reagents’ ability to generate a clot and the analyzer’s ability to detect a clot. Control testing confirms the performance of both the meter and test strips and should be completed for each new lot of test strips.
15. Rechargeable Lithium Battery
Description and statements to be added.
CoaguSense, Inc. For In Vitro Diagnostic Use Page 43
16. Cleaning and Disinfecting the Meter
No maintenance is required other than routine cleaning and/or disinfecting. To clean the outside of the meter use a clean damp non-abrasive cloth.
If instructions for use are properly followed, patients should not come in direct contact with the Coag-Sense PT2 Professional meter thereby reducing the possible transmission of bloodborne pathogens between patients. Sample should always be transferred from the patient to the meter using a new disposable sample transfer tube.
The meter housing can be disinfected using a 10% bleach solution (EPA reg. No. 5813-50) or 70% isopropyl alcohol. Apply the disinfecting product to a lint-free cloth and wipe the meter for a minimum contact time of 2 minutes. Alcohol prep pads may also be used.
Placementonwhereto cleanoutsidemeter
The test strip is designed to contain the patient sample, preventing it from entering the meter. Do not clean/disinfect inside the meter where the test strip is inserted, cleaning this area
Page 44 For In Vitro Diagnostic Use CoaguSense, Inc.
should be avoided. Please call Technical Support at 1-866-903-0890 if this area requires cleaning/disinfecting.
After disinfecting the meter, gloves should be removed and hands washed before proceeding to the next patient.
Please call Technical Support at 1-866-903-0890 with any cleaning or disinfecting questions.
WARNING:
Do not put the meter in liquid. Do not allow liquids to get inside the meter or into any of the connectors or plugs on the meter. If you suspect any physical damage or deterioration of the meter (such as cracking or gross distortion), or if the meter does not turn on after cleaning, call Technical Support.
Always refer to local, state and federal disinfecting guidelines. More information on bloodborne pathogen safety and proper disinfecting techniques can be found at:
“FDA Public Health Notification: Use of Fingerstick Devices on More than One Person Poses Risk for Transmitting Bloodborne Pathogens: Initial Communication” (2010)
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm224025 .htm
“CDC Clinical Reminder: Use of Fingerstick Devices on More than One Person Poses Risk for Transmitting Bloodborne Pathogens” (2010)
http://www.cdc.gov/injectionsafety/Fingerstick-DevicesBGM.htm
CoaguSense, Inc. For In Vitro Diagnostic Use Page 45
17. Troubleshooting
You may see the following error messages while using the Coag-Sense meter. This section discusses how to resolve most problems that you might encounter. If you have any questions or problems during the troubleshooting process, note the display wording and contact Technical Support at 866-903-0890 or email techsupport@coagusense.com.
Meter Display Possible Cause Solution
REMOVE STRIP
NO SAMPLE DETECTED
Meter turned off with used strip in it.
If no strip present possible shipment damage.
Either no sample or not enough sample was applied to the strip within 2 after the “Apply Sample” message was displayed. This can also happen if sample is applied on the strip but outside of the sample application well.
1/2 minutes
Remove the strip and begin again.
Call Technical Support
Repeat the entire procedure (including fingerstick on a different finger) with a new strip.
Apply the sample
within 2 after display of the “Apply Sample” message.
Ensure that the
transfer tube touches the sample well before dispensing sample.
1/2 minutes
Page 46 For In Vitro Diagnostic Use CoaguSense, Inc.
Meter Display Possible Cause Solution
CLOT TIME TOO SHORT
The clotting time was very short and out of testing range (<8 seconds).
An air bubble was detected in the sample.
Lancing the finger before ¨Apply Sample¨ displayed on screen.
Taking too long to collect the sample in transfer tube (make sure of using 21g needle lancet for good flow of blood).
Repeat the entire procedure (including fingerstick on a different finger) with a new strip.
Verify that the Sample Transfer Tubes exhibit proper capillary action.
Visually confirm that no air bubbles are in the sample before applying to test strip.
Gently squeeze the transfer tube bulb until the blood exits being sure not to introduce air bubbles.
If the same message repeats, contact Technical Support.
CoaguSense, Inc. For In Vitro Diagnostic Use Page 47
Meter Display Possible Cause Solution
NO CLOT DETECTED
The sample clotting time was very long and out of testing range.
There was insufficient sample transferred to the test strip. Possible causes include; improper lancing (21g lancet required), an air bubble in the sample, not allowing sample to completely fill glass portion of transfer tube, or the sample was drawn back into the transfer tube before removing tip from the test strip well.
Confirm that the patient has not recently taken heparin or other contraindicated drugs listed on the test strip package insert.
Verify that the Sample Transfer Tubes exhibit proper capillary action.
Visually confirm that no air bubbles are in the sample and that the glass portion of the transfer tube is full before applying to test strip.
Release pressure on the transfer tube bulb only after removing transfer tube from sample application well.
Repeat the entire procedure (including fingerstick) with a new strip. If the same message displays, use an alternative testing method and contact Technical Support.
Page 48 For In Vitro Diagnostic Use CoaguSense, Inc.
Meter Display Possible Cause Solution
TEST STRIP EXPIRED SEE MANUAL
CONTROL OUT OF RANGE
ROOM TEMP INCORRECT SEE MANUAL
The lot of strips has expired.
Date is incorrect.
The control strip result is outside of its acceptable range. This may be due to a problem with the shipment/storage of the control strips or the control activation solution. Plasma on control strips has a limited shelf life and the clotting time will change when exposed to temperatures outside the storage range.
The temperature of the room is either below or above the operating temperature range of the meter.
Use a different lot of strips that has not expired.
Verify the date setting on the meter is current.
Repeat test with another control strip. If the second test is out of range, contact Technical Support.
Control strips should be tested immediately upon receipt of your shipment of new test strips as they have a limited shelf life.
This does not indicate meter malfunction.
Move the meter to a place that is within the operating temperature range of the meter (65ºF to 90ºF, 18ºC to 32ºC) and allow meter time to adjust to correct temperature. Repeat testing.
CoaguSense, Inc. For In Vitro Diagnostic Use Page 49
Meter Display Possible Cause Solution
WHEEL PROBLEM
BAR CODE READ FAILURE
The test strip was not inserted fully or may have been inserted at an incorrect angle or incorrect speed.
There may be a problem with the wheel on the strip or with the meter.
The strip was inserted at an incorrect angle or speed.
There may be a problem with the bar code on the strip or with the bar code reader in the meter.
The meter is in direct sunlight or near a high-intensity light source.
Reinsert the strip holding the back of the meter steady with one hand while inserting the strip completely using a quick smooth motion with the other hand. If display persists, try again with another new strip.
If the message displays again, contact Technical Support.
Take the strip out and reinsert holding the back of the instrument steady with one hand while inserting the strip completely with the other hand. Insert the strip using a quick smooth motion.
Move the meter indoors into room lighting or away from light source.
If error persists, try again with another strip. If the message displays again, contact Technical Support.
Page 50 For In Vitro Diagnostic Use CoaguSense, Inc.
Meter Display Possible Cause Solution
HEATER PROBLEM
DETECT PROBLEM
The meter is too warm or too cold, or there may be a problem with the meter.
There may be a problem with the strip insertion or with the motor carriage in the meter.
Move the meter to a place that is within the operating temperature range of the meter (57ºF to 90ºF, 14ºC to 32ºC) and allow meter time to adjust to correct temperature. Repeat testing.
Turn meter off then on again after 5-7 minutes
Try again with another strip.
If the display persists, contact Technical Support.
Take the strip out and reinsert holding the back of the instrument steady with one hand while inserting the strip completely with the other hand. Insert the strip using a quick smooth motion.
Try again with another strip.
If the message persists, contact Technical Support.
CoaguSense, Inc. For In Vitro Diagnostic Use Page 51
Meter Display Possible Cause Solution
LIQUID PROBLEM
MOTOR PROBLEM
There may be a problem with the strip or with the optical system of the meter.
There may be a problem with the motor function of the meter.
Take the strip out and reinsert holding the back of the instrument steady with one hand while inserting the strip completely with the other hand. Insert the strip using a quick smooth motion.
Try again with another strip.
If the message persists, contact Technical Support.
Turn the meter off then back on. Try again with another strip. If the message persists, contact Technical Support.
Page 52 For In Vitro Diagnostic Use CoaguSense, Inc.
18. Performance Characteristics
Expected Values: Results are reported in INR units equivalent to
the plasma reference method. For PT testing, variations in the source of thromboplastin may cause some differences in results between methods. It is recommended that the same method be used to monitor the anticoagulation therapy over time.
Measuring Range: INR 0.8 to 8.0
Normal Range: The following example represents a common
normal range for the Coag-Sense PT/INR system.
INR: 0.7 to 1.2 PT: 8.0 to 15.0
CoaguSense, Inc. For In Vitro Diagnostic Use Page 53
19. Meter Specifications
Operating Temperature 65°F to 90°F (18°C to 32°C)
Operating Humidity 10% to 85% (without condensation)
Storage Temperature -4°F to 122°F (-20°C to 50°C)
Storage Humidity 10% to 85% (without condensation)
Memory
Lithium Battery
AC Input
Power Output 5.0V, 2.0A
Blood Sample Size 10-12 µL
Ports USB, Micro USB, Ethernet
Size 1.2” x 3.9” x 5.9”
Weight 0.67 lbs.
Equipment Classification Class II with external power supply.
Capable of storing 100 tests with time and date
Rechargeable lithium polymer battery (3.7V, 2350mAh)
120V AC (Use with Coag-Sense Adapter Only)
Internally powered when operated with batteries. IPXO rating.
WARNING:
Use only the Coag-Sense AC adapter or damage to the meter may result.
Page 54 For In Vitro Diagnostic Use CoaguSense, Inc.
20. Warranty
Limited One (1) Year Warranty
Use of the Coag-Sense PT2 Professional PT/INR Monitoring System
The Coag-Sense PT2 Professional PT/INR monitoring system is designed for use in monitoring patients on oral anticoagulant therapy. Proper adherence to the instructions in this User Manual and package insert are critical to proper operation. WARNING:
Failure to comply with the User Manual could lead to inaccurate PT/INR results which could lead to incorrect medication dosing which could lead to injury or death.
Limited Warranty
CoaguSense warrants that the Coag-Sense meter is free from all defects in material and workmanship for a period of one (1) year from date of purchase. When the meter is used for the intended purpose and in the appropriate manner, the remedy is repair or replacement at CoaguSense’s option. The warranty does not apply to a meter damaged by misuse, alteration or tampering to either the hardware or software. Contact Technical Support at 1-866-903-0890 for instructions.
THIS WARRANTY APPLIES ONLY TO THE METER. COAGUSENSE’S ENTIRE LIABILITY IN CONNECTION WITH THE METER, REGARDLESS OF THE LEGAL OR EQUITABLE BASIS OF ANY CLAIM, IS LIMITED TO THE PURCHASE PRICE OF THE METER. IN NO EVENT SHALL COAGUSENSE, INC. BE LIABLE TO THE PURCHASER FOR ANY INCIDENTAL, CONSEQUENTIAL (INCLUDING BUT NOT LIMITED TO LOSS OF INCOME OR PROFITS) SPECIAL, INDIRECT, OR PUNITIVE DAMAGES ARISING FROM OR IN ANY WAY CONNECTED
CoaguSense, Inc. For In Vitro Diagnostic Use Page 55
WITH THE PURCHASE OR OPERATION OF THE METER OR ITS PARTS. NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE IS IMPLIED FROM THE SALE OF THE COAG-SENSE PT/INR SYSTEM. NO WARRANTY, EXPRESS OR IMPLIED (IF ANY) SHALL EXTEND FOR A LONGER DURATION THAN THE DURATION OF THE EXPRESS WARRANTY STATED ABOVE.
Instructions for Meter or Product Return
Upon review and agreement with CoaguSense Technical Service, you may be directed to return the unit. Should this occur, clean the outside surface using 10% bleach solution as described in the “Cleaning and Disinfecting the Meter” section. The original packaging may be required for this purpose. If this is not available, a cushioned shipping box may be required.
Page 56 For In Vitro Diagnostic Use CoaguSense, Inc.
21. Index
A
AC Adapter, 20 AC Power, 41,42 Air Bubbles, 30 Alcohol Wipe, 33
B
Bar Code Read Failure, 50 Blood Flow, 33 Blood- Minimum Amount, 36
C
Calibration, 8 Class II Equipment, 18 Cleaning the Meter, 44 Clock, 21 Clot Time Too Long, 48 Clot Time Too Short, 47 Collecting a Fingerstick Sample,
33 Control Out of Range, 49 Control Strips, 41 Customer Service, 3, 19, 60
D
Date, 20, 21, 31, 38, 41 Detect Problem, 51
E
E-Mail Support, 60 Expected Values, 53
F
Fingerstick Sample, 33 Flashing Green Light, 29
H
Hazards And Symbols, 18 Heater Problem, 51 High Control Strip, 22, 26
I
IEC 60601-1, 15 INR, 8 INR Results, 30
L
Lancet, 14, 36 Liquid Problem, 52
Lithium Polymer Battery 42
Low Control Strip, 22
M
Measuring Range, 53 Memory, 31, 38 Meter, 10, 14 MiniPipette, 24 Motor Problem, 52
N
No Sample Detected, 46 Normal Range, 53
P
Performing a Control Test, 22 Performing a Patient Test, 27 Power, 38 Printing, 39 PT, 30 PT Test Strip, 27
CoaguSense, Inc. For In Vitro Diagnostic Use Page 57
R
Remove Strip, 46 Room Temp Incorrect, 49
S
Sharps Container, 33 System Description, 8
T
Test Strip, 11
Troubleshooting, 46
U
Unexpected Results, 32, 34
W
Warnings and Precautions, 12 Warranty, 55 Wheel Problem, 49
Page 58 For In Vitro Diagnostic Use CoaguSense, Inc.
FCC Statement
Federal Communication Commission Interference
Statement
This equipment has been tested and found to comply with
the limits for a Class B digital device, pursuant to Part 15 of
the FCC Rules. These limits are designed to provide
reasonable protection against harmful interference in a
residential installation. This equipment generates, uses and
can radiate radio frequency energy and, if not installed and
used in accordance with the instructions, may cause
harmful interference to radio communications. However,
there is no guarantee that interference will not occur in a
particular installation. If this equipment does cause harmful
interference to radio or television reception, which can be
determined by turning the equipment off and on, the user is
encouraged to try to correct the interference by one of the
following measures:
Reorient or relocate the receiving antenna.
Increase the separation between the equipment and
receiver.
Connect the equipment into an outlet on a circuit different
from that to which the receiver is connected.
Consult the dealer or an experienced radio/TV technician
for help.
This device complies with Part 15 of the FCC Rules.
Operation is subject to the following two conditions: (1) This
device may not cause harmful interference, and (2) this
device must accept any interference received, including
interference that may cause undesired operation.
FCC Caution: Any changes or modifications not expressly
approved by the party responsible for compliance could void
the user’s authority to operate this equipment.
This device and its antenna(s) must not be co-located or
operation in conjunction with any other antenna or
transmitter.
For product available in the USA/Canada market, only
channel 1~11 can be operated. Selection of other channels
is not possible.
This device is going to be operated in 5.15~5.25GHz
frequency range, it is restricted in indoor environment only.
IMPORTANT NOTE:
FCC Radiation Exposure Statement:
This equipment complies with FCC radiation exposure limits
set forth for an uncontrolled environment.
This equipment should be installed and operated with
minimum distance 20cm between the radiator & your body.
서식 있음: 영어(미국)
Technical Support
CoaguSense, Inc. 48377 Fremont Blvd., STE 113 Fremont, CA 94538 Toll Free: 1-866-903-0890
E-Mail
:
techsupport@coagusense.com
i-SENS, Inc. www.i-sens.com 43, Banpo-daero 28-gil, Seocho-gu, Seoul 06646, Korea
EMERGO EUROPE Prinsessegracht 20 2514 AP, The Hague The Netherlands
Product Made in U.S.A
. Korea
REF Part No. 100220200220 CSI P/N 100220 200220 Rev AHDRAFT
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