Professional Documents
Culture Documents
Introduction
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Customer Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Proprietary Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Patent Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii Instrument Disclaimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii Pictorial Disclaimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii Abbott Instrument Warranty . . . . . . . . . . . . . . . . . . . . . . . . iii Safety Agency Approvals . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Trademark Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Instrument Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii Conventions Used in This Manual . . . . . . . . . . . . . . . . . . . xiii Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Revision Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi Revision Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix
Chapter 2: Installation
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1 Initial Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3 Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3 Package Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3 Space Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4 Waste Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5 Power Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
Printer Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-7 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7 Ticket Printer Installation Procedure . . . . . . . . . . . . . . . . 2-10 Sample Loader Set Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12 Instrument Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15 Relocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-19
Introduction to WBC Flagging . . . . . . . . . . . . . . . . . . . . . 3-42 Cell Populations and Flagging . . . . . . . . . . . . . . . . . . . . . 3-45 Flagging Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-49 WBC Descriptors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-49 Suspect Parameter Flags . . . . . . . . . . . . . . . . . . . . . . . . . . 3-50 Suspect Population Flags . . . . . . . . . . . . . . . . . . . . . . . . . 3-54 Flagging Diagnostics Screen . . . . . . . . . . . . . . . . . . . . . . . 3-59 Interpretive Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-60 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-63
Sample Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-89 Instrument Start Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-92 Sample Analysis Using the SL Model . . . . . . . . . . . . . . . . 5-92 Sample Analysis Using the CS Model . . . . . . . . . . . . . . . . 5-99 Using The Work List . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-103 Sample Analysis Using the Work List . . . . . . . . . . . . . . . 5-114 Using The Data Log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-121 Data Log Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-122 Data Log Set Up Procedures . . . . . . . . . . . . . . . . . . . . . . 5-135 Data Review from the Data Log . . . . . . . . . . . . . . . . . . . 5-140 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-143
Chapter 6: Calibration
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-1 When to Calibrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1 Open and Closed Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Calibration Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3 Calibration Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3 Calibration Procedural Summary . . . . . . . . . . . . . . . . . . . 6-11 Conventions Used in this Chapter . . . . . . . . . . . . . . . . . . 6-11 Calibration Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-13 Calibration Menu Flowchart . . . . . . . . . . . . . . . . . . . . . . 6-13 Calibration Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-14 Open Sampler/Closed Sampler Soft Key . . . . . . . . . . . . . 6-15 Print Soft Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-15 Main Soft Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-16 Enter Factor Soft Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-16 Calibration Log Soft Key . . . . . . . . . . . . . . . . . . . . . . . . . . 6-18 Auto-Calibrate Soft Key . . . . . . . . . . . . . . . . . . . . . . . . . . 6-19 Pre-Calibration Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-27 Calibration Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-27 Pre-Calibration Procedures Checklist . . . . . . . . . . . . . . . . 6-29 Auto-Cal Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-33 Auto-Cal Sample Capacity . . . . . . . . . . . . . . . . . . . . . . . . 6-34 Auto-Cal Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-34 Calibration Requirements for Auto-Cal . . . . . . . . . . . . . . 6-35 Auto-Cal Using Calibrator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-37 Starting Auto-Cal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-37 Entering the Reference Values . . . . . . . . . . . . . . . . . . . . . 6-37 Collecting the Calibration Data . . . . . . . . . . . . . . . . . . . . 6-38 Calibration Factor Calculation . . . . . . . . . . . . . . . . . . . . . 6-40 Determining Which Parameters Need Calibration . . . . . 6-41 Calibrating All Parameters . . . . . . . . . . . . . . . . . . . . . . . . 6-43 Calibrating Individual Parameters . . . . . . . . . . . . . . . . . . 6-44 Completing Open Mode Calibration . . . . . . . . . . . . . . . . 6-44 Auto-Cal Calibration Criteria Worksheet . . . . . . . . . . . . . 6-45
Auto-Cal Using Whole Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-47 Starting Auto-Cal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-47 Entering the Reference Values . . . . . . . . . . . . . . . . . . . . . 6-48 Collecting the Calibration Data . . . . . . . . . . . . . . . . . . . . 6-48 Calibration Factor Calculation . . . . . . . . . . . . . . . . . . . . . 6-50 Determining Which Parameters Need Calibration . . . . . 6-52 Calibrating All Parameters . . . . . . . . . . . . . . . . . . . . . . . . 6-54 Calibrating Individual Parameters . . . . . . . . . . . . . . . . . . 6-55 Completing Whole Blood Open Mode Calibration . . . . . 6-55 Auto-Cal Calibration Criteria Worksheet . . . . . . . . . . . . . 6-57 Manual Calibration Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-59 Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-60 Manual Calibration Procedure Open Mode. . . . . . . . . . . . . . . 6-61 Preparing for Manual Calibration . . . . . . . . . . . . . . . . . . 6-61 Determining the Open Mode Mean . . . . . . . . . . . . . . . . . 6-61 Calibration Factor Calculations . . . . . . . . . . . . . . . . . . . . 6-62 Determining Which Parameters Need Calibration . . . . . 6-63 Calibrating the Open Mode . . . . . . . . . . . . . . . . . . . . . . . 6-65 Completing Manual Calibration . . . . . . . . . . . . . . . . . . . 6-66 Manual Calibration Worksheet . . . . . . . . . . . . . . . . . . . . 6-68 Mode To Mode Calibration Overview . . . . . . . . . . . . . . . . . . . . . 6-71 Auto-Cal Mode to Mode Calibration . . . . . . . . . . . . . . . . 6-71 Manual Mode to Mode Calibration . . . . . . . . . . . . . . . . . 6-72 Mode to Mode Calibration Preparation . . . . . . . . . . . . . . 6-72 Closed Mode Calibration Confirmation . . . . . . . . . . . . . 6-72 Mode To Mode Auto-Cal Calibration (Closed Sampler Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-73 Determining Reference Values . . . . . . . . . . . . . . . . . . . . . 6-73 Starting Auto-Cal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-74 Entering the Reference Values . . . . . . . . . . . . . . . . . . . . . 6-74 Collecting the Calibration Data . . . . . . . . . . . . . . . . . . . . 6-75 Calibration Factor Calculation . . . . . . . . . . . . . . . . . . . . . 6-77 Determining Which Parameters Need Calibration . . . . . 6-78 Calibrating All Parameters . . . . . . . . . . . . . . . . . . . . . . . . 6-80 Calibrating Individual Parameters . . . . . . . . . . . . . . . . . . 6-81 Completing Mode to Mode Calibration . . . . . . . . . . . . . . 6-82 Optional Calibration Confirmation . . . . . . . . . . . . . . . . . 6-82 Mode to Mode Auto-Cal Calibration Criteria Worksheet 6-83 Manual Mode to Mode Calibration (CS or SL) . . . . . . . . . . . . . . 6-85 Preparing for Manual Mode to Mode Calibration . . . . . . 6-85 Determining the Open Mode Mean . . . . . . . . . . . . . . . . . 6-85 Determining the Closed Mode Mean . . . . . . . . . . . . . . . . 6-86 Percent Difference Calculation . . . . . . . . . . . . . . . . . . . . 6-87 Determining Which Parameters Need Calibration . . . . . 6-88 Calibration Factor Calculation . . . . . . . . . . . . . . . . . . . . . 6-90 Calibrating the Closed Mode . . . . . . . . . . . . . . . . . . . . . . 6-90
Completing Mode to Mode Calibration . . . . . . . . . . . . . . 6-91 Optional Calibration Confirmation . . . . . . . . . . . . . . . . . 6-91 Manual Mode to Mode Calibration Worksheet . . . . . . . . 6-93 Post-Calibration Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-95 Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-95 Calibration Backup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-95 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-99
Chapter 8: Hazards
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-1 Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1 Warning Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1 Hazard Information and Precautions. . . . . . . . . . . . . . . . . . . . . . .8-3 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3 Biohazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3 Handling and Disposing of Biohazardous Materials . . . . . 8-4 Chemical Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4 Electrical Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-5 Physical and Mechanical Hazards . . . . . . . . . . . . . . . . . . . 8-6 Laser Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Chapter 9: Maintenance
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1 Preventive Maintenance Schedule . . . . . . . . . . . . . . . . . . . 9-2 Analyzer Flow Panel Components Diagram . . . . . . . . . . . . 9-2 Decontamination Procedures . . . . . . . . . . . . . . . . . . . . . . . 9-4 Special Protocols Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-5 Emptying the Transducers . . . . . . . . . . . . . . . . . . . . . . . . . 9-6 Draining the Reagent Reservoirs . . . . . . . . . . . . . . . . . . . . 9-7 Accessing the Maintenance Log . . . . . . . . . . . . . . . . . . . . . 9-8 Accessing the Shear Valve . . . . . . . . . . . . . . . . . . . . . . . . . . 9-9
Disabling/Enabling the Analyzer . . . . . . . . . . . . . . . . . . . . 9-9 Special Protocols Screen #2 . . . . . . . . . . . . . . . . . . . . . . . 9-10 Maintenance Log Set Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-13 Interval Set Up Procedure . . . . . . . . . . . . . . . . . . . . . . . . . 9-15 Update Maintenance Log Procedure . . . . . . . . . . . . . . . . 9-16 Daily Maintenance Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . 9-19 Auto-Clean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-19 Sample Loader Aspiration Needle . . . . . . . . . . . . . . . . . . 9-21 Closed Sampler Aspiration Needle . . . . . . . . . . . . . . . . . . 9-22 Weekly Maintenance Procedures . . . . . . . . . . . . . . . . . . . . . . . . . 9-23 Shear Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-23 Sample Aspiration Peristaltic Pump Tubing . . . . . . . . . . . 9-26 Sample Loader Tray, Racks, and Safety Cover . . . . . . . . . 9-27 Extended Auto Clean . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-28 Monthly Maintenance Procedures . . . . . . . . . . . . . . . . . . . . . . . . 9-29 Reagent Syringes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-29 Analyzer Air Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-32 WOC Transfer Peristaltic Pump Tubing . . . . . . . . . . . . . . 9-33 Extended Auto-Clean . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-35 As Required. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-37 10-mL Reagent Syringe . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-37 Aperture Plates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-39 Hemoglobin Flow Cell Manual Cleaning . . . . . . . . . . . . . 9-43 Unclogging the Open Sample Aspiration Probe . . . . . . . 9-45 Bar Code Reader Window . . . . . . . . . . . . . . . . . . . . . . . . . 9-46 Flushing the Y Fitting Open and Closed Modes . . . . 9-47 Special Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-51 Closed Sampler Tube Retainer Adjustment (CS System Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-51 Preparation for Inactivity or Shipping . . . . . . . . . . . . . . . 9-52 Repackaging for Shipment . . . . . . . . . . . . . . . . . . . . . . . . 9-54
Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-27 Procedure: MCV or MPV Calibration . . . . . . . . . . . . . . . 13-28 Pre-Calibration Procedures . . . . . . . . . . . . . . . . . . . . . . . 13-28 Determining the Calibration Factors for MCV and MPV 13-29 Entering the Calibration Factor . . . . . . . . . . . . . . . . . . . 13-29 Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-31 Adding New Animal Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-33 Adding a New Configuration File . . . . . . . . . . . . . . . . . . 13-34 Customizing the Display . . . . . . . . . . . . . . . . . . . . . . . . 13-36 Turning on the Gains Template . . . . . . . . . . . . . . . . . . . 13-37 Preparing the Samples . . . . . . . . . . . . . . . . . . . . . . . . . . 13-38 Running the Samples . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-38 Determining the Variance . . . . . . . . . . . . . . . . . . . . . . . 13-39 Baso Box Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-46 Vet Package Suggestions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-49 Examples of Customer-Defined Default Codes . . . . . . . 13-50 Turning The Vet Package Off . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-53 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-55
Bibliography
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bibliography-1
Appendix C
Appendix C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix C-1
List of Figures
List of Figures
Figure 1.1: CELL-DYN 3700SL System. . . . . . . . . . . . . . . . . . . . 1-1 Figure 1.2: CELL-DYN 3700 System . . . . . . . . . . . . . . . . . . . . . 1-5 Figure 1.3: CELL-DYN 3700CS System Analyzer Front View . . 1-6 Figure 1.4: Analyzer Flow Panel Components . . . . . . . . . . . . . 1-9 Figure 1.5: Analyzer Left Side Panel Components . . . . . . . . . 1-14 Figure 1.6: Analyzer Rear Panel Components . . . . . . . . . . . . . 1-17 Figure 1.7: Power Supply Module Voltage Switch Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-18 Figure 1.8: Data Station Front View. . . . . . . . . . . . . . . . . . . 1-19 Figure 1.9: Data Station Rear Components . . . . . . . . . . . . . 1-21 Figure 1.10: Control Button Front View . . . . . . . . . . . . . . . . 1-23 Figure 1.11: Inputs Diagram . . . . . . . . . . . . . . . . . . . . . . . . . . 1-25 Figure 1.12: Caution Label . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-28 Figure 2.1: Data Station Rear Components . . . . . . . . . . . . . . . . 2-8 Figure 2.2: CELL-DYN 3700SL . . . . . . . . . . . . . . . . . . . . . . . . . 2-12 Figure 2.3: Tube Rack Showing Label Placement Locations. . 2-13 Figure 2.4: Left Side Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16 Figure 2.5: Front Flow Panel . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18 Figure 3.1: Volumetric Metering . . . . . . . . . . . . . . . . . . . . . . . Figure 3.2: WOC Flow Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 3.3: WBC Light Scatter . . . . . . . . . . . . . . . . . . . . . . . . . Figure 3.4: Optical Bench Assembly . . . . . . . . . . . . . . . . . . . . Figure 3.5: Mononuclear-Polymorphonuclear Scatter . . . . . . Figure 3.6: Neutrophil-Eosinophil Scatter. . . . . . . . . . . . . . . . Figure 3.7: Mononuclear Scatter . . . . . . . . . . . . . . . . . . . . . . . Figure 3.8: WBC Histograms . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 3.9: WBC Data and Scatterplots . . . . . . . . . . . . . . . . . . Figure 3.10: Volumetric Metering . . . . . . . . . . . . . . . . . . . . . . Figure 3.11: RBC Data and Histogram. . . . . . . . . . . . . . . . . . . Figure 3.12: PLT Data and Histogram . . . . . . . . . . . . . . . . . . . Figure 3.13: Flagging Diagnostics Screen . . . . . . . . . . . . . . . . Figure 3.14: Scatterplot with Increased Stroma in the N1 Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11 3-14 3-15 3-17 3-20 3-21 3-22 3-24 3-25 3-28 3-30 3-33 3-41 3-43
Figure 5.1: Data Station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2 Figure 5.2: Main Menu Screen. . . . . . . . . . . . . . . . . . . . . . . . . . 5-3 Figure 5.3: Set Up Menu Screen . . . . . . . . . . . . . . . . . . . . . . . 5-13 Figure 5.4: Date/Time Set Up Screen. . . . . . . . . . . . . . . . . . . . 5-14 Figure 5.5: Patient Limit Set Screen. . . . . . . . . . . . . . . . . . . . . 5-16 Figure 5.6: Diluent Log Screen . . . . . . . . . . . . . . . . . . . . . . . . 5-19
List of Figures
Figure 5.7: QC Set Up Menu Screen . . . . . . . . . . . . . . . . . . . . 5-21 Figure 5.8: QC File Set Up (Lot Number Entry) Screen . . . . . 5-22 Figure 5.9: QC File Set Up (Replicate ID Entry) Screen . . . . . 5-23 Figure 5.10: QC Range Entry Screen . . . . . . . . . . . . . . . . . . . . 5-27 Figure 5.11: QC Means/Limits Entry Screen . . . . . . . . . . . . . . 5-28 Figure 5.12: QC Means/Limits Entry Screen Showing the Update From File Key . . . . . . . . . . . . . . . . . . . . . . . . . . 5-30 Figure 5.13: Customize QC Display Screen. . . . . . . . . . . . . . . 5-32 Figure 5.14: Customize QC Display Screen Showing Standard Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-35 Figure 5.15: Customize QC Printout Screen . . . . . . . . . . . . . . 5-37 Figure 5.16: X-B Set Up Screen . . . . . . . . . . . . . . . . . . . . . . . . 5-40 Figure 5.17: Operation Set Up Menu Screen. . . . . . . . . . . . . . 5-43 Figure 5.18: Bar Code Set Up Screen . . . . . . . . . . . . . . . . . . . . 5-44 Figure 5.19: Computer Set Up Screen . . . . . . . . . . . . . . . . . . . 5-46 Figure 5.20: Units Selection Screen . . . . . . . . . . . . . . . . . . . . . 5-49 Figure 5.21: Customize Displayed Report Screen . . . . . . . . . . 5-52 Figure 5.22: Customize Printed Report Screen for Pre-Printed Tickets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-56 Figure 5.23: Customize Printed Report Screen for Blank Tickets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-58 Figure 5.24: Customize Printed Report Screen for the Graphics Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-61 Figure 5.25: Customize Printout Header Screen for the Graphics Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-64 Figure 5.26: Run Screen for Patient Samples . . . . . . . . . . . . . 5-68 Figure 5.27: Run Screen for Auxiliary Samples . . . . . . . . . . . . 5-70 Figure 5.28: Run Screen Showing Count Times and Flagging Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-73 Figure 5.29: Run Screen Showing Flagging Messages, RBC CLOG Message, and RBC Up Time . . . . . . . . . . . . . . . 5-73 Figure 5.30: Run Screen Showing Bulletin Line Message . . . . 5-74 Figure 5.31: Work List Screen . . . . . . . . . . . . . . . . . . . . . . . . . 5-75 Figure 5.32: Specimen Type Screen. . . . . . . . . . . . . . . . . . . . . 5-77 Figure 5.33: Run Screen for Patient Samples . . . . . . . . . . . . . 5-78 Figure 5.34: Run Screen for a QC File . . . . . . . . . . . . . . . . . . . 5-79 Figure 5.35: Run Screen for Background Counts . . . . . . . . . . 5-80 Figure 5.36: Run Screen for Electrical Background Counts . . 5-81 Figure 5.37: Run Screen for Resistant RBC Specimen Type . . 5-82 Figure 5.38: Auxiliary Specimen Type Screen . . . . . . . . . . . . . 5-83 Figure 5.39: Run Screen for the Auxiliary Specimen Type . . . 5-85 Figure 5.40: Work List Screen . . . . . . . . . . . . . . . . . . . . . . . . 5-104 Figure 5.41: Work List Set Up Screen . . . . . . . . . . . . . . . . . . 5-108 Figure 5.42: Data Log Screen . . . . . . . . . . . . . . . . . . . . . . . . . 5-121 Figure 5.43: Display Specimen Screen . . . . . . . . . . . . . . . . . 5-124 Figure 5.44: Data Log Search Screen . . . . . . . . . . . . . . . . . . . 5-126 Figure 5.45: Data Log Screen Showing Reject From X-B Key 5-127
List of Figures
Figure 5.46: Data Log Screen Showing Accept Into X-B Key Figure 5.47: Customize Display for Data Log Screen . . . . . . Figure 5.48: Customize Display Showing Standard Groups . Figure 5.49: Customize Printout for Data Log Screen . . . . . Figure 5.50: Print Data Log Screen . . . . . . . . . . . . . . . . . . . . Figure 5.51: Customize Display for Data Log Screen Showing Standard Groups . . . . . . . . . . . . . . . . . . . . . . . . Figure 5.52: Customize Printout for Data Log Screen Showing Customized Print Group . . . . . . . . . . . . . . . . . . Figure 5.53: Display Specimen Screen . . . . . . . . . . . . . . . . . Figure 5.54: Edit Specimen Screen . . . . . . . . . . . . . . . . . . . .
Figure 6.1: Calibration Screen Displaying Open Mode Calibration Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 6.2: Calibration Menu Screen Displaying Closed Mode Calibration Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 6.3: Enter Calibration Factor Screen . . . . . . . . . . . . . . Figure 6.4: Calibration Log Screen . . . . . . . . . . . . . . . . . . . . . Figure 6.5: Auto-Calibration Screen for CELL-DYN 3700CS System . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 6.6: Whole Blood Auto-Cal Screen. . . . . . . . . . . . . . . . Figure 6.7: Whole Blood Auto-Cal Screen. . . . . . . . . . . . . . . . Figure 6.8: Whole Blood Auto-Cal Results Screen . . . . . . . . . Figure 6.9: Whole Blood Auto-Cal Results Screen with Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 6.10: Calibrator Auto-Cal Screen . . . . . . . . . . . . . . . . . Figure 6.11: Latex Auto-Cal Screen . . . . . . . . . . . . . . . . . . . . .
6-14 6-15 6-16 6-18 6-19 6-20 6-22 6-23 6-24 6-25 6-26
Figure 7.1: QC Menu Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3 Figure 7.2: The X-B RBC Data Screen . . . . . . . . . . . . . . . . . . . . 7-4 Figure 7.3: The X-B RBC Graphs Screen . . . . . . . . . . . . . . . . . . 7-5 Figure 7.4: The X-B WBC Data Screen. . . . . . . . . . . . . . . . . . . . 7-6 Figure 7.5: The X-B WBC Graphs Screen. . . . . . . . . . . . . . . . . . 7-7 Figure 7.6: The View QC Log Screen . . . . . . . . . . . . . . . . . . . . . 7-8 Figure 7.7: The Levey-Jennings Menu Screen . . . . . . . . . . . . . 7-11 Figure 7.8: QC Log Screen With Rejected Results. . . . . . . . . . 7-12 Figure 7.9: Levey-Jennings Menu Screen Showing Westgard Rule Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18 Figure 8.1: Laser Hazard Label. . . . . . . . . . . . . . . . . . . . . . . . . . 8-8 Figure 8.2: Laser Aperture and Warning Label Position Protective Cover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-8 Figure 8.3: Laser Warning Label Position - Flow Panel. . . . . . . 8-9 Figure 8.4: Class 2 Laser Caution Label. . . . . . . . . . . . . . . . . . . 8-9 Figure 8.5: Class 2 Laser Caution Label Location . . . . . . . . . . . 8-9 Figure 8.6: Laser Label, Rear Panel . . . . . . . . . . . . . . . . . . . . . 8-10 Figure 8.7: Class 1 Laser Product Label Location . . . . . . . . . . 8-10
List of Figures
Figure 9.1: Analyzer Flow Panel Components . . . . . . . . . . . . . 9-3 Figure 9.2: Special Protocols Screen . . . . . . . . . . . . . . . . . . . . . 9-5 Figure 9.3: Reagent Reservoir Screen . . . . . . . . . . . . . . . . . . . . 9-7 Figure 9.4: Special Protocols Screen 2. . . . . . . . . . . . . . . . . . . . 9-9 Figure 9.5: Maintenance Log Screen . . . . . . . . . . . . . . . . . . . . 9-13 Figure 9.6: Interval Set Up Screen . . . . . . . . . . . . . . . . . . . . . . 9-15 Figure 9.7: Update Maintenance Log Screen. . . . . . . . . . . . . . 9-16 Figure 9.8: Special Protocols: Auto-Clean Screen . . . . . . . . . . 9-19 Figure 9.9: Shear Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-23 Figure 9.10: Sample Aspiration Peristaltic Pump . . . . . . . . . . 9-26 Figure 9.11: WOC Syringes and Syringe Assembly . . . . . . . . . 9-29 Figure 9.12: Analyzer Left Side Panel . . . . . . . . . . . . . . . . . . . 9-32 Figure 9.13: WOC Transfer Peristaltic Pump . . . . . . . . . . . . . 9-33 Figure 9.14: Special Protocols: Extended Auto-Clean Screen . 9-35 Figure 9.15: von Behrens Transducer Assembly . . . . . . . . . . . 9-40 Figure 9.16: Transducer Assembly and Aperture Plate . . . . . . 9-41 Figure 9.17: The von Behrens WIC Transducer, HGB Flow Cell, and Solenoid 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-43 Figure 9.18: Open Sample Aspiration Probe . . . . . . . . . . . . . . 9-45 Figure 9.19: Flow Panel Open/Closed Mode Tubing . . . . . . . 9-48 Figure 9.20: Closed Sampler Module . . . . . . . . . . . . . . . . . . . 9-51 Figure 9.21: Analyzer Flow Panel: Accessing Normally Closed Valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-52 Figure 10.1: First Diagnostics Menu Screen . . . . . . . . . . . . . . 10-5 Figure 10.2: Operator Correctable Fault Report Screen . . . . . 10-6 Figure 10.3: Fatal Fault Report Screen. . . . . . . . . . . . . . . . . . . 10-7 Figure 10.4: Fault Report No Fault Pending Screen. . . . . . . 10-7 Figure 10.5: Count Rate Summary Screen. . . . . . . . . . . . . . . . 10-8 Figure 10.6: WOC Count Rate Data (Tabular Format) . . . . . . 10-9 Figure 10.7: WOC Count Rate Graph . . . . . . . . . . . . . . . . . . 10-10 Figure 10.8: Raw Data Summary Screen . . . . . . . . . . . . . . . . 10-11 Figure 10.9: Second Diagnostics Menu Screen . . . . . . . . . . . 10-12 Figure 10.10: Pump Operation Screen . . . . . . . . . . . . . . . . . 10-13 Figure 10.11: Pump Operation Screen Vacuum ON . . . . . 10-14 Figure 10.12: Inhibit Pumps Screen . . . . . . . . . . . . . . . . . . . 10-15 Figure 10.13: Vacuum Test Screen . . . . . . . . . . . . . . . . . . . . 10-16 Figure 10.14: Drain Accumulators Screen . . . . . . . . . . . . . . . 10-17 Figure 10.15: Third Diagnostics Menu Screen . . . . . . . . . . . 10-18 Figure 10.16: Voltage Readings Screen . . . . . . . . . . . . . . . . . 10-19 Figure 10.17: Fourth Diagnostics Menu Screen . . . . . . . . . . 10-20 Figure 10.18: Fifth Diagnostics Menu Screen (CELL-DYN 3700SL System) . . . . . . . . . . . . . . . . . . . . . . . 10-21 Figure 10.19: Auto-Sampler Version Screen . . . . . . . . . . . . . 10-22 Figure 10.20: Serial Test Screen. . . . . . . . . . . . . . . . . . . . . . . 10-23 Figure 10.21: Serial Test Transmit Message Screen Transmit Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-25
List of Figures
Figure 10.22: Sample Loader Vent/Aspiration Needle Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-33 Figure 10.23: Sample Loader Vent/Aspiration Needle Tubing Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-34 Figure 10.24: Volumetric Metering . . . . . . . . . . . . . . . . . . . . 10-50 Figure 12.1: Analyzer with Sample Loader . . . . . . . . . . . . . . . 12-1 Figure 12.2: Rack Movement - Top View . . . . . . . . . . . . . . . . 12-2 Figure 12.3: Tube Labeling Requirements. . . . . . . . . . . . . . . . 12-3 Figure 12.4: Sample Loader . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5 Figure 12.5: Operation Keyboard . . . . . . . . . . . . . . . . . . . . . . 12-6 Figure 12.6: Tower Stations . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7 Figure 12.7: Tube Racks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10 Figure 13.1: Operation Set Up Menu Screen. . . . . . . . . . . . . . 13-9 Figure 13.2: Set Up Menu Screen . . . . . . . . . . . . . . . . . . . . . 13-11 Figure 13.3: Animal Type Set Up Screen . . . . . . . . . . . . . . . . 13-12 Figure 13.4: View Animal Type Set Up Screen . . . . . . . . . . . 13-13 Figure 13.5: Animal Limit Set 1. . . . . . . . . . . . . . . . . . . . . . . 13-14 Figure 13.6: Animal Type Catalog Screen . . . . . . . . . . . . . . . 13-16 Figure 13.7: Catalog Contents, Animal Type Set Up Screen . 13-17 Figure 13.8: Expected Ranges . . . . . . . . . . . . . . . . . . . . . . . . 13-18 Figure 13.9: Run Screen for Animals . . . . . . . . . . . . . . . . . . . 13-21 Figure 13.10: Animal Type Selection Screen . . . . . . . . . . . . . 13-22 Figure 13.11: Specimen Type Screen. . . . . . . . . . . . . . . . . . . 13-23 Figure 13.12: Dog Background Count. . . . . . . . . . . . . . . . . . 13-24 Figure 13.13: Enter Calibration Factor Screen . . . . . . . . . . . 13-28 Figure 13.14: Add New Animal Type Screen . . . . . . . . . . . . . 13-34 Figure 13.15: Customized Display for Adding New Animals 13-36 Figure 13.16: Gains Template . . . . . . . . . . . . . . . . . . . . . . . . 13-37 Figure 13.17: Target Locations for the Neutrophil and Lymphocyte populations . . . . . . . . . . . . . . . . . . . . . . . . . 13-39 Figure 13.18: Set Point Entry Screen . . . . . . . . . . . . . . . . . . . 13-44 Figure 13.19: Baso Box Set Up. . . . . . . . . . . . . . . . . . . . . . . . 13-46 Figure 14.1: Operation Set Up Menu Screen with Reticulocyte Package Disabled . . . . . . . . . . . . . . . . . . . . . . Figure 14.2: Operation Set Up Menu Screen with Reticulocyte Package Enabled. . . . . . . . . . . . . . . . . . . . . . Figure 14.3: Reticulocyte Main Menu Screen . . . . . . . . . . . . Figure 14.4: Reticulocyte Set Up Screen . . . . . . . . . . . . . . . . Figure 14.5: Reticulocyte Patient Limits Screen . . . . . . . . . . Figure 14.6: Reticulocyte QC Set Up Screen . . . . . . . . . . . . . Figure 14.7: Retic QC Range Entry Screen . . . . . . . . . . . . . . Figure 14.8: Retic QC Means/Limits Screen . . . . . . . . . . . . . Figure 14.9: Retic Set Up QC Screen . . . . . . . . . . . . . . . . . . .
List of Figures
Figure 14.10: Operation Set Up Menu Screen with Reticulocyte Package Enabled. . . . . . . . . . . . . . . . . . . . . . 14-27 Figure 14.11: Reticulocyte Units Selection Screen . . . . . . . . 14-28 Figure 14.12: Reticulocyte Data Log Screen . . . . . . . . . . . . . 14-31 Figure 14.13: Reticulocyte Display Specimen Screen . . . . . . 14-33 Figure 14.14: Reticulocyte Data Log Search Screen . . . . . . . 14-35 Figure 14.15: Reticulocyte Data Log Screen Showing the Starting Reticulocyte Sequence Number Field . . . . . . . . . 14-36 Figure 14.16: Reticulocyte Display Specimen Screen . . . . . . 14-37 Figure 14.17: Reticulocyte QC Log Screen . . . . . . . . . . . . . . 14-39 Figure 14.18: View Reticulocyte QC Log Screen . . . . . . . . . . 14-41 Figure 14.19: The Reticulocyte Levey-Jennings Screen. . . . . 14-44 Figure 14.20: View Reticulocyte QC Log Screen with Rejected Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-45 Figure 14.21: Reticulocyte Diagnostics Screen . . . . . . . . . . . 14-48 Figure 14.22: Reticulocyte Count Rate Summary Screen (Tabular Format) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-49 Figure 14.23: Reticulocyte Count Rate Summary Screen (Graphic Format) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-50 Figure 14.24: Reticulocyte Raw Data Summary Screen . . . . 14-51 Figure 14.25: Reticulocyte Special Protocols Screen. . . . . . . 14-53 Figure 14.26: Reticulocyte Run Screen . . . . . . . . . . . . . . . . . 14-57 Figure 14.27: The First Reticulocyte Patient Specimen Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-58 Figure 14.28: The Second Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID is Found) . . . 14-59 Figure 14.29: The Third Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID Found is More Than Eight Hours Old) . . . . . . . . . . . . . . . . . . . . . . 14-60 Figure 14.30: The Fourth Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID Is Not Found) 14-61 Figure 14.31: The Reticulocyte Run Result Screen for a Patient Specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-62 Figure 14.32: Reticulocyte Run Result Screen for a QC Specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-65 Figure 14.33: Reticulocyte Run Result Screen for a Background Specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-66 Figure A.1: Bar Code Label Specifications . . . . . . . . . Appendix A-6 Figure A.2: Tube Labeling Requirements . . . . . . . . . Appendix A-8
List of Tables
List of Tables
Table 3.1: Parameter Flagging Messages . . . . . . . . . . . . . . . . . 3-39 Table 4.1: Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3 Table 4.2: Power Specifications . . . . . . . . . . . . . . . . . . . . . . . . . 4-4 Table 4.3: Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9 Table 4.4: Power Specifications . . . . . . . . . . . . . . . . . . . . . . . . 4-10 Table 4.5: Precision of the Hemogram and Reticulocyte Parameters (N = 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16 Table 4.6: Precision of the WBC Differential Parameters . . . . 4-16 Table 4.7: Linearity Specifications . . . . . . . . . . . . . . . . . . . . . 4-17 Table 4.8: Accuracy of Hemogram Parameters . . . . . . . . . . . . 4-18 Table 4.9: Accuracy of WBC Differential Parameters . . . . . . . 4-19 Table 4.10: Carryover for WBC, RBC, HGB, PLT and Retics . . 4-19 Table 4.11: Typical Precision for Hemogram Parameters. . . . 4-20 Table 4.12: Reference Range for Distributional Flagging . . . . 4-21 Table 4.13: Reference Range for Morphologic Flagging . . . . . 4-21 Table 4.14: Abnormalities Evaluated. . . . . . . . . . . . . . . . . . . . 4-22 Table 4.15: Flagging Analysis Truth Table . . . . . . . . . . . . . . . 4-23 Table 4.16: Analysis of False Negative Results . . . . . . . . . . . . 4-23 Table 5.1: Report Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-50 Table 6.1: Calibration Criteria. . . . . . . . . . . . . . . . . . . . . . . . . Table 6.2: Calibration Criteria. . . . . . . . . . . . . . . . . . . . . . . . . Table 6.3: Calibration Criteria. . . . . . . . . . . . . . . . . . . . . . . . . Table 6.4: Mode to Mode Calibration Criteria . . . . . . . . . . . . Table 6.5: Mode to Mode Calibration Criteria . . . . . . . . . . . . 6-41 6-51 6-63 6-78 6-87
Table 7.1: Troubleshooting X-B RBC. . . . . . . . . . . . . . . . . . . . 7-23 Table 7.2: Default (Preset) X-B WBC Values . . . . . . . . . . . . . . 7-25 Table 13.1: Precision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Table 13.2: Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Table 13.3: Linearity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Table 13.4: Carryover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5 13-6 13-7 13-7
Table 14.1: Potential Interfering Substances. . . . . . . . . . . . . 14-69 Table B.1: CELL-DYN 3700 Accessories Kit (List Number 06H88-01) . . . . . . . . . . . . . . . . . . . . . Appendix B-1 Table B.2: CELL-DYN 3700 Sample Loader Accessories Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix B-2 Table B.3: CELL-DYN 3700 Optional Accessories . . . Appendix B-3 Table B.4: CELL-DYN 3700 Calibrators and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix B-4 Table B.5: CELL-DYN 3700 Reagents. . . . . . . . . . . . . Appendix B-4
CELL-DYN 3700 Operators Manual
List of Tables
NOTES
Introduction
Foreword
We welcome you to the role of Operator of a CELL-DYN 3700 System. Your system, which includes state-of-the-art technology, is designed to function consistently and dependably from day to day. The CELL-DYN 3700 System is backed by dedicated professionals who excel in engineering, medical technology, training, and service. As part of the customer training program, we will teach you to operate, maintain and troubleshoot your System. Abbott Laboratories is dedicated to manufacturing the highest quality, most reliable instrumentation available. We look forward to serving your needs in any way possible.
Customer Service
United States: 1 (877) 4ABBOTT or 1 (877) 422-2688 Abbott Diagnostics Division Customer Service 200 Abbott Park Road Abbott Park, IL 60064, USA Canada: 1 (800) 387-8378 For customers outside the US, call your local Customer Service Representative.
Intended Use
The CELL-DYN 3700 System is a multiparameter, automated hematology analyzer designed for in vitro diagnostic use in clinical laboratories.
Proprietary Statement
The entire contents are copyright 2000, 2003, 2004, and 2007 by Abbott Laboratories. Abbott Laboratories software programs are protected by copyright. All rights are reserved. This software was developed solely for use with Abbott Laboratories equipment and for in vitro diagnostic applications as specified in the operating instructions. No part of this document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical, photocopied, recorded, or otherwise) without the prior written permission of Abbott Laboratories.
Patent Statement
The CELL-DYN 3700 instrument system is covered by one or more of the following US Patents: 4,710,021; 4,726,237; 5,378,633; 5,510,267; 5,733,784; 5,017,497; 5,958,781; and 6,740,527.
Instrument Disclaimer
All operating instructions must be followed. In no event shall Abbott be responsible for failures, errors, or other liabilities resulting from customers noncompliance with the procedures and precautions outlined herein. Abbott has designed the CELL-DYN 3700 System components for optimal performance. Substitution of reagents, calibrators, controls, and components manufactured by other companies may adversely affect the performance of the Analyzer.
Pictorial Disclaimer
All samples (printouts, graphics, displays or screens, etc.) are for information and illustration purposes only and shall not be used for clinical or maintenance evaluations.
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Approved Approved
Trademark Statements
CELL-DYN, and CELL-DYN HemCal are registered trademarks of Abbott Laboratories. MAPSS is a trademark of Abbott Laboratories. CONTRAVES, COULTER, EPSON, EPSON STYLUS, HEMOGARD, Luer-Lok, MICROLINE, OKIDATA, PLEXIGLAS, TEFLON, TYGON, VACUTAINER, and Westgard are not trademarks of Abbott Laboratories.
Symbols
The symbols listed below are used on CELL-DYN labeling, including the instrument, reagents, calibrators, controls, and this manual. Please note that Warning and Caution symbols and statements are in this manual in Chapter 8: Hazards. General Instrument Symbols
Alternating Current Input Protective Conductor (Ground) Terminal Off ON
iv
Alternating Current Input Alarm Auto Loader Auto Sampler Busy Communications Port 1 Communications Port 2 Data Station Emergency Stop Fault Frequency Fuses Hard Disk Drive Hemoglobin Flowcell High Speed Serial Link Initialize Installation Disk Keyboard Line Frequency Select Line Voltage Select First Parallel Printer Port Second Parallel Printer Port Manual Mode Maximum Power Mixing Chamber
MODEL MONITOR PAUSE PERISTALTIC PUMP POWER RBC METERING RBC TRANSDUCER READY REPEAT RESET REV RS232 SERVICE DISK SET-UP DISK SN SOL START TEST INTERFACE TOUCH WASTE WASTE CHAMBER 1 WASTE CHAMBER 2 WASTE SENSOR WIC METERING WIC TRANSDUCER
Model Number Monitor Pause Peristaltic Pump Power RBC Metering Assembly RBC Transducer Assembly Ready Repeat Reset Revision Recommended Specification 232 Service Disk Set-up Disk Serial Number Solenoid Start Test Interface Touch Waste Waste Chamber 1 Waste Chamber 2 Waste Sensor WBC Impedance Count Metering Assembly WBC Impedance Count Transducer Assembly
Reagent related
CN-FREE HGB/WIC LYSE DETERGENT DILUENT ENZYMATIC CLEANER CONCENTRATE HGB HGB LYSE HGB/WIC LYSE LOT SHEATH
8oC 2 oC
Cyanide-Free Hemoglobin/WBC Impedance Count Lyse Reagent Detergent Reagent Diluent Reagent Enzymatic Cleaner Concentrate Hemoglobin Hemoglobin Lyse Reagent Hemoglobin/WBC Impedance Count Lyse Lot Number Sheath Reagent Storage temperature. (Example shows Store at 28C)
Calibrator/Control related
ASSAY VALUE CONTROL CONTROL ASSAY CONTROL L N H CONTROL L CONTROL N CONTROL H CONTROL I CONTROL II MEAN RANGE MEAN VALUE PARAMETER RETIC CONTROL
Assay Value Control Control Assay Disk Control, Tri-Level Control, Low Control, Normal Control, High Control, Level I Control, Level II Mean Range Mean Value Parameter Reticulocyte Control
CELL-DYN 3700 System Operators Manual
vi
Calibrator/Control related
SYSTEM WB CONTROL L WB CONTROL N WB CONTROL H WB CONTROL TRI-LEVEL WB CAL WB CONTROL
System Whole Blood Control, Low Whole Blood Control, Normal Whole Blood Control, High Whole Blood Control, Tri-Level Whole Blood Calibrator Whole Blood Control
Date of Manufacture Authorized Representative For In Vitro Diagnostic Use List Number Separate collection for electrical and electronic equipment waste per Directive 2002/96/EC in the European Union
vii
Instrument Labeling
The following labels are affixed to the CELL-DYN 3700 System: Current CELL-DYN customers instruments are CE Marked to the European Electro-Magnetic Compliance (EMC) and Low-Voltage Directives and have the following labels:
DANGER GEFAHR DANGER PELIGRO PERICOLO
LASER LIGHT WHEN OPEN. BEI OFFENER ABDECKUNG TRITT LASERSTRAHL AUS. RAYON LASER SI OUVERT. RADIACION LASER SI SE ABRE. LUCE LASER SE APERTO.
AVOID DIRECT EXPOSURE TO BEAM. NICHT DIREKT IN DEN LASERSTRAHL BLICKEN. EVITER TOUTE EXPOSITION DIRECTE AU FAISCEAU LASER. NO SE EXPONGA DIRECTAMENTE AL RAYO LASER. EVITARE OGNI ESPOSIZIONE DIRETTA AL RAGGIO.
PN 9230701D
ABBOTT DIAGNOSTICS
A wholly owned subsidiary of Abbott Laboratories Abbott Park IL. 60064
THIS PRODUCT CONFORMS TO THE APPLICABLE REQUIREMENTS OF 21 CFR SUBCHAPTER J AT THE DATE OF MANUFACTURE MANUFACTURED DATE MODEL NO. SERIAL NO. LIST NO.
MADE IN U.S.A.
REV
PN 9230308 REV E
WARNING: SET FOR 120 VOLTS When operation at other line voltage is required, refer to operation manual for detailed instructions. WARNUNG: FUER 120 VOLT EINGESTELLT Ist der Betrieb mit einer anderen Netzspannung erforderlich, entnehmen Sie die genauen Anweisungen der Bedienungsanleitung. MISE EN GARDE : PARAMETRE POUR UTILISATION SUR 120 VOLTS Si une utilisation une tension de rseau diffrente est requise, reportez-vous au Manuel Technique pour de plus amples informations. ADVERTENCIA: CONFIGURADO PARA 120 VOLTIOS Si se necesita otra tensin diferente a la indicada, consulte el Manual de Operaciones para instrucciones ms detalladas. AVVERTENZA: CONFIGURATO PER 120 VOLT Se la tensione di voltaggio diverso, fare riferimento alle istruzioni dettagliate nel Manuale di Impiego. PN 9230003
CE Label
CAUTION: DO NOT HANDLE SOLUTION CONTAINER UNLESS PROPERLY PROTECTED. REFER TO OPERATORS MANUAL FOR INSTALLATION PROCEDURE.
PN 9230334
ix
New CELL-DYN customers instruments are CE Marked to the European In Vitro Diagnostic Directive, which encompasses the requirements of the EMC and Safety Directives, and have the following labels:
THIS PRODUCT CONFORMS TO THE APPLICABLE REQUIREMENTS OF 21 CFR SUBCHAPTER J AT THE DATE OF MANUFACTURE DATE OF MANUFACTURE
MADE IN U.S.A.
PN 9230308 REV G
Biological Risk
PN 9231446
PN 9230751A
AVVERTENZA: CONFIGURATO A 120 VOLT / AVISO: CONFIGURADO PARA 120 VOLTS / ADVARSEL: KONFIGURERET TIL 120 V / VARNING: INST LLD F R 120 VOLT / : 120 VOLTS
WARNING: SET FOR 120 VOLTS / ACHTUNG: F R 120 VOLT EINGESTELLT / MISE EN GARDE : UTILISATION A 120 VOLTS / ADVERTENCIA: 120 VOLTIOS /
Consult instructions for use if different voltage is required. / Ist der Betrieb mit einer anderen Netzspannung erforderlich, in der Bedienungsanleitung nachlesen. / Si une utilisation une tension diff rente est requise, consulter les instructions dutilisation. / Consulte las instrucciones de uso si la tensi n es distinta. / Per un voltaggio diverso, consultare le istruzioni per luso. / Se for necess ria uma voltagem diferente, consultar as instru es de utiliza o. / Se brugermanualen, hvis der er behov for drift med en anden netspnding. / L s tillh rande dokumentation om en annan sp nning beh vs. / , . PN 9230003F
appropri e. PRECAUCI N: no maneje el recipiente de la soluci n a menos que est protegido adecuadamente. ATTENZIONE: Non maneggiare il recipiente della soluzione se non si protetti in modo adeguato. ATEN O: n o manipular o recipiente da solu o sem estar devidamente protegido. VIGTIGT: Beholderen med oplsning m ikke h ndteres, medmindre brugeren er korrekt beskyttet. VIKTIGT: Anv nd skyddskl der vid hantering av l sningsbeh llarna. : . UPOZORNN: Nemanipulujte s ndobou obsahujc roztok, pokud nen dn zabezpeena.
Consult instructions for use. / Gebrauchsanweisung beachten. / Consulter les instructions dutilisation. / Consulte las instrucciones de uso. / Consultare le istruzioni per luso. / Consultar as instru es de utiliza o. / Se brugsanvisningen. / L s tillh rande dokumentation. / . / Viz nvod k pouit.
PN 9230334F
xi
PN 9230751A PN 9230963
CAUTION - CLASS 2 LASER LIGHT WHEN OPEN AND INTERLOCK IS DEFEATED DO NOT STARE INTO THE BEAM PN 9230323
MADE IN U.S.A.
PN 9230010 REV K
xii
SUBMENU KEYS
xiii
Flowchart Conventions
Menus are shown as square-cornered rectangles in the flowcharts, and soft keys are shown as round-cornered rectangles:
MAIN MENU Ready
SET UP
RUN
DATA LOG
QUALITY CONTROL
When procedures are depicted in flowcharts, shaded boxes and bold lines indicate which soft keys to press:
MAIN MENU Ready
SET UP
RUN
DATA LOG
QUALITY CONTROL
PATIENT LIMITS
REAGENT LOG
QC SET UP MENU
OPERATION SET UP
xiv
Safety
The CELL-DYN 3700 System has been designed to minimize hazards to the operator. Operation, maintenance, and servicing of hematology systems may expose individuals to potential safety and health hazards. All work must be performed in accordance with procedures described in the CELL-DYN Operators Manual or as directed by an Abbott Representative. For detailed Safety information refer to Chapter 8: Hazards. Warnings are inserted in this manual to alert personnel to potential hazards. The standard warning conventions including signal words (e.g., Caution) and symbols are described in Chapter 8: Hazards.
xv
Revision Status
Document Control Number(s)
Original Issue (9140320A) 9140320B
Revision Date
12/98 3/99
Section(s) Revised
Not Applicable Chapter 10 Chapter 14
9140320C 9140320D
11/00 6/03
All Master Table of Contents Foreword 1: System Description 2: Installation 3: Principles of Operation 4: System Specifications 5: Operating Instructions
6: Calibration 7: Quality Control 8: Hazards 9: Maintenance 10: Troubleshooting 12: Sample Loader 13: Veterinary Package 14: Reticulocyte
Revision Date
9/2004
Section(s) Revised
Master Table of Contents Foreword 1: System Description 2: Installation 3: Principles of Operation 4: System Specifications 5: Operating Instructions 6: Calibration All All
1-1; 1-6; 1-9; 1-24 through 1-27 2-1; 2-3; 2-5; 2-9; 2-12 and 2-13; 2-15 3-36 through 3-49; 3-55 and 3-56 4-6; 4-11; 4-17; 4-19 5-17 through 5-19; 5-50; 5-87 through 5-89; 5 103; 5-110; 5-123 6-1; 6-3; 6-30; 6-35; 6-38; 6-53; 6-57; 6-64; 6-68 and 6-69; 6-79; 6-82 and 6-83; 6-89 and 6-90; 6-92 through 6-96 7-15 through 7-19; 7-23; 7-26 9-2 and 9-3; 9-19 and 9-20; 9-23; 9-26 and 9-27; 9-29 and 9-30; 9-32 through 9-34; 9-36 and 9-37; 9-40; 9-43; 9-45 and 9-46; 9-48; 9-52; 9-54 10-23; 10-25; 10-28; 10-32; 10-34 through 10-37; 10-42; 10-57 and 10-58; 10-60 through 10-65; 10-76; 10-78 through 10-87 11-4; 11-6; 11-13 12-1 and 12-3 13-8 14-14; 14-32 through 14-34; 14-69; 14-71; 14-82 7 and 8 1 and 2; 4 New
10: Troubleshooting
11: Printers 12: Sample Loader 13: Veterinary Package 14: Reticulocyte Appendix A Appendix B Appendix C
xvii
Revision Date
4/2007
Section(s) Revised
Master Table of Contents List of Figures List of Tables Foreword 1: System Description 2: Installation 3: Principles of Operation 4: System Specifications 5: Operating Instructions 6: Calibration 7: Quality Control 9: Maintenance 10: Troubleshooting 11: Printers 13: Veterinary Package 14: Reticulocyte Bibliography Appendix B Index All All All
i through iv; vi and vii, x, xviii through xx 1-5; 1-19 through 1-21; 1-23 through 1-32 2-7 through 2-20 3-1 through 3-20; 3-36; 3-39; 3-43 through 3-64 4-15; 4-17; 4-20; 4-23; 4-25 5-88; 5-90 through 5-91; 5-143 6-5 and 6-6; 6-29; 6-35; 6-99 7-9; 7-16 through 7-17 9-54 10-61 All 13-8 14-7 and 14-8; 14-68; 14-69; 14-71; 14-77 and 14-78; 14-83 All B-4 All
xviii
Revision Log
Instructions: Use this log to provide a permanent record to verify that revised chapter(s) and/or page(s) have been added to this manual. 1. Record the document control number of the revised section in the first column. You will find the number in the footer. Make an entry for each chapter you receive and place in the manual. 2. Record the revision date, also found in the footer, in the second column. 3. Record the current CELL-DYN 3700 System software version in the third column. 4. Write your initials or signature in the fourth column to verify that you have placed the revised page(s) in the manual. 5. Record the date that you added the revised section to the manual in the fifth column.
Revision Date
Software Version
Revision Incorporated by
Date Incorporated
xix
NOTES
xx
Chapter 1
System Description
System Description
Overview
The CELL-DYN 3700 System is a multi-parameter, automated hematology analyzer designed for in vitro diagnostic use in clinical laboratories. The instrument has two versions: the CELL-DYN 3700SL System with an automated Sample Loader and the CELL-DYN 3700CS System with a manual Closed Sampler.
Figure 1.1:
The CELL-DYN 3700SL System is equipped with an automated Sample Loader module. The Sample Loader provides continuous closed sampling for up to 100 tubes at a time. (See the preceding figure.) The CELL-DYN 3700CS System is equipped with a built-in manual Closed Sample Aspiration Module referred to as the Closed Sampler. The Closed Sampler aspirates blood from a closed collection tube that has been inserted in the Closed Sampler Module.
1-1
System Description
Overview
Chapter 1
NOTES
1-2
Chapter 1
System Description
Intended Use
The CELL-DYN 3700 System generates the following hematologic measurements on EDTA-anticoagulated whole blood: WBC White Blood Cell or Leukocyte count NEU Neutrophil absolute count LYM Lymphocyte absolute count MONO Monocyte absolute count EOS Eosinophil absolute count BASO Basophil absolute count %N Neutrophil percent %L Lymphocyte percent %M Monocyte percent %E Eosinophil percent %B Basophil percent
RBC Red Blood Cell or Erythrocyte count HGB Hemoglobin concentration HCT Hematocrit MCV Mean Corpuscular Volume MCH Mean Corpuscular Hemoglobin MCHC Mean Corpuscular Hemoglobin Concentration RDW Red Cell Distribution Width PLT Platelet or Thrombocyte count MPV Mean Platelet Volume PDW* Platelet Distribution Width PCT* Plateletcrit RETIC % Reticulocyte Percent RETIC ABS Reticulocyte Absolute IRF Immature Reticulocyte Fraction
* Clinical significance has not been established for these parameters. Therefore they are not reportable in the U.S. They are provided for laboratory use only.
1-3
System Description
Intended Use
Chapter 1
NOTES
1-4
System Components
The two main modules of the CELL-DYN 3700 System are depicted in the following two figures. (The Sample Loader Module included with the CELL-DYN 3700SL System is illustrated and described in Chapter 2: Installation and Chapter 12: Sample Loader.)
Data Station
Analyzer
Figure 1.2:
Analyzer: The Analyzer contains the hardware to aspirate, dilute, and analyze each whole blood specimen. Data Station: The Data Station contains a Flat Panel Display Monitor, a Keyboard, and a CPU (Central Processing Unit).
1-5
System Description
System Components
Chapter 1
Analyzer
Overview
The Analyzer is the central unit of the CELL-DYN 3700 System. It aspirates and dilutes whole blood specimens, transports and analyzes the prepared dilutions, and rinses fluidic components in preparation for the next specimen. Except for those components directly related to the Closed Sample Processing Method (automated or manual), the CELL-DYN 3700CS System and CELL-DYN 3700SL System are identical. In the description of components on the following pages, those components applicable to only one of the systems will be identified as such. A complete description of the automated Sample Loader can be found in Chapter 12: Sample Loader.
Front Panel
The components visible on the front of the Analyzer are depicted in the following figure. The functional description of each component follows.
Right Front Cover Viewing Window
Touch Plate
1-6
Touch Plate
The Touch Plate is located directly behind the Open Sample Aspiration Probe. Pressing the Touch Plate starts the selected run cycle for both the Open Mode and Closed Mode on the CELL-DYN 3700CS System. If the Closed Sampler Mode is selected on the CS instrument, the cycle will begin only if a tube has been properly inserted in the holder. On the CELL-DYN 3700SL System, the Touch Plate is used for Open Mode only.
CELL-DYN 3700 System Operators Manual
1-7
System Description
System Components
Chapter 1
Flow Panel
The major components of the Flow Panel are depicted in the following figure. The functional description of each component follows.
1-8
Chapter 1
Figure 1.4:
Grounding Wire Clip WOC Mixing Chamber A.C.C. Interlock Switch Grounding Wire Clip Sample Aspiration Peristaltic Pump Mounting Bracket WOC Flow Cell Cover Mounting Bracket Optical Bench Assembly
Mounting Bracket
Overflow Chamber
Aerosol Filter
Wash Block
Mounting Bracket
Waste Chamber 1
System Description
System Components
1-9
System Description
System Components
Wash Block
The Wash Block rinses the outside of the Open Sample Aspiration Probe with Diluent. It air dries the probe and routes the external and internal rinses to a waste chamber.
Syringe Assembly
The Syringe Assembly contains a set of five syringes: two WIC/HGB Syringes operated by the same stepper motor and three others (RBC Diluent, WOC Sheath, and WOC Metering Syringes), each operated by a separate stepper motor. RBC/PLT Diluent Syringe delivers a specific volume of Diluent to transport the blood from the Shear Valve to the Mixing Chamber in the von Behrens RBC/PLT Transducer. WIC/HGB Diluent Syringe delivers a specific volume of Diluent to transport the blood from the Shear Valve to the WIC/HGB Mixing Chamber in the von Behrens WIC Transducer. WIC/HGB Lyse Syringe dispenses a specific volume of WIC/HGB Lyse into the WIC/HGB Mixing Chamber at the same time as the diluted sample is dispensed into the chamber. WOC Sheath Syringe delivers a specific volume of Sheath Reagent to transport the blood from the Shear Valve to the WOC Mixing Chamber. WOC Metering Syringe injects a specific volume of the WOC dilution into the WOC Flow Cell.
Waste Chambers
Two Waste Chambers collect the waste liquid from the Analyzer Flow Panel.
1-10
1-11
System Description
System Components
Chapter 1
Aerosol Filter
The Aerosol Filter is used to filter aerosols out of the air that leaves the instrument.
Overflow Chamber
The Overflow Chamber collects excess fluid from the Mixing Chambers.
1-12
1-13
System Description
System Components
Chapter 1
Detergent Reservoir
Solenoid Valves
The Solenoid Valves are used to control pressure and vacuum. The three valves in the top row control the hydraulic pressure to the system. The three valves in the bottom row control the vacuum used to fill the reagent reservoirs.
1-14
Diluent Reservoir
The Diluent Reservoir maintains the Diluent supply in the Analyzer.
Sheath Reservoir
The Sheath Reservoir maintains the Sheath Reagent supply in the Analyzer.
Detergent Reservoir
The Detergent Reservoir maintains the Detergent supply in the Analyzer.
1-15
System Description
System Components
Chapter 1
1-16
Rear Panel
The components visible on the Rear Panel of the Analyzer are depicted in the following figure. The functional description of each component follows.
Fans Line Frequency and Voltage Select Switches Fuse
Analyzer Power Receptacle RS-232 Test Interface Port Data Station Port Figure 1.6: Analyzer Rear Panel Components
Fans
Three fans cool the internal components of the Analyzer.
PN 9230003E
1-17
System Description
System Components
Chapter 1
100V 50HZ 120V 50HZ 220V 50HZ 240V 50HZ 100V 60HZ 120V 60HZ 220V 60HZ 240V 60HZ
Figure 1.7:
WARNING: These switches are set at the factory for 120 volts. When operation at other line voltage is required, refer to Figure 1.7.
Fuse
An 8-amp (100/120V)T (Slo-Blo) or 4-amp (220/240V)T (Slo/Blo) fuse protects the Analyzer from power surges.
1-18
Data Station
The CELL-DYN 3700 operations are controlled by high-speed microprocessors that monitor system status, perform the various analytical routines used by the instrument, perform diagnostic checks, and store result data. Serial data (ASCII format) may be output to a Laboratory Information System (LIS) through an RS-232 connector. Data transmission may be performed either automatically as samples are processed or by command of the operator. Parallel data may be output to an on-line printer. The Data Station Computer consists of: 80486 microprocessor (IBM AT compatible) 8 megabytes RAM minimum 1.2-gigabyte hard drive minimum 15-inch color monitor or flat panel display NOTE: Components for both are described in this section. VGA graphics
The results are stored on the hard drive for the most recent 10,000 cycles. Complete graphical data are also stored for the most recent 10,000 cycles.
Screen Monitor Soft Keys Monitor Power Switch Contrast Control Brightness Control CPU Floppy Disk Drive
Figure 1.8:
CELL-DYN 3700 System Operators Manual
System Description
System Components
Chapter 1
The Data Station and monitor components are shown in the previous figure. The Standard Computer Keyboard is also shown. The functional description of each component follows.
Soft Keys
A row of eight unlabeled pressure-sensitive soft keys is located directly below the screen. Each key generates an audible tone when pressed and initiates a function defined by the screen label currently displayed directly above it.
Brightness Control
The Brightness Control adjusts the brightness of the Data Station screen.
Contrast Control
The Contrast Control adjusts the contrast of the Data Station screen.
1-20
Rear Components
The rear components located on the Data Station and monitor are depicted in the following figure. The functional description of each component follows.
Monitor Serial Number Power Outlet Connector Monitor Video Cable Soft Key Interface Cable Com 2/ RS 232 Com 1/ External Computer Analyzer Port Monitor Video Cable Port Keyboard Data Station Port Soft Key Power Plug Interface Connector CPU Monitor Port Voltage Power (Touch Port) Selector Port Figure 1.9: Data Station Rear Components LPT 1 Graphics Printer Port
1-21
System Description
System Components
Chapter 1
Fan
The Fan cools the Data Station computer.
Analyzer Port
The Analyzer Port is used to connect the cable from the Data Station to the Analyzer.
Keyboard Port
The Keyboard Port is used to connect the Standard Computer Keyboard to the Data Station.
Voltage Selector
The Voltage Selector sets the line voltage for the Data Station.
Figure 1.10:
Touch Screen
The Touch Screen allows commands to be transferred from the Flat Panel Monitor to the Data Station computer. A row of eight touch keys is displayed on the screen. Each key generates an audible tone when pressed and initiates the function defined by the screen label.
Screen Controls
Controls are described in order from left to right. 1. Earphone enables the user to connect a headset. 2. Auto Tuning automatically sizes, centers and fine-tunes the video signal to eliminate noise and distortion. NOTE: Refer to the procedure following the description of the controls. 3. On Screen Display (OSD) menu/select displays the OSD menus and is used to select from the displayed options. 4. Decrease used to decrease the value of a selected OSD option. 5. Increase used to increase the value of a selected OSD option. 6. Power switch powers the Flat Panel Monitor ON or OFF.
CELL-DYN 3700 System Operators Manual
1-23
System Description
System Components
Chapter 1
1-24
Figure 1.11:
Inputs Diagram
Cable Connections
Cable connections are described in order from left to right. 1. Power AC In AC power input for 110/220 VAC power 2. 8-Switch/RS232 8-switch or RS232 25-pin touch screen. Note that the RS232 is for the use of ELOs serial touch screen driver, AccuTouch (cable required). 3. PC In VGA video input 4. USB optional USB port for connecting ELOs serial touch screen driver, AccuTouch, supported by a virtual COM port (VCP) driver from FTDI. 5. Audio optional audio port (Line In) that can be connected to any stereo audio out source 6. RS232/USB optional switch used to select RS232 or USB that must be set for RS232 or USB bidirectional communication only.
1-25
System Description
System Components
Chapter 1
1-26
Printer
The Printer is discussed in detail in Chapter 11: Printers.
Sample Loader
The Sample Loader is discussed in detail in Chapter 12: Sample Loader.
Reagent System
Overview
The Reagent System is formulated specifically for the CELL-DYN 3700 instrument flow systems in order to provide optimal system performance. Use of reagents other than those specified in this manual is not recommended as instrument performance can be affected. Each CELL-DYN System is checked at the factory using the specified reagents and all performance claims were generated using these reagents. Reagents must be stored at room temperature to ensure optimal performance. All reagents should be protected from direct sunlight, extreme heat, and freezing during storage. Temperatures below 32F (0C) may cause reagent layering that changes the tonicity and conductivity of the reagents. CAUTION: If any reagent has been frozen, it should not be used. The Reagent Inlet Tubes have a cap attached that minimizes evaporation and contamination during use. However, reagent quality may deteriorate with time. Therefore, use all reagents within the dating period indicated on the label. NOTE: Never add remaining reagent from a container being replaced to a freshly opened container. This may contaminate the new reagent. Before operating the instrument for the first time, make sure each reagent line is connected to the appropriate inlet and reagent container.
1-27
System Description
System Components
Chapter 1
A facsimile of the label that is on the reagent panel is shown below in Figure 1.12.
VORSICHT: Die Reagenzbeh lter nur ordnungsgem gesichert bewegen. ATTENTION : Ne pas manipuler le flacon de solution sans protection appropri e. PRECAUCI N: no maneje el recipiente de la soluci n a menos que est protegido adecuadamente. ATTENZIONE: Non maneggiare il recipiente della soluzione se non si protetti in modo adeguato. ATEN O: n o manipular o recipiente da solu o sem estar devidamente protegido. VIGTIGT: Beholderen med oplsning m ikke h ndteres, medmindre brugeren er korrekt beskyttet. VIKTIGT: Anv nd skyddskl der vid hantering av l sningsbeh llarna. : . UPOZORNN: Nemanipulujte s ndobou obsahujc roztok, pokud nen dn zabezpeena.
Consult instructions for use. / Gebrauchsanweisung beachten. / Consulter les instructions dutilisation. / Consulte las instrucciones de uso. / Consultare le istruzioni per luso. / Consultar as instru es de utiliza o. / Se brugsanvisningen. / L s tillh rande dokumentation. / . / Viz nvod k pouit.
PN 9230334F
Figure 1.12:
Caution Label
HGB/WIC Lyse
CELL-DYN HGB/WIC Lyse is formulated to meet the following requirements: Rapidly lyse the red blood cells and minimize the resultant stroma. Strip the white cell cytoplasm leaving the nuclear membrane intact so the white cell nuclei can be enumerated. Convert hemoglobin to a modified hemiglobincyanide complex that is measurable at 540 nm. (The quaternary ammonium lysate participates as a chromagen.)
1-28
Detergent
CELL-DYN Detergent is formulated to meet the following requirements: Provide an optically clear solution that is needed to obtain the zero reference during the HGB measurement cycle. Provide proper meniscus formation in the WIC and RBC/PLT Metering Tubes and maintain it during each run cycle. Rinse the WIC Counting Chamber, the WIC Metering Tube, RBC/PLT Counting Chamber, the RBC/PLT Metering Tube, and the HGB Flow Cell with minimal bubble formation.
Sheath Reagent
CELL-DYN Sheath Reagent is formulated to meet the following requirements: Osmotically lyse the red cells. Maintain the light scattering properties of the WBCs for the duration of the measurement period. Serve as a Sheath fluid for the hydrodynamic focusing process. Provide sufficient wetting action to prevent accumulation of air bubbles in the WOC flow system. Provide a WOC background count equal to or less than 0.3 x 103/L (109/L).
Enzymatic Cleaner
CELL-DYN Enzymatic Cleaner is formulated to effectively remove protein buildup within the instrument.
1-29
System Description
System Components
Chapter 1
used. Reagent tubes have been capped to minimize evaporation. However, reagent quality may deteriorate with time. Therefore, use all reagents within the dating period indicated on the label.
1-30
Controls and Calibrator are reference materials used to test, set, and monitor CELL-DYN 3700 performance.
Controls
Day-to-day verification of System calibration is performed using CELL-DYN controls. Running these stabilized reference products every day of operation is recommended to test instrument accuracy. NOTE: Always store controls and calibrators according to the directions in the package inserts that accompany them.
Calibrator
Calibration of the directly measured parameters can be performed using CELL-DYN Calibrators. Calibration is discussed in detail in Section 6: Calibration Procedures.
1-31
System Description
Controls and Calibrator
Chapter 1
NOTES
1-32
Chapter 2
Installation
Installation
Overview
The CELL-DYN 3700 System should only be installed by an authorized Abbott representative to ensure that all system components are functioning correctly and to verify system performance. NOTE: Installation of the Analyzer by an unauthorized or untrained person could result in damage to the system. Never attempt to install the system without an authorized Abbott representative present. Additionally, all service and repair must be performed by authorized ABBOTT TRAINED Abbott representatives. This chapter contains general installation, inventory, package inspection, and relocation information. It also provides space, waste, and power requirements for installing the CELL-DYN 3700 System, and it includes procedures for setting up the Sample Loader and for installing the Graphics Printer and optional Ticket Printer.
2-1
Installation
Overview
Chapter 2
NOTES
2-2
Chapter 2
Installation
Initial Preparation
Inventory
The instrument is shipped from the factory with the following:
Package Inspection
All crates should be inspected for damage. If there is any damage, or if any crates or boxes are missing, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US). The reagents needed for installation may be shipped separately from the instrument. This shipment includes: Diluent, HGB/WIC Lyse Reagent, Sheath Reagent, and Detergent. The calibrator and controls needed for the installation may be shipped separately from the instrument. The Enzymatic Cleaner is shipped separately.
2-3
Installation
Initial Preparation
Chapter 2
Space Requirements
The CELL-DYN 3700 System requires approximately five linear feet of space on a countertop. In addition, sufficient space is required beneath for Diluent, WIC/HGB Lyse, Sheath Reagent, Detergent, and the waste container (if one is used). Six inches of space behind and on the left side of the Analyzer must be allowed for air flow in order to maintain the constant circulating internal air stream required to cool circuitry and components whenever the power is ON. Six inches of space must also be allowed behind the Data Station for air flow. The Data Station may be placed in direct contact with the right side of the Analyzer. If possible, there should be 24 inches of space above and to either side of the Analyzer for service access. Allow adequate space around the instrument to perform necessary maintenance procedures, to provide service access, and to allow the instrument to be easily disconnected from its power source. In addition to these space requirements, the instrument should also be located: On a stable, level surface. On a nonporous, nonabsorbing work surface and flooring that can be easily cleaned and disinfected using recommended procedures. Away from direct sunlight. Away from the path of a cooled or heated air outlet. Away from any other equipment that may interfere with it, such as a centrifuge, any x-ray equipment, a CRT, a video terminal, a computer, or a copier. Please note that the CELL-DYN 3700 System has been evaluated to EN 55011 and EN 61000 for electromagnetic emissions and immunity, respectively. Always place the reagents below (never above) the instrument.
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Installation Chapter 2
Initial Preparation
Waste Requirements
A suitable properly labeled waste container must be located near enough to the CELL-DYN 3700 System to connect to the Analyzer Waste Outlet Tube, or the instrument must be positioned to permit the waste to be routed directly to a drain. The drain must be suitable for disposal of waste with possible biological and chemical hazard. Ensure that the waste outlet tube is secured in the drain hole and all System Components are located away from possible waste overflow. Regulations on permissible substances, and their amounts, for disposal in public sewer systems vary from state to state and even community to community. Customers are advised to be knowledgeable of all applicable local, state, and federal requirements, and the contents of the effluent streams, before disposing of waste in public sewer systems. Make sure the waste line is connected to the appropriate outlet and routed to a suitable waste container or drain. If the waste is routed to a waste container, make sure the Waste Sensor is properly connected. If an external waste container is used, the Waste Full Sensor Plug (attached to the caps electrode wires) should be inserted into the Waste Sensor Connector on the Left Side Panel of the Analyzer. If the waste tube is placed directly into a drain, the Dummy Plug provided in the Accessory Kit must be inserted into the Waste Sensor Connector or the EXTERNAL WASTE FULL alert will be activated. NOTE: If a Waste Container is used, the container should be labeled with the Biohazard Symbol.
Power Requirements
Three power outlets are required for the CELL-DYN 3700SL System and three are required for the CELL-DYN 3700CS System. A grounded power outlet and voltage regulator are required for optimum performance. Refer to Chapter 4: System Specifications for the electrical requirements for each system.
2-5
Installation
Initial Preparation
Chapter 2
NOTES
2-6
Chapter 2
Installation
Printer Installation
Overview
Remove the printer(s) from its shipping container and visually inspect it for damage. Find a suitable location adjacent to the instrument. Be sure the printer power switch is in the OFF position. Retain the manuals shipped with the printer(s) and store them in a convenient location. NOTE: If the printer is placed on top of the instrument, be sure that the paper does not restrict air flow to the rear panel fan. Basic installation procedures follow for the Graphics and Ticket Printers. When used with the CELL-DYN 3700, the Graphics Printer prints color or black-and-white graphic reports and the Ticket Printer prints tickets or black-and-white graphic reports. Depending on the output desired, one or both printers may be connected to the instrument. Follow installation instructions carefully to be sure that the printer(s) is connected to the correct port. (See Figure 2.1.) For convenience, general instructions are provided for loading individual pre-printed tickets in the Ticket Printer. For a detailed description of the printer components and operating instructions, refer to the manuals that accompany the printer. IMPORTANT: The CELL-DYN 3700 System has been configured for and tested with specific printers, such as the printer shipped with the analyzer. For additional information about specific printer capability with the CELL-DYN 3700 System, US Customers, please contact Abbott Diagnostics Customer Service at 1-877-4ABBOTT (1-877-422-2688). Customers outside the US should contact your local Customer Service representative. Use of printers other than those recommended by Abbott Laboratories may lead to erroneous printer functionality.
2-7
Installation
Printer Installation
Chapter 2
Monitor Video Cable Soft Key Interface Cable Com 2/ RS 232 Com 1/ External Computer Analyzer Port Monitor Video Cable Port
Keyboard Data Station Port Power Plug Connector CPU Monitor Voltage Power Selector Port Figure 2.1:
Installation Chapter 2
Printer Installation
Self-Test Printouts
Run any self-test printouts (as directed in the printer manual) before using the printer for the first time. These self-tests may be run any time to verify proper printer operation. IMPORTANT The CELL-DYN 3700 software automatically controls and adjusts most print conditions for the Graphics Printer, including page width. If printing is not what you expect, refer to the printer manual for guidance in making adjustments. If you have additional questions or experience any problems, call Abbott Customer Service for assistance.
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Installation
Printer Installation
Chapter 2
2-10
Installation Chapter 2
Printer Installation
1. Be sure that the printer is turned ON and the printer cable is connected to the Ticket Printer connector on the back of the Data Station. If the connection is incorrect, turn the Data Station power OFF, change the position of the cable and turn the power back ON. 2. Set the ribbon cartridge headgap lever to adjust for the thickness of the tickets. Refer to the printer manual for detailed instructions. 3. Move the paper selection lever to the rear position to select single-feed paper. 4. Open the access cover and be sure the guide wire on the paper separator is pushed back into the locked position. 5. Raise the separator to its upright position. 6. Place a ticket on the paper separator and adjust the guides so that they barely touch the edges of the ticket. 7. Pull the bail lever forward. The ticket will automatically feed into place. Release the bail lever. 8. Be sure the printer is deselected (Sel indicator is not illuminated). Set the Top of Form by pressing and holding the TOF/Quiet key and pressing the Form Feed key to move the ticket up or pressing the Line Feed key to move the ticket down. (The ticket moves in very fine increments so it can be precisely positioned.) NOTE: The ticket will only move down to a certain point to prevent potential ticket jams. Do not move the top of the page below the paper bail. 9. Position the ticket so that the lower red line on the paper shield (located between the print head and the paper) is positioned where the first line of printing should occur. NOTE: When the Top of Form is set, the position is retained in the printer memory until it is reset. 10. Press the Sel key to select the printer. The printer is now ready to print.
Self-Test Printouts
Run any self-test printouts indicated in the printer manual before using the Ticket Printer for the first time. These self-tests may be run any time to verify proper printer operation.
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Installation
Printer Installation
Chapter 2
Figure 2.2:
CELL-DYN 3700SL
2-12
Installation Chapter 2
Printer Installation
Black End Rack Visual Indicator Label (END RACK ONLY) Rack ID Number Label
Tube Rack
Figure 2.3:
5. Place five racks in the open area to the left of the tower and five racks in the open area to the right of the tower. Push all of the right side racks toward the Analyzer. Pull all of the left side racks away from the Analyzer. All ten racks must be in place for proper operation.
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Installation
Printer Installation
Chapter 2
NOTE: Be sure each rack is placed with its bar coded rack ID label and open slot facing toward the Analyzer. NOTE: Liquid spills in the rack drive mechanism are a potential reason for failure of the rack to advance. Liquid spills that flow in the Sample Loader Control Panel could cause operational failure. For further assistance, call Abbott Diagnostics Customer Service (at 1-877-4ABBOTT in the US).
Power On
Turn the Sample Loader Power Switch on the Left Side Panel ON. When the initialization process is complete, the light above the Sample Loader Start key will flash. This indicates that the Sample Loader is ready to start processing samples. The message AUTO SAMPLER READY is displayed in the Data Station bulletin line.
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Installation Chapter 2
Printer Installation
Instrument Installation
Reagent Tubing Installation Materials
1. Lint-free pads 2. CELL-DYN Reagents
Procedure
1. Place the reagents in a suitable location below the Analyzer. Sufficient space is required below for Diluent, WIC/HGB Lyse, Sheath Reagent, Detergent, and the waste container (if one is used). NOTE: Never place the reagents above the Analyzer, in direct sunlight, or in the path of a cooled or heated air outlet. 2. Remove the Reagent Inlet Tubing and the Waste Tubing from the Accessory Kit. 3. Inspect each length of tubing carefully for damage or cracks. 4. Attach the non-weighted end of the Detergent Tubing (the tubing with the green label) to the Green Detergent Fitting on the Left Side Panel of the Analyzer. (See the following figure.) Wipe the outside of the tubing with a damp lint-free pad and place the weighted end into the container of CELL-DYN Detergent. Secure the cap. 5. Attach the non-weighted end of the Diluent Tubing (the tubing with the red label) to the Red Diluent Fitting on the Left Side Panel of the Analyzer. Wipe the outside of the tubing with a damp lint-free pad and place the weighted end into the container of CELL-DYN Diluent. Secure the cap. 6. Attach the non-weighted end of the WIC/HGB LYSE Tubing (the tubing with the blue label) to the Blue WIC/HGB Lyse Fitting on the Left Side Panel of the Analyzer. Wipe the outside of the tubing with a damp lint-free pad and place the weighted end into the container of CELL-DYN WIC/HGB Lyse. Secure the cap. 7. Attach the non-weighted end of the Sheath Tubing (the tubing with the purple label) to the Purple Sheath Fitting on the Left Side Panel of the Analyzer. Wipe the outside of the tubing with a damp lint-free pad and place the weighted end into the container of CELL-DYN Sheath. Secure the cap.
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Installation
Printer Installation
Chapter 2
Waste Outlet Fitting Normally Closed Valves Figure 2.4: Left Side Panel
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Installation Chapter 2
Printer Installation
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Installation
Printer Installation
Chapter 2
Figure 2.5:
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Installation Chapter 2
Relocation
Relocation
Your CELL-DYN 3700 System has some fragile components, and you must follow this relocation procedure to ensure proper instrument function after relocation. 1. Shut down the system according to the procedure described in Chapter 9: Maintenance, Subsection: Special Procedures, Preparation for Inactivity or Shipping. 2. Prepare the new location site before moving the system. Refer to the following subsections within Initial Preparation at the beginning of this chapter: Space Requirements Waste Requirements Power Requirements CAUTION: The CELL-DYN 3700SL weighs 288 pounds and the CELL-DYN 3700CS weighs 190 pounds. Obtain assistance when moving and/or use a mechanical lifting device. 4. Install the system in the new location according to Installation within this chapter. 5. Turn the system ON according to the process described in Chapter 10: Troubleshooting: Troubleshooting Procedure, Power ON. NOTE: All system and hematology data file information is saved when power to the system is removed, including date, time, and calibration. However, if new reagents are installed upon relocation the appropriate Reagent Logs should be updated, and instrument performance confirmed as described below, before running any patient samples. 6. Run five backgrounds and confirm that they are acceptable before running controls or patient samples. If backgrounds or controls are unacceptable, refer to Chapter 10: Troubleshooting and follow established laboratory operating procedures.
2-19
Installation
Relocation
Chapter 2
NOTES
2-20
Chapter 3
Principles of Operation
Principles of Operation
Overview
The principles used by the CELL-DYN 3700 System to measure, count, and calculate the hematologic parameters are discussed generally in the first section of this chapter as part of an overview of the four measurement cycles. The parameters are then discussed individually in relation to the methodology used. At the end of the chapter is a discussion of operational messages and flags that pertain to the parameter measurements and data results. Four independent measurements are used in the CELL-DYN 3700 System to obtain the hematologic parameters. The WBC Optical Count (WOC) and the WBC Differential data are measured in the Optical Flow channel. The WBC Impedance Count (WIC) is measured in one Electrical Impedance channel. The RBC and PLT data are measured in a second Electrical Impedance channel. The HGB is measured in the Spectrophotometric channel. During each instrument cycle, the sample is aspirated, diluted, and mixed, and the measurements for each parameter are performed.
3-1
Principles of Operation
Overview
Chapter 3
NOTES
3-2
Chapter 3
Principles of Operation
Sample Aspiration
The CELL-DYN 3700 System performs whole blood sample aspiration using two modes. The operator selects the desired mode from the Data Station RUN Screen. The Open Sampler Mode is used to aspirate the sample from a collection tube that has been opened and is held under the Open Sample Aspiration Probe. The manual Closed Sampler Mode or automated Sample Loader Mode is used to aspirate the blood directly from a capped collection tube by piercing the tube stopper. The aspiration volumes are: Open Mode Closed Mode (CS) Sample Loader (SL) 130 L 5% 240 L 5% 355 L 5%
Once the mode of aspiration has been selected, the whole blood sample is aspirated into the Analyzer by the Aspiration Peristaltic Pump. The pump aspirates the sample through the Shear Valve. Optical sensors check the integrity of the sample stream.
3-3
Principles of Operation
Sample Aspiration
Chapter 3
NOTES
3-4
Chapter 3
Principles of Operation
WBC Analysis
WBCs are analyzed in two separate channels: Optical (WOC) and Impedance (WIC).
WOC Measurement
WBC Optical Count (WOC) measurement is performed as follows: 1. The WOC Sheath Syringe dispenses 1.6 mL of Sheath Reagent through the Shear Valve, where it picks up the 32-L WOC sample segment. 2. The sample segment and sheath are then routed to the WOC Mixing Chamber, where the dilution is bubble-mixed. The final dilution is 1:51. NOTE: The ratio 1:51 represents 1 part in a total of 51 parts, not 1 part plus 51 parts. 3. The WOC Peristaltic Pump transfers the WOC dilution from the WOC Mixing Chamber to the Sample Feed Nozzle in the WOC Flow Cell. 4. A stream of WOC Sheath Reagent is directed through the Flow Cell. 5. The WOC Metering Syringe injects 78 L of the WOC dilution into the Flow Cell sheath stream. The dilution is hydrodynamically focused into a narrow stream. (Hydrodynamic focusing is discussed later in this chapter.)
3-5
Principles of Operation
Sample Analysis Cycle Overview
Chapter 3
6. A laser beam is focused on the Flow Cell. As the sample stream intersects the laser beam, the light scattered by the cells is measured at four different angular intervals. (Light scatter is discussed later in this chapter.)
WIC Measurement
WBC Impedance Count (WIC) measurement is performed as follows: 1. The WIC/HGB Diluent Syringe dispenses 5.25 mL of Diluent through the Shear Valve, where it picks up the 20-L WIC/HGB sample segment. 2. The segment and Diluent are then routed to the Mixing Chamber in the von Behrens WIC Transducer. At the same time, the WIC/HGB Lyse Syringe delivers 0.75 mL of WIC/HGB Lyse to the Mixing Chamber. 3. The dilution is then bubble-mixed. The final WIC/HGB dilution is 1:301. 4. The dilution is pulled through the aperture by vacuum. A process known as volumetric metering (discussed later in this chapter) ensures that 200 L of the dilution are used for the measurement. 5. Electrical Impedance (discussed later in this chapter) is used to count the WBCs as they traverse the aperture. 6. When the count portion of the cycle is completed, the aperture is automatically cleaned by the Aperture Cleaning Circuit.
RBC/PLT Analysis
1. The RBC Diluent Syringe dispenses 7.2 mL of Diluent through the Shear Valve, where it picks up the 0.74-L RBC/PLT sample segment. 2. The sample segment and Diluent are then routed to the Mixing Chamber of the von Behrens RBC/PLT Transducer, where the dilution is bubble-mixed. The final dilution is 1:9,760. 3. The dilution is pulled through the aperture by vacuum. The volumetric metering process ensures that 100 L of the dilution are used for the measurement. 4. Electrical Impedance (discussed later in this chapter) is used to count the RBCs and PLTs as they traverse the aperture.
Reticulocyte Analysis
Reticulocytes are discussed in Chapter 14: Reticulocyte Package.
3-6
Hemoglobin Analysis
1. After 200 L of the WIC/HGB dilution are metered through the WIC aperture, the remaining dilution is transferred to the HGB Flow Cell. 2. The HGB concentration is measured spectrophotometrically. This process is discussed in detail later in this chapter.
Results Displayed
All data are transmitted to the Data Station for analysis. Results are computed for all parameters and are displayed on the Data Station RUN Screen. Results are also stored in a log format called the Data Log.
Instrument Rinsed
1. The Open Sample Aspiration Probe is rinsed internally and externally with Diluent. 2. The needle used in both the automated and the manual Closed Mode is rinsed internally and externally with Diluent. 3. The WIC Mixing Chamber and the RBC/PLT Mixing Chamber are rinsed with Diluent. 4. The WOC Mixing Chamber is rinsed with Sheath Reagent. 5. The WIC Metering Tube and the RBC/PLT Metering Tube are rinsed with detergent. 6. The HGB Flow Cell is rinsed with detergent.
3-7
Principles of Operation
Sample Analysis Cycle Overview
Chapter 3
NOTES
3-8
Chapter 3
Principles of Operation
WBC Analysis
Two WBC values are provided by the CELL-DYN 3700 System: The WIC (WBC Impedance Count) The WOC (WBC Optical Count) The WOC is the primary value reported as the WBC count. Whenever a clinically significant difference between WIC and WOC is present, the data is further evaluated to determine the most accurate value.
WIC/WOC Interaction
The WIC (WBC Impedance Count) interacts with the WOC (WBC Optical Count) to produce the final reported WBC value. Two methods are provided because both measurements have strengths and limitations. Because the limitations of each method differ, providing both methods enhances the instruments ability to provide a more accurate WBC count in the presence of certain interfering substances and pathological conditions. A data analysis algorithm automatically evaluates each measurement and selects the appropriate result to report. The algorithm used by the CELL-DYN 3700 System is divided into three main areas: 1) the WOC decision tree, to analyze and output the WOC data; 2) the WIC decision tree, to analyze and output the WIC data; and 3) a WIC/WOC comparison decision tree, to compare the two outputs. The WOC decision tree calculates the WOC result for the WBC count and the Differential count. It evaluates the results for correctness and flagging. Finally, the algorithm outputs the WOC with appropriate flags to the WIC/WOC comparison decision tree. The WIC decision tree evaluates the WIC for correctness and flagging and outputs the WIC to the WIC/WOC comparison decision tree. The WIC/WOC comparison decision tree compares the two outputs for a difference between the results. If a clinically significant difference exists, results are further evaluated to determine the cause. Depending on the nature of the cause (the type of interference), the algorithm reports either the WOC value or the WIC value, whichever is more accurate, with the appropriate flags (or no flags) as the reported WBC.
3-9
Principles of Operation
WBC Analysis
Chapter 3
WIC Measurement
Overview
The WBC Impedance Channel is used for the determination of the WIC. A 1:301 dilution of the sample is made with Diluent and WIC/HGB Lyse. The WIC/HGB Lyse Reagent lyses the RBCs and strips the cytoplasm from the WBCs. The WBC nuclei are counted using the impedance method as they pass through the 100 x 77m aperture in the von Behrens WIC Transducer. The 200-L volume of sample that is analyzed is precisely regulated by the WIC Metering Assembly. WIC data are collected in 256 channels. The WIC data may be presented in a histogram at the request of the operator. NOTE: If NRBCs are present, they are lysed and their nuclei are included in the WIC. Consequently, when NRBCs are present the WIC data provide a total nucleated cell count including the NRBCs.
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Volumetric Metering
An absolute cell count cannot be obtained unless the precise volume of diluted whole blood that passes through the aperture during the count cycle is known.1 The CELL-DYN 3700 System utilizes the Volumetric Metering process to regulate the count cycle and ensure that a precise volume of sample is analyzed for the WIC measurement. The WIC Metering Assembly contains a precision-bore glass tube fitted with two optical detectors. (See the following figure.) The distance between the detectors is set to precisely measure 200 L. Detergent is added to the Diluent in the metering tube to create a meniscus in the liquid. When the WIC cycle is initiated, the liquid flows down the metering tube.
Meniscus
Count Time
3-11
Principles of Operation
WBC Analysis
Chapter 3
The count portion of the cycle is initiated when the meniscus reaches the upper detector. The count cycle stops when the meniscus reaches the lower detector. The amount of time required for the meniscus to travel from the upper to the lower detector is called the WIC Count Time. The computer also monitors the time it takes the meniscus to reach the upper detector once the WIC cycle is initiated. This is called the WIC Upper Metering Time. The WIC Count Time (WCT) and the WIC Upper Metering Time (WUT) are automatically monitored to detect variation from the expected values. Variation may be caused by debris in the aperture, vacuum fluctuation, or air bubbles in the metering tube. If significant variation is detected, the bulletin line on the Data Station RUN screen displays the message: WIC METERING FAULT CLOG or FLOW ERROR and the WBC and Differential data are suppressed. At the end of each cycle, the WIC Count Time is displayed on the Data Station RUN screen below and to the right of the BASO results. If a WIC metering fault was detected, one of two messages is displayed and printed: the WIC CLOG message if either time is too slow or the WIC FLOW ERROR message if either time is too fast. Both the WIC Upper Metering Time (WUT) and the WIC Count Time (WCT) are printed when a WIC metering fault occurs.
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WOC Analysis
The CELL-DYN 3700 System uses laser-based flow cytometric techniques to analyze the WBC subpopulations. The first part of this section gives a brief introduction to the principles of flow cytometry.2 The second part of this section gives a detailed description of the WOC measurement and the WBC differential analysis.
3-13
Principles of Operation
WBC Analysis
Chapter 3
Sample Stream
Sheath Stream
Figure 3.2:
In a flow cytometer, the cell suspension is pumped from the specimen container through a sample tube into a special flow chamber with a small opening at the tip. The suspension is then injected into a stream of fast-moving, cell-free liquid (sheath fluid). Since the two liquids travel at different rates of speed, they do not intermingle. This is called laminar flow. The special geometry of the Flow Cell and the flow rate of the sheath fluid forces the cells into single file. This process is known as hydrodynamic focusing. (See the preceding figure for a drawing of the WOC Flow Cell.) As the cells enter the view volume (specific viewing area), they interact with the laser beam. The cells scatter the laser light at different angles, yielding information about cell size, internal structure, granularity, and surface morphology. The optical signals the cells generate are detected and converted to electrical impulses which are then stored and analyzed by the computer. Flow cytometers generally measure two angles of scatter. Forward angle light scatter is roughly a measure of cell size. Right angle (orthogonal) light scatter is a measure of cell surface and internal structure but is primarily a measurement of internal granularity. Combining the information from the two scatter measurements provides more accurate discrimination between cell populations than either single measurement.
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0 Scatter
Figure 3.3:
The CELL-DYN 3700 System measures four angles of scatter (see the preceding figure): Forward Angle Light Scatter (measured at 0), which can be used to measure cell size Narrow-Angle Light Scatter (measured at 10), which can be used to measure cell complexity Orthogonal or Ninety-Degree Light Scatter (measured at 90), which can be used to measure cell surface and internal structure (lobularity) Orthogonal or Ninety-Degree Depolarized Light Scatter (measured at 90D, using a depolarizing filter), which can be used to measure certain types of cell granularity Combining the information from multiple scatter measurements provides more accurate discrimination between cell populations than any single measurement would provide.
3-15
Principles of Operation
WBC Analysis
Chapter 3
Sheath Reagent
The Sheath Reagent is an integral part of the WOC analysis. WBCs diluted in the Sheath Reagent maintain cellular integrity that is close to their native state. The structure of the basophils changes slightly due to the water-soluble nature of the basophilic granules.
3-16
RBCs, however, are altered by the Sheath Reagent because the osmotic pressure of the RBC is higher than that of the Sheath Reagent. Therefore the hemoglobin in the RBC diffuses out of the cell and water from the Sheath Reagent diffuses into the cell. The cell membrane remains intact but the RBC now has the same refractive index as the sheath, thereby rendering it invisible to the laser.
90 Light Scatter PMT Front Surface Mirror Cylindrical Lens 700 m Slit Front Surface Mirror 125 m Vertical Slit Figure 3.4:
Imaging Lens
0 Light Scatter WBC Photodiode Flow Obscuration Perforated Cell Bar Mirror
3-17
Principles of Operation
WBC Analysis
Chapter 3
The WOC Metering Syringe slowly injects 78 L of the WOC dilution into the Sheath stream in the WOC Flow Cell. The sample is hydrodynamically focused into a small stream approximately 30 m in diameter. This focused stream aligns the diluted cells in single file as they pass through the sensing region, which allows them to be analyzed one at a time. Since the average WBC is much smaller than the focused laser beam, the cells do not scatter much laser light. If the remaining so-called axial light were allowed to reach the 0 detector, it would saturate the electronics. Therefore, it is blocked from the detector by the obscuration bar. The forward angle scatter is directed to a perforated mirror. The 0 light scatter passes through the mirror to the 0 silicon photodiode detector. The 10 light scatter is deflected off the mirror to the 10 silicon photodiode detector. The orthogonal scatter is directed through a 700-m slit, which blocks the scatter from the walls of the Flow Cell. A beam splitter then separates the orthogonal light scatter into two portions. One portion of the light is directed to the 90 PMT (photomultiplier tube). The remaining light is directed through a horizontal polarizer. Only light that has changed polarization (depolarized light) can pass through the polarizer to the 90D PMT. (PMTs are used because relatively little light is scattered at this high angle.) The light signals collected by each detector are converted into electrical signals or pulses. The pulses are digitized based on intensity and sorted into 256 channels for each angle of light measured. If a pulse falls above the hardware threshold (channel 23) in the 0 detector, the cell counter counts the pulse and stores it for further evaluation. Pulses that fall below this threshold are not included in the count and, therefore, are not included in the differential. If this raw count is estimated to be below a predetermined value, the instrument automatically continues to count WBCs for an extended count period. The results from the two count periods are averaged. The information from each detector is collected in list mode. This format stores the channel information from each of the four dimensions. The data are then used to determine the differential.
3-18
3-19
Principles of Operation
WBC Analysis
Chapter 3
WBC Scatterplots
90 Lobularity
10 Complexity
90 Lobularity
10 Complexity
Figure 3.5:
Mononuclear-Polymorphonuclear Scatter
Mononuclear-Polymorphonuclear Separation
The scatter information is plotted with the 90 scatter on the Y axis and the 10 scatter on the X axis. (The 90/10 scatterplot is shown in the preceding figure.) Two populations of cells are clearly seen on the display. The mononuclear cells fall in the cluster in the lower left corner of the scatterplot and the polymorphonuclear cells fall in the cluster above and to the right of them. The instrument uses a dynamic threshold to determine the best separation between the two populations. Each cell is then identified as a MONO or a POLY. Once each cell is identified, it retains this classification no matter where it appears on other scatterplots.
3-20
90 Depolarized Granularity
90 Depolarized Granularity
Polymorphonuclear Separation
The scatter information is plotted with the 90D scatter on the Y axis and the 90 scatter on the X axis. (The 90D/90 scatterplot is shown in the preceding figure.) Only the polymorphonuclear cells are plotted on this scatterplot. The mononuclear cells have been identified and therefore do not interfere in the further classification of the polymorphonuclear cells. Two populations of polymorphonuclear cells are clearly seen on the display. The neutrophils fall in the lower of the two clusters. The eosinophils fall in the upper cluster. The instrument uses a dynamic threshold to determine the best separation between the two populations. Each cell is then classified as a NEUT or an EOS. All cells scatter a certain amount of 90D light. The eosinophils scatter more 90D light than any of the other cells because of the unique nature of granules they contain. This property of the eosinophils is used to positively identify them and thus clearly differentiate them from the neutrophil population.
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Principles of Operation
WBC Analysis
Chapter 3
Mononuclear Separation
Mononuclear Identification
0 Size
10 Complexity
0 Size
10 Complexity
Figure 3.7:
Mononuclear Scatter
Mononuclear Separation
The scatter information is plotted with the 0 scatter on the Y axis and the 10 scatter on the X axis. (The 0/10 scatterplot is shown in the following figure.) The mononuclear cells are plotted on this scatterplot. The algorithm also uses the orientation of the neutrophil cluster to aid in classifying the mononuclears. Three populations of mononuclear cells are clearly seen on the display. There are three populations of mononuclears because basophils are included in the mononuclear cluster. Typically, basophils are granulated cells and therefore more complex than the mononuclear cells. However, the basophilic granules are water soluble and dissolve in the Sheath Reagent. Consequently, the degranulated basophil becomes a less complex cell that falls into the mononuclear cluster.
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The lymphocytes fall in the lowest large cluster. (The small population of cells below the lymphocytes contains particles that are unlikely to be WBCs.) The basophils fall in the cluster above and slightly to the right of the lymphocytes. The monocytes fall in the cluster above the lymphocytes and basophils. The instrument uses dynamic thresholds to determine the best separation between the three main populations. Each cell is then classified as a LYMPH, a MONO or a BASO. Finally, the instrument evaluates the area below the lymphocyte cluster but above the hardware threshold (channel 23). Any particles that fall in this area are separated from the lymphocytes by a dynamic threshold. The following cell types may be present in this region: NRBCs Unlysed RBCs Giant PLTs PLT clumps NOTE: Information from the WIC channel is used to assist in discriminating these particles. All particles in this region are excluded from the WBC count and the Differential.
Other Scatterplots
90/0 The scatter information is plotted with the 90 scatter on the Y axis and the 0 scatter on the X axis. 90D/0 The scatter information is plotted with the 90D scatter on the Y axis and the 0 scatter on the X axis. 90D/10 The scatter information is plotted with the 90D scatter on the Y axis and the 10 scatter on the X axis. All scatterplots may be displayed and printed at operator request.
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Principles of Operation
WBC Analysis
Chapter 3
WBC Histograms
The CELL-DYN 3700 System can also present the WBC scatter information as two histograms. The WIC can also be presented in histogram format (shown in the following figure). These histograms can be displayed and printed at the operator's request.
Figure 3.8:
WBC Histograms
MONO-POLY Histogram
The Mononuclear-Polymorphonuclear Scatter information is plotted with the relative number of cells on the Y axis and the mononuclear and polymorphonuclear size distribution data on the X axis.
NWBC-LYM-MONO Histogram
The Non-WBC-Lymphocyte-Monocyte Scatter information is plotted with the relative number of cells on the Y axis and the non-WBC, lymphocyte, and monocyte size distribution data on the X axis.
WIC Histogram
The WIC data are plotted with the relative number of cells on the Y axis and the WIC size distribution data on the X axis.
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WBC Parameters
Figure 3.9:
The WBC data are generally displayed as depicted in the preceding figure. All numeric and graphical data are automatically displayed on the Data Station RUN screen in the format selected by the operator. After the WBC scatter information has been plotted and the cells have been classified into the five subpopulations, the instrument determines the WOC by counting the pulses above the dynamic threshold in the 0 channel and comparing the data to the WIC data. The algorithms then determine the WBC and the percent of cells in each subpopulation.
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Principles of Operation
WBC Analysis
Chapter 3
Once the WBC count is determined, the absolute number of cells in each subpopulation is calculated by multiplying that WBC count by the percentage. The results are expressed as follows: WBC NEU LYM MONO EOS # x 103/L (109/L) # x 103/L (109/L) and % # x 103/L (109/L) and % # x 103/L (109/L) and % # x 103/L (109/L) and %
BASO # x 103/L (109/L) and % The decimal point moves to display up to three decimal places for the absolute number and percent. The WBC scatter information is usually displayed in the two scatterplots shown in the preceding figure: SIZE/COMPLEXITY The size information (0 scatter) is plotted on the Y axis and the complexity information (10 scatter) is plotted on the X axis. The granularity information (90D scatter) is plotted on the Y axis and the lobularity information (90 scatter) is plotted on the X axis.
GRANLRTY/LOBULARITY
WBC Flagging
For a detailed discussion of the WIC/WOC algorithm and all of the WBC flagging messages, refer to Operational Messages and Data Flagging within this chapter.
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Principles of Operation
RBC/PLT Analysis
Overview
An impedance channel is used for the determination of RBC and PLT data. A 1:9,760 dilution of the sample is made with the Diluent. The cells are counted and sized using the impedance method as they pass through the 60 x 70m aperture in the von Behrens RBC/PLT Transducer. Dynamic thresholding separates the PLTs from the RBCs. The 100-L volume of sample that is analyzed is precisely regulated by the RBC/PLT metering assembly. Data is collected in 256 channels for both RBCs and PLTs.
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Principles of Operation
RBC/PLT Analysis
Chapter 3
RER
The RER (Red Cell Editing Ratio) is a process of pulse editing that is applied to the RBC pulses before the MCV is derived. The instrument compensates for the aberrant pulses produced by the non-axial and coincidence passage of the RBCs through the aperture. These pulses are included in the RBC count but eliminated from the RBC sizing determination.
Volumetric Metering
An absolute cell count cannot be obtained unless the precise volume of diluted whole blood that passes through the aperture during the count cycle is known.1 The CELL-DYN 3700 System utilizes the Volumetric Metering process to regulate the count cycle and ensure that a precise volume of sample is used for the RBC/PLT measurement.
Meniscus
Count Time
Figure 3.10:
Volumetric Metering
The RBC/PLT metering assembly contains a precision-bore glass tube fitted with two optical detectors. (See the preceding figure.) The distance between the detectors is set to precisely measure 100 L. Detergent is added to the Diluent in the metering tube to create a meniscus in the liquid. When the RBC/PLT cycle is initiated, the liquid flows down the metering tube.
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The count portion of the cycle is initiated when the meniscus reaches the upper detector. The count cycle stops when the meniscus reaches the lower detector. The amount of time required for the meniscus to travel from the upper to the lower detector is called the RBC Count Time. The computer also monitors the time it takes the meniscus to reach the upper detector once the RBC/PLT cycle is initiated. This is called the RBC Upper Metering Time. (For convenience, these times are referred to as RBC times. Both times actually monitor the RBC/PLT metering process.) The RBC Count Time (RCT) and the RBC Upper Metering Time (RUT) are automatically monitored to detect variation from the expected values. Variation may be caused by debris in the aperture, vacuum fluctuation or air bubbles in the metering tube. If significant variation is detected, the bulletin line on the Data Station RUN screen displays the message RBC METERING FAULT-CLOG or FLOW ERROR and the RBC and PLT data are suppressed. At the end of each cycle, the RBC Count Time is displayed on the Data Station RUN screen to the right of the MPV result. If an RBC metering fault was detected, one of two messages is displayed and printed: the RBC CLOG message if either time is too slow or the RBC FLOW ERROR message if either time is too fast. Both the RBC Upper Metering Time (RUT) and the RBC Count Time (RCT) are displayed and printed when an RBC metering fault occurs.
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Principles of Operation
RBC/PLT Analysis
Chapter 3
RBC Parameters
Figure 3.11:
All numeric and frequency size distribution data are automatically displayed on the Data Station RUN screen in the format selected. The size distribution data for the red cells are displayed graphically as a histogram with the distribution data plotted on the X axis and the relative number of cells normalized and plotted on the Y axis. The RBC data are shown in the preceding figure.
RBC Count
The red blood cell count (RBC count) is directly measured, gives the number of RBCs, and is expressed as follows: RBC = # x 106/L (1012/L) Counts below 1.0 x 106/L (1012/L) are displayed to three decimal places. The RBC count is automatically corrected for the WBC count, and the corrected RBC count is displayed on the main RUN screen.
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MCV
The mean corpuscular volume (MCV) is the average volume of the individual red blood cells. The MCV is derived from the RBC size distribution data and is expressed in femtoliters.
HCT
The hematocrit (HCT) is the ratio of red blood cells to plasma and is expressed as a percentage of the whole blood volume. The HCT is calculated from the RBC count and the MCV as follows: HCT = (RBC x MCV)/10
MCH
The mean corpuscular hemoglobin (MCH) is the average amount of hemoglobin contained in the red blood cell, expressed in picograms. The MCH is calculated from the RBC and the HGB as follows: MCH = (HGB/RBC) x 10
MCHC
The mean corpuscular hemoglobin concentration (MCHC) is the ratio of the weight of hemoglobin to the volume of the average red blood cell, expressed in percent. It is calculated from the HGB and the HCT as follows: MCHC = (HGB/HCT) x 100
RDW
Red cell distribution width (RDW) is a measure of the heterogeneity of the RBC population. The CELL-DYN 3700 System reports a relative RDW equivalent to a CV in percent. The RDW is derived from the RBC histogram using the width of the RBC distribution at 50% of the peak height.
RBC Flagging
For a detailed discussion of the RBC flagging messages, refer to Operational Messages and Data Flagging within this chapter.
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Principles of Operation
RBC/PLT Analysis
Chapter 3
Reticulocytes
Reticulocytes are transitional red cells between nucleated red cells (NRBCs) and the so-called mature erythrocytes. The CELL-DYN 3700 System reports the reticulocyte percent, the Immature Reticulocyte Fraction (IRF), and will report the reticulocyte absolute number if the RBC value is entered. Reticulocytes and Reticulocyte flagging are discussed in detail in Chapter 14: Reticulocyte Package.
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PLT Parameters
Figure 3.12:
All numeric and frequency size distribution data are automatically displayed on the Data Station RUN screen in the format selected. The size distribution data for the platelets are displayed graphically as a histogram with the size distribution data plotted on the X axis and the relative number of cells normalized and plotted on the Y axis. The PLT data and histogram are shown in the preceding figure.
PLT Count
The platelet count (PLT count) is derived from the PLT histogram after the PLT data have been analyzed by the platelet algorithm. The PLT count is expressed as follows: PLT = # x 103/L (109/L)
MPV
The mean platelet volume (MPV) is derived from the PLT histogram after the PLT count has been determined. The MPV is expressed in femtoliters.
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RBC/PLT Analysis
Chapter 3
PCT
The plateletcrit (PCT) is the product of the PLT count and the MPV, and it is analogous to the hematocrit. It is expressed in percent and is calculated as follows: PCT = (PLT x MPV)/10,000
PDW
The platelet distribution width (PDW) is a measure of the heterogeneity of the PLT population. It is expressed as the geometric standard deviation. NOTE: Clinical significance has not been established for PCT and PDW. Therefore, they are not reportable in the U.S. They are provided for laboratory use only.
Platelet Flagging
For a detailed discussion of the PLT flagging messages, refer to Operational Messages and Data Flagging within this chapter.
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Principles of Operation
Hemoglobin Analysis
Overview
The HGB channel is used for the colorimetric determination of hemoglobin. A 1:301 dilution of the sample is made with the Diluent and the WIC/HGB lyse reagent in the mixing chamber of the WIC transducer. This dilution is used for the WIC count and the HGB measurement. Traditionally, the HGB concentration is measured using a modified hemiglobincyanide method. However, in an effort to create a safe, environmentally-responsible atmosphere, the CELL-DYN 3700 System can use a cyanide-free reagent. This reagent converts HGB to a hemiglobinhydroxylamine complex. A filtered LED with a wavelength of 540 nm is the light source. A photodetector measures the light that is transmitted.
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Principles of Operation
Hemoglobin Analysis
Chapter 3
HGB Parameters
The Hemoglobin is directly measured and is expressed in grams of hemoglobin per deciliter of whole blood. When the WBC is >30 K/L, the hemogobin value is automatically corrected for the WBC Count. The corrected hemoglobin value is displayed on the main RUN screen. The hemoglobin value is suppressed, with <<<< displayed for the hemoglobin result, whenever the WBC count is greater than 250 x 103/L (WOC) or 99.9 x 103/L (WIC). NOTE: Never use a hemoglobin standard designed for use with reference cyanmethemoglobin methodology directly on the CELL-DYN 3700 System. The CELL-DYN 3700 System uses a modified hemiglobincyanide or modified hemiglobin-hydroxylamine method, which is not designed to analyze these standards directly.
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Principles of Operation
Interfering Substances
It is important to note that there are commonly occurring interfering substances that can affect the results reported by hematology analyzers. While the CELL-DYN 3700 has been designed to detect and flag many of these substances, it may not always be possible to do so. The following indicates the substances that may interfere with each of the listed parameters. WBC: Fragile WBCs, neutrophil aggregates, lytic-resistant RBCs, NRBCs, PLT clumps, cryofibrinogen, cryoglobulin, paraproteins Elevated WBC count, increased numbers of giant PLTs, auto-agglutination, in vitro hemolysis Elevated WBC count, increased plasma substances (triglycerides, bilirubin, in vivo hemolysis), lytic-resistant RBCs. Elevated WBC count, hyperglycemia, in vitro hemolysis, increased numbers of giant PLTs.
RBC: HBG:
MCV:
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PLT:
WBC fragments, in vitro hemolysis, microcytic RBCs, cryofibrinogen, cryoglobulins, PLT clumping, increased numbers of giant PLTs.
For additional information on interfering substances, refer to the table provided in Appendix C. For a detailed description of the flags that are generated, refer to Section 3: Principles of Operation; Subsection: Operational Messages and Data Flagging.
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Parameter WBC*
Dispersional Data Alerts Result displays in yellow if below lower limit Result displays in purple if above upper limit Result underlined on graphics printout when limits exceeded Result underlined on blank ticket when limits exceeded Result marked with asterisk (*) on pre-printed ticket when results exceeded
Differential NEU LYM MONO EOS BASO RBC MCV RDW MCH MCHC
Neutropenia Neutrophilia Lymphopenia Lymphocytosis Monocytosis Eosinophilia Basophilia Anemia Polycythemia Microcytic RBC Macrocytic RBC Hypochromic Hyperchromic Anisocytosis
PLT MPV
Same as WBC
MPV Suppressed Thrombocytopenia (not displayed or Thrombocytosis printed) Microcytic PLT Macrocytic PLT
* One of the WBC descriptors (WIC or WOC) will be displayed next to the WBC value either, when the WIC and WOC differ by a clinically significant percentage or when the declining rate is detected and the count in the N1 (stroma) region of the scatterplot is less than 2.9% of the total WBC. The WBC value is reportable if there are no additional Suspect Parameter Flags present. If no descriptor or WBC Suspect Parameter Flag is present, the value selected is the WOC.
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Operational Messages and Data Flagging
Chapter 3
Specimens with results that exceed the linearity should be diluted with Diluent according to the laboratorys procedure and repeated. (Be sure to correct the results for the dilution factor used.) If desired, diluted specimens may be run in the Auxiliary Mode. Refer to the directions given in Chapter 5: Operating Instructions, Subsection: Specimen Type Soft Key, Auxiliary Soft Key. NOTE: MCV, MCH, MCHC, and MPV are unaffected by dilution and do not require correction. It is suggested that one Patient Limit Set be used to enter instrument-specific laboratory action limits. If the Interpretive Report option is enabled, the Interpretive messages, such as leukocytosis, anemia, thrombocytopenia, etc., will be displayed when a result falls outside the appropriate limit. A result that falls outside a laboratory action limit can also indicate the need for the operator to follow a laboratory protocol, such as repeating the sample, notifying the physician or performing a smear review. In cases where a cellular abnormality is present that alters cellular morphology to the point that the cells do not fit the criteria used by the instrument to generate a flag, dispersional data alerts may be the only flag(s) that will alert the operator to a potentially erroneous result.
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CELL-DYN 3700 System Operators Manual
Spec ID -----------Sequence #
BAND FLAG ESTIMATE REGION %: IG FLAG ESTIMATE REGION %: BLAST FLAG ESTIMATE REGION %: VAR LYM FLAG ESTIMATE REGION %: NRBC FLAG REGION ESTIMATE PER 100 WBCS:
MONO-POLY
LOBULARITY
9 0 d e g
9 0 d e g
10 deg PRINT
0 deg RETURN
Figure 3.13:
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Operational Messages and Data Flagging
Chapter 3
The Specimen ID and Sequence Number for the specimen currently displayed are indicated in the upper left-hand corner. The information displayed in the upper right-hand corner indicates the current operational status of the Analyzer including the current date, time, operator ID, Sequence Number, and Sampler Mode (Open or Closed). The region percentage estimates for the Suspect BAND, IG, BLAST and VAR LYM flags are displayed on the left side of the screen. Each percentage is an estimate of the number of cells present in the region of scatter on the 0/10 plot where that population is typically located. The NRBC estimate is expressed in #/100 WBC. Consequently, this percentage information is included in the criteria used to generate these Suspect Population Flags, which are displayed on the RUN screen and the Data Log DISPLAY SPECIMEN screen. The Flagging Diagnostics information is provided to indicate the possible severity of the Suspect flag. The graphs located on the right side of the screen are determined by the parameter set the operator selected for the displayed specimen. The number of the selected parameter set is indicated on the RUN screen and the Data Log DISPLAY SPECIMEN screen. The parameter set can be edited after the sample is processed by using the [EDIT SPECIMEN] key on the Data Log DISPLAY SPECIMEN screen. The Flagging Diagnostics information is provided for laboratory use only, and it is suggested that the information be incorporated into the laboratory's review criteria.
WBC Descriptors
The descriptors discussed in this section are displayed on the screen to provide additional information about the reported WBC value. A descriptor is displayed next to the WBC value only when the WIC and WOC differed by a clinically significant percentage and, consequently, the appropriate WBC as indicated by the descriptor is displayed. If no descriptor or WBC Suspect Parameter Flag is present, the WOC is the chosen value.
WIC
There is a clinically significant difference between the WIC and WOC values and the algorithm selected the WIC count as the most accurate WBC. Refer to Subsection: Flagging Summary, WBC Descriptors within this section for action to be taken when the WIC Descriptor is displayed.
WOC
There is a clinically significant difference between the WIC and WOC values and the algorithm selected the WOC count as the most accurate WBC. Refer to Subsection: Flagging Summary, WBC Descriptors within this section for action to be taken when the WOC Descriptor is displayed.
S I Z E Dynamic Threshold
N1 Region COMPLEXITY Figure 3.14: Scatterplot with Increased Stroma in the N1 Region
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Chapter 3
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Was the specimen run in the Resistant RBC mode? Is the Lymphocyte % greater than 60? Is there a kinetic decline in the WOC count? Is the count in the area (N1 region) below the dynamic WBC threshold (0/10 scatterplot) greater than 2.9% of the total WBC count? The flags that result from the instruments evaluation of the above criteria are discussed in the following section. The individual flags, including cause and corrective action, are also discussed in Flagging Summary at the end of this chapter.
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Operational Messages and Data Flagging
Chapter 3
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DFLT (NLMEB)
The DFLT flag indicates that default (preset) criteria were used to determine the five-part differential. This is caused by the presence of abnormal cell clusters that the instrument cannot reliably discriminate between, or by a low number of cells in a specific subpopulation. Descriptors in parentheses are added to the flag to indicate which subpopulation(s) is (are) suspect, based on the criteria used. The descriptors are N, L, M, E, and B. (N=Neutrophils, L=Lymphocytes, M=Monocytes, E=Eosinophils, and B=Basophils.) The following criteria can cause the DFLT flag: 1. A default (preset) value or threshold was used to determine the five-part differential. 2. A valley was not detected within the region that usually separates a given cell population from another cell population. 3. There is an abnormally low number of cells in a specific subpopulation.
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Chapter 3
NOTES
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Flagging Summary
WBC Descriptors
A descriptor is displayed next to the WBC value to indicate that WIC and WOC differed by a clinically significant percentage and the appropriate WBC as indicated by the descriptor is displayed. WIC Cause Action
There is a clinically significant Review a stained smear and follow difference between the WIC and your laboratorys protocol to WOC values, and/or a kinetic confirm the WIC result. decline in the WOC count rate was detected, and the count in the N1 (stroma) region of the scatterplot is less than 2.9% of the total WBC. The algorithm selected the WIC count as the most accurate WBC. WOC Cause There is a clinically significant difference between the WIC and WOC values and, therefore, the algorithm selected the WOC count as the most accurate WBC. Action Review a stained smear and follow your laboratorys protocol to confirm the WOC result.
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Flagging Summary
Chapter 3
WBC Flags
WBC Flag displayed next to the WBC result Cause 1. A clinically significant difference exists between the WIC and WOC values and the algorithm is unable to determine the most accurate WBC value. The algorithm selects what is estimated to be the best count for the reported WBC value and the WBC flag is displayed indicating that the result is suspect. Action If the NRBC and/or RRBC flags are displayed with the WBC flag, repeat the specimen using the Resistant RBC cycle to eliminate interference caused by lyticresistant RBCs. If the flag persists, review a stained smear for the presence of NRBCs which may affect the WIC count and verify the LYM value. Verify the WBC value by an alternate method according to your laboratorys protocol.
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WBC Flag displayed next to the WBC result (Continued) Cause 2. There is a kinetic decline in the WOC count rate. A kinetic decline generally indicates the presence of fragile WBCs that gradually disintegrate in the Sheath Reagent. When a kinetic decline is detected and the count in the N1 (stroma) region of the scatterplot is less 2.9% of the total WBC, then: WIC, which is estimated to be the most accurate result, is the reported WBC. (Over range will be displayed if the value is greater than 99.9 x 103/L.) The WBC Suspect Parameter Flag is displayed next to the WBC result. The FWBC or RRBC Suspect Population Flag may also be displayed. No WBC Differential results are displayed. If the WBC result is greater than 99.9 x 103/L., the hemoglobin result is suppressed and displayed as <<<<. When the hemoglobin result is displayed as <<<<, MCH and MCHC results are not displayed. Action
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Flagging Summary
Chapter 3
DFLT (NLMEB) displayed next to the BASO % Cause Default (preset) criteria were used to determine the five-part differential and therefore, some of the populations are suspect. Descriptors, in parentheses, are added to the flag to indicate which subpopulation(s) is (are) suspect, based on the criteria used. The descriptors are N, L, M, E, and B. (N=Neutrophils, L=Lymphocytes, M=Monocytes, E=Eosinophils, B=Basophils.) The following criteria can cause the DFLT flag: 1. A default (preset) value or threshold was used to determine the five-part differential. 2. A valley was not detected within the region that usually separates a given cell population from another cell population. 3. There is an abnormally low number of cells in a specific subpopulation. Action Examine a stained smear to verify the differential values for the subpopulation(s) identified by the descriptor(s).
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PLT Flags
LRI (Lower Region Interference) displayed next to the MPV result Cause Interference in the lower threshold region (13 fL) is greater than a predetermined limit. This is generally non-biologic interference. The flag may be caused by: Debris (dirty aperture) Contaminated reagent Electronic noise Microbubbles URI (Upper Region Interference) displayed next to the MPV result Cause Interference in the upper threshold region (1535 fL) is greater than a predetermined limit. This is generally biologic interference. The flag may be caused by: Microcytic RBCs Schistocytes Giant Platelets Sickle Cells Platelet Clumps NOTE: A bumpy platelet histogram may indicate the presence of platelet clumps. Action Review the MCV and the PLT histogram. If the MCV is low and/ or the histogram indicates an overlap (poor separation at the upper discriminator) in the RBC and PLT populations, review a stained smear to determine the cause and verify the PLT count. Action Check the background count. If it exceeds the limits, troubleshoot accordingly. If it is within limits, repeat the specimen. If the flag persists, review a stained smear to determine the cause of the interference and verify the PLT count.
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Flagging Summary
Chapter 3
LURI (Lower and Upper Region Interference) displayed next to the MPV result Cause Action
Interference is present in both the Follow the guidelines given above upper and lower regions of the PLT for the LRI and URI flags. histogram. PLTR (Platelet Recount) displayed next to the platelet count Cause The PLT count was <120 K/L and, therefore, a platelet recount was performed. The difference between the count and recount values exceeds expected limits. Action Repeat the specimen. If the flag is no longer displayed and there are no other data invalidating flags, the PLT count is reportable. If the flag persists, review a stained smear and verify the PLT count
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WBC Flags
BAND displayed next to the NEU % Cause 1. The count in the region of scatter (on the 0/10 plot) where bands are typically located is >12.5% of the total WBC count. 2. The ratio of suspected bands to mature neutrophils is >50%. 3. The CV of the neutrophil cluster on the 0 axis exceeds expected criteria. IG (Immature Granulocyte) displayed next to the NEU % Cause The count in the region of scatter (on the 0/10 plot) where immature granulocytes are typically located is >3% of the total WBC count. Action Review a stained smear for the presence of immature granulocytes and follow your laboratorys review criteria. When IGs are present, they are included in the total neutrophil count. Action Review a stained smear for the presence of bands and follow your laboratorys review criteria. When bands are present, they are included in the total neutrophil count.
BLAST displayed next to the LYM % Causes The count in the region of scatter (on the 90/0 plot) where blasts are typically located is >1% of the total WBC count. Action Review a stained smear for the presence of blasts and follow your laboratorys review criteria. When blasts are present, they are typically included in the monocyte count.
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Chapter 3
VAR LYM displayed next to the LYM % Cause 1. The count in the region of scatter on the size/complexity (0/10) scatterplot where variant Lymphs are typically located is >10% of the total WBC count. 2. The absolute lymphocyte or the absolute mononuclear (including basophils) count exceeds expected criteria and the ratio of lymphocytes to monocytes exceeds a predetermined limit. 3. The ratio of neutrophils to lymphocytes falls below expected criteria. 4. The WIC/WOC comparison indicates the suspected presence of variant lymphocytes. NOTE: This flag may be displayed singly or in combination with the blast flag. If the flag is displayed with the blast flag, it is displayed as VLYM/BLAST. Action Review a stained smear for the presence of variant lymphocytes and/or smudge cells and follow your laboratory's review criteria. When variant lymphocytes or smudge cells are present, they are included in the lymphocyte count.
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NWBC (NonWhite Blood Cell) displayed next to the Mono % result Causes A non-WBC population is present in the N1 region below the dynamic WBC threshold on the size/ complexity (0/10) scatterplot. The count in the N1 region is greater than 2.9% of the total WBC. The WIC value is equal to the WOC value and WOC is the reported WBC. The cell types that may be present in the N1 region are: Low levels of NRBCs Unlysed RBCs PLT clumps Giant PLTs Action Review a stained smear and follow your laboratory's review criteria to determine the cause of the elevated count in the N1 region. If NRBCs are present and correction of the WBC is required, correct the WIC value and use the resultant number to confirm the WOC. If no other Suspect Parameter flags are present, the corrected WIC (or confirmed WOC) value is reportable. If something other than NRBCs caused the elevated count in the N1 region, follow your laboratorys protocol for reporting the WBC result.
FWBC (Fragile White Blood Cells) displayed next to the Mono % result Causes The presence of fragile WBCs is suspected. A kinetic decline in the WOC count rate was detected and the count in the N1 (stroma) region of the scatterplot is less than 2.9% of the total WBC. The algorithm selects WIC, estimated to be the best count for the reported WBC value, and displays the WBC flag to indicate that the result is suspect. Action Review a stained smear and follow your laboratory's review criteria to confirm the LYM values and the reported WBC value. If no suspect parameter flags are present, the confirmed WBC and Differential may be reported.
NOTE: Mechanical and chemical trauma may increase cellular destruction. Consequently, specimens containing fragile WBCs should not be run in the Resistant RBC cycle because the extended lysing time will increase cellular destruction. However, if the reported WBC value exceeds the linearity, it is appropriate to run the diluted specimen in the Auxiliary Mode to obtain the WBC value. Always compare the results and flags displayed in the Auxiliary Mode to those obtained in the Patient Run Mode, and evaluate the individual flags displayed in both modes as described in this section.
CELL-DYN 3700 System Operators Manual
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NRBC (Nucleated Red Blood Cells) displayed next to the MONO % Causes The presence of NRBCs is suspected. The WIC count is higher than the WOC and the WOC is the reported value. The count in the N1 region, below the dynamic WBC threshold on the size/complexity (0/10) scatterplot, is greater than 2.9% of the total WBC. Cell types that may be present in the N1 region: NRBCs PLT clumps Giant PLTs. Action Review a stained smear for the presence of NRBCs and follow your laboratory's review criteria. If NRBCs are present they should be quantified according to your laboratory's procedure. If correction of the WBC is required, correct the WIC value and use the resultant number to confirm the WOC result. If no other Suspect Parameter Flags are present, the corrected WIC (or confirmed WOC) value is reportable. If the WBC flag is displayed with the NRBC flag, repeat the specimen using the Resistant RBC cycle to eliminate possible interference from any lytic-resistant RBCs that may be present with the NRBCs.
RRBC (Resistant Red Blood Cells) displayed next to the Mono % result Causes The presence of lyse-resistant RBCs is suspected. The WOC count is higher than the WIC count and there is a significant amount of stroma present (>2.9% of the total WBC) in the N1 region, below the dynamic WBC threshold on the size/ complexity (0/10) scatterplot. Action Repeat the specimen using the Resistant RBC cycle to eliminate interference from any lytic-resistant RBCs that may be present. (The Resistant RBC cycle reduces the number of flags generated. However, an increase in false positive band flags may be evident.) The appropriate WBC value is selected as indicated by the descriptor. If the WBC flag is displayed, review a stained smear to determine the cause of the interference. Verify the WBC value by an alternate method according to your laboratorys protocol.
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RBC Flag
RBC MORPH displayed next to the HCT result Cause One or more of the following parameters exceeds expected limits: MCV <80 fL or >100 fL MCH <25 pg or >34 pg MCHC <29 g/dL or >37 g/dL RDW >18.5% Action Review a stained smear for abnormal RBC or PLT morphology and follow your laboratorys review criteria.
PLT Flag
No MPV result displayed (data suppressed) Cause The PLT histogram did not meet expected criteria (non-log normal distribution). Action Review a stained smear for abnormal PLT morphology or the presence of PLT aggregates and follow your laboratorys review criteria. Verify the PLT count.
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Interpretive Messages
Interpretive messages appear only on the graphics report and are generated when the numeric limits entered in the Patient Limit Sets are exceeded. (See Set Up Instructions in Chapter 5: Operating Instructions for an explanation). These messages are printed only when the Interpretive Report option is selected on the CUSTOMIZE REPORT Screen. The Interpretive messages are summarized below.
WBC Messages
Message Leukopenia Leukocytosis Neutropenia Neutrophilia Lymphopenia Lymphocytosis Monocytosis Eosinophilia Basophilia Cause Result falls below the lower limit for WBC. Result exceeds the upper limit for WBC. Result falls below the lower limit for Neutrophil absolute number. Result exceeds the upper limit for Neutrophil absolute number. Result falls below the lower limit for Lymphocyte absolute number. Result exceeds the upper limit for Lymphocyte absolute number. Result exceeds the upper limit for Monocyte absolute number. Result exceeds the upper limit for Eosinophil absolute number. Result exceeds the upper limit for Basophil absolute number.
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Cause Result falls below the lower limit for RBCs. Result exceeds the upper limit for RBCs. Result falls below the lower limit for MCV. Result exceeds the upper limit for MCV. Result falls below the lower limit for MCHC. Result exceeds the upper limit for MCHC. Result exceeds the upper limit for RDW.
PLT Messages
Message Thrombocytopenia Thrombocytosis Microcytic PLT Macrocytic PLT Cause Result falls below the lower limit for PLTs. Result exceeds the upper limit for PLTs. Result falls below the lower limit for MPV. Result exceeds the upper limit for MPV.
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References
1. International Committee For Standardization in Haematology (ICSH). The Assignment of Values to Fresh Blood Used for Calibrating Automated Cell Counters. Clinical and Laboratory Hematology 1988; 10:203-212. 2. American Society of Clinical Pathologists (ASCP). Clinical Applications of Flow Cytometry. ASCP National Meeting. Spring 1990. 3. Shapiro Howard. Practical Flow Cytometry. New York: LISS. 1985. 4. Clinical and Laboratory Standards Institute/NCCLS. Methods for Reticulocyte Counting (Automated Blood Cell Counters, Flow Cytometry, and Supravital Dyes); Approved Guideline Second Edition. CLSI/NCCLS document H44-A2 (ISBN 1-56238-5275) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2004.
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Principles of Operation
References
Chapter 3
NOTES
3-64
Chapter 4
System Specification
System Specifications
Overview
This chapter includes physical, power, and operational specifications for both the CELL-DYN 3700SL System and the CELL-DYN 3700CS System. It also includes bar code specifications for the CELL-DYN 3700SL System. In addition, measurement specifications, performance specifications, and performance characteristics are included for both systems.
4-1
System Specifications
Overview
Chapter 4
NOTES
4-2
Analyzer with Sample Loader Height Width Depth Weight 27" (68 cm) 30" (76 cm) 31" (79 cm) 288 lb (131kg)
CPU 6.4 (16.3 cm) 16.9 (42.9 cm) 17.3 (43.9 cm) 32 lb (14.5 Kg)
Display Monitor 15 (38.1 cm) 14 (35.5 cm) 16 (40.6 cm) 30 lb (13.6 Kg)
Ticket Printer 6" (15 cm) 16.5" (41 cm) 14.5" (39 cm) 16.5 lb (7.5 kg)
Graphics Printer 13" (33 cm) 19" (48 cm) 24" (61 cm) 14.3 lb (6.5 kg)
4-3
System Specifications
CELL-DYN 3700SL System Specifications
Chapter 4
Power Specifications
Table 4.2: Power Specifications
Analyzer Input Requirements Setting 100 120 220 240 Range 90110 VAC 110130 VAC 200240 VAC 220260 VAC Data Station Input Requirements Setting 120 240 Range 90130 VAC 180260 VAC Printer Input Requirements (Graphics) Setting 120 VAC 240 VAC Frequency 50/60 Hz 50/60 Hz Frequency 50/60 Hz 50/60 Hz Frequency 50/60 Hz 50/60 Hz 50/60 Hz 50/60 Hz
Sample Loader Input Requirements Setting 100 100 115 215 230 Range 90110 VAC 90110 VAC 105125 VAC 195235 VAC 210250 VAC Frequency 50 Hz 60 Hz 60 Hz 50 Hz 50 Hz
4-4
Consumption
Analyzer: Data Station: Graphics Printer: Ticket Printer: Sample Loader: 900 watts 300 watts 110 watts 145 watts 50 watts
4-5
System Specifications
CELL-DYN 3700SL System Specifications
Chapter 4
Operational Specifications
Operating Environment
Indoor Use Temperature Patient Samples: Room Temperature (1530C) Monocyte values exhibit a change at lower and higher temperatures. A 1.5% decrease is seen in the total monocyte percent at lower temperatures (<18C). A 6% increase will be seen at higher temperatures (>32C). Background values for RBC and PLT may exhibit an increase at lower environmental temperatures (<18C). Instrument: 1530C Relative Humidity 10% to 85%, RHNC
* The laser requires a 15-minute warm-up time. If the power has been OFF longer than 5 minutes, wait 10 minutes after the Auto-Startup Cycle is complete before processing samples.
Batch Size
1100 tubes per batch
4-6
Throughput
Maximum throughput = 90 samples/hour NOTE: Maximum throughput is achieved with normal samples that do not generate any instrument operational messages.
4-7
System Specifications
CELL-DYN 3700SL System Specifications
Chapter 4
NOTES
4-8
Analyzer Height Width Depth Weight 24" (61 cm) 30" (76 cm) 22" (56 cm) 190 lb (86 kg)
CPU 6.4 (16.3 cm) 16.9 (42.9 cm) 17.3 (43.9 cm) 32 lb (14.5 Kg)
Display Monitor 15 (38.1 cm) 14 (35.5 cm) 16 (40.6 cm) 30 lb (13.6 Kg)
Ticket Printer 6" (15 cm) 16.5" (41 cm) 14.5" (39 cm) 16.5 lb (7.5 kg)
Graphics Printer 13" (33 cm) 19" (48 cm) 24" (61 cm) 14.3 lb (6.5 kg)
4-9
System Specifications
CELL-DYN 3700CS System Specifications
Chapter 4
Power Specifications
Table 4.4: Power Specifications
Analyzer Input Requirements Setting 100 120 220 240 Range 90110 VAC 110130 VAC 200240 VAC 220260 VAC Data Station Input Requirements Setting 120 240 Range 90130 VAC 180260 VAC Printer Input Requirements (Graphics) Setting 120 VAC 240 VAC Frequency 50/60 Hz 50/60 Hz Frequency 50/60 Hz 50/60 Hz Frequency 50/60 Hz 50/60 Hz 50/60 Hz 50/60 Hz
Consumption
Analyzer: Data Station: Graphics Printer: Ticket Printer: 900 watts 300 watts 110 watts 145 watts
4-10
Operational Specifications
Operating Environment
Temperature Patient Samples: Room Temperature (1530C) Monocyte values exhibit a change at lower and higher temperatures. A 1.5% decrease is seen in the total monocyte percent at lower temperatures (<18C). A 6% increase will be seen at higher temperatures (>32C). Instrument: 1530C Background values for RBC and PLT may exhibit an increase at lower environmental temperatures (<18C). Relative Humidity 10% to 85%, RHNC
* The laser requires a 15 minute warm up time. If the power has been OFF longer than 5 minutes, wait 10 minutes after the Auto-Startup Cycle is complete before processing samples.
4-11
System Specifications
CELL-DYN 3700CS System Specifications
Chapter 4
NOTES
4-12
Data Collection
WOC:
Laser light scatter Vertically polarized 510 mW heliumneon laser 632.8 nm 1:51 of blood in Sheath Reagent Four angles measured: 0, 10, 90, and 90 depolarized. Data collected in 256 channels for each angle of light scatter.
4-13
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
HGB
Method Modified hemiglobincyanide or modified hemiglobinhydroxylamine Light Emitting Diode, wavelength: 555 nm Interference Filter Center wavelength: 540 nm Bandwidth (at 1/2 peak): 22 nm 1:301 of blood in Diluent and WIC/HGB Lyse or WIC/HGB Cyanide-Free Lyse Average of 5 absorbance readings for the detergent blank, average of 5 absorbance readings for the sample dilution
Dilution
Data Collection
4-14
Performance Specifications
Background Counts (Acceptable Up to Limits Listed)
WIC WOC RBC HGB PLT RETIC <0.30 <0.30 <0.03 <0.20 <10.0 <100 counts/count cycle
NOTE: Background counts must be within acceptable limits before running controls and patient specimens.
Precision
Samples that are used to verify precision specifications should have results that fall within the laboratory's normal range. These samples should not display any of the following WBC descriptors or Suspect Parameter Flags: WBC WIC WOC RBC MORPH LRI URI LURI PLTR Fragile RBCs ERL ENC The stated precision values are applicable to the Open, Closed Sampler, and Sample Loader Modes.
4-15
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
Hemogram Parameters
Precision specifications for the hemogram parameters are given as a 95% confidence limit for the Coefficient of Variation (CV) of at least 31 determinations of the same sample.
Table 4.5: Precision of the Hemogram and Reticulocyte Parameters (N = 31)
Parameter WBC (WOC) WBC (WIC) RBC HGB MCV RDW PLT MPV RETIC %
NOTE: If the reported WBC is not accompanied by a WBC descriptor (WIC or WOC), the WBC (WOC) precision specification applies because WOC is the primary reported value when WIC and WOC values are equal.
4-16
Linearity
Linearity specifications were determined by analyzing dilutions of a commercially available linearity control material that contains no interfering substances. Specifications are determined by taking multiple measurements for each dilution to minimize the effect of imprecision. The stated limits (refer to the following table) are determined by regression through the origin (0,0), throughout the linear reportable range. Reticulocyte linearity was determined by running six levels of reticulocyte control material prepared by mixing varying concentrations of two stock preparations. The general method described in CLSI/NCCLS Document EP6-A, Evaluation of the Linearity of Quantitative Analytical Methods, was used.1 Specifically, six concentration levels were run in quadruplicate, and the method of least squares regression was used for analysis of the reticulocyte percentage result. NOTE: Results that exceed the linear range must be confirmed by diluting the specimen until the result falls within the appropriate linear range and then correcting that result for the dilution in order to obtain a reportable result.
Table 4.7: Linearity Specifications
Parameter WBC
Linear Range 099.9 K/L 0250 K/L 08 M/L 024 g/dL 50200 fL 02000 K/L 518 fL 030 %
Acceptable Limits (whichever is greater) +0.4 or 3.0% +0.4 or 4.0% +0.1 or 2.5% +0.3 or 2.0% +3.0 or 3.0% +10.0 or 7% +1.0 or 6.0% +1.1 or 7.0%
WIC WOC
4-17
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
Accuracy
The CELL-DYN 3700 System can be calibrated to agree with reference values within the allowable calibration ranges. Both modes of operation, Open and Closed (CS and SL), may be calibrated. Thus, it is possible to compensate for differences between modes due to differing aspiration pathways. When each mode is properly calibrated according to the directions given in this manual, bias between the modes is clinically insignificant. Accuracy specifications are determined by correlation to reference values obtained from comparison analyzers or analysis by reference methodology. Samples that are used for correlation studies should not display any Suspect Parameter Flags.
Hemogram Parameters
Table 4.8: Accuracy of Hemogram Parameters
Due to differences in methodology, the bias results from clinical studies showed that the CELL-DYN 3700 IRF does not have the same sensitivity as a fluorescent method, such as that used on the CELL-DYN 4000 System. This is especially true at low and lownormal threshold levels.
4-18
Parameter Neutrophil # and % Lymphocyte # and % Monocyte # and % Eosinophil # and % Basophil # and %
Carryover
Carryover is determined by running samples with high concentrations of WBCs, RBCs, HGB, PLTs and Retics. Each sample is run in triplicate followed by three background cycles. Reticulocyte carryover was determined by running specimens with high reticulocyte or RBC counts. Each specimen was run in triplicate followed by three background cycles. Since reticulocyte background results are given as count/count cycle, the specimen value used in the calculation is the List Mode WOC value which is displayed on the RETICULOCYTE RAW DATA SUMMARY screen. This screen is accessed from the RETICULOCYTE DIAGNOSTICS screen. The percent carryover is calculated using the following formula: % Carryover = Background1 Background3 x 100 Sample3 Background3
RBC 7.5M/L
HGB 22.5g/dl
Carryover <1.0% or <1.0% or <1.0% or <1.0% or (in % or <0.1 K/L <0.03 M/L <0.1 g/dL <10 K/L Absolute)
4-19
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
Performance Characteristics
Typical Precision
The pooled precision values (CVs) for the hemogram parameters are based on the analysis of data from replicate runs of N=31. The data were obtained from several CELL-DYN 3700 Systems over a period of weeks and derived using samples with results in the normal range. These precision values represent the typical performance that can be expected from instruments that are maintained properly, are operating in acceptable environmental conditions, and are using only recommended reagents and supplies.
Table 4.11: Typical Precision for Hemogram Parameters
4-20
Table 4.12:
4-21
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
Abnormalities Evaluated
Table 4.16 lists the abnormalities and the number of cases of each abnormality that were evaluated during the testing period.
Table 4.14: Abnormalities Evaluated
Abnormality Granulocytosis Granulocytopenia Lymphocytosis Lymphocytopenia Monocytosis Eosinophilia Basophilia Bands >12% Metamyelocytes >1% Myelocytes >1% Promyelocytes >1% Blasts >1% Variant Lymphocytes >3% NRBCs >1/100 WBCs
4-22
Truth Table
The Truth Table showing the sensitivity and specificity and the analysis of the false negative results is presented in this section. The data are based on the evaluation of a total of 374 cases, many of which had multiple abnormalities. Arbitration using the 95% confidence envelope at the upper limit of the range was applied to the manual differential results. In the following table: TP = True Positive
TN = True Negative FP = FN =
Table 4.15: Flagging Analysis Truth Table
CELL-DYN 3700 Normal Reference Normal Reference Morphological Positive Reference Distributional Positive Total 165 TN 2 FN 1 FN 168
NOTE: The false positive and false negative ratios shown above express the results as a percentage of the total true positive and total true negative results, respectively, in accordance with CLSI/NCCLS Document H20-A.2 The previous version of this manual expressed the results as a percentage of the total specimens evaluated.
Table 4.16: Analysis of False Negative Results
Manual Differential Morphological False Negative Distributional False Negative 2% Metamyelocytes 4% Metamyelocytes 6.3% Lymphocytes
4-23
System Specifications
Combined Specifications for the SL and CS Systems
Chapter 4
NOTES
4-24
References
1. Clinical and Laboratory Standards Institute/NCCLS. Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach; Approved Guideline. CLSI/ NCCLS document EP6-A (ISBN 1-56238-498-8) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2003. 2. Clinical and Laboratory Standards Institute. Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods; Approved Standard. CLSI/NCCLS document H20-A (ISBN 1-56238-131-8) NCCLS, 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 1992.
4-25
System Specifications
References
Chapter 4
NOTES
4-26
Chapter 5
Operating Instructions
Operating Instructions
Overview
This chapter discusses the operation of the CELL-DYN 3700 System. It is divided into four sections. The first section, the Overview, contains (1) instructions for an Instrument Logbook, (2) a Data Station Program Overview, and (3) a Menu Flowchart showing the different screens that are available on the Data Station. The other three sections in this chapter are identified by subtabs: Set Up Instructions, Routine Operation, and Using the Data Log. These three sections describe three of the major menus used in operating the instrument: the SET UP MENU, the RUN menu, and the DATA LOG menu. The other major menus are described in other chapters. The QUALITY CONTROL menu is described in Chapter 7: Quality Control. The CALIBRATION menu is described in Chapter 6: Calibration. The DIAGNOSTICS menu is described in Chapter 10: Troubleshooting. And the SPECIAL PROTOCOLS menu is described in Chapter 9: Maintenance.
Instrument Logbook
Create a logbook for the instrument. This logbook should contain all necessary calibration documentation and other information that is pertinent to your instrument. Suggested sections that you may wish to include in the logbook are: Installation documentation Your laboratorys operating procedure Quality control Calibration Maintenance Reagent lot number changes Troubleshooting and problem resolution Printed fault reports Service calls and problem resolution/service performed Software upgrades This logbook should be stored near the instrument and be accessible to all operators and Abbott Service Personnel.
5-1
Operating Instructions
Overview
Chapter 5
Screen
Soft Keys
Figure 5.1:
Data Station
The Data Station menus are presented as key labels displayed across the bottom of the screen. Each menu is accessed by pressing the soft key located directly below the label. (From left to right, these soft keys correspond to keys F1 F8 on the standard computer keyboard.)
5-2
Version X.XX
15:50 sh 0067
SET UP
RUN
DATA LOG
QUALITY CONTROL
CALIBRATION
DIAGNOSTICS
SPECIAL PROTOCOLS
Figure 5.2:
When the Data Station is turned ON, the MAIN MENU screen, depicted in the preceding figure, is displayed. The key labels displayed across the bottom of this screen are used to access all of the submenus that are available. The MAIN MENU screen displays the following soft key labels: SET UP RUN DATA LOG RETIC DATA LOG* QUALITY CONTROL CALIBRATION DIAGNOSTICS SPECIAL PROTOCOLS
5-3
Operating Instructions
Overview
Chapter 5
Each of these MAIN MENU keys, in turn, accesses its own hierarchy of screens and options. The different menus allow the operator to perform various functions, such as configuring the system for operation, running specimens, performing calibration and diagnostic functions, reviewing data, and printing customized reports. The MAIN MENU screen is depicted in the preceding figure. The upper left-hand corner shows the current version of the instrument software. The upper right-hand corner shows the current date and time, the operator ID, and the sequence number. The information in the upper right corner is displayed on every screen during operation. NOTE: The cursor is positioned at the <OPERATOR ID> entry field when the MAIN MENU screen is displayed. An operator ID of up to three alphanumeric characters may be entered. (An operator ID may also be entered from the CALIBRATION screen.) This operator ID will be displayed on all other screens and printed on all reports. The Status Box is displayed in the top center of the screen. This box appears on every screen to show the following: Menu in use (such as MAIN MENU) Analyzer status (such as READY) Other applicable information such as report or file identity and any existing fault messages Finally, the MAIN MENU key labels are displayed across the bottom of the MAIN MENU screen.
5-4
SUBMENU KEYS
Flowchart Conventions
Menus are shown as square-cornered rectangles in the flowcharts, and soft keys are shown as round-cornered rectangles:
MAIN MENU Ready
SET UP
RUN
DATA LOG
QUALITY CONTROL
5-5
Operating Instructions
Overview
Chapter 5
Menu Flowcharts
After pressing one of the MAIN MENU soft keys, the appropriate submenu is displayed. From the submenus, more options are available. The MAIN MENU options flowchart is shown on this page. On the following pages, flowcharts show the submenus under each MAIN MENU option.
SET UP
RUN
DATA LOG
QUALITY CONTROL
CALIBRATION
DIAGNOSTICS
SPECIAL PROTOCOLS
5-6
Overview
DATE/ TIME
PATIENT LIMITS
REAGENT LOG
MAIN
LIMIT SET 1
LIMIT SET 2
LIMIT SET 3
LIMIT SET 4
RETURN
DELETE ENTRY
DILUENT LOG
SHEATH LOG
DETERGENT LOG
PRINT LOG
X-B SET UP
LAB ID SET UP
QC LIMITS
SET UP QC FILE
MAIN
TOGGLE ON/OFF
SET UP
TURN X-B TURN X-B RBC ON WBC ON TURN X-B TURN X-B RBC OFF WBC OFF
RETURN
TOGGLE ONE/ALL
RETURN
LOAD LOW
LOAD NORMAL
LOAD HIGH
RETURN SELECT PARAMETER CANCEL SELECTION STANDARD GROUPS CUSTOM PLACEMENT TOGGLE ONE/ALL RETURN
CONFIRM UPDATE
CANCEL UPDATE
TOGGLE ON/OFF
RETURN
PLACE PARAMETER
WBC GROUP
RBC GROUP
PLT GROUP
DIFF GROUP
LATEX SET
PARAM SET 1
PARAM SET 2
PARAM SET 3
PARAM SET 4
SELECT GRAPH
SET UP
PARAM SET 2
PARAM SET 3
PARAM SET 4
PLACE GRAPH
SET UP
TICKET CUSTOMIZE STOP CUSTOMIZE TOGGLE PRINTER DISPLAY PRINTING HEADER ON/OFF RESTORE PRE-PRNTD GRAPHICS TICKET PRINTER HEADER BLANK CONFIRM CANCEL TICKET STOP STOP
SET UP
RESTORE HEADER
SET UP
5-7
Operating Instructions
Overview
Chapter 5
WORK LIST
SPECIMEN CUSTOMIZE CHANGE TYPE REPORT SAMPLER see CUSTOMIZE REPORT of SET UP MENU
PRINT TICKET
MAIN
PATIENT
QC SPECIMEN
BACKGROUND
ELECTRICL BACKGRND
LATEX
RESISTANT RBC
AUXILIARY
RETURN
WORK LIST BAR CODE ON ON WORK LIST BAR CODE OFF OFF
INSERT/ DELETE
DELETE ALL
RETURN
CONFIRM DELETION
CANCEL DELETION
TOGGLE ON/OFF
RETURN
INSERT
DELETE
RETURN
CONFIRM PURGE
CANCEL PURGE
EDIT ID
PRINT FIND REJECT CUSTOMIZE TRANSMIT DISPLAY DATA LOG SPECIMEN SPECIMEN FROM X-B DATA LOG DATA ACCEPT INTO X-B SELECT STANDARD CUSTOMIZE PARAMETER GROUPS PRINTOUT
MAIN
RETURN
RETURN
RETURN
RETURN
WBC GROUP
RBC GROUP
PLT GROUP
DIFF GROUP
EDIT PREVIOUS NEXT CUSTOMIZE TRANSMIT SPECIMEN SPECIMEN SPECIMEN REPORT SPECIMEN
PRINT TICKET
RETURN
CONFIRM
CANCEL
5-8
QC MENU Ready
X-B SET UP
X-B FILE
VIEW QC LOG
QC LIMITS
SET UP QC FILE
MAIN
TURN ON TURN ON X-B WBC X-B RBC TURN OFF TURN OFF X-B WBC X-B RBC
RETURN SELECT CANCEL STANDARD PARAMETER SELECTION SELECTION PLACE PARAMETER TOGGLE ONE/ALL RETURN
RETURN
SELECT PARAMETER PLACE PARAMETER WBC GROUP LOT NUMBER REPLICATE ID RANGE ENTRY
CANCEL SELECTION
TOGGLE ONE/ALL
RETURN
RBC GROUP
PLT GROUP
DIFF GROUP
LATEX SET
TOGGLE ON/OFF
RETURN
RETURN
MEANS/ LIMITS WRITE QC TO DISK LOAD LOW LOAD NORMAL LOAD HIGH RETURN
PURGE QC LOG
LEVEYJENNINGS
DELETE SPECIMEN
MOVE SPECIMEN
PRINT QC LOG
RETURN
CONFIRM PURGE
CANCEL PURGE
CONFIRM UPDATE CONFIRM CANCEL DELETION DELETION MOVE TO FILE CANCEL MOVE
CANCEL UPDATE
GROUP 1
GROUP 2
GROUP 3
GROUP 4
RETURN
WRITE LOW
WRITE NORMAL
WRITE HIGH
RETURN
5-9
Operating Instructions
Overview
Chapter 5
ENTER FACTOR
CALIBRATN LOG
AUTOCALIBRATE
MAIN
RESTORE FACTORS
RETURN WHOLE BLOOD CALIBRATR MPV LATEX CHANGE SAMPLER (CS MODEL ONLY) RETURN
PRINT LOG
RETURN
START AUTO-CAL
CONTINUE AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
CANCEL QUIT
START AUTO-CAL
PRINT SUMMARY
RETURN
PREVIOUS SPECIMEN
NEXT SPECIMEN
REPEAT SPECIMEN
ACCEPT MEANS
RETURN
CONFIRM REPEAT
CANCEL ACCEPT
5-10
FAULT REPORT
EXECUTION TIMES
CLEAR FAULTS
MORE
MAIN
WOC RBC PLT WIC CNT RATE CNT RATE CNT RATE CNT RATE WOC RBC PLT WIC CNT GRAPH CNT GRAPH CNT GRAPH CNT GRAPH
RETURN
INITIALIZATION
MORE
MAIN
CYCLE BANK
STEP SOLENOID
DIAGNOSTICS
DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
VACUUM PRESSURE INHIBIT ON ON PUMPS VACUUM PRESSURE ENABLE OFF OFF PUMPS
VACUUM TEST
PRESSURE TEST
DIAGNOSTICS
HOME MOTORS
EXERCISE MOTOR
SHEAR VAL SHEAR VAL PRINT TIME DISPENSE SHEAR VAL ASPIRATE
DIAGNOSTICS
FINISH SELECT
SELECT
DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
VERIFY GAINS
ENTER SETTINGS
CURRENT SETTINGS
SIGNAL GENERATOR
DIAGNOSTICS
MAM TESTING
SPM TESTING
WIM TESTING
RETURN
WOC DATA
RBC PLT WIC MORE DATA DATA DATA RBC PLT WIC HISTOGRAM HISTOGRAM HISTOGRAM
MAIN
SERIAL TEST
MORE
MAIN
CALC CV
SCATTER GRAPHS
DIAGNOSTICS
STOP TRANSMISS
TRANSMIT MESSAGE
DIAGNOSTICS
5-11
Operating Instructions
Overview
Chapter 5
MAINTEN LOG
CLEAN DISABLE SHEAR VAL ANALYZER ENABLE RESTORE SHEAR VAL ANALYZER
MORE
MAIN
INTERVAL SET UP
UPDATE LOG
PRINT LOG
RETURN
RETURN
FLUSH SHEATH
AUTO CLEAN
DAILY SHUTDOWN
PREPARE SHIPPING
CLEAN NEEDLE
EXTEND AUTOCLEAN
MORE
MAIN
5-12
Set Up Instructions
When the [SET UP] key on the MAIN MENU screen is pressed, the SET UP MENU screen is displayed. (See the following figure.) The options accessible from this screen are used to configure the system according to the laboratorys requirements. The function of each soft key is discussed on the following pages, and setup procedures are included where applicable.
DATE/ TIME
PATIENT LIMITS
REAGENT LOG
QC SET UP MENU
OPERATION SET UP
UNITS SELECTION
CUSTOMIZE REPORT
MAIN
Figure 5.3:
SET UP
The [SET UP] key is used to display the SET UP MENU screen. The following soft key labels are displayed on this screen: DATE/TIME PATIENT LIMITS REAGENT LOG QC SET UP MENU OPERATION SET UP UNITS SELECTION CUSTOMIZE REPORT MAIN These keys are used to set up the system for operation.
5-13
Operating Instructions
Set Up Instructions
Chapter 5
Enter desired date display option and/or set date and time:
2 3
RETURN
Figure 5.4:
DATE/ TIME
The [DATE/TIME] key on the SET UP MENU is used to display the DATE/TIME SET UP screen (shown in the preceding figure). This screen is used to enter the date and time. This screen allows the operator to select the format for displaying the date and to change the date and time as required. Four different date formats are available. The circled numbers shown in the preceding figure correspond to the following numbered options: 1. The Display Format Selection Box is used to select the format in which the date is displayed: 1: Month/Day/Year 2: Day/Month/Year 3: Year/Month/Day 4: Year/Day/Month 2. The <DATE> entry field contains the operator-entered date. 3. The <TIME> entry field contains the operator-entered time.
5-14
The desired format is selected by typing the corresponding number in the entry field displayed to the left of the list (1). When the Enter key on the keyboard is pressed, the selected format is displayed in the <DATE> entry field (2) and the cursor moves to the entry position of this field. After the date has been entered, the cursor moves to the <TIME> entry field (3).
Procedure: Date/Time
1. From the SET UP MENU screen, press the [DATE/TIME] key to display the DATE/TIME SET UP screen. 2. Type the number of the desired format at the cursor. 3. Press the Enter key on the keyboard to save the entry and advance the cursor to the <DATE> entry field. 4. Type the date in the selected format using one or two digits. Separate the day, month, and year with a slash (/) or a period (.). The entry order of the date should conform to the date format just selected. 5. Press the Enter key on the keyboard to save the entry and advance the cursor to the <TIME> entry field. 6. Type the time in the 24-hour (military) time format using one or two digits. Separate the hours and minutes with a colon (:) or a period (.). 7. Press the Enter key on the keyboard to save the entry. 8. Press the [RETURN] key to return to the SET UP MENU screen.
5-15
Operating Instructions
Set Up Instructions
Chapter 5
LIMIT SET 4
RETURN
Figure 5.5:
PATIENT LIMITS
The [PATIENT LIMITS] key on the SET UP MENU is used to display one of the four LIMIT SET screens. (See the preceding figure.) These screens are used to enter upper and lower flagging limits for groups of patient samples. (For example, limits may be entered for adult males, adult females, neonates, etc.) The following soft key labels are displayed when the [PATIENT LIMITS] key is pressed: LIMIT SET 1* LIMIT SET 2* LIMIT SET 3* LIMIT SET 4* PRINT RETURN * The key label for the limit set displayed on the screen is not shown. Whenever one of the four limit set soft keys is pressed, a screen for that limit set is displayed and the soft key for that limit set is no longer displayed. Four different sets of limits can be entered.
CELL-DYN 3700 System Operators Manual
5-16
Whenever a parameter result falls outside the entered limits, the result is displayed in color on the screen to alert the operator. Results displayed in yellow are below the limit, and results displayed in purple are above the limit. The flagged result is underlined on the graphics report and the blank ticket report. The flagged result is marked with an asterisk (*) on the preprinted ticket report. It is suggested that one Patient Limit Set be used to enter instrument-specific laboratory action limits. If the Interpretive Report option is enabled, the Interpretive messages, such as leukocytosis, anemia, thrombocytopenia, etc., will be displayed when a result falls outside the appropriate limit. A result that falls outside a laboratory action limit can also indicate the need for the operator to follow a laboratory protocol, such as repeating the sample, notifying the physician or performing a smear review. In cases where a cellular abnormality is present that alters cellular morphology to the point that the cells do not fit the criteria used by the instrument to generate a flag, dispersional data alerts may be the only flag(s) that will alert the operator to a potentially erroneous result.
WBC Messages
Leukopenia Leukocytosis Neutropenia Neutrophilia
CELL-DYN 3700 System Operators Manual
Result falls below the lower limit for WBC. Result exceeds the upper limit for WBC. Result falls below the lower limit for neutrophil absolute number. Result exceeds the upper limit for neutrophil absolute number.
5-17
Operating Instructions
Set Up Instructions Lymphopenia Lymphocytosis Monocytosis Eosinophilia Basophilia
Chapter 5
Result falls below the lower limit for lymphocyte absolute number. Result exceeds the upper limit for lymphocyte absolute number. Result exceeds the upper limit for monocyte absolute number. Result exceeds the upper limit for eosinophil absolute number. Result exceeds the upper limit for basophil absolute number.
RBC Messages
Anemia Polycythemia Microcytic RBC Macrocytic RBC Hypochromic Hyperchromic Anisocytosis Result falls below the lower limit for RBCs. Result exceeds the upper limit for RBCs. Result falls below the lower limit for MCV. Result exceeds the upper limit for MCV. Result falls below the lower limit for MCHC. Result exceeds the upper limit for MCHC. Result exceeds the upper limit for RDW.
PLT Messages
Thrombocytopenia Thrombocytosis Microcytic PLT Macrocytic PLT Result falls below the lower limit for PLTs. Result exceeds the upper limit for PLTs. Result falls below the lower limit for MPV. Result exceeds the upper limit for MPV.
DELETE ENTRY
SHEATH LOG
DETERGENT LOG
PRINT LOG
MAIN
Figure 5.6:
REAGENT LOG
The [REAGENT LOG] key is used to display one of the reagent logs. (The name of the displayed log is indicated in the Status Box.) Any one of the other three reagent logs may be displayed by pressing the appropriate soft key. The following soft key labels are displayed when the [REAGENT LOG] key is pressed: DELETE ENTRY DILUENT LOG* WIC/HGB LYSE LOG* SHEATH LOG* DETERGENT LOG* PRINT LOG MAIN * The soft key for the reagent log currently displayed on the screen is not shown.
5-19
Operating Instructions
Set Up Instructions
Chapter 5
Each reagent log can hold 10 entries. The following information may be entered for each reagent: List Number Expiration Date Lot Number Open Date
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File Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. FILE 1 FILE 2 FILE 3 FILE 4 FILE 5 FILE 6 FILE 7 FILE 8 FILE 9 FILE 10
# Specimens 0 0 0 0 0 0 0 0 0 0 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
File Name FILE 11 FILE 12 FILE 13 FILE 14 FILE 15 FILE 16 FILE 17 FILE 18 FILE 19 FILE 20
# Specimens 0 0 0 0 0 0 0 0 0 0
Select a QC file with the arrow keys or enter a new file name.
X-B SET UP
LAB ID SET UP
QC LIMITS
SET UP QC FILE
CUSTOMIZE DISPLAY
CUSTOMIZE PRINTOUT
RETURN
Figure 5.7:
QC SET UP MENU
The [QC SET UP MENU] key is used to display a list of the QC files (see the preceding figure). This is the first of a series of screens and menu options that allow the operator to set up the QC files. The following soft key labels are displayed when the [QC SET UP MENU] key is pressed: X-B SET UP LAB ID SET UP QC LIMITS SET UP QC FILE CUSTOMIZE DISPLAY CUSTOMIZE PRINTOUT RETURN NOTE: QC Set up for Reticulocytes is described in Chapter 14: Reticulocyte Package.
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15:33 sh 0630
Lot Number:
12345 12/30/98
2 3
Expiration Date (Month/Day/Year): WESTGARD RULE SELECTION: ON ON ON ON ON ON RULE 1: Value outside 3 SD.
RULE 2: Two consecutive values outside SAME 2 SD. RULE 3: Two consecutive values outside OPPOSITE 2 SD. RULE 4: Two of three consecutive values outside SAME 2 SD. RULE 5: Four consecutive values outside SAME 1 SD. RULE 6: Ten consecutive values on SAME side of mean. REPLICATE ID TOGGLE ON/OFF PRINT RETURN
Figure 5.8:
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13:33 sh 0630
1 3
WESTGARD RULE SELECTION: ON ON ON ON ON ON
RULE 1: Value outside 3 SD. RULE 2: Two consecutive values outside SAME 2 SD. RULE 3: Two consecutive values outside OPPOSITE 2 SD. RULE 4: Two of three consecutive values outside SAME 2 SD. RULE 5: Four consecutive values outside SAME 1 SD. RULE 6: Ten consecutive values on SAME side of mean.
LOT NUMBER
TOGGLE ON/OFF
RETURN
Figure 5.9:
SET UP QC FILE
The [SET UP QC FILE] key is used to configure the selected QC file. Pressing this key will display a QC FILE SET UP screen from which the lot number or replicate ID can be entered, and the Westgard Rules selected. If the file is used for a commercial control, the lot number and expiration date may be entered by pressing the [LOT NUMBER] key. If the file is used for a patient control, the ID number of the control may be entered by pressing the [REPLICATE ID] key. When the [SET UP QC FILE] key is pressed, the following soft key labels are displayed: REPLICATE ID or LOT NUMBER
(This key label alternates between these two selections when the soft key is pressed.) (This key label is present only when the cursor is in one of the Westgard Rule Selection fields.)
TOGGLE ON/OFF
PRINT RETURN
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Chapter 5
The QC FILE SET UP screens for <LOT NUMBER> entry and <REPLICATE ID> entry are shown in the preceding two figures. The numbers on these screens correspond to the following numbered options: 1. <REPLICATE ID> entry field. This entry field is displayed when the [REPLICATE ID] key is pressed. This designation is intended for QC files that are used for patient controls. 2. <LOT NUMBER> and <EXPIRATION DATE> entry fields. These entry fields are displayed when the [LOT NUMBER] key is pressed. This designation is intended for QC files that are used for commercial controls. 3. WESTGARD RULE SELECTION: RULE 1: Value outside 3 SD. RULE 2: Two consecutive values outside SAME 2 SD. RULE 3: Two consecutive values outside OPPOSITE 2 SD. RULE 4: Two of three consecutive values outside SAME 2 SD. RULE 5: Four consecutive values outside SAME 1 SD. RULE 6: Ten consecutive values on SAME side of mean. NOTE: Westgard Rules are discussed in detail in Chapter 7: Quality Control within this manual. The Westgard Rule selections are available on either of the QC FILE SET UP screens.
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5. Use the arrow keys on the keyboard to move the cursor back into the selected file. 6. Press the [SET UP QC FILE] key to display the QC FILE SET UP screen.
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Operating Instructions
Set Up Instructions
Chapter 5
The [LAB ID SET UP] key enables the entry of QC limits into a QC file from a floppy disk. The [LAB ID SET UP] key on the QC SET UP MENU is used to enter Laboratory identification information for the QC files. This information is necessary for participants in the CELL-DYN Interlaboratory QC Program who wish to submit their results on a floppy disk. Laboratory Identification information must be entered before QC data can be transferred to the floppy disk.
The [QC LIMITS] key is used to display the QC MEANS/LIMITS ENTRY screen and the following soft key labels: RANGE ENTRY or MEANS/LIMITS (This key label alternates between these two selections when the soft key is pressed.)
UPDATE FROM FILE LOAD FROM DISK PRINT RETURN QC limits are entered by pressing the [QC LIMITS] key. This key is available on both the QC SET UP MENU screen and the QC MENU screen. The QC MENU screen is discussed in Chapter 7: Quality Control. Two types of QC limits are available:
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If the RANGE ENTRY screen is selected by pressing the [RANGE ENTRY] key, the current upper and lower limits for the selected file will be displayed as described above. If the MEANS/LIMITS screen is selected by pressing the [MEANS/LIMITS] key, the current means and limits for the selected file will be displayed as described above.
QC RANGE ENTRY Ready FOR LOW Lower Limits WOC WIC WBC NEU %N LYM %L MONO %M EOS %E BASO 2.0 2.0 2.0 1.1 66.5 0.0 7.6 0.0 3.4 0.0 0.0 0.0 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL Upper Limits 2.6 2.6 2.6 2.3 80.5 0.9 21.6 0.4 13.4 0.1 5.0 0.5 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT PDW
Nov 21 1998 Operator ID Sequence # Lower Limits 0.0 2.33 6.6 18.5 78.8 25.8 31.4 13.8 43. 9.4 0.05 14.8 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
16:24 757 9110 Upper Limits 6.5 2.63 7.2 21.5 82.8 29.8 37.4 17.8 61. 11.4 0.07 16.2 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
MEANS/ LIMITS
RETURN
Figure 5.10:
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Set Up Instructions
Chapter 5
3. Use the arrow keys on the keyboard to move the cursor to the desired entry field. 4. Type the appropriate numbers and press the Enter key on the keyboard to save each entry and advance the cursor to the next entry field. 5. Repeat step 4 until all entries have been made. 6. To obtain a printout of the entered values, press the [PRINT] key. 7. Press [RETURN] to save the entries and return to the QC SET UP MENU screen. NOTE: When the entries are saved, the software automatically checks to see if any entries would result in the upper limit being less than the lower limit. If this situation occurs, the limits will automatically be reversed and the Bulletin line will display the following message: LIMITS WERE EXCHANGED TO MAKE UPPER > LOWER.
Means WOC WIC WBC NEU %N LYM %L MONO %M EOS %E BASO 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL
Limits(+/-) 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 50.0 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT PDW
Means 5.00 50.0 50.0 500. 50.0 50.0 50.0 500. 50.0 5.00 50.0 50.0 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
Limits(+/-) 5.00 50.0 50.0 500. 50.0 50.0 50.0 500. 50.0 5.00 50.0 50.0 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
RANGE ENTRY
RETURN
Figure 5.11:
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16:24 sh 0630
Means WIC WOC WBC NEU %N LYM %L MONO %M EOS %E BASO 7.5 7.5 7.5 4.8 64.0 1.5 20.8 0.8 10.7 0.2 2.7 0.2 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL
Limits(+/-) 0.6 0.6 0.6 1.5 7.0 0.8 10.0 0.5 3.5 0.2 1.5 0.2 K/uL K/uL K/uL K/uL %N K/uL %L K/uL %M K/uL %E K/uL %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT PDW
Means 2.7 4.21 12.5 39.1 92.9 29.7 32.0 15.6 229. 10.3 5.00 50.0 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
Limits(+/-) 2.7 0.18 0.4 2.4 3.0 2.0 3.0 2.2 25. 1.0 4.99 50.0 %B M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
RANGE ENTRY
RETURN
Figure 5.12:
The [UPDATE FROM FILE] key is displayed on the QC MEANS/LIMITS ENTRY and QC RANGE ENTRY screens (see the preceding figure). Pressing this key will cause the bulletin line to display the message USE CONFIRM UPDATE TO SET MEANS AND LIMITS FROM QC FILE, and the following soft key labels will be displayed: CONFIRM UPDATE CANCEL UPDATE These keys are used to confirm or cancel the Update From File command. NOTE: A message <Cannot UPDATE from FILE. File must have at least 2 valid values per parameter> is displayed on the bulletin line if there are less than 2 results in the file.
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The [LOAD FROM DISK] key is used to enter the lot number, expiration date, and assay values into a QC file directly from a floppy disk. When this option is used, the lot number, expiration date, mean value and limits (either for QC Range entry or QC Means/Limits entry) are automatically entered in the selected file. The values may be edited after they are displayed on the screen. NOTE: The information is entered for each level, one level at a time.
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Chapter 5
7. Check the status box to be sure the correct file is selected and press the appropriate soft key: [LOAD LOW] to load the low control assay data. [LOAD NORMAL] to load the normal control assay data. [LOAD HIGH] to load the high control assay data. 8. The limits are displayed for the selected file. If desired, the limits may be edited. 9. Press [RETURN] to return to the QC MENU screen. 10. Select the next file and repeat steps 7 and 8 to load the assay data for the appropriate level of control. 11. When all the assay data has been loaded, remove the disk from the disk drive.
CUSTOMIZE QC DISPLAY Ready FOR FILE 1 Customize QC display for all QC files Group 1: Group 2: Group 3: Group 4: WBC RBC PLT WBC NEU HGB MPV %N LYM HCT PCT %L MONO EOS MCV PDW %M %E %B MCH BASO MCHC RDW
16:23 0067
STANDARD GROUPS
TOGGLE ONE/ALL
RETURN
Figure 5.13:
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Set Up Instructions The [CUSTOMIZE DISPLAY] key is used to display the CUSTOMIZE QC DISPLAY screen for the selected file. This screen allows the operator to customize the display of information in the QC logs. (See the preceding figure.) The following soft key labels are displayed on the CUSTOMIZE QC DISPLAY screen: SELECT PARAMETER STANDARD GROUPS TOGGLE ONE/ALL RETURN The screen displays a matrix showing the groups of parameters that are currently selected. A list of all available parameters is displayed under the matrix. There are several additional parameters included in the list that may be displayed in the QC file if desired. These include the following: RUT1 and RUT2 RUT1 is the RBC/PLT Upper Metering Time. RUT2 is the RBC/PLT Upper Metering Time for an extended count. RCT1 is the RBC/PLT Count Time. RCT2 is the RBC/PLT Count Time for an extended count. WUT is the WIC Upper Metering Time. WCT is the WIC Count Time. WIC is the WBC Impedance Count. WOC is the WBC Optical Count. EMPTY inserts an empty column in the display.
The [SELECT PARAMETER] key is used to select parameters and place them in the desired location. The [STANDARD GROUPS] key is used to select a predetermined group of parameters that will be placed on a designated page. The display may be customized by selecting the individual parameters, standard groups of parameters, or a combination of the two. On the CUSTOMIZE QC DISPLAY screen, the selections included in Parameter Group 1 will be displayed (in the order indicated from left to right) on the first VIEW QC LOG screen. The remaining groups will be displayed on subsequent screens that are accessed by pressing the right arrow key on the keyboard. The left arrow key is used to page back through the screens to the first screen. The VIEW QC LOG screen is discussed in Chapter 7: Quality Control.
STANDARD GROUPS
TOGGLE ONE/ALL
The [TOGGLE ONE/ALL] key is used to customize one file only or all files the same way.
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Set Up Instructions
Chapter 5
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CUSTOMIZE QC DISPLAY Ready FOR FILE 1 Customize QC display for the current file Group 1: Group 2: Group 3: Group 4: WBC RBC PLT WBC NEU HGB MPV %N LYM HCT PCT %L MONO EOS MCV PDW %M %E %B MCH BASO MCHC RDW
16:23 0067
WBC GROUP
RBC GROUP
PLT GROUP
DIFF GROUP
LATEX SET
CUSTOM PLACEMENT
TOGGLE ONE/ALL
RETURN
Figure 5.14:
STANDARD GROUPS
Predetermined groups of parameters, called Standard Groups, may be selected by pressing the [STANDARD GROUPS] key. The preceding figure shows the CUSTOMIZE QC DISPLAY screen with the Standard Groups displayed. The following soft key labels are displayed when the [STANDARD GROUPS] key is pressed: WBC GROUP RBC GROUP PLT GROUP DIFF GROUP LATEX SET CUSTOM PLACEMENT (This key is used to return to the CUSTOMIZE QC DISPLAY screen for operator-selected placement.)
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Set Up Instructions
Chapter 5
The WBC, RBC, PLT, and DIFF Standard Groups are shown in the preceding figure. They contain the following parameters: WBC Group (Group 1):WBC, NEU, LYM, MONO, EOS, BASO RBC Group (Group 2): RBC, HGB, HCT, MCV, MCH, MCHC, RDW PLT Group (Group 3): PLT, MPV, PCT, PDW DIFF Group (Group 4): WBC, %N, %L, %M, %E, %B
The [LATEX SET] key is used to customize the QC file to store information generated by polystyrene microspheres. Information is stored for each of the four angles of scatter used to determine the differential. This key is intended for Abbott service personnel. The [TOGGLE ONE/ALL] key is used to customize one file only or all files the same way.
TOGGLE ONE/ALL
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16:23 sh 0630
Customize QC PRINTOUT for the current QC file WBC %N %L %M %E %B RBC HGB HCT MCV MCH MCHC
SELECT PARAMETER
STANDARD SELECTION
TOGGLE ONE/ALL
RETURN
Figure 5.15:
CUSTOMIZE PRINTOUT
The [CUSTOMIZE PRINTOUT] key on the QC SET UP MENU screen is used to display the CUSTOMIZE QC PRINTOUT screen, which is used to customize the printout format for the QC logs. (See the preceding figure.) The following soft key labels are displayed on this screen: SELECT PARAMETER or PLACE PARAMETER (This key label alternates between these two selections.) STANDARD SELECTION TOGGLE ONE/ALL RETURN
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Chapter 5
The CUSTOMIZE QC PRINTOUT screen displays the group of parameters that is currently selected. A list of all available parameters is displayed under the selected group. The following parameters are also included in this list and can be printed in the QC Log if desired: RUT1 and RUT2 RUT1 is the RBC/PLT Upper Metering Time. RUT2 is the RBC/PLT Upper Metering Time for an extended count. RCT1 is the RBC/PLT Count Time. RCT2 is the RBC/PLT Count Time for an extended count. WUT is the WIC Upper Metering Time. WCT is the WIC Count Time. WIC is the WBC Impedance Count. WOC is the WBC Optical Count.
The [SELECT PARAMETER] key is used to select parameters and place them in the desired location. The [STANDARD SELECTION] key is used to automatically arrange the parameters in the predetermined print group shown in the preceding figure.
STANDARD SELECTION
TOGGLE ONE/ALL
The [TOGGLE ONE/ALL] key is used to customize one file only or all files the same way.
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5. If necessary, use the arrow keys on the keyboard to move the cursor to the desired location and press the [PLACE PARAMETER] key. NOTE: When the [PLACE PARAMETER] key is pressed, the selected parameter will be displayed in the position indicated by the cursor and the cursor will then be advanced to the next parameter in the list under the printout group. 6. Repeat steps 35 until all entries have been made. 7. To obtain a printout of the configuration, press the Print Screen key on the keyboard. 8. Press the [RETURN] key to return to the QC SET UP MENU screen. 9. Repeat this procedure to customize the printout for other QC Logs.
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Set Up Instructions
Chapter 5
08:49 0067
1
Parameter MCV MCH MCHC Parameter LYM 0D LYM 10D NEU 0D NEU 10D NEU 90D NEU 90DEP NEU-EO Lower/Upper Limits 55.0/125. fL 20.0/40.0 pg 24.0/44.0 g/dL Lower/Upper 48/ 70 51/ 67 141/179 128/170 87/163 11/ 31 14.0/ 32.0
2
Target Value 89.9 fL 30.5 pg 33.9 g/dL
3
Action Limit 3.0 % 3.0 % 3.0 % Action Limit 7.0 % 5.0 % 4.0 % 5.0 % 10.0 % 19.0 % 13.0 %
The X-B WBC program is ON. Limits Target Value Channel 59 Channel Channel 59 Channel Channel 160 Channel Channel 149 Channel Channel 125 Channel Channel 21 Channel Degree 23.0 Degree
RETURN
Figure 5.16:
X-B SET UP
The [X-B SET UP] key on the QC SET UP MENU screen is used to display the X-B SET UP screen. (See the preceding figure.) This screen is used to enter upper and lower acceptance limits, target values, and action limits for the X-B Moving Average QC Program. The following soft key labels are displayed when the [X-B SET UP] key is pressed: TURN X-B RBC ON or TURN X-B RBC OFF TURN X-B WBC ON or TURN X-B WBC OFF PRINT RETURN
(This key label alternates between these two selections.) (This key label alternates between these two selections.)
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The numbers on the X-B SET UP screen shown in the preceding figure correspond to the following numbered options: 1. Lower/Upper Limits The Lower and Upper Limits determine which patient results will be used in the X-B RBC and WBC Moving Average calculations. Results that fall outside these limits are automatically excluded from the appropriate X-B calculations. These limits should be set wide to exclude grossly abnormal samples that would bias the calculation, but the limits should include at least 95% of the patient results. 2. Target Value The Target Values for the X-B RBC and WBC Analyses are similar to the assay values for commercial controls. They are derived from the patient populations that are analyzed on the instrument. 3. Action Limit The Action Limits are the acceptable limits of variation around the X-B RBC and X-B WBC target values. NOTE: The X-B Program is discussed in detail in Chapter 7: Quality Control.
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Chapter 5
7. Press the [TURN X-B WBC ON] key to enable the X-B WBC Program if this key label is displayed. NOTE: When the X-B WBC Program is enabled, the screen displays the message The X-B WBC Program is ON, and the [TURN X-B WBC OFF] key is displayed. 8. Press the [RETURN] key to return to the QC SET UP MENU screen.
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To turn on the RETIC PKG you must enter to operator ID and the instrument must be in Open mode. To turn on the VET PKG you must exit the RETIC PKG.
COMPUTER SET UP
RETURN
Figure 5.17:
OPERATION SET UP
The [OPERATION SET UP] key on the SET UP MENU screen is used to display the OPERATION SET UP MENU screen (see the preceding figure). This screen allows the operator to select the type of bar code used and configure the transmission to an on-line computer. The Veterinary Package and the Reticulocyte Package for the CELL-DYN 3700 System can be enabled or disabled from this screen. The following soft key labels are displayed on the OPERATION SET UP MENU screen: TURN ON VET PKG or TURN VET PKG OFF TURN ON RETIC PKG or TURN OFF RETIC PKG BAR CODE SET UP COMPUTER SET UP RETURN
(This key label alternates between these two selections.) (This key label alternates between these two selections.)
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Set Up Instructions
Chapter 5
The [TURN ON VET PKG] or [TURN VET PKG OFF] key enables or disables the Veterinary Package. This option is used to configure the instrument to run various types of animal specimens. The Veterinary Package is discussed in detail in Chapter 13: Veterinary Package.
The [TURN ON RETIC PKG] or [TURN OFF RETIC PKG] key enables or disables the Reticulocyte Package. This option is used to analyze a whole blood specimen for reticulocytes. The Reticulocyte Package is discussed in Chapter 14: Reticulocyte Package.
ON 1
Bar Code Check Digit Bar Code Symbology (1=CODE39, 2=I2OF5, 3=CODABAR, 4=CODE128)
SET UP
Figure 5.18:
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The [BAR CODE SET UP] key is used to display the BAR CODE SET UP screen, which is used to select the type of bar code to be read and to enable or disable the Check Digit option for a specific bar code. (See the preceding figure.) If the Check Digit option is enabled, the Analyzer reads only the type of bar code selected. If the option is disabled, the Analyzer ignores the selected bar code and reads all four types of bar codes (Code 39, Interleaved 2 of 5, Codabar, and Code 128). NOTE: For more information about Check Digits and bar codes, refer to Appendix A: Bar Codes.
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Set Up Instructions
Chapter 5
1 2 3 4 5
Auto-transmission of ALERTED parameter data Auto-transmission of NON-ALERTED parameter data Auto-transmission of ALERTED graph data Auto-transmission of NON-ALERTED graph data Transmission CTS enabled Transmission Data bits (7, 8) Transmission Stop bits (1, 2) Transmission Parity (0=None, 1=Odd, 2=Even) Transmission time out (0.1 to 9.9) Computer Baud Rate (300, 600, 1200, 2400, 4800, 9600)
REINIT INTERFACE
STOP TRANSMISS
TOGGLE ON/OFF
SET UP
Figure 5.19:
COMPUTER SET UP
The [COMPUTER SET UP] key on the OPERATION SET UP MENU screen is used to display the COMPUTER SET UP screen (see the preceding figure) and the following soft key labels: REINIT INTERFACE STOP TRANSMISS TOGGLE ON/OFF SET UP The CELL-DYN 3700 System has the capability to transmit data to an on-line computer (Laboratory Information System, or LIS). Data can be transmitted automatically as each sample is run, or data can be transmitted at the operators request. The CELL-DYN 3700 System can also receive patient information that is transmitted to it by the on-line computer. The COMPUTER SET UP screen is used to configure the transmission format to meet the requirements of the LIS or online computer. Instructions for using this option are given after the following description of the soft keys.
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The [REINIT INTERFACE] key on the COMPUTER SET UP screen is used to initialize the RS-232 Interface for the displayed transmission configuration after it is entered. NOTE: Refer to the Interface Specification (L/N 02H33-01) for complete information on interfacing.
The [STOP TRANSMISS] key stops the current data transmission to the on-line computer. When the [STOP TRANSMISS] key is pressed, the following soft key labels are displayed: CONFIRM STOP CANCEL STOP These keys confirm or cancel the Stop Transmission command.
The [TOGGLE ON/OFF] key enables or disables the first five options in the list displayed on the COMPUTER SET UP screen. The numbers on the COMPUTER SET UP screen shown in the preceding figure correspond to the following numbered options: 1. Auto-transmission of ALERTED parameter data When this option is enabled, a report is automatically transmitted to the LIS for any sample with flagged parameter results. 2. Auto-transmission of NON-ALERTED parameter data When this option is enabled, a report is automatically transmitted to the LIS for any sample without flagged parameter results. 3. Auto-transmission of ALERTED graph data When this option is enabled, histograms are automatically transmitted to the LIS for any sample with flagged results. 4. Auto-transmission of NON-ALERTED graph data When this option is enabled, histograms are automatically transmitted to the LIS for any sample without flagged results.
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Chapter 5
5. The remaining options are configured according to the transmission requirements of the LIS: Transmission CTS enabled Transmission Data bits (7, 8) Transmission Stop bits (1, 2) Transmission Parity (0=None, 1=Odd, 2=Even) Transmission time out (0.1 to 9.9) Computer Baud Rate (300, 600, 1200, 2400, 4800, 9600) The numbers in parentheses after the options indicate the selections available. NOTE: Refer to the Interface Specification (L/N 02H33-01) for complete information on interfacing.
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USA UNITS
SI UNITS
SI MOD UNITS
SET 1 UNITS
SET 2 UNITS
SELECT UNITS
RETURN
Figure 5.20:
UNITS SELECTION
The [UNITS SELECTION] key on the SET UP MENU screen is used to display the UNITS SELECTION screen. This screen allows the selection of the report units for the indicated parameters. Units may be selected for each parameter individually or a set of units may be selected by pressing the appropriate soft key. (See the preceding figure.) The following soft key labels are displayed on the UNITS SELECTION screen: USA UNITS SI UNITS SI MOD UNITS SET 1 UNITS SET 2 UNITS SELECT UNITS RETURN
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Chapter 5
The units selected by each of the soft keys are shown on the screen display in the preceding figure. The following table shows an example of the same sample displayed with each of the four units selections. Refer to Section: Reticulocyte Package, Subsection: Retic Units Selection Softkey for information on reticulocyte units.
Table 5.1:
SI MOD Units
G/L T/L g/L L/L fL pg g/L %CV G/L fL mL/L 10GSD
SET 1 Value
5.32 5.15 162 47.6 92.3 31.5 341 12.5 323 8.26 0.267 17.5
SET 2 Value
53.2 515. 16.2 47.6 92.3 31.5 34.1 12.5 32.3 8.26 0.267 17.5
Parameter WBC* RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT*** PDW**, ***
Value
5.32 5.15 16.2 47.6 92.3 31.5 34.1 12.5 323 8.26 0.267 17.5
Units
K/L M/L g/dL % fL pg g/dL % K/L fL % 10GSD
Value
5.32 5.15 10.1 0.476 92.3 1.96 21.2 12.5 323 8.26 2.67 17.5
Units
10e9/L 10e12/L mmol/L L/L fL fmol mmol/L %CV 10e9/L fL mL/L 10GSD
Units
10e3/L 10e6/L g/L % fL pg g/L %CV 10e3/L fL % 10GSD
Units
10e2/L 10e4/L g/dL % fL pg g/dL % 10e4/L fL % 10GSD
*NEU, LYM, MONO, EOS, and BASO are reported in the same units as the WBC. **Report Unit is Geometric Standard Deviation. ***Clinical significance has not been established for these parameters. Therefore, they are not reportable in the US.
The [CUSTOMIZE REPORT] key on the SET UP MENU screen is used to customize the displayed and printed reports. From this screen, the parameters and graphs to be displayed on reports can be selected, the header can be customized, and the type of printout can be selected. When the [CUSTOMIZE REPORT] key is pressed, one of three possible screens will be displayed (whichever one was used last). The three possible screens are the CUSTOMIZE DISPLAYED REPORT screen, the CUSTOMIZE PRINTED REPORT screen, and the CUSTOMIZE PRINTOUT HEADER screen. (See the following flowchart.)
SET UP MENU Ready CUSTOMIZE REPORT
PARAM SET 1
PARAM SET 2
PARAM SET 3
PARAM SET 4
SELECT GRAPH
SET UP
RESTORE HEADER
SET UP
PARAM SET 1
PARAM SET 2
PARAM SET 3
PARAM SET 4
PLACE GRAPH
SET UP
TICKET CUSTOMIZE STOP CUSTOMIZE TOGGLE PRINTER DISPLAY PRINTING HEADER ON/OFF RESTORE PRE-PRNTD GRAPHICS TICKET PRINTER HEADER BLANK CONFIRM CANCEL TICKET STOP STOP
SET UP
Each one of these three possible screens displays two of the following three soft key labels: CUSTOMIZE DISPLAY CUSTOMIZE PRINTOUT CUSTOMIZE HEADER Each of these three screens is explained individually on the following pages. NOTE: The [CUSTOMIZE REPORT] key can also be accessed from the RUN screen and the DISPLAY SPECIMEN screen in the Data Log.
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CUSTOMIZE DISPLAYED REPORT Ready PARAMETER SET 1 SELECTED ON ON ON ON ON ON ON ON ON ON ON ON ON WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW Size-Cmp (0-10) Grn-Lob (90D-90) 10 deg-90 deg 0 deg-90 deg 10 deg-90 deg D 0 deg-90 deg D N-L-M Histogram M-P Histogram RBC Histogram PLT Histogram WIC Histogram Empty
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ON ON ON ON ON
%N %L %M %E %B
Size-Cmp (0-10)
Grn-Lob (90D-90)
ON PLT ON MPV Auto-Sampler Busy PARAM SET 2 PARAM SET 3 PARAM SET 4
RBC Histogram
PLT Histogram
CUSTOMIZE PRINTOUT
CUSTOMIZE HEADER
SELECT GRAPH
SET UP
Figure 5.21:
CUSTOMIZE DISPLAY
The CUSTOMIZE DISPLAYED REPORT screen (see the preceding figure) for the indicated parameter set will be displayed when the [CUSTOMIZE DISPLAY] key is pressed. The following soft key labels are displayed on the CUSTOMIZE DISPLAYED REPORT screen: PARAM SET 1* PARAM SET 2* PARAM SET 3* PARAM SET 4* CUSTOMIZE PRINTOUT CUSTOMIZE HEADER or CANCEL GRAPH (This key label alternates between these two selections when the [SELECT GRAPH] key is pressed.) SELECT GRAPH or PLACE GRAPH or TOGGLE PARAMETER (This key label alternates between these three selections when the soft key is pressed.) SET UP *The soft key label for the parameter set currently displayed on the screen is not shown.
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PARAM SET X
Using the [PARAM SET X] key, the display can be customized for four different sets of parameters. Up to 20 individual parameters and up to four scatterplots and/or histograms can be displayed in each set. (The empty selection may be used to blank the scatterplot or histogram display at the selected position.) Individual parameters are listed in the left portion of the screen, and the scatterplots and histograms are listed in the right portion.
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10. To obtain a printout of the selected Parameter Set, press the Print Screen key on the keyboard. 11. To select another Parameter set, press the [PARAM SET X] key. To customize the display for it, repeat steps 310. 12. Press the [SET UP] key to return to the SET UP MENU screen.
The CUSTOMIZE PRINTED REPORT screen will be displayed when the [CUSTOMIZE PRINTOUT] key is pressed. This screen is used to customize the printout for the Graphics Printer or the Ticket Printer. The following soft key labels are displayed when the [CUSTOMIZE PRINTOUT] key is pressed: GRAPHICS PRINTER or TICKET PRINTER
(This key label alternates between these two selections when the soft key is pressed.)
CUSTOMIZE DISPLAY STOP PRINTING CUSTOMIZE HEADER TOGGLE ON/OFF SET UP When the [TICKET PRINTER] key is pressed, the key label changes to [GRAPHICS PRINTER] and the following soft key labels are also displayed: BLANK TICKET or PRE-PRNTD TICKET (This key label alternates between these two selections when the soft key is pressed.) (This key label appears only when the [BLANK TICKET] key is selected.)
RESTORE HEADER
When the [CUSTOMIZE PRINTOUT] key is pressed, the screen that was used for the last entry is displayed. A brief description of the function of the soft keys is given in this section. For ease of explanation, the keys are grouped according to the type of printer selected. This section contains the following subsections: General Purpose Soft Keys Ticket Printer Soft Keys Graphics Printer Soft Keys
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The [CUSTOMIZE DISPLAY] key is used to switch to the CUSTOMIZE DISPLAYED REPORT screen (discussed in the preceding section). The [STOP PRINTING] key is used to stop printing that is in progress. When the [STOP PRINTING] key is pressed, the following soft key labels are displayed: CONFIRM STOP CANCEL STOP These keys confirm or cancel the Stop Printing command. If the [CONFIRM STOP] key is pressed, the print buffer (the memory area where the material is stored while awaiting printing) is cleared and the bulletin line displays the following message: PRINTING STOPPED. RESET PAPER TO THE TOP OF THE PAGE.
STOP PRINTING
CUSTOMIZE HEADER
The [CUSTOMIZE HEADER] key is used to move to the CUSTOMIZE PRINTOUT HEADER screen (discussed in the following section). The [TOGGLE ON/OFF] key enables or disables the option selected by the position of the cursor. The key label is not displayed when a numeric entry is required. The [SET UP] key is used to return to the SET UP MENU screen.
TOGGLE ON/OFF
SET UP
Two options are available when the [TICKET PRINTER] key is pressed: BLANK TICKET or PRE-PRNTD TICKET
(This key label alternates between these two selections when the soft key is pressed.)
The [PRE-PRNTD TICKET] key is used to customize the printed report for a preprinted ticket. The [BLANK TICKET] key is used to customize the printed report for a blank ticket.
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1 2 3 4
TICKET PRINTER - PRE-PRINTED TICKET AUTO-PRINT results for ALERTED specimens AUTO-PRINT results for NON-ALERTED specimens Print PCT, PDW results
BLANK TICKET
GRAPHICS PRINTER
CUSTOMIZE DISPLAY
STOP PRINTING
CUSTOMIZE HEADER
TOGGLE ON/OFF
SET UP
Figure 5.22:
PRE-PRINTD TICKET
The [PRE-PRNTD TICKET] key is used to display the CUSTOMIZE PRINTED REPORT screen for preprinted tickets. The numbers on the screen shown in the preceding figure correspond to the following numbered options: 1. TICKET PRINTER PRE-PRINTED TICKET When this option is enabled, the Ticket Printer is configured for a preprinted ticket. (The blank ticket option is automatically turned OFF.) 2. AUTO-PRINT results for ALERTED specimens When this option is enabled, results for flagged specimens are automatically printed as tickets are inserted in the printer. Flagged results are marked with an asterisk (*). 3. AUTO-PRINT results for NON-ALERTED specimens When this option is enabled, results for specimens that are not flagged are automatically printed as tickets are inserted in the printer.
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TICKET PRINTER - BLANK TICKET AUTO-PRINT results for ALERTED specimens AUTO-PRINT results for NON-ALERTED specimens Print PCT, PDW results Print Limits Report Print Specific Alerts Print Manual Differential Grid for ALERTED specimens Print Manual Differential Grid for NON-ALERTED specimens Line-feeds per page for ticket printer (1 to 99) Number of lines for the customize ticket header (0 to 2) . . . . . . . . . 1 . . . . . . . . . .2 . . . . . . . . . . 3 . . . . . . . . . . . . .
RESTORE HEADER
PRE-PRNTD TICKET
GRAPHICS PRINTER
CUSTOMIZE DISPLAY
STOP PRINTING
CUSTOMIZE HEADER
TOGGLE ON/OFF
SET UP
Figure 5.23:
BLANK TICKET
The [BLANK TICKET] key is used to display the CUSTOMIZE PRINTED REPORT screen for blank tickets. The numbers on the screen shown in the preceding figure correspond to the following numbered options: 1. TICKET PRINTER BLANK TICKET When this option is enabled, the Ticket Printer is configured for a blank ticket. (The preprinted ticket option is automatically turned OFF.) 2. AUTO-PRINT results for ALERTED specimens When this option is enabled, a ticket is automatically printed for any sample with flagged results. Flagged results are indicated by the letters AL (for alert) on the printout when the Print Specific Alerts option is turned OFF (see number 6 below). Results that fall outside of Patient Limits are underlined on the printout. 3. AUTO-PRINT results for NON-ALERTED specimens When this option is enabled, a report is automatically printed for any sample without flagged results.
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4. Print PCT, PDW Results When this option is enabled, the results for PCT and PDW are printed on the report. NOTE: Clinical significance has not been established for these parameters. Therefore, they are not reportable. 5. Print Limits Report When this option is enabled, the Patient Limits Set that was applied to the results is printed on the report. 6. Print Specific Alerts When this option is enabled, the specific flag (BAND, LRI, etc.) replaces the AL on the printout. 7. Print Manual Differential Grid for ALERTED specimens When this option is enabled, a grid that can be used to report a manual differential is printed on the report for any specimen that is flagged. 8. Print Manual Differential Grid for NONALERTED specimens When this option is enabled, a grid that can be used to report a manual differential is printed on the report for any specimen that is not flagged. 9. Line-feeds per page for ticket printer (1 to 99) This option is used to select the size of the printed report. (A blank ticket typically has 68 lines.) 10. Number of lines for the customize ticket header (0 to 2) This option is used to select the number of lines for the header on the blank ticket. The numbers across the top of the header can be used to center the header information on the ticket. Centering the information under the number 2 centers it on the ticket.
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2. Use the arrow keys on the keyboard to move the cursor to the desired selection. 3. Press the [TOGGLE ON/OFF] key to enable or disable the selection. 4. Repeat steps 2 and 3 until all selections have been made. 5. A numeric entry is required for the <Line-feeds per page for ticket printer> entry field (a blank ticket typically has 68 lines) and for the <Number of lines for the customize ticket header> entry field. 6. Type the desired number of line-feeds in the entry field and press the Enter key on the keyboard to save the entry and advance the cursor. 7. Type the desired number of lines for the header and press the Enter key on the keyboard to save the entry and advance the cursor. 8. Type the first line of the header and press the Enter key on the keyboard to save the entry and advance the cursor. Each line holds 35 characters. If desired, type a second line and press the Enter key on the keyboard to save the entry and advance the cursor. 9. To obtain a printout of the selections, press the Print Screen key on the keyboard. 10. Press the [SET UP] key to return to the SET UP MENU screen.
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GRAPHICS PRINTER 1 2 3 4 5 6 7 8 9 10 11 12 OFF OFF OFF OFF ON ON OFF OFF OFF OFF 66 OFF AUTO-PRINT results for ALERTED specimens AUTO-PRINT results for NON-ALERTED specimens Print graphs for ALERTED specimens only Print PCT, PDW results Print X-B RBC Program status Print X-B WBC Program status Print Interpretive Report Print Limits Report Print Manual Differential Grid for ALERTED specimens Print Manual Differential Grid for NON-ALERTED specimens Line-feeds per page for graphics printer (1 to 99) Color Printing
TICKET PRINTER
CUSTOMIZE DISPLAY
STOP PRINTING
CUSTOMIZE HEADER
TOGGLE ON/OFF
SET UP
Figure 5.24:
GRAPHICS PRINTER
The [GRAPHICS PRINTER] key is used to display the CUSTOMIZE PRINTED REPORT screen for the Graphics Printer. The numbers on the CUSTOMIZE PRINTED REPORT screen shown in the preceding figure correspond to the following numbered options: 1. AUTO-PRINT results for ALERTED specimens When this option is enabled, a report is automatically printed for any sample with flagged results. 2. AUTO-PRINT results for NON-ALERTED specimens When this option is enabled, a report is automatically printed for any sample without flagged results. 3. Print graphs for ALERTED specimens only When this option is enabled, scatterplots and histograms are printed only for samples with flagged results. 4. Print PCT, PDW results When this option is enabled, the results for PCT and PDW are printed on the report. NOTE: Clinical significance has not been established for these parameters. Therefore, they are not reportable.
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Set Up Instructions 5. Print X-B RBC Program status When this option is enabled, the status of the X-B RBC program is printed on the report. The X-B RBC status (for example, X-B RBC: 13/OUT2) is printed at the top of the page. 6. Print X-B WBC Program status When this option is enabled, the status of the X-B WBC program is printed on the report. The X-B WBC status (for example, X-B WBC: 13/OUT2) is printed at the top of the page. 7. Print Interpretive Report When this option is enabled, the Interpretive Report messages are printed on the report. These messages are generated when results exceed the Patient Limits and/or instrument-generated flags are present. For an explanation of the Interpretive Report messages, refer to Chapter 3: Principles of Operation, Subsection: Operational Messages and Data Flagging. (Also see the [PATIENT LIMITS] key discussion earlier in this section.) 8. Print Limits Report When this option is enabled, the Patient Limits Set that was applied to the results is printed on the report. 9. Print Manual Differential Grid for ALERTED specimens When this option is enabled, a grid that can be used to report a manual Differential is printed on the report for any specimen that is flagged. 10. Print Manual Differential Grid for NONALERTED specimens When this option is enabled, a grid that can be used to report a manual Differential is printed on the report for any specimen that is not flagged. 11. Line-feeds per page for graphics printer (1 to 99) This option is used to select the size of the printed report. The line-feeds should be 66 lines for 8 x 11 paper. 12. Color printing When this option is enabled, a color printout can be obtained on the CELL-DYN 3700 System by pressing the [COLOR PRINT] key. It is not possible to automatically obtain color printouts.
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Please enter the number of lines for the customize header (0..4) : 0 Print current Date/Time and Software Version : OFF . . . . . . . 1. . . . . . . . 2 . . . . . . . . . 3 . . . . . . . . 4 . . . . . . . . 5 . . . . . . . . 6 . . . . . . . . 7 . . . .
RESTORE HEADER
BLANK HEADER
CUSTOMIZE DISPLAY
CUSTOMIZE PRINTOUT
SET UP
Figure 5.25:
CUSTOMIZE HEADER
The CUSTOMIZE PRINTOUT HEADER screen is displayed when the [CUSTOMIZE HEADER] key is pressed. (See the preceding figure.) This screen is used to customize the printout header for the graphics report. Any report printed in a graphics format will be printed with this header. The following soft key labels are displayed on the CUSTOMIZE PRINTOUT HEADER screen: RESTORE HEADER BLANK HEADER CUSTOMIZE DISPLAY CUSTOMIZE PRINTOUT SET UP
BLANK HEADER
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RESTORE HEADER
The [RESTORE HEADER] key is used to restore the header to the previous entry. This key is only functional immediately after a new header has been entered. Once a new header is entered and the CUSTOMIZE PRINTOUT HEADER screen has been exited, the previous header is removed from the memory. The [CUSTOMIZE DISPLAY] key is used to switch to the CUSTOMIZE DISPLAYED REPORT screen (discussed in the preceding section). The [CUSTOMIZE PRINTOUT] key is used to switch to the CUSTOMIZE PRINTED REPORT screen (discussed in the preceding section). The [SET UP] key is used return to the SET UP MENU screen.
CUSTOMIZE DISPLAY
CUSTOMIZE PRINTOUT
SET UP
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NOTES
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Routine Operation
The routine operation of the CELL-DYN 3700 System proceeds from the RUN screen, which is accessed from the MAIN MENU screen. (See the flowcharts at the beginning of this chapter.) Information and procedures related to the RUN screen and the submenus accessed from it are presented in this section. These include the following: A description of the RUN menu and soft keys Sample analysis information and procedures Daily start up Daily QC checks Running samples Daily shutdown How to set up the Work List Sample analysis using the Work List Some of the operating procedures differ between the CELL-DYN 3700SL System and the CELL-DYN 3700CS System. Where the two systems are identical, as in the RUN screen, only one description is presented. Where there are differences, as in the sample analysis and Work List descriptions, a complete description is presented for the CELL-DYN 3700SL System followed by a complete description for the CELL-DYN 3700CS System. For more detailed information about the Sample Loader and the use of bar codes labels, refer to Chapter 12: Sample Loader and Appendix A: Bar Codes, respectively.
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Run Menu
Next ID -----------Auto Patient ---------------Sex(M/F):- DOB:--/--/-Dr ---------------------Param : 1 Limits: 1 WBC K/uL NEU %N LYM %L MONO %M EOS %E BASO %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST SPECIMEN TYPE CUSTOMIZE REPORT
1 2 3 4 5
S I Z E
COMPLEXITY
LOBULARITY
RBC MAIN
Figure 5.26:
RUN
The [RUN] key on the MAIN MENU screen is used to display the RUN screen. (See the preceding figure.) The following soft key labels are displayed on the RUN screen: CLEAR APERTURES or CLEAR FAULT or PRIME WORK LIST SPECIMEN TYPE CUSTOMIZE REPORT CHANGE SAMPLER or TOGGLE AUTO ID PRINT TICKET PRINT REPORT or COLOR PRINT MAIN (This key label changes to [COLOR PRINT] when the color printing option is selected.) (This key label alternates between these two selections.)
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Run Screens
There are seven possible RUN screens, each customized for one of the following different types of specimen: Patient, QC Specimen, Background, Electrical Background, Latex, Resistant RBC, and Auxiliary. These customized screens are accessed by pressing the [SPECIMEN TYPE] key on each RUN screen and then choosing the desired specimen type.
2. <PATIENT>
NOTE: If the resistant RBC RUN screen is selected, <RES RBC> will be displayed on this entry field. 3. <SEX (M/F):/DOB: --/--/--> 4. <DR> Used to enter the sex and birth date of the patient.
Used to enter the name of the patients physician. (Up to 22 characters may be entered.) XB RBC or XB WBC: If the XB RBC and/or XB WBC Analysis is enabled, the file status is displayed to the right of the <DR> entry field. WL: The status (OFF/ON) of the Work List is displayed after the X-B status field.
5. <PARAM:/LIMITS:>
Displays the number (14) of the Parameter and Limit Sets that will be applied to the sample results.
NOTE: Both Parameter and Limit Sets may be changed after the sample has been run. Refer to the description of the [EDIT SPECIMEN] key given in Using the Data Log within this chapter.
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1 2 3 5 6
Next ID -----------Auxiliary---------------NOTE-------------- DOB:--/--/-- 4 Rslts Multiplied by 1.00 Param: 1 Limits: 1 WBC NEU %N LYM %L MONO %M EOS %E BASO %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL SPECIMEN TYPE
RUN Ready
S I Z E
LOBULARITY
RBC
MAIN
Figure 5.27:
2. <AUXILIARY>
3. <NOTE>*
4. <DOB: --/--/-->
5. <RSLTS MULTIPLIED BY>* Used to enter the dilution factor used for the specimen run.
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6. <PARAM:/LIMITS:>
Displays the number (14) of the Parameter and Limit Sets that will be applied to the sample results.
* The information in these fields is entered on the AUXILIARY SPECIMEN TYPE screen.
Param Set:
Status Box
The Status Box is displayed in the top center of every RUN screen. It contains the following information: Menu in use The Status of the Analyzer the Ready, Not Ready and Fault messages are displayed here Report or file identity for results currently displayed The Status Box also displays status and instructive messages during the RUN cycle, such as the following: Aspirating Remove specimen Dispensing Counting Extended Count Rinsing Ready
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The top right-hand corner of the RUN screen displays the following information: Current date and time Operator ID identification of the current operator Sequence # automatically incremented as samples are run Work List status OFF/ON Selected sampler mode Open Sampler or Closed Sampler The center section of the RUN screen displays the results. A list of the parameters and results is displayed on the left side. Scatterplots and histograms are displayed on the right side. The area between the parameter data and the graphic data is used to display suspect flagging messages and count times. Examples of the count times and some of the suspect flagging messages are shown in the following two figures. A detailed explanation of all flagging messages is given in Chapter 3: Principles of Operation, Subsection: Operational Messages and Data Flagging, Parameter Flagging Messages.
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Next ID -----------Auto RUN Dec 21 1998 16:29 Patient ---------------Operator ID rcs Ready Sex(M/F):- DOB:--/--/-Sequence # 0843 Open Sampler Dr ---------------------XBRBC: 13/IN XBWBC: 4/IN WL: OFF Param: 1 Limits: 1 SUSPECT G WBC 8.34 K/uL R NEU 4.97 59.6 %N S A I LYM 2.50 29.9 %L VAR LYM N Z L MONO .551 6.61 %M E R EOS .208 2.50 %E T BASO .114 1.36 %B DFLT (LM) Y WCT:4.45 RBC 5.69 M/uL COMPLEXITY LOBULARITY HGB 16.1 g/dL HCT 49.3 % MCV 86.7 fL MCH 28.4 pg MCHC 32.7 g/dL RDW 14.1 % PLT MPV 360. 10.4 K/uL fL WORK LIST
RCT:6.63 RBC Auto-Sampler Ready SPECIMEN TYPE CUSTOMIZE REPORT CHANGE SAMPLER PRINT TICKET
CLEAR APERTURES
Figure 5.28:
Next ID -----------Auto Patient ---------------Sex(M/F):- DOB:--/--/-Dr ---------------------Param: 1 Limits: 1 WBC 7.93 K/uL NEU 4.71 59.4 %N LYM 2.39 30.1 %L MONO .557 7.03 %M EOS .178 2.25 %E BASO .092 1.16 %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST
S I Z E WCT: 4.43
LOBULARITY
16.1
RBC CLOG RUT: 8.86 RCT: 0.00 RBC Auto-Sampler Ready SPECIMEN TYPE CUSTOMIZE REPORT CHANGE SAMPLER PRINT TICKET
Figure 5.29:
Run Screen Showing Flagging Messages, RBC CLOG Message, and RBC Up Time 5-73
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Next ID -----------Auto RUN Dec 21 1998 16:29 Ready Patient ---------------Operator ID rcs Report for XXX Sex(M/F):- DOB:--/--/-Sequence # 0843 Open Sampler Dr ---------------------XBRBC: 13/IN XBWBC: 4/IN WL: OFF Param: 1 Limits: 1 SUSPECT G WBC 8.34 K/uL R NEU 4.97 59.6 %N S A I LYM 2.50 29.9 %L VAR LYM N Z L MONO .551 6.61 %M E R EOS .208 2.50 %E T BASO .114 1.36 %B DFLT (LM) Y WCT:4.45 RBC 5.69 M/uL COMPLEXITY LOBULARITY HGB 16.1 g/dL HCT 49.3 % MCV 86.7 fL MCH 28.4 pg MCHC 32.7 g/dL RDW 14.1 % PLT MPV 360. 10.4 K/uL fL WORK LIST
RCT:6.63 RBC Auto-Sampler Pause SPECIMEN TYPE CUSTOMIZE REPORT CHANGE SAMPLER PRINT TICKET
CLEAR APERTURES
Figure 5.30:
Bulletin Line
The Bulletin Line is displayed immediately above the soft key labels. Messages appear in this line to identify status or fault conditions. An example of a Bulletin Line message (Auto-Sampler Pause) is shown in the preceding figure.
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The [CLEAR APERTURES] key is used to initiate a special cleaning sequence that flushes the WIC and RBC/PLT Apertures to remove obstructions. The sequence takes approximately 35 seconds. When the [CLEAR APERTURES] key is pressed, the message CLEARING APERTURES is displayed in the Status Box. The [CLEAR APERTURES] key label changes to [CLEAR FAULT] whenever a system fault occurs (for example, Diluent Empty). This key is used to clear the fault message and return the Analyzer to the Ready status after corrective action has been taken. NOTE: A message describing the fault appears in the Bulletin Line. A list of fault conditions and corrective action is given in Chapter 10: Troubleshooting. When the system enters the Standby state while the RUN screen is displayed, the [CLEAR APERTURES/CLEAR FAULT] key label will change to the [PRIME] key label. Pressing the [PRIME] key primes the system and brings it to the Ready state.
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BAR CODE ON # 1 4DIG BC SPECIMEN ID SPECIMEN NAME L 1 P 1 DOCTOR DATE OF BIRTH --/--/-S RACK/ TUBE
WORK LIST ON
INSERT/ DELETE
DELETE ALL
PURGE COMPLETED
RETURN
Figure 5.31:
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WORK LIST
The [WORK LIST] key is used to display the WORK LIST screen (see the preceding figure). The following soft key labels are displayed on the WORK LIST screen: WORK LIST ON or WORK LIST OFF BAR CODE ON or BAR CODE OFF (This key label alternates between these two selections.) (This key label alternates between these two selections.)
INSERT/DELETE DELETE ALL PURGE COMPLETED WORK LIST SET UP PRINT WORK LIST RETURN These keys are used to create the Work List, which is used to preassign specimen identification, display, and print criteria for specimens that will be run. It is essentially a list of specimens (including the preassigned information) that the operator intends to run on the instrument. The Work List may be used with or without bar code labels on the tubes. The functions of the Work List keys are described in Routine Operation, Using the Work List within this chapter.
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File Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Low Normal High low normal high Replicate FILE 8 FILE 9 FILE 10
# Specimens 11 13 0 0 0 0 0 0 0 0 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
File Name Patient File 12 FILE 13 FILE 14 FILE 15 FILE 16 FILE 17 LOW 11 NORMAL 11 HIGH 11
# Specimens 30 0 0 0 0 0 0 0 0 0
PATIENT
QC SPECIMEN
BACKGROUND
ELECTRICL BACKGRND
LATEX
RESISTANT RBC
AUXILIARY
RETURN
Figure 5.32:
SPECIMEN TYPE
The [SPECIMEN TYPE] key on the RUN screen is used to select the type of specimen that will be run. (See the preceding figure.) When the [SPECIMEN TYPE] key is pressed, the screen displays a list of the QC files and the following soft key labels: PATIENT QC SPECIMEN BACKGROUND ELECTRICL BACKGRND LATEX RESISTANT RBC AUXILIARY RETURN The function of each key is discussed in the following section.
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Chapter 5
Next ID ------------ Auto Patient ---------------Sex(M/F):-DOB:--/--/-Dr ---------------------Param: 1 Limits: 1 WBC K/uL NEU %N LYM %L MONO %M EOS %E BASO %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST
S I Z E WCT: COMPLEXITY
G R A N L R T Y LOBULARITY
RCT:
SPECIMEN TYPE
CUSTOMIZE REPORT
Figure 5.33:
PATIENT
The [PATIENT] key on the SPECIMEN TYPE screen is used to display the RUN screen for patient samples. (See the preceding figure.) Patient identification and demographics may be entered on the RUN screen after this key is pressed. Results from this run option are stored in the Data Log.
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11/120
WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES
LOBULARITY
Figure 5.34:
QC SPECIMEN
The [QC SPECIMEN] key on the SPECIMEN TYPE screen is used to select a QC file designated by the position of the cursor on the screen. After the cursor is moved to the desired file, the [QC SPECIMEN] key is pressed to display the RUN screen for the selected file. (See the preceding figure.) Results from this run option are stored in the selected file and in the Data Log. NOTE: The selected QC file is identified on the same line as the <Patient> entry field. It will also be identified in the Status Box after the specimen has been run.
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WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES
LOBULARITY
Figure 5.35:
BACKGROUND
The [BACKGROUND] key on the SPECIMEN TYPE screen is used to display the RUN screen for background counts. (See the preceding figure.) Results from this run option are identified by the designation BACKGROUND in the Data Log and are automatically excluded from the X-B Analysis.
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WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES
LOBULARITY
Figure 5.36:
ELECTRICL BACKGRND
The [ELECTRICL BACKGRND] key on the SPECIMEN TYPE screen is used to select the run mode for electrical background counts. (See the preceding figure.) Electrical backgrounds are used to check for electrical interference in the system. (Aperture current is turned OFF during this cycle.) Results from this run option are identified by the designation ELEC BKGND in the Data Log and are automatically excluded from the X-B Analysis.
The [LATEX] key is used to select the Run mode for polystyrene microspheres. This key is used by Abbott service personnel. (No screen shown.)
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Routine Operation
Next ID _ _ _ _ _ _ _ _ Auto ResRBC Sex (M/F): _ DOB: - -/- -/- Dr: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Param : 1 Limits: 1 WBC NEU %N LYM %L MONO %M EOS %E BASO %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST
S I Z E
LOBULARITY
Figure 5.37:
RESISTANT RBC
The [RESISTANT RBC] key is used to select the Resistant RBC mode. This mode is used to process specimens containing RBCs that are lyse resistant. The sample is held in the WOC Mixing Chamber for approximately 15 seconds longer than the normal mixing time. The extra time enhances the osmotic lysing effect of the Sheath Reagent and reduces interference from the lyse-resistant RBCs. (The interference caused by these RBCs frequently generates WBC and Differential flags. The Resistant RBC cycle reduces the number of WBC and Differential flags generated.) This key is available only when the Open Mode is selected.
The [AUXILIARY] key on the SPECIMEN TYPE screen is used to select the Auxiliary Specimen Type, which allows the operator to run a diluted specimen. This Specimen Type is used to process samples that exceed the instrument linearity limit and require dilution. The Auxiliary Specimen Type allows the operator to enter the dilution factor and will automatically calculate the result based on the dilution factor that was entered. NOTE: The [AUXILIARY] key is available only in the Open Mode with the Work List turned OFF.
Note: WBC Diluted sample results multiplied by: 3.00 (1.00 to 99.99)
Warning, during processing in this mode, Sample Sensor checks are not performed for: Incomplete Aspiration. Press CONFIRM SPECIMEN to select entries and enter Run Menu. Press CANCEL SPECIMEN to cancel entries and return to the Specimen Menu.
CONFIRM SPECIMEN
CANCEL SPECIMEN
Figure 5.38:
Procedure: Auxiliary
1. Dilute the specimen with Diluent according to your laboratorys procedure. 2. If necessary, from the RUN screen press the [CHANGE SAMPLER] key to select the Open Mode. 3. Press the [SPECIMEN TYPE] key followed by the [AUXILIARY] key to select the Auxiliary Specimen Type.
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4. The AUXILIARY SPECIMEN TYPE screen is displayed (see the preceding figure), and the cursor is positioned in the <NOTE> entry field, which can hold up to 7 characters. It is suggested that this field be used to identify the parameter(s) that exceeded the linearity limits. 5. Press Enter on the keyboard to advance the cursor to the <DILUTION> entry field (the line that reads Diluted sample results multiplied by:). 6. Type the desired dilution factor. (For example, type 3 for a 1:3 dilution, etc.) Press Enter to save the entry. NOTE: Exercise caution when evaluating HGB results that have been diluted by ratios greater than 1:4. 7. Press the [CONFIRM SPECIMEN] key to save the entries and display the RUN screen for the Auxiliary Specimen Type. (See the following figure.) 8. The dilution factor and the information entered in the <NOTE> entry field on the previous screen are displayed in the upper left-hand corner of the Auxiliary RUN screen. Confirm that these entries were made correctly. 9. Enter the appropriate Patient ID number in the <Next ID> entry field. 10. If desired, the patient name may be entered in the <Auxiliary> entry field. 11. Run the diluted specimen in the Open Mode. 12. When the cycle is complete, the instrument automatically exits from Auxiliary and returns to the patient RUN screen. 13. The corrected results for all parameters (results that have been multiplied by the dilution factor) are displayed. NOTE: If chevrons (>>>>) are displayed for the parameter that exceeded the linearity, further dilution is required because the result, before it is multiplied by the dilution factor, still exceeds the linearity. NOTE: Always compare the results and flags displayed in Auxiliary to those obtained in the Patient Run Mode and evaluate the individual flags displayed in both modes as described in Chapter 3: Principles of Operation, Subsection: Operational Messages and Data Flagging. 14. To run another dilution, repeat steps 1-13.
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Next ID Auxiliary Note DOB: Rslts Multiplied by 3.00 Param: Limits: WBC K/uL NEU %N LYM %L MONO %M EOS %E BASO %B WCT: RBC HGB HCT MCV MCH MCHC RDW PLT MPV CLEAR APERTURES M/uL g/dL % fL pg g/dL % K/uL fL
S I Z E
LOBULARITY
PLT
Figure 5.39:
The [CUSTOMIZE REPORT] key on the RUN screen is discussed earlier in this chapter, in Set Up Instructions, Customize Report Soft Key.
The [CHANGE SAMPLER] key on the RUN screen is used to select the Open or Closed Mode of operation. When the key is pressed, the mode changes from the one currently selected to the other operating mode. The Status Box displays the message SELECTING OPEN MODE or SELECTING CLOSED MODE. When the cursor is positioned on the word AUTO (at the end of the <NEXT ID> entry field), this key label changes to [TOGGLE AUTO ID] and the auto increment feature is enabled (the word AUTO is highlighted) or disabled. Refer to the Sample Analysis section of this chapter for a discussion of the auto increment feature.
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The [PRINT TICKET] key on the RUN screen is used to print a report on a ticket when the Ticket Printer is connected to the Data Station. The report is printed on the type of ticket that is selected from the CUSTOMIZE PRINTED REPORT screen (discussed in Set Up Instructions within this chapter).
The [PRINT REPORT] key on the RUN screen is used to print a graphics report when the Graphics Printer is connected to the Data Station. When the Color Graphics Printer is connected to the Data Station and the color printing option (on the CUSTOMIZE PRINTED REPORT screen) is ON, the key label changes to [COLOR PRINT]. (The CUSTOMIZE PRINTED REPORT screen is discussed earlier in this chapter, in Set Up Instructions, Customize Report Soft Key.) A color graphics report is printed when the [COLOR PRINT] key is pressed.
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Specimen Stability
Fresh whole blood specimens are recommended. The International Committee for Standardization in Haematology (ICSH) defines a fresh blood specimen as one processed within four hours after collection.1 The hemogram parameters RBC, HGB, HCT, MCV, MCH, MCHC, RDW, PLT, and MPV are stable (5%) for up to 24 hours after collection. The total WBC is stable (5%) for up to 12 hours after collection. The stability of the total WBC decreases to 7% at 24 hours after collection. The WBC Differential parameters NEU, LYM, MONO, EOS, and BASO are stable (10%) for up to 12 hours after collection. An increase in false positive Suspect Population Flags may be seen on samples processed less than 30 minutes after collection time or more than 4 hours after collection time. Stability studies conducted at Abbott indicate that specimens exhibit increased stability when they are stored at room temperature rather than in a refrigerator. The stability of capillary specimens collected in microtainers may vary depending on the microtainer manufacturer. Refer to the manufacturers package insert for stability claims. NOTE: Reticulocyte stability is discussed in Chapter 14: Reticulocyte Package.
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Specimen Collection
All specimens should be collected using proper technique and following the tube manufacturers recommendations. NOTE: For additional information on collecting venous and capillary specimens, refer to CLSI/NCCLS Standards, H3-A52 and H4-A5.3 Specimens that will be run on the Sample Loader must be collected in 13 x 75-mm tubes. The recommended tube is a 13 x 75-mm tube with a HEMOGARD closure that draws 13 mL of blood. The specimen volume in this tube ensures proper mixing by the Sample Loader. A minimum of 180 L should be collected for capillary specimens. This ensures an adequate amount of blood for the Open Mode aspiration (130 L). WARNING: Potential Biohazard. Consider all specimens, controls, calibrators, surfaces, or components that contain or have contacted blood, serum, or other bodily fluid as potentially infectious. Wear gloves, a lab coat, and protective eyewear, and follow other biosafety practices as specified in the OSHA Bloodborne Pathogen Rule (29 CFR Part 1910.1030) or other equivalent biosafety procedures.
Interfering Substances
It is important to note that there are commonly occurring interfering substances that can affect the results reported by hematology analyzers. While the CELL-DYN 3700 has been designed to detect and flag many of these substances, it may not always be possible to do so. The following indicates the substances that may interfere with each of the listed parameters. WBC: Fragile WBCs, neutrophil aggregates, lytic-resistant RBCs, NRBCs, PLT clumps, cryofibrinogen, cryoglobulin, paraproteins Elevated WBC count, increased numbers of giant PLTS, auto-agglutination, in vitro hemolysis Elevated WBC count, increased plasma substances (triglycerides, bilirubin, in vivo hemolysis), lyticresistant RBCs. elevated WBC count, hyperglycemia, in vitro hemolysis, increased numbers of giant PLTs. WBC fragments, in vitro hemolysis, microcytic RBCs, cryofibrinogen, cryoglobulins, PLT clumping, increased numbers of giant PLTs.
CELL-DYN 3700 System Operators Manual
RBC: HGB:
MCV:
PLT:
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For additional information on interfering substances, refer to the table provided in Appendix C. For a detailed description of the flags that are generated, refer to Chapter 3: Principles of Operation, Subsection: Operational Messages and Data Flagging.
Sample Analysis
Certain general guidelines should be followed when running samples on either the Sample Loader or the Closed Sampler instruments. Samples should not be run until the instrument has been properly started up and daily QC checks have been performed. The Ready message must be displayed in the Status Box on the Data Station RUN screen before samples can be analyzed. Samples should be well mixed (a rotary mixer is preferred) before they are run in the Open Mode or the Closed Mode on the CELL-DYN 3700CS System. The Sample Loader automatically mixes the samples before aspiration. However, samples must be well mixed before they are placed in the Sample Loader racks.
Operator ID
The operator should enter an Operator ID before running samples. The Operator ID is displayed on all screens and printed on the graphics report and the blank ticket report. It is also retained in the QC Logs and the Data Log. The operator ID can be entered from the MAIN MENU screen or the CALIBRATION screen. When either screen is selected, the cursor is positioned in the <OPERATOR ID> entry field. Type up to three alphanumeric characters and press the Enter key on the keyboard to save the ID number.
Specimen Identification
A specimen identification name or number can be entered in the upper left-hand corner of the RUN screen. These entry fields are made available by pressing the [SPECIMEN TYPE] key followed by the [PATIENT] key. 1. A Specimen ID name or number of up to 12 characters can be entered in the <NEXT ID> entry field.
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2. An Auto-Increment feature is available, which automatically increments the Specimen ID number by 1 each time a sample is run. It is selected by moving the cursor to the word AUTO (displayed at the end of the <NEXT ID> entry field). The [CHANGE SAMPLER] key changes to [TOGGLE AUTO ID]. Press the [TOGGLE AUTO ID] key to turn the feature ON or OFF. If the word AUTO is highlighted, the feature is enabled. Enabling this feature automatically increments the ID number after the first entry is made. NOTE: Up to 12 characters can be entered, but the AutoIncrement feature is limited by the number of characters currently entered. The number changes to zeros when the maximum value is reached. For example, if a three-digit ID number is entered, the number changes from 999 to 000. If a five-digit number is entered, the number changes from 99999 to 00000. Therefore, leading zeros should precede the number to maximize the use of this feature. (For example, 00099.) 3. The remaining patient demographic information may be entered in the other data entry fields at the operators discretion. 4. The results of the run will be displayed and printed using Parameter Set 1 and Patient Limit Set 1 if no changes are made in these entry fields. When the results are displayed (but before the next sample is run), other parameter and limit sets can be displayed by moving the cursor to the appropriate field and typing the desired number. NOTE: When the results have been stored in the Data Log, other parameter and limit sets may be selected by using the [EDIT SPECIMEN] key on the DISPLAY SPECIMEN screen accessed through the DATA LOG screen. For complete instructions, refer to Using the Data Log within this chapter.
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Instrument Start Up
The Analyzer and Data Station power switches should be left ON at all times. The instrument has been designed to automatically maintain itself when it is idle. If the instrument is idle for five minutes, a cleaning cycle will be automatically initiated. If the instrument is idle for four hours, an automatic Shutdown Cycle will be initiated. The instrument will be placed in the Standby state at the end of the automatic Shutdown Cycle. Power to the Printer may be left ON or OFF at the operators discretion. For complete instructions on Printer operation, refer to Chapter 11: Printers. Power to the Sample Loader may be left ON or OFF at the operators discretion. For complete instructions on Sample Loader operation, refer to Chapter 12: Sample Loader. A complete procedure for turning the system ON or OFF is given in Chapter 10: Troubleshooting.
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5. When the automatic Start Up Cycle is completed, a background count is automatically performed and the Open Mode is selected. 6. Verify that the background counts are acceptable. If the background counts are unacceptable, repeat the background cycle. If the counts are still unacceptable, troubleshoot accordingly, as directed in Chapter 10: Troubleshooting, Subsection: Troubleshooting Guide. NOTE: Background counts may be repeated by pressing the Touch Plate. 7. Perform the daily quality control procedures as directed in the following section, Daily Quality Control Procedures. NOTE: Whenever the CELL-DYN 3700 System has been in standby, before running any control or patient specimen in the Closed Sampler or Sample Loader Mode, it is recommended that a prime specimen be run in the Closed Sampler or Sample Loader Mode first.
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3. If necessary, press the [CHANGE SAMPLER] key to select the Open Mode. 4. Run the control. NOTE: For complete instructions on running samples, refer to Running Samples within this chapter (following the QC procedures). 5. Verify that the results are acceptable. NOTE: Out-of-range results are displayed in color. 6. If the results are unacceptable, repeat the run. If the results are still unacceptable, obtain a new bottle of the control, be sure that it is warmed and mixed properly, and again repeat the run. If the results are still unacceptable, run the other levels of control material. If the results on all levels are unacceptable, troubleshoot accordingly, as directed in Chapter 10: Troubleshooting, Subsection: Troubleshooting Guide. 7. When the control results are acceptable, patient samples may be analyzed.
Closed Mode QC
QC samples can be run on the Sample Loader using the Q Labels, which are bar code labels that are available for the Sample Loader. Each label is designated Qx, where x indicates the file number. If these labels are placed on the control tubes, the results are automatically transmitted to the file indicated by the label. QC samples can also be run on the Sample Loader without these labels. NOTE: Be sure the Work List is OFF before beginning these procedures. If necessary, refer to Work List within this chapter for instructions.
6. Be sure that all 10 racks (5 on each side) and the Safety Cover are in place and press the Start key on the Sample Loader. 7. The Sample Loader reads the Q Label and transmits the results to the appropriate QC file. 8. When all controls have been run, press the [MAIN] key followed by the [QUALITY CONTROL] key. 9. Use the arrow keys on the keyboard to move the cursor to the desired file. 10. Press the [VIEW QC LOG] key to display the QC log. 11. Verify that the results are acceptable. NOTE: Out-of-range results are displayed in color. 12. Repeat steps 810 for all controls that were run. 13. If the results are unacceptable, repeat the run. If the results are still unacceptable, obtain a new tube of control, be sure that it is warmed and mixed properly according to the manufacturers recommendations, and again repeat the run. If the results are still unacceptable, run the other levels of control material. If the results on all levels are unacceptable, troubleshoot accordingly, as directed in Chapter 10: Troubleshooting, Subsection: Troubleshooting Guide. 14. When the control results are acceptable, patient samples may be analyzed.
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5. Be sure that all 10 racks (5 on each side) and the Safety Cover are in place and press the Start key on the Sample Loader. 6. After the first control is aspirated, press the Pause key on the Sample Loader. 7. After the results are displayed, press the [SPECIMEN TYPE] key. 8. Use the arrow keys on the keyboard to move the cursor to the file for the next control to be run and press the [QC SPECIMEN] key. 9. Press the Start key on the Sample Loader. 10. Repeat steps 69 until all levels of controls have been run. 11. When all of the controls have been run, press the [MAIN] key followed by the [QUALITY CONTROL] key. 12. Use the arrow keys on the keyboard to move the cursor to the desired file. 13. Press the [VIEW QC LOG] key to display the QC Log. 14. Verify that the results are acceptable. NOTE: Out-of-range results are displayed in color. 15. Repeat steps 1114 for all levels of controls that were run. 16. If the results are unacceptable, repeat the run. If the results are still unacceptable, obtain a new tube of control, be sure that it is warmed and mixed properly, and again repeat the run. If the results are still unacceptable, run the other levels of control material. If the results on all levels are unacceptable, troubleshoot accordingly, as directed in Chapter 10: Troubleshooting, Subsection: Troubleshooting Guide. 17. When the control results are acceptable, patient samples may be analyzed.
Running Samples
Two modes of running samples are available with the SL Model: Open Mode Analysis The Open Sampler Mode aspirates the sample from an opened collection tube. OPEN SAMPLER is displayed in the upper right corner of the RUN screen when this mode is selected. The Open Sample Aspiration Probe is available only when this mode is selected.
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Daily Shutdown
It is not necessary to perform a Daily Shutdown Procedure, as the instrument automatically goes into a Standby state if it has been idle for four hours. If desired, the operator may place the instrument in the Standby state by pressing the [DAILY SHUTDOWN] key on the second SPECIAL PROTOCOLS screen. NOTE: The instrument should not be turned off unless directed to do so by an authorized Abbott Representative or in case of emergency. When the key is pressed or when the Automatic Shutdown is initiated, the cycle: Rinses the Flow System. Sets the timer control that periodically opens all of the solenoid valves to prevent pinched tubing.
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Running Samples
Two modes of running samples are available with the CS Model: Open Mode Analysis The Open Sampler Mode aspirates the sample from an opened collection tube. OPEN SAMPLER is displayed in the upper right corner of the RUN screen when this mode is selected. The Open Sample Aspiration Probe is available only when this mode is selected. Closed Mode Analysis The Closed Sampler Mode on Closed Sampler (CS) instruments aspirates the sample from a closed collection tube that has been inserted in the Closed Sampler Module. CLOSED SAMPLER is displayed in the upper right corner of the RUN screen when this mode is selected. The Wash Block moves down to the end of the Open Sample Aspiration Probe when this mode is selected.
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3. Invert the well-mixed specimen and place the stoppered end down into the Closed Sampler Module. Push the end of the tube securely into the Tube Retainer. NOTE: Place the tube cap-down and make sure it is seated correctly. (The Touch Plate will not operate if the tube is not seated correctly.) For instructions on adjusting the Tube Retainer, refer to Chapter 9: Maintenance, Subsection: Special Procedures. 4. Press the Touch Plate located behind the probe to start the cycle. The word BUSY on the Analyzer Status Indicator Panel will be illuminated in yellow. 5. Remove the tube when the beep sounds. 6. When the cycle is completed, the word READY on the Analyzer Status Indicator Panel will be illuminated in green, and the results will be displayed on the RUN screen. 7. Repeat this procedure for subsequent samples.
Daily Shutdown
It is not necessary to perform a Daily Shutdown Procedure, as the instrument automatically goes into a Standby state if it has been idle for four hours. If desired, the operator may place the instrument in the Standby state by pressing the [DAILY SHUTDOWN] key on the second SPECIAL PROTOCOLS screen. When the key is pressed or when the Automatic Shutdown is initiated, the cycle: Rinses the Flow System. Sets the timer control that periodically opens all of the solenoid valves to prevent pinched tubing.
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The [WORK LIST] key on the Data Station RUN screen is used to display the WORK LIST screen. (See the following figure.) The following soft key labels are displayed on the WORK LIST screen: WORK LIST ON or WORK LIST OFF BAR CODE ON or BAR CODE OFF INSERT/DELETE DELETE ALL PURGE COMPLETED WORK LIST SET UP PRINT WORK LIST RETURN
(This key label alternates between these two selections.) (This key label alternates between these two selections.)
1 2
Work List ON
Bar Code ON
3
# 11 2 3 4 5 6
4
4DIG BC
5
SPECIMEN ID 123456 234567 345678 456789 567890
6
SPECIMEN NAME Jones, Mary Smith, John White, Bob Black, Sue Green, Kermit
7
L 1
8
P 1
9
DOCTOR 1 1 1 1 1 1
10
DATE OF BIRTH 1 --/--/-- N A 1 F 1 1 1 1
11
S
12
RACK/ TUBE
INSERT/ DELETE
DELETE ALL
PURGE COMPLETED
RETURN
Figure 5.40:
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The numbers on the WORK LIST screen (shown in the preceding figure) correspond with the following numbered options: 1. <WORK LIST> The status of the Work List (OFF or ON) is displayed in this field. 2. <BAR CODE> The status of the Bar Code selection (OFF or ON) is displayed in this field. 3. <#> The sequential number of the Work List entries is displayed in this field. The Work List holds 800 entries. When the Work List is full, existing entries must be deleted before additional entries can be made. 4. <4DIG BC> (4-Digit Bar Code) If the 4-digit bar code was selected from the WORK LIST SET UP screen and the Bar Code option is ON, the bar code number must be entered in this field. 5. <SPECIMEN ID> A bar code number, specimen identification number, or name can be entered in this field. Up to 12 characters can be entered. The sample is identified on the RUN screen, in the Data Log, and on the printed report using the information entered in this field. NOTE: An entry must be made in this field to create a Work List. 6. <SPECIMEN NAME> The name entered in this field should be associated with the identification number entered in the <SPECIMEN ID> field. Up to 16 characters can be entered in this field. 7. <L> (Limit Set) This field is used to enter the number of the Patient Limit Set that will be used for flagging the sample. If no entry is made, the default (pre-selected) Patient Limit Set will be used. 8. <P> (Parameter Set) This field is used to enter the number of the Parameter Set that will be used for the sample. If no entry is made, the default (preselected) Parameter Set will be used.
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9. <DOCTOR> This field is used to enter the name of the patients physician. 10. <DATE OF BIRTH> This field is used to enter the date of birth of the patient. 11. <S> (Status) As the samples are processed, the status is indicated in this field. The operator cannot enter information in this field. The following codes may be displayed: N A Non-Alerted The sample was not flagged in any way. Alerted The sample was flagged because results exceeded the selected Patient Limits or because a morphological flag was generated. Fault A Metering Fault (for WIC or RBC/PLT) or a Sampling Error message was generated as the sample was processed, either with or without the Sample Loader; or a Mixing Error message was generated as the sample was processed (only when using the Sample Loader).
12. <RACK/TUBE> As samples are processed on the Sample Loader, the rack number and tube number (position of the tube in the rack) are displayed in this field. The operator cannot enter information in this field. The display shows RxTx (where x indicates the number of the rack or tube).
The [WORK LIST ON] key is used to turn on the Work List feature. The key label changes to [WORK LIST OFF] when the Work List feature is enabled. The upper left-hand corner of the screen indicates the status of the Work List.
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The [BAR CODE ON] key is used to create a Work List for samples that are identified with bar code labels. The key label changes to [BAR CODE OFF] when the Bar Code feature is enabled. The upper left corner of the screen indicates the status of the Bar Code feature.
When the [INSERT/DELETE] key is pressed, the following soft key labels are displayed: INSERT DELETE
The [INSERT] key is used to insert a line of information into the Work List. The line is inserted at the cursor position, and the remainder of the Work List is moved down one line.
The [DELETE] key is used to delete a line of information from the Work List. (When information is deleted, the line remains blank.) When the [DELETE] key is pressed, the following soft key labels are displayed: CONFIRM DELETION CANCEL DELETION These keys are used to confirm or cancel the [DELETE] command.
The [DELETE ALL] key is used to delete all data from the Work List. When the [DELETE ALL] key is pressed, the following soft key labels are displayed: CONFIRM DELETION CANCEL DELETION These keys are used to confirm or cancel the [DELETE ALL] command.
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The [PURGE COMPLETED] key is used to delete all Work List entries for samples that have been successfully run through the Analyzer (marked with an N or A in the Status field). When the [PURGE COMPLETED] key is pressed, the Bulletin Line displays the following message: ALL SPECIMENS MARKED WITH N OR A WILL BE PURGED The following soft key labels are displayed: CONFIRM CANCEL These keys are used to confirm or cancel the [PURGE COMPLETED] command. NOTE: The Purge Completed option is not available when the Bar Code feature is OFF.
10:09 sh 0630
1 1
Bar Code ID associated with : 1 = 4-digit bar code 2 = Laboratory Specimen ID Specimen Name entry selected Patient Limits entry selected Default Patient Limit Set (1..4) Parameter Set entry selected Default Parameter Set (1..4) Doctor Name entry selected Date of Birth entry selected TOGGLE ON/OFF RETURN
Figure 5.41:
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The [WORK LIST SET UP] key on the WORK LIST screen is used to display the WORK LIST SET UP screen shown in the preceding figure. The numbers on the screen correspond to the following numbered options: 1. <Bar Code ID associated with:> 1 = 4-digit bar code 2 = Laboratory Specimen ID This field is used to specify the type of bar code that will be used when the Bar Code feature is ON. If option 2 is selected, the bar code number must be entered in the <Specimen ID> field. 2. <Specimen Name entry selected> This field is used to specify whether a specimen name will be entered in the Work List. 3. <Patient Limits entry selected> This field is used to specify which Patient Limits are assigned to each sample. The default Patient Limit Set will be used if no specification is made. 4. <Default Patient Limit Set (1..4)> This field is used to specify the default (preassigned) Patient Limit Set that will be automatically assigned to each sample unless otherwise indicated in the Work List. 5. <Parameter Set entry selected> This field is used to specify which Parameter Set will be assigned to each sample. The Default Parameter Set will be used if no specification is made. 6. <Default Parameter Set (1..4)> This field is used to specify the default (preassigned) Parameter Set that is automatically assigned to each sample unless otherwise indicated in the Work List. 7. <Doctor Name entry selected> This field is used to specify whether a doctor name will be entered in the Work List. 8. <Date of Birth entry selected> This field is used to specify whether the patients date of birth will be entered in the Work List.
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The [PRINT WORK LIST] key is used to print the Work List.
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Type the number of the desired Limit Set (1-4) and press the Enter key on the keyboard. The cursor advances to the <Doctor Name> entry field. 8. Press the [TOGGLE ON/OFF] key to select (or deselect) the Doctor Name entry option. The cursor advances to the <Date of Birth> entry field. 9. Press the [TOGGLE ON/OFF] key to select (or deselect) the <Date of Birth> entry option. The cursor advances to the next entry field.
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As indicated earlier in the Work List section, two types of bar code labels can be used on the Cell-Dyn 3700 as described in the following paragraphs.
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NOTE: Samples can be run with the WORK LIST screen displayed. As the samples are processed, the status of each sample will be displayed in the <STATUS> field on the Work List. Additional entries can be made to the Work List while processing takes place. 7. As each sample is processed, the Work List is searched for the bar code number. When a match is found, the entered information is transferred from the Work List to the RUN screen and is also displayed in the Data Log.
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5. Using the hand held bar code reader, scan the bar code label on the tube. If the hand held reader is unavailable, type the Specimen ID in the next ID field. 6. Aspirate the sample. NOTE: Samples can be run with the WORK LIST screen displayed. As the samples are processed, the status of each sample is displayed in the <STATUS> field on the Work List. Additional entries can be made to the Work List while processing takes place. 7. As each sample is processed, the Work List is searched for the bar code number. When a match is found, the entered information is transferred from the Work List to the RUN
screen and is also displayed in the Data Log. Procedure: Sample Analysis with Bar Codes in the Open Mode
1. After the information for all samples has been entered, press the [RETURN] key to return to the RUN screen. 2. Press the [SPECIMEN TYPE] key followed by the [PATIENT] key. 3. If necessary, press the [CHANGE SAMPLER] key to select the Open Mode. 4. Using the hand held bar code reader, scan the bar code label on the tube. If the hand held reader is unavailable, type the Specimen ID in the next ID field. 5. Aspirate the sample. NOTE: Samples can be run with the WORK LIST screen displayed. As the samples are processed, the status of each sample is displayed in the <STATUS> field on the Work List. Additional entries can be made to the Work List while processing takes place. 6. As each sample is processed, the Work List is searched for the bar code number. When a match is found, the entered information is transferred from the Work List to the RUN screen and is also displayed in the Data Log.
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NOTE: Misidentification of samples can occur if they are not processed in the order of entry into the Work List. Consequently, it is recommended that the WORK LIST screen be displayed or printed. when running samples without bar codes. The status of each sample is displayed in the <STATUS> field on the Work List and additional entries can be made while processing takes place. 5. Aspirate the sample. 6. As each sample is processed, the entered information for the next sequential specimen ID number is transferred from the Work List to the RUN screen and is also displayed in the Data Log. Therefore, samples must be processed in the order in which information has been entered into the Work List, to avoid misidentification.
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NOTES
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Seq 833 834 835 836 837 838 839 840 841 w 842 b 843 844 r r r r r r
Specimen ID 1912584436 1910952241 1912077932 1911764321 1911815501 1911187621 low ctrl low ctrl low ctrl
BACKGROUND
WBC 3.83 7.50 .192 6.26 4.37 7.07 8.06 7.96 8.21 7.93 8.34 .079
NEU 2.30 4.53 .052 4.99 2.75 6.02 4.71 4.78 4.86 4.71 4.97
LYM .315 2.16 .116 .828 .984 .612 2.44 2.32 2.45 2.39 2.50
MONO 1.04 .536 .012 .252 .519 .218 .621 .601 .598 .557 .551
EOS .012 .106 .002 .019 .001 .069 .213 .183 .204 .178 .208
BASO .173 .141 .010 .176 .116 .150 .074 .080 .099 .092 .114
Date C07/21/98 C07/21/98 C07/21/98 C07/21/98 C07/21/98 C07/21/98 O07/21/98 O07/21/98 O07/21/98 K07/21/98 O07/21/98 O07/21/98
Time 14:40 14:40 14:41 14:42 14:43 14:43 16:20 16:20 16:21 16:26 16:28 16:30
Op rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs
Seq EDIT ID
WBC
NEU
LYM
MONO EOS
Time
Op MAIN
FIND SPECIMEN
Figure 5.42:
NOTE: Press the F12 key followed by the F1 key on the keyboard to toggle between this Data log screen and the Retic Data Log screen.
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The [DATA LOG] key on the MAIN MENU is used to display the DATA LOG screen (see the preceding figure) and the following soft key labels: EDIT ID (This key label is displayed only if the cursor is positioned next to a patient record.)
DISPLAY SPECIMEN FIND SPECIMEN REJECT FROM X-B (This key label is displayed if the sequence number of the patient record is preceded by a b, r, or w. See the preceding figure.) CUSTOMIZE DATA LOG TRANSMIT DATA PRINT DATA LOG MAIN Information that can be viewed from the DATA LOG screen includes the following: Sequence number and specimen ID assigned to the sample (left portion of screen). A b, r, or w may appear to the left of the sequence number. b Specimen is included in both X-B WBC and X-B RBC Analysis r Specimen is included in X-B RBC Analysis w Specimen is included in X-B WBC Analysis Set of parameter data that can be customized by pressing the [CUSTOMIZE DATA LOG] key (center portion of screen). Date and time sample was run and operator ID (right portion of screen).
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Also listed in the right portion of the DATA LOG screen, immediately to the left of the date, is a letter. This letter represents the following Data Log codes that identify conditions of the sample run: O Sample was run in the Open Mode C Sample was run in the Closed Mode N Incomplete aspiration in the Open Mode I Incomplete aspiration in the Closed Mode K WIC or RBC/PLT metering fault (Clog or Flow Error) M Mixing error on the Sample Loader R Resistant RBC key was used to run this sample V Sample was run in the Veterinary mode B Blood in line A Auxiliary The keys and functions accessible from the DATA LOG screen are described on the following pages.
The [EDIT ID] key is used to edit the specimen ID displayed on the DATA LOG screen. When the [EDIT ID] key is pressed, the cursor moves into the <SPECIMEN ID> field and all key labels are blank. Edits are saved by pressing the Enter key on the keyboard after the new ID is entered. NOTE: The [EDIT ID] key is available only when the cursor is positioned next to a patient record. It is not available for background or QC records. When using the Edit Specimen ID feature in the Data Log, set up a laboratory procedure to verify any Specimen ID that has been manually edited in the Data Log by showing the content of the Specimen ID before and after editing. Such verification could be: Printouts of the Data Log summary reports that show the edited ID. These printouts should be signed, dated and saved to ensure tracking of any changes to specimen identification within your laboratory. or Re-running any specimen unintentionally identified with a Rack and Tube Number, via Open or Closed Mode, to confirm that the correct Specimen ID is applied.
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LOBULARITY
RCT:6.53 RBC Auto-Sampler Ready EDIT SPECIMEN CUSTOMIZE REPORT TRANSMIT SPECIMEN PRINT TICKET
NEXT SPECIMEN
Figure 5.43:
DISPLAY SPECIMEN
The [DISPLAY SPECIMEN] key on the DATA LOG screen is used to display the results for the record indicated by the cursor position. (See the preceding figure.) The following soft key labels are displayed on the DISPLAY SPECIMEN screen: PREVIOUS SPECIMEN This label key is not displayed when the first specimen in the log is on the screen. NEXT SPECIMEN EDIT SPECIMEN CUSTOMIZE REPORT TRANSMIT SPECIMEN PRINT TICKET PRINT REPORT or COLOR PRINT (The key label alternates between these two selections, depending on whether the Color Print option has been enabled.) This label key is not displayed when the last specimen in the log is on the screen. This label key is displayed for the patient records only.
RETURN
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The [PREVIOUS SPECIMEN] key on the DISPLAY SPECIMEN screen is used to display the results for the sequence number preceding the one currently displayed without returning to the main DATA LOG screen.
The [NEXT SPECIMEN] key is used to display the results for the sequence number following the one currently displayed without returning to the main DATA LOG screen.
The [EDIT SPECIMEN] key is used to edit patient demographic information for the selected record. It may also be used to edit and display the results using a Parameter Set or Patient Limit Set different from the one currently displayed. The following soft key labels are displayed when the [EDIT SPECIMEN] key is pressed: CONFIRM CANCEL These keys are used to [CONFIRM] or [CANCEL] the edits. The Bulletin Line displays the following message: PRESS CONFIRM TO SAVE CHANGES OR CANCEL TO CANCEL CHANGES. When the [CONFIRM] key is pressed, the edited record is displayed.
The [CUSTOMIZE REPORT] key is used to customize the RUN screen display, header, and printout as described in Set Up Instructions within this chapter.
The [TRANSMIT SPECIMEN] key is used to transmit the displayed report to a Laboratory Information System or on-line computer.
The [PRINT TICKET] key is used to print a ticket (in the currently selected format) for the displayed record.
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The [PRINT REPORT] key is used to print a graphics report (in the currently selected format) for the displayed record. NOTE: If color printing has been selected (refer to Set Up Instructions within this chapter), the key label changes to [COLOR PRINT].
The [RETURN] key is used to return to the main DATA LOG screen.
b r
r r
Seq 700 701 702 703 704 705 706 707 708 709 710 711
Specimen ID BACKGROUND 1911937231 1911359331 1911883246 LATEX LATEX BACKGROUND 1912696001 1911187621 1912395001 1910851733 BACKGROUND
WBC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
WIC .006 9.89 6.44 11.9 1.71 1.64 .009 8.21 8.23 7.75 9.91 .013
WOC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
RBC 0.00 3.76 3.88 0.00 0.00 0.00 3.33 3.29 3.77 3.77 .001
HGB .027 10.1 10.2 10.1 .081 .061 .027 9.54 9.94 11.5 10.7 .027
Date O07/20/98 C07/20/98 C07/20/98 K07/20/98 O07/20/98 O07/20/98 O07/20/98 C07/20/98 C07/20/98 C07/20/98 C07/20/98 O07/20/98
Time 14:38 14:42 14:43 14:43 14:50 14:51 14:53 14:57 14:57 14:58 14:59 15:47
Op rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs
Seq EDIT ID
WBC
WIC
WOC
RBC
HGB
MCV
Time
Op MAIN
FIND SPECIMEN
Figure 5.44:
FIND SPECIMEN
The [FIND SPECIMEN] key on the DATA LOG screen is used to locate a particular record by entering the sequence number, specimen ID number, or patient name for the desired record. When this key is pressed, the DATA LOG SEARCH screen is displayed. (See the preceding figure.) If the record is not found in the Data Log, the Bulletin Line displays the message NO ENTRY FOUND.
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The letter b, r, or w will appear to the left of the sequence number for certain samples. b Specimen is included in both X-B WBC and X-B RBC Analysis r Specimen is included in X-B RBC Analysis w Specimen is included in X-B WBC Analysis If the cursor is positioned at a sample identified with a b, r, or w preceding the sequence number (indicating that the results are included in the X-B Analysis), the [REJECT FROM X-B] key label is displayed on the DATA LOG screen. (See the preceding figure.) When the [REJECT FROM X-B] key is pressed, the sample is marked with an R located on the right side of the specimen ID. The results are excluded from the X-B Analysis (the b, r, or w is deleted) and the key label changes to [ACCEPT INTO X-B]. (See the following figure.) If the [ACCEPT INTO X-B] key is pressed, the R is deleted, a b, r, or w is displayed, and results are now included in the X-B Analysis.
b r
r r
Seq 700 701 702 703 704 705 706 707 708 709 710 711
Specimen ID BACKGROUND 1911937231 1911359331 1911883246 LATEX LATEX BACKGROUND 1912696001 1911187621 R 1912395001 1910851733 R BACKGROUND
WBC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
WIC .006 9.89 6.44 11.9 1.71 1.64 .009 8.21 8.23 7.75 9.91 .013
WOC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
RBC 0.00 3.76 3.88 0.00 0.00 0.00 3.33 3.29 3.77 3.77 .001
HGB .027 10.1 10.2 10.1 .081 .061 .027 9.54 9.94 11.5 10.7 .027
Date O12/20/98 C12/20/98 C12/20/98 K12/20/98 O12/20/98 O12/20/98 O12/20/98 C12/20/98 C12/20/98 C12/20/98 C12/20/98 O12/20/98
Time 14:38 14:42 14:43 14:43 14:50 14:51 14:53 14:57 14:57 14:58 14:59 15:47
Op rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs
Seq EDIT ID
WBC
WIC
WOC
RBC
HGB
MCV
Time
Op MAIN
Auto-Sampler Pause FIND SPECIMEN REJECT FROM X-B CUSTOMIZE DATA LOG
Figure 5.45:
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b r w
r b r
Seq 700 701 702 703 704 705 706 707 708 709 710 711
Specimen ID BACKGROUND 1911937231 1911359331 1911883246 LATEX LATEX BACKGROUND 1912696001 1911187621 R 1912395001 1910851733 R BACKGROUND
WBC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
WIC .006 9.89 6.44 11.9 1.71 1.64 .009 8.21 8.23 7.75 9.91 .013
WOC .006 9.42 5.52 11.4 3.25 3.25 .035 7.96 8.10 6.88 9.53 .013
RBC 0.00 3.76 3.88 0.00 0.00 0.00 3.33 3.29 3.77 3.77 .001
HGB .027 10.1 10.2 10.1 .081 .061 .027 9.54 9.94 11.5 10.7 .027
Date O12/20/98 C12/20/98 C12/20/98 K12/20/98 O12/20/98 O12/20/98 O12/20/98 C12/20/98 C12/20/98 C12/20/98 C12/20/98 O12/20/98
Time 14:38 14:42 14:43 14:43 14:50 14:51 14:53 14:57 14:57 14:58 14:59 15:47
Op rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs
Seq EDIT ID
WBC
WIC
WOC
RBC
HGB
MCV
Time
Op MAIN
Auto-Sampler Pause FIND SPECIMEN ACCEPT INTO X-B CUSTOMIZE DATA LOG
Figure 5.46:
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10:29 sh 0630
%B
SELECT PARAMETER
STANDARD GROUPS
CUSTOMIZE PRINTOUT
RETURN
Figure 5.47:
CUSTOMIZE DATA LOG
The [CUSTOMIZE DATA LOG] key on the DATA LOG screen is used to customize the Data Log display. The CUSTOMIZE DISPLAY for Data Log screen (see the preceding figure) and the following soft key labels are displayed when the [CUSTOMIZE DATA LOG] key is pressed: SELECT PARAMETER or PLACE PARAMETER (This key label alternates between these two selections.) STANDARD GROUPS or CUSTOM PLACEMENT (This key label alternates between these two selections.) CUSTOMIZE PRINTOUT RETURN
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The CUSTOMIZE DISPLAY (for Data Log) screen displays a matrix showing the four parameter groups and a list of the available parameters. Parameter Group 1 is displayed (in the order indicated from left to right) on the first DATA LOG screen. The remaining groups are displayed on subsequent screens that are accessed by pressing the Right arrow key on the keyboard. The Left arrow key is used to page back through the screens to the first screen. Setting up the CUSTOMIZE DISPLAY screen is discussed more fully later in this section, in Data Log Set Up Procedures.
The [SELECT PARAMETER] key is used to select a parameter designated by the cursor. When the key is pressed, the selected parameter will be highlighted, the label will change to [PLACE PARAMETER], and a [CANCEL SELECTION] key will be displayed. The [PLACE PARAMETER] key is used to display the parameter in the location indicated by the position of the cursor. Cancel Selection Soft Key The [CANCEL SELECTION] key is used to cancel the selection and display the [SELECT PARAMETER] key again.
CANCEL SELECTION
10:29 sh 0630
LYM HCT
PCT** PDW** %L %M %E %B
WBC GROUP
RBC GROUP
PLT GROUP
DIFF GROUP
CUSTOM PLACEMENT
CUSTOMIZE PRINTOUT
RETURN
STANDARD GROUPS
Predetermined groups of parameters, called Standard Groups, may be selected by pressing the [STANDARD GROUPS] key on the CUSTOMIZE DISPLAY screen. The preceding figure shows the CUSTOMIZE DISPLAY screen with the Standard Groups displayed. The following soft key labels are displayed when the [STANDARD GROUPS] key is pressed: WBC GROUP RBC GROUP PLT GROUP DIFF GROUP CUSTOM PLACEMENT* CUSTOMIZE PRINTOUT RETURN * The [CUSTOM PLACEMENT*] key is used to display the CUSTOMIZE DISPLAY for Data Log screen for operator-selected placement. ** Clinical significance has not been established for these parameters. Therefore, they are not reportable in the U.S. The preceding figure shows the WBC Group placed in GROUP 1, the RBC Group placed in GROUP 2, the PLT Group placed in GROUP 3, and the Diff Group placed in GROUP 4. When each soft key is pressed, the designated parameter group will be placed in the position indicated by the cursor.
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10:31 sh 0630
SELECT PARAMETER
STANDARD SELECTION
RETURN
Figure 5.49:
CUSTOMIZE PRINTOUT
The [CUSTOMIZE PRINTOUT] key on the CUSTOMIZE DISPLAY for Data Log screen is used to customize the printout format of the Data Log. (See the preceding figure.) The following soft key labels are displayed when the [CUSTOMIZE PRINTOUT] key is pressed: SELECT PARAMETER or PLACE PARAMETER (This key label alternates between these two selections.) STANDARD SELECTION RETURN The CUSTOMIZE PRINTOUT for Data Log screen shows the order (from left to right) in which the indicated parameters will be printed. Procedures for Customizing the Data Log Printout are included later in this section under Data Log Set Up Procedures.
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Select Parameter Soft Key The [SELECT PARAMETER] key on the CUSTOMIZE PRINTOUT screen is used to select a parameter designated by the cursor. When the key is pressed, the selected parameter is highlighted, the label changes to [PLACE PARAMETER], and a [CANCEL SELECTION] key is displayed. The [PLACE PARAMETER] key is used to display the parameter in the location indicated by the position of the cursor. The [CANCEL SELECTION] key is used to cancel the selection and display the [SELECT PARAMETER] key again. Standard Selection Soft Key The [STANDARD SELECTION] key on the CUSTOMIZE PRINTOUT for Data Log screen is used to configure the printout in the predetermined print group shown in the preceding figure. When the key is pressed, the print group will be changed to the Standard Selection. Return Soft Key The [RETURN] key is used to return to the main DATA LOG screen.
CANCEL SELECTION
STANDARD SELECTION
RETURN
The [TRANSMIT DATA] key on the DATA LOG screen is used to transmit a record to a Laboratory Information System or on-line computer. When the [TRANSMIT DATA] key is pressed, the screen will prompt the operator to enter the starting and ending sequence numbers (from the lowest to the highest) for the desired transmission. Records may be transmitted singly or in batches as designated by the sequence number(s).
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The [PRINT DATA LOG] key on the DATA LOG screen is used to print the Data Log. When the [PRINT DATA LOG] key is pressed, the screen prompts the operator to enter the starting and ending sequence numbers (from the lowest to the highest) for the desired printout. (See the following figure.) When the Enter key is pressed after the sequence numbers have been entered, the screen will become a DATA LOG screen for the record(s) and a time indicator will appear in the upper right-hand corner to record the printing progress.
Seq Specimen ID 833 1912584436 834 1910952241 835 1912077932 836 1911764321 837 1911815501 838 1911187621 839 low ctrl 840 low ctrl 841 low ctrl 842 b 843 BACKGROUND 844 r r r r r r
WBC 3.83 7.50 .192 6.26 4.37 7.07 8.06 7.96 8.21 7.93 8.34 .079
NEU 2.30 4.53 .052 4.99 2.75 6.02 4.71 4.78 4.86 4.71 4.97
LYM .315 2.16 .116 .828 .984 .612 2.44 2.32 2.45 2.39 2.50
MONO 1.04 .563 .012 .252 .519 .218 .621 .601 .598 .557 .551
EOS .012 .106 .002 .019 .001 .069 .213 .183 .204 .178 .208
BASO .173 .141 .010 .176 .116 .150 .074 .080 .099 .092 .114
Date C12/21/98 C12/21/98 C12/21/98 C12/21/98 C12/21/98 C12/21/98 O12/21/98 O12/21/98 O12/21/98 K12/21/98 O12/21/98 O12/21/98
Time 14:40 14:40 14:41 14:42 14:43 14:43 16:20 16:20 16:21 16:26 16:28 16:30
Op rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs rcs
WBC
NEU
LYM
MONO EOS
Time
Op MAIN
Auto-Sampler Ready FIND SPECIMEN REJECT FROM X-B CUSTOMIZE DATA LOG
Figure 5.50:
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10:57 sh 0630
%B
Figure 5.51:
* Clinical significance has not been established for these parameters. Therefore, they are not reportable in the U.S.
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The display may be customized by selecting the individual parameters, Standard Groups of parameters, or a combination of the two. In addition to the usual hematologic parameters, the following parameters may also be displayed in the Data Log: RUT1 and RUT2 RUT1 is the RBC/PLT Upper Metering Time. RUT2 is the RBC/PLT Upper Metering Time for an extended count. RCT1 is the RBC/PLT Count Time. RCT2 is the RBC/PLT Count Time for an extended count. WUT is the WIC Upper Metering Time. WCT is the WIC Count Time. WIC is the WBC Impedance Count. WOC is the WBC Optical Count. An empty column is inserted in the display.
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7. To obtain a printout of the selected groups, press the Print Screen key on the keyboard. 8. Press the [RETURN] key to return to the DATA LOG screen. 9. The Data Log will be displayed configured with the selected parameters.
Standard Groups
The Data Log display may also be customized using predetermined groups of parameters (Standard Groups) by pressing the [STANDARD GROUPS] key on the CUSTOMIZE DISPLAY for Data Log screen. The preceding figure shows the WBC Group placed in GROUP 1, the RBC Group placed in GROUP 2, the PLT Group placed in GROUP 3, and the Diff Group placed in GROUP 4.
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11:00 sh 0630
Figure 5.52:
Customize Printout for Data Log Screen Showing Customized Print Group
* Clinical significance has not been established for these parameters. Therefore, they are not reportable in the U.S.
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The CUSTOMIZE PRINTOUT for Data Log screen (see the preceding figure) shows the group of parameters that will be printed on a Data Log printout. A list of the available parameters is displayed under the group. The parameters can be selected from the list and placed in the desired position to customize the printout. In addition to the usual hematologic parameters, the following parameters can also be printed in the Data Log: RUT1 and RUT2 RCT1 and RCT2 WUT WCT WIC WOC RUT1 is the RBC/PLT Upper Metering Time. RUT2 is the RBC/PLT Upper Metering Time for an extended count. RCT1 is the RBC/PLT Count Time. RCT2 is the RBC/PLT Count Time for an extended count. WUT is the WIC Upper Metering Time. WCT is the WIC Count Time. WIC is the WBC Impedance Count. WOC is the WBC Optical Count.
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Displaying a Record
A copy of the RUN screen may be displayed for all 10,000 records in the CELL-DYN 3700 System Data Log. A record is displayed by positioning the cursor at the desired record in the Data Log listing and pressing the [DISPLAY SPECIMEN] key. The Status Box indicates DISPLAY SPECIMEN on results displayed (or printed) from the Data Log record. (See the following figure.)
Spec ID ------------ 9742/B Patient ---------------Sex(M/F):- DOB:--/--/-Dr ---------------------Param Set: 1 Limits: 1 WBC 4.97 K/uL NEU 3.53 71.0 %N LYM .813 16.4 %L MONO .450 9.05 %M EOS .103 2.07 %E BASO .074 1.49 %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV 5.48 15.7 58.2 106. 28.7 27.0 14.5 254. 8.38 M/uL g/dL % fL pg g/dL % K/uL fL NEXT SPECIMEN
LOBULARITY
PREVIOUS SPECIMEN
Figure 5.53:
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3. Use the arrow keys on the keyboard to move the cursor to the desired identifier: sequence number, specimen ID number, or name. 4. Type the appropriate information and press the Enter key on the keyboard to start the search. NOTE: If necessary, you may press the Escape (ESC) key or the Enter key on the keyboard to exit from the search function and return to the DATA LOG screen. 5. If the requested record is available, the screen will display the Data Log page containing it. (The cursor will be located at the sequence number of the record.) 6. Press the [DISPLAY SPECIMEN] key to display the RUN screen for the selected record. 7. To obtain a printout, press the [PRINT REPORT] key. NOTE: If color printing has been selected, the key label will change to [COLOR PRINT] and a color printout will be generated when the key is pressed. 8. The [PREVIOUS SPECIMEN] or [NEXT SPECIMEN] key may now be used to display records listed in the Data Log which are adjacent to the one currently displayed.
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Editing a Record
The Patient Demographics and the Parameter and Patient Limit Sets may be edited for each record. (See the following figure.)
Spec ID ------------ 9742/B Patient ---------------Sex(M/F):- DOB:--/--/-Dr ---------------------Param Set: 1 Limits: 1 WBC 4.97 K/uL NEU 3.53 71.0 %N LYM .813 16.4 %L MONO .450 9.05 %M EOS .103 2.07 %E BASO .074 1.49 %B RBC HGB HCT MCV MCH MCHC RDW PLT MPV 5.48 15.7 58.2 106. 28.7 27.0 14.5 254. 8.38 M/uL g/dL % fL pg g/dL % K/uL fL NEXT SPECIMEN
LOBULARITY
PLT RCT:6.09 Press CONFIRM to save changes or CANCEL to cancel changes. EDIT SPECIMEN CUSTOMIZE REPORT TRANSMIT SPECIMEN PRINT TICKET
PREVIOUS SPECIMEN
Figure 5.54:
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References
1. International Committee for Standardization in Haematology (ICSH). Protocol for Evaluation of Automated Blood Cell Counters. Clinical and Laboratory Hematology. 1984; 6:6984. 2. Clinical and Laboratory Standards Institute/NCCLS. Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard Fifth Edition. CLSI/NCCLS document H3-A5 (ISBN 1-56238-515-1) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2003. 3. Clinical and Laboratory Standards Institute/NCCLS. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens; Approved Standard Fifth Edition. CLSI/NCCLS document H4-A5 (ISBN 1-56238-538-0) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2004.
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NOTES
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Chapter 6
Calibration
Calibration
Overview
The CELL-DYN 3700 System is calibrated at the factory just prior to shipment. An Abbott Field Service Representative will assist the operator in confirming this calibration during instrument installation. The instrument is very stable and should not require frequent recalibration when it is operated and maintained according to the recommendations in this manual. The following parameters may be calibrated: WBC (WIC and WOC), RBC, HGB, MCV, PLT and MPV. This Overview contains the following subsections: When to Calibrate Open and Closed Modes Calibration Methods Calibration Materials Conventions Used in This Chapter The rest of this chapter contains the following subsections: Calibration Procedural Summary Calibration Menus Pre-Calibration Procedures Auto-Cal Calibration Manual Calibration Mode-to-Mode Calibration WIC/WOC Post-Calibration Procedures
When to Calibrate
Scheduled calibration of the CELL-DYN 3700 System should conform to the guidelines established by regulatory agencies. Calibration should be confirmed by running controls on a regular basis according to the requirements governing quality control in your laboratory. In keeping with good laboratory practices, this should include daily confirmation and following a reagent lot number change. Unscheduled calibration is indicated following service adjustments performed by Abbott Field Service Representatives such as major component changes.
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Chapter 6
Unscheduled calibration is also necessary when indicated by the results of the Quality Control program. However, calibration should be considered as the very last step in a troubleshooting sequence. Performing unnecessary calibrations may mask an underlying problem with instrument performance. On-board Quality Control programs are designed to provide continual monitoring and verification of instrument calibration. The laboratory should make the decision to recalibrate based on the performance of the CELL-DYN 3700 System in these Quality Control programs. The programs include (1) statistical computations and Westgard Rules for commercial or patient controls and (2) monitoring of patient samples for WBC parameters with moving averages and RBC parameters using Bulls Moving Average Program (X-B). Confirmation of calibration is also recommended following the replacement of any major instrument component (for example, the Shear Valve) that could affect calibration. Calibration may be confirmed by running appropriate commercial controls or by using fresh whole blood samples that were analyzed on a reliably calibrated hematology analyzer or by reference methodology.
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Calibration Chapter 6
Overview
Calibration Methods
Two methods can be used to calibrate the CELL-DYN 3700 System: Auto-Cal is an automatic calibration program that is incorporated into the Data Station software. NOTE: Auto-Cal is available in the Open Mode only on the CELL-DYN 3700SL System. Therefore, all references to Closed Mode calibration with Auto-Cal pertain to the CELL-DYN 3700CS System. Manual Calibration is an alternative to Auto-Cal calibration. The instruments Open Mode is calibrated with the calibration material of choice, using the method of choice. The Closed Mode is then calibrated to match it, with fresh whole blood samples using the Mode to Mode Calibration method of choice.
Calibration Materials
Two calibration materials can be used to calibrate the CELL-DYN 3700 System: Commercial Calibrator Calibration with CELL-DYN Calibrator is most efficiently performed by calibrating the Open Mode. The Closed Mode is then calibrated to match the Open Mode using fresh whole blood samples. Fresh Whole Blood Calibration with fresh whole blood is accomplished by performing multiple analyses of each specimen by acceptable reference methodology and calculating the mean reference value for each parameter. The same specimens are then analyzed on the CELL-DYN 3700 System in the Open Mode. The Closed Mode is then calibrated to match the Open Mode using another set of fresh whole blood specimens. A detailed discussion of Reference Whole Blood Calibration is given in the next section.
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Overview
Chapter 6
All cellular morphology must be normal. No known interfering substances should be present (for example, lipemia, icterus, drugs). All specimens must be properly collected in tubes containing the EDTA anticoagulant used by the laboratory. Each tube should contain at least 90% of the nominal collection volume of blood.
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Calibration Chapter 6
Overview
Reference Methods
Reference values for a Reference Whole Blood Calibration should be determined according to the following ICSH recommendations. WBC, RBC, and PLT Reference values for white blood cells, red blood cells, and platelets may be determined using multiple counts from a certified hemocytometer, from a counter that meters a fixed, calibrated sample volume, or from a reliably calibrated hematology analyzer. NOTE: Enter the reference value for WBC as the WIC reference value and enter the same value as the WOC reference value.
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Calibration
Overview
Chapter 6
HGB Reference values for hemoglobin may be determined using either the reference cyanmethemoglobin method or a reliably calibrated hemoglobinometer or hematology analyzer. NOTE: DO NOT attempt to calibrate the CELL-DYN 3700 System with a hemoglobin standard designed for the calibration of specific reference cyanmethemoglobin methods. The instrument uses a modified hemiglobincyanide or a modified hemiglobinhydroxyalamine method which is not designed to analyze these standards directly. MCV Reference values for the mean cell volume may be determined by calculation from the reference microhematocrit and RBC measurements or from multiple analyses on a reliably calibrated hematology analyzer. NOTE: Reference microhematocrit values may be determined by multiple analyses using the CLSI/NCCLS method for Packed Cell Volume (PCV).2 Use only plain (non-anticoagulated) capillary tubes. Be certain to verify the proper operation of the microhematocrit centrifuge and the timer as recommended by CLSI/NCCLS.
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Overview
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Overview
Chapter 6
NOTES
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Calibration Chapter 6
Overview
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Overview
Chapter 6
NOTES
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Overview
Auto-Cal Using Commercial Calibrator Auto-Cal Using Fresh Whole Blood* Manual Calibration*
Choose ONE:
Auto-Cal Mode to Mode Calibration for CELL-DYN 3700CS* Manual Mode to Mode Calibration for CELL-DYN 3700SL or CS*
Be sure to read Calibration Materials, Whole Blood Calibration Guidelines within the Overview of this chapter for complete information on fresh whole blood sample requirements.
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Overview
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NOTES
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Calibration Menu
Calibration Menu
Calibration Menu Flowchart
CALIBRATION Ready
ENTER FACTOR
CALIBRATN LOG
AUTOCALIBRATE
MAIN
RESTORE FACTORS
RETURN WHOLE BLOOD CALIBRATR MPV LATEX CHANGE SAMPLER (CS MODEL ONLY) RETURN
PRINT LOG
RETURN
START AUTO-CAL
CONTINUE AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
CONFIRM CLEAR
CANCEL CLEAR
CONFIRM QUIT
CANCEL QUIT
START AUTO-CAL
PRINT SUMMARY
RETURN
PREVIOUS SPECIMEN
NEXT SPECIMEN
REPEAT SPECIMEN
ACCEPT MEANS
RETURN
CONFIRM REPEAT
CANCEL ACCEPT
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Calibration Menu
Chapter 6
Calibration Screen
CALIBRATION Ready Dec 20 1998 Operator ID Sequence # 16:01 rcs 0711
Open Sampler Open Sampler Calibration Factors: Parameter WOC WIC RBC HGB MCV PLT MPV Method ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR FACTORY Factor 1.054 0.958 0.841 0.924 0.878 0.787 1.000 Date 12/20/98 12/20/98 12/20/98 12/20/98 12/20/98 12/20/98 --/--/-Time 14:15 14:15 14:15 14:15 14:15 14:15 --:-Operator rcs rcs rcs rcs rcs rcs ---
ENTER FACTOR
CALIBRATN LOG
AUTOCALIBRATE
CLOSED SAMPLER
MAIN
Figure 6.1:
CALIBRATION
The CALIBRATION screen is accessed from the MAIN MENU screen by pressing the [CALIBRATION] key. The CALIBRATION screen displays the current calibration factors for the mode indicated, the calibration method used, the date and time the factors were entered, and the operator ID. The following soft key labels are displayed on the CALIBRATION screen: ENTER FACTOR CALIBRATN LOG AUTO-CALIBRATE OPEN SAMPLER or CLOSED SAMPLER (This key label alternates between these two selections when the soft key is pressed.)
PRINT MAIN
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Calibration Menu
The function of each key is discussed briefly in this section. The Auto-Cal Calibration Procedures provide detailed instructions for using the Auto-Cal program. NOTE: For ease of explanation, the key labels may not always be discussed in the order in which they appear on the screen.
CALIBRATION Ready
Open Sampler Closed Sampler Calibration Factors: Parameter WOC WIC RBC HGB MCV PLT MPV Method ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR ENTER FACTOR FACTORY Factor 1.054 0.958 0.841 0.924 0.878 0.787 1.000 Date 12/20/98 12/20/98 12/20/98 12/20/98 12/20/98 12/20/98 --/--/-Time 14:15 14:15 14:15 14:15 14:15 14:15 --:-Operator rcs rcs rcs rcs rcs rcs ---
ENTER FACTOR
CALIBRATN LOG
AUTOCALIBRATE
OPEN SAMPLER
MAIN
Figure 6.2:
The [OPEN SAMPLER/CLOSED SAMPLER] key is used to display the current calibration factors for the mode selected (see the two preceding figures). NOTE: The key is labeled for the sampler mode that is NOT currently displayed.
The [PRINT] key is used to print the Current Whole Blood Factors displayed on the CALIBRATION screen.
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The [ENTER FACTOR] key is used to display the ENTER CALIBRATION FACTOR screen showing the current Open and Closed Calibration Factors (see the following figure). Calibration factors may be changed on this screen by moving the cursor to the desired position, typing the new factor, and pressing the Enter key on the keyboard. The following soft key labels are displayed on this screen: RESTORE FACTORS RESET ALL TO 1.000 RETURN
Open Sampler Factor 1.008 1.008 1.071 1.124 0.985 1.028 1.000
Closed Sampler Factor 1.056 1.056 1.060 1.136 0.985 0.939 1.000
RESTORE FACTORS
RETURN
Figure 6.3:
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Calibration Menu
The [RESTORE FACTORS] key is used to restore the previous calibration factors. This key is only active immediately after factors have been changed.
The [RESET ALL TO 1.000] key is used to reset all of the calibration factors to 1.000.
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Open Sampler Open Sampler Calibration Log Date 12/20/98 Comments: Time 14:15 OpID rcs WOC 1.05(E) WIC 0.96(E) RBC 0.84(E) HGB 0.92(E) MCV 0.88(E) PLT 0.79(E) MPV 1.00(F)
CLOSED SAMPLER
PRINT LOG
RETURN
Figure 6.4:
CALIBRATN LOG
The [CALIBRATN LOG] key is used to display the CALIBRATION LOG screen for the Open or Closed Mode. The following soft key labels are displayed when the [CALIBRATN LOG] key is pressed: OPEN SAMPLER or CLOSED SAMPLER PRINT LOG RETURN (This key label alternates between these two selections.)
The [OPEN SAMPLER/CLOSED SAMPLER] key is used to display the calibration log for the selected mode. NOTE: The key is labeled for the sampler mode that is NOT currently displayed.
The [PRINT LOG] key is used to print the Calibration Log for the displayed mode.
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Calibration Menu
Open Sampler Open sampler is selected. To calibrate using the closed sampler (SL), refer to the manual mode to mode calibration procedure given in the operators manual. To proceed, press the key for the specimen type being used (WHOLE BLOOD, CALIBRATR, or MPV LATEX).
WHOLE BLOOD
CALIBRATR
MPV LATEX
CHANGE SAMPLER
RETURN
Figure 6.5:
AUTOCALIBRATE
The [AUTO-CALIBRATE] key is used to access the Auto-Calibration program. The AUTO-CALIBRATION screen and the following soft key labels are displayed when this key is pressed: WHOLE BLOOD CALIBRATR MPV LATEX CHANGE SAMPLER RETURN (This key is available on the CELL-DYN 3700CS System only.)
The [CHANGE SAMPLER] key is used to change the Sample Aspiration Mode of the Analyzer from the currently selected mode that is indicated on the screen. NOTE: This key is available on the CELL-DYN 3700CS System only.
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Open Sampler Enter reference value for each parameter to be calibrated: (up to 10 specimens) Spec ID Min Max CAL#01 CAL#02 RUNS 1 10 3 3 WOC 1.99 25.0 7.30 ---WIC 1.99 25.0 7.30 ---RBC 2.00 6.50 4.24 ---HGB 3.99 24.0 12.9 ---MCV 70.0 100. 90.0 ---PLT 50.0 600. 244. ----
START AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
Figure 6.6:
WHOLE BLOOD
The [WHOLE BLOOD] key is used to display the WHOLE BLOOD AUTOCAL screen. This screen accesses the Auto-Cal program that is used to calibrate the instrument with fresh whole blood samples. The following soft key labels are displayed on this screen: EDIT REF VAL START AUTO-CAL QUIT AUTO-CAL CLEAR REF VALS PRINT SUMMARY RETURN
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Calibration Menu
The [EDIT REF VAL] key is used to edit the displayed reference value indicated by the position of the cursor. The key deletes the existing value and the cursor remains in position for the new entry.
The [CLEAR REF VALS] key is used to delete the reference values that are currently displayed. The following soft key labels are displayed when the [CLEAR REF VALS] key is pressed: CONFIRM CLEAR CANCEL CLEAR These keys are used to confirm or cancel the Clear Reference Values command.
The [PRINT SUMMARY] key is used to print the entered reference values.
The [START AUTO-CAL] key starts the Auto-Cal program by initiating three background counts.
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Open Sampler Enter reference value for each parameter to be calibrated: (up to 10 specimens) Spec ID Min Max CAL#01 CAL#02 RUNS 1 10 3 3 WOC 1.99 25.0 7.30 ---WIC 1.99 25.0 7.30 ---RBC 2.00 6.50 4.24 ---HGB 3.99 24.0 12.9 ---MCV 70.0 100. 90.0 ---PLT 50.0 600. 244. ----
CONTINUE AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
Figure 6.7:
CONTINUE AUTO-CAL INTERRUPT AUTO-CAL
The [CONTINUE AUTO-CAL] key is displayed after the background counts are completed. (See the preceding figure.) The key label changes to [INTERRUPT AUTO-CAL] after the key is pressed. The WHOLE BLOOD AUTO-CAL RESULTS screen (see the following figure) and the following soft key labels are displayed when the [CONTINUE AUTO-CAL] key is pressed: INTERRUPT AUTO-CAL QUIT AUTO-CAL PRINT RETURN
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Calibration Menu
Open Sampler RESULTS FOR SPECIMEN #1 Spec 1 RUN1 Factor ------------------------------------Mean Factor(1) ------------------Factor %Diff -------------------
INTERRUPT AUTO-CAL
QUIT AUTO-CAL
RETURN
Figure 6.8:
INTERRUPT AUTO-CAL CONTINUE AUTO-CAL
The [INTERRUPT AUTO-CAL] key is used to interrupt (pause) the Auto-Cal program. Quit Auto-Cal Soft Key The [QUIT AUTO-CAL] key is used to exit from the Auto-Cal program before it is completed. When the [QUIT AUTO-CAL] key is pressed, the Bulletin Line displays the message ALL EXISTING DATA AND RESULTS WILL BE CLEARED. The following soft key labels are displayed: CONFIRM QUIT CANCEL QUIT These keys are used to confirm or cancel the Quit Auto-Cal command. Print Soft Key The [PRINT] key is used to print the WHOLE BLOOD AUTO-CAL RESULTS screen.
QUIT AUTO-CAL
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RETURN
Return Soft Key The [RETURN] key is used to return to the REFERENCE VALUE ENTRY screen. Repeat Specimen Soft Key
Open Sampler RESULTS FOR SPECIMEN #1 Parameter WOC WIC RBC HGB MCV PLT Value 7.30 7.30 4.24 12.9 90.0 244. RUN1 7.42 7.42 4.39 13.0 91.0 254. RUN2 RUN3 ------------------------------------Spec 1 Factor 0.980 0.980 0.970 0.990 0.990 0.960 Mean Factor(1) ------------------Factor %Diff -------------------
REPEAT SPECIMEN
INTERRUPT AUTO-CAL
QUIT AUTO-CAL
RETURN
Figure 6.9:
REPEAT SPECIMEN
The [REPEAT SPECIMEN] key is displayed when the first run of the first specimen is completed (see the preceding figure). This key is used to delete all results (runs) for the current specimen. NOTE: This key deletes ALL RESULTS for ALL RUNS of the current specimen. It does not delete one run only.
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Calibration Chapter 6
Calibration Menu
Open Sampler Enter reference value for each parameter to be calibrated: (up to 10 specimens) Spec ID Min Max CAL#01 CAL#02 Runs 1 10 3 3 WOC 4.59 10.2 7.30 ---WIC 4.59 10.2 7.30 ---RBC 3.00 5.50 4.46 ---HGB 10.0 15.5 13.2 ---MCV 85.0 97.0 85.4 ---PLT 150. 400. 257. ---MPV 4.99 20.0 8.00
START AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
Figure 6.10:
CALIBRATR
The [CALIBRATR] key is used to display the CALIBRATOR AUTO-CAL screen (see the preceding figure). This screen accesses the Auto-Cal program that is used to calibrate the instrument with a commercial calibrator. The following soft key labels are displayed on this screen: EDIT REF VAL START AUTO-CAL QUIT AUTO CAL CLEAR REF VALS PRINT SUMMARY RETURN These soft keys have the same functions as described for the WHOLE BLOOD AUTO-CAL screen. NOTE: If Auto-Cal was last performed with a calibrator, the following key labels are displayed when the [WHOLE BLOOD] key is pressed: CONFIRM SELECTION CANCEL SELECTION
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These keys are used to confirm or cancel the Whole Blood Auto-Cal selection. The Bulletin Line displays the following message: PRESS CONFIRM SELECTION TO CLEAR PREVIOUS AUTO-CAL REFERENCE VALUES.
Open Sampler Enter latex reference value for MPV: (up to 10 specimens) Spec ID Min Max CAL#01 CAL#02 RUNS 1 10 3 3 MPV 4.99 20.0 7.30 ----
START AUTO-CAL
QUIT AUTO-CAL
PRINT SUMMARY
RETURN
Figure 6.11:
MPV LATEX
The [MPV LATEX] key is used to display the MPV LATEX AUTO-CAL screen (see the preceding figure).
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Pre-Calibration Procedures
Pre-Calibration Procedures
It is advisable to perform calibration at a time when it can be completed without interruption. The Pre-Calibration procedures in this section verify proper instrument performance to ensure a successful calibration. These steps should be completed just prior to beginning the calibration procedure itself. If problems are detected during these checks, do not attempt to calibrate the instrument. If necessary, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the U.S.). After the problems have been resolved, repeat the Pre-Calibration procedures to verify proper performance. The Pre-Calibration Procedures Checklist included in this section may be duplicated as needed.
Calibration Guidelines
1. Always perform the daily, weekly, and monthly scheduled maintenance as directed in Chapter 9: Maintenance before calibrating the instrument. Instrument cleanliness is essential for accurate calibration. Therefore, each laboratory should perform any additional maintenance according to its requirements. 2. Use only recommended CELL-DYN reagents. 3. Verify the precision for the Open and Closed Modes prior to calibration as directed in the Pre-Calibration Procedures Checklist. 4. Precision should be verified for both WIC and WOC. This is accomplished by configuring a QC file to display and print both results. NOTE: If necessary, refer to the directions for customizing the display and printout of a QC file given in Chapter 5: Operating Instructions, Subsection: Set-Up Instructions. 5. Select and process all whole blood samples according to the requirements given in the Overview, Calibration Materials, Whole Blood Calibration Guidelines within this chapter. 6. Be certain that any calibrator material is brought to room temperature and mixed according to the manufacturers instructions given in the package insert. 7. Be certain that the operator performing the calibration has read and understands the information contained in the package insert for the calibrator. 8. Be certain that the operator performing the calibration has read and understands the calibration procedure(s).
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Pre-Calibration Procedures
1._______ Perform all required maintenance. 2._______ Verify that all reagent containers are at least 1/3 full. 3._______ Verify that the reagents have not reached the expiration date. Diluent: WIC/HGB Lyse: Sheath Reagent: Detergent: Lot #____________ Lot #____________ Lot #____________ Lot #____________ Exp. date _______ Exp. date _______ Exp. date _______ Exp. date _______
4._______ If applicable, verify that the calibrator has not reached the expiration date. Lot #____________ Exp. date _______
5._______ After the maintenance has been completed, verify that the background counts are within the acceptable limits. Record the background counts below or attach a printout to this document. WIC WOC RBC HGB PLT <0.3 <0.3 <0.03 <0.2 <10.0 ________ ________ ________ ________ ________
6._______ Verify that the WIC Count Time is at the baseline value. Record the count time below. WIC Count Time __________ 7._______ Verify that the RBC Count Time is at the baseline value. Record the count time below. RBC Count Time __________ 8._______ From the DIAGNOSTICS MENU, obtain a printout of the VOLTAGE READINGS screen. Attach the printout to these worksheets. 9._______ Prime the instrument with five normal whole blood samples that are less than eight hours old.
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10.______ Confirm the Open Mode precision by analyzing a fresh, normal, whole blood sample 10 times in succession. Run the sample in an empty control file and record the CVs below or attach a file printout to this document. PARAMETER WIC WOC RBC HGB MCV PLT 11.______ CV% LIMIT <2.8% <2.5% <1.5% <1.2% <1.0% <5.0% CV ________ ________ ________ ________ ________ ________
a. CELL-DYN 3700SL System: Confirm the Closed Mode precision of the Sample Loader by obtaining 15 mL of blood from the same donor. Aliquot the blood into five 5-mL tubes that contain no anticoagulant. Run each tube twice in succession. Run the samples in an empty control file and record the CVs below or attach a file printout to this document. PARAMETER WIC WOC RBC HGB MCV PLT CV% LIMIT <2.8% <2.5% <1.5% <1.2% <1.0% <5.0% CV ________ ________ ________ ________ ________ ________
b. CELL-DYN 3700CS System: Confirm the precision of the Closed Sampler by analyzing a fresh, normal, whole blood sample 10 times in succession. Run the samples in an empty control file and record the CVs below or attach a file printout to this document. PARAMETER WIC WOC RBC HGB MCV PLT CV% LIMIT <2.8% <2.5% <1.5% <1.2% <1.0% <5.0% CV ________ ________ ________ ________ ________ ________
12.______ If any problems are detected during the procedures outlined above, document them on the following page.
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Problems Detected
_______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________
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NOTES
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Auto-Cal Overview
Auto-Cal Overview
The Auto-Cal program provides an automated calibration method that prepares the CELL-DYN 3700 System for calibration, calculates new calibration factors, and calibrates the instrument. The Auto-Cal program allows calibration with commercial calibrators or whole blood samples. Auto-Cal may be performed in either of the following two modes: Open Mode Closed Mode (CELL-DYN 3700CS System only) On the CELL-DYN 3700SL System, Auto-Cal is available in the Open Mode only. Therefore, all references to Closed Mode calibration with Auto-Cal pertain to the CELL-DYN 3700CS System. Some parameters may not need to be calibrated. Therefore, each procedure includes specific criteria that are used to determine which parameters require calibration. The criteria are: Validation Range Calibration Limit Calibration Range Calibration not required Do not calibrate, possible instrument problem exists Calibration is required
Complete instructions for using these criteria and a Calibration Criteria Chart are included with each procedure to facilitate the decision. The calibration procedures have been divided into subsections that consist of a series of easy-to-follow steps. Always follow the entire procedure unless specifically directed to skip to another section. Worksheets are provided at the end of each procedure to assist in determining which parameters require calibration. For manual calibration, worksheets can be used to assist in making the necessary calculations. These worksheets can be duplicated as needed. NOTE: Always complete the Pre-Calibration procedures before beginning any calibration.
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Chapter 6
Auto-Cal Methodology
The Auto-Cal program automatically computes a calibration factor based on all acceptable data. (New factors are calculated using 1.000 as the reference.) NOTE: Because the instrument uses 1.000 as the reference, results generated in the Auto-Cal mode may not correlate with results previously seen in the RUN mode. This DOES NOT indicate a problem. New calibration factors are computed for each parameter by comparing each mean to the reference value entered for that sample. If more than one sample is used, factors are computed for each parameter from each of the samples. All of these factors are averaged to obtain the final calibration factor for a given parameter. NOTE: When calibrating with whole blood, the reference WBC value must be entered for WIC and WOC in order to compute calibration factors for both parameters. The program computes the percent difference between the existing calibration factor and the new one it computed. The operator either accepts or rejects the new factors based on the calibration criteria listed in Table 6.1, Calibration Criteria Chart.
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Auto-Cal Overview
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Auto-Cal Using Calibrator
Starting Auto-Cal
1. From the MAIN MENU screen, press the [CALIBRATION] key. 2. If necessary, press the [OPEN SAMPLER] key to display the Open Sampler calibration factors. 3. To obtain a printout of the Open Sampler Calibration Factors displayed on the screen, press the [PRINT] key. NOTE: These calibration factors are retained in the Auto-Cal Calibration Log until 10 entries have been made. As each subsequent entry is made, the oldest existing entry will be deleted. 4. Press the [AUTO-CALIBRATE] key to select the AUTOCALIBRATION screen. 5. If necessary, press the [CHANGE SAMPLER] key to select the Open Mode. 6. Press the [CALIBRATR] key to select Calibrator Auto-Cal.
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3. Type the desired number in the <# OF RUNS> field. Press the Enter key on the keyboard to save the entry and advance the cursor. NOTE: The calibrator should be cycled for a minimum of 6 and a maximum of 10 consecutive runs in the Open Mode. In order to most efficiently use the Auto-Cal program, it is suggested that the calibrator be cycled for 9 consecutive runs as if it were three separate calibrators. This is accomplished by entering three for the number of runs for each calibrator and entering the assay value three times. 4. Type the assay value for each parameter in the appropriate parameter reference values field. Press the Enter key on the keyboard after each entry to save the entry and advance the cursor. NOTE: For parameters with assigned values that exceed the Auto-Calibration pre-set entry limits, use the manual method for Calibration. 5. To obtain a printout of the reference values, press the [PRINT SUMMARY] key.
Calibration Chapter 6
Auto-Cal Using Calibrator
5. When the background results are acceptable, press the [CONTINUE AUTO-CAL] key. 6. Prepare the calibrator for use according to the directions given in the package insert. Be certain to carefully read and follow directions given for warming and mixing. 7. Run the calibrator one time. The reference value, VALUE, and the results of the analysis, RUN1, will be displayed on the CALIBRATOR AUTO-CAL, RESULTS FOR SPECIMEN (N) screen. The Auto-Cal program automatically compares the results of the first run of the calibrator with the Parameter Reference Values entered for that specimen, to verify that the difference is within acceptable limits. If the first run passes this internal Reference Check, proceed to step 10. If the first run fails the Reference Check for any parameter, the results are highlighted and the Bulletin Line displays the following message: THIS RESULT IS OUTSIDE THE ALLOWED LIMITS. REPEAT THIS SPECIMEN. Proceed to step 8. 8. The run may be repeated at this time by pressing the [REPEAT SPECIMEN] key followed by the [CONFIRM REPEAT] key. When the repeat function is used, all the results for that specimen will be automatically deleted. If the run passes the Reference Check, proceed to step 10. If the repeated run also fails the Reference Check, the results will be highlighted and no calibration factor will be calculated for that parameter. Proceed to step 9. If all parameters fail the Reference Check, results of that run are not displayed and the Bulletin Line displays following the message: ABANDON CAL FOR SPECIMEN 1 RESULT NOT INCLUDED IN MEAN. Proceed to step 9. 9. If necessary, repeat the run as directed in step 8. If the run passes the Reference Check, proceed to step 10. If all parameters on the repeated run also fail the Reference Check, confirm that the reference values were entered correctly. If the reference values are correct, discard the calibrator vial. Obtain a new vial (be sure that it is properly warmed and mixed) and repeat the procedure. If all parameters fail again, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the U.S.).
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10. After a run has passed the internal Reference Check, consecutively run the calibrator for the remaining runs. Each subsequent run must pass the Reference Check and an additional internal Precision Check. If a run fails either check, the result for that parameter is highlighted and no calibration factor will be calculated for the parameter. Calibration must be repeated for the highlighted parameter. Calibration factors will be calculated for the remaining parameters. NOTE: Five runs are displayed on the screen. Press the Left arrow key on the keyboard to view the first runs. Press the Right arrow key on the keyboard to view the last runs.
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Auto-Cal Using Calibrator
3. To determine which parameters require calibration, continue with the next section in this chapter, Determining Which Parameters Need Calibration.
Table 6.1: Calibration Criteria
Calibration Criteria Validation Range (Cal Not Required) WOC WIC RBC HGB MCV PLT <1.5% <1.5% <1.0% <1.0% <1.0% <3.0% Calibration Range (Cal Required) >1.5% but <10% >1.5% but <10% >1.0% but <10% >1.0% but <10% >1.0% but <10% >3.0% but <15% Calibration Limit (Do Not Cal) >10% >10% >10% >10% >10% >15%
If the results for all parameters are less than the values given above, press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key. If desired, the Calibrator Auto-Cal Calibration results may be documented in the Auto-Cal Calibration Log. The Auto-Cal Calibration Log is available for comments only when a calibration factor is changed or reentered. Therefore, to document the calibration in the <COMMENTS> line, access the log as follows. 1. From the CALIBRATION screen press the [ENTER FACTOR] key. 2. Retype any existing Cal Factor. Ensure that the cursor is in the <Open Sampler Factor> column. Press the Enter key on the keyboard to save the entry and advance the cursor.
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3. Press the [RETURN] key. 4. When the CALIBRATION LOG screen is displayed, indicate in the <COMMENTS> line that instrument calibration was confirmed and no changes were required. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. Be certain to retain all necessary documentation in the instrument logbook.
Calibration Limit
If the factor % difference for a particular parameter is greater than the following value, the value has exceeded the Calibration Limit and there may be an instrument problem. Results greater than the Calibration Limit: WIC/WOC >10% RBC HGB MCV PLT >10% >10% >10% >15%
1. Check to see if any component that could affect the calibration was changed, as this could cause the factor % difference to exceed the above limits. For example: Shear Valve WOC Flow Cell WIC Transducer WIC Aperture Plate RBC/PLT Transducer RBC/PLT Aperture Plate Hemoglobin Flow Cell Syringe(s)
If a component has been changed, then calibrate the instrument as needed according to the directions in this procedure. If no components have been changed and the factor % difference exceeds these limits, do not calibrate. Confirm that all Pre-Calibration procedures were completed, and then call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the U.S.). 2. Press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key to exit Auto-Cal. 3. Troubleshoot accordingly. Be certain to retain all necessary documentation in the instrument logbook.
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Calibration Range
If the factor % difference falls within the following Calibration Range, calibration is required for that parameter. That is, a new calibration factor must be entered. Calibrate the Open Mode as directed in this procedure, either for all parameters or for specific parameters. Results within the Calibration Range: WIC/WOC RBC HGB MCV PLT >1.5% >1.0% >1.0% >1.0% >3.0% but < 10% but < 10% but < 10% but < 10% but < 15%
If all parameters require calibration, continue with the next section in this procedure, Calibrating All Parameters. If only specific parameters require calibration, skip to Calibrating Individual Parameters within this chapter.
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4. Type any comments in the <COMMENTS> field. Press the Enter key on the keyboard to save the entry and advance the cursor. NOTE: Comments may be added to the Calibration Log only after a calibration factor is changed or reentered. 5. To obtain a printout of the Calibration Log for documentation, press the [PRINT LOG] key.
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* Delete the sign of the factor % difference before entering it on the worksheet. ** Do not calibrate. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the U.S.).
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NOTES
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Calibration
Starting Auto-Cal
1. From the MAIN MENU screen, press the [CALIBRATION] key. 2. If necessary, press the [OPEN SAMPLER] key to display the Open Mode calibration factors. 3. To obtain a printout of the Open Mode Calibration Factors displayed on the screen, press the [PRINT] key. NOTE: These calibration factors are retained in the Auto-Cal Calibration Log until 10 entries have been made. As each subsequent entry is made, the oldest existing entry is deleted. 4. Press the [AUTO-CALIBRATE] key to select the AUTO-CALIBRATION screen. 5. If necessary, press the [CHANGE SAMPLER] key to select the Open Mode. (CS Mode only) 6. Press the [WHOLE BLOOD] key to select Whole Blood Auto-Cal.
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4. When the problem has been resolved, return to the CALIBRATION screen and press the [AUTO-CALIBRATE] key followed by the [WHOLE BLOOD] key and the [START AUTO-CAL] key. NOTE: The information entered in step 2 of Entering the Reference Values will be retained. 5. When the background results are acceptable, press the [CONTINUE AUTO-CAL] key. 6. Run the first whole blood specimen one time. The reference value, VALUE, and the results of the analysis, RUN1, will be displayed on the WHOLE BLOOD AUTO-CAL, RESULTS FOR SPECIMEN (N) screen. The Auto-Cal program automatically compares the results of the first run of each whole blood specimen with the Parameter Reference Values entered for that specimen, to verify that the difference is within acceptable limits. If the first run passes this internal Reference Check, proceed to step 9. If the first run fails the Reference Check for any parameter, the results are highlighted and the Bulletin Line displays the following message: THIS RESULT IS OUTSIDE THE ALLOWED LIMITS. RERUN THIS SPECIMEN. Proceed to step 7. 7. The specimen may be repeated at this time by pressing the [REPEAT SPECIMEN] key followed by the [CONFIRM REPEAT] key. When the repeat function is used, all the results for that specimen will be automatically deleted. If the run passes the Reference Check, proceed to step 9. If the repeated run also fails the Reference Check, the results will be highlighted and no calibration factor will be calculated for that parameter. Proceed to step 8. If all parameters fail the Reference Check, results of that run are not displayed and the Bulletin Line displays the following message: ABANDON CAL FOR SPECIMEN 1 RESULT NOT INCLUDED IN MEAN. Proceed to step 8.
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8. If necessary, repeat the specimen as directed in step 7. NOTE: Check to be sure the correct specimen was run before repeating it. If the run passes the Reference Check, proceed to step 9. If all parameters on the repeated run also fail the Reference Check, discard that sample and continue with the next calibration sample. If desired, a replacement sample may be added after the remaining samples have been run. 9. After a run has passed the internal Reference Check, run each sample for the number of runs entered in step 2 of Entering the Reference Values. Each subsequent run must pass the Reference Check and an additional internal Precision Check. If a run fails either check, the result for that parameter is highlighted and no calibration factor will be calculated for the parameter. Calibration must be repeated for the highlighted parameter. Calibration factors will be calculated for the remaining parameters. 10. When all runs of a sample have been completed, the Bulletin Line displays the following message: NEW CAL FACTOR COMPUTED. READY FOR NEXT CAL SPECIMEN. 11. Press the [NEXT SPECIMEN] key to run the next sample.
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1. Press the [PREVIOUS SPECIMEN] key and/or the [NEXT SPECIMEN] key to review and/or print the results of all whole blood samples that were analyzed. NOTE: These results are only available for review and printout before the [ACCEPT MEANS] key is pressed. 2. Press the [PRINT] key to obtain a printout of the SPEC and MEAN FACTORS and the FACTOR % DIFF. NOTE: Once this screen is exited, these results are no longer available for review or printout. 3. Enter the factor % difference for each parameter in the Auto-Cal Calibration Criteria Worksheet provided at the end of this procedure. (This worksheet may be duplicated as needed.) The calibration criteria are depicted in the following table. NOTE: Delete the sign of the factor % difference value before entering it on the worksheet. To determine which parameters require calibration, continue with the next section in this chapter, Determining Which Parameters Need Calibration.
Table 6.2: Calibration Criteria
Calibration Criteria Validation Range Cal Not Required WOC WIC RBC HGB MCV PLT <1.5% <1.5% <1.0% <1.0% <1.0% <3.0% Calibration Range Cal Required >1.5% but <10% >1.5% but <10% >1.0% but <10% >1.0% but <10% >1.0% but <10% >3.0% but <15% Calibration Limit Do Not Cal >10% >10% >10% >10% >10% >15%
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If the results for all parameters are less than the values given above, press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key. If desired, the Whole Blood Auto-Cal Calibration results may be documented in the Auto-Cal Calibration Log. The Auto-Cal Calibration Log is available for comments only when a calibration factor is changed or reentered. Therefore, to document the calibration in the <COMMENTS> line, access the log as follows. 1. From the CALIBRATION screen, press the [ENTER FACTOR] key. 2. Retype any existing Cal Factor. Ensure that the cursor is in the <Open Sampler Factor> column. Press the Enter key on the keyboard to save the entry and advance the cursor. 3. Press the [RETURN] key. 4. When the CALIBRATION LOG screen is displayed, indicate in the <COMMENTS> line that instrument calibration was confirmed and no changes were required. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. Be certain to retain all necessary documentation in the instrument logbook.
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Calibration Limit
If the factor % difference for a particular parameter is greater than the following value, as the value has exceeded the Calibration Limit and there may be an instrument problem. Results greater than the Calibration Limit: WIC/WOC RBC HGB MCV PLT >10% >10% >10% >10% >15%
1. Check to see if any component that could affect the calibration has been changed, as this could cause the factor % difference to exceed the above limits. For example: Shear Valve WOC Flow Cell WIC Transducer WIC Aperture Plate RBC/PLT Transducer RBC/PLT Aperture Plate Hemoglobin Flow Cell Syringe(s)
If a component has been changed, then calibrate the instrument as needed according to the directions in this procedure. If no components have been changed and the factor % difference exceeds these limits, do not calibrate. Confirm that all Pre-Calibration procedures were completed, and then call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US). 2. Press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key to exit Auto-Cal. 3. Troubleshoot accordingly. Be certain to retain all necessary documentation in the instrument logbook.
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Calibration Range
If the factor % difference falls within the following Calibration Range, calibration is required for that parameter. That is, a new Calibration Factor must be entered. Calibrate the Open Mode as directed in this procedure, either for all parameters or for specific parameters. Results within the Calibration Range: WIC/WOC RBC HGB MCV PLT >1.5% >1.0% >1.0% >1.0% >3.0% but <10% but <10% but <10% but <10% but <15%
If all parameters require calibration, continue with the next section in this chapter, Calibrating All Parameters. If only specific parameters require calibration, skip to Calibrating Individual Parameters within this chapter.
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4. Type any comments in the <COMMENTS> field. Press the Enter key on the keyboard to save the entry and advance the cursor. NOTE: Comments may be added to the Calibration Log only after a calibration factor is changed or reentered. 5. To obtain a printout of the Calibration Log for documentation, press the [PRINT LOG] key.
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* Delete the sign of the factor % difference before entering it on the worksheet. ** Do not calibrate. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Complete instructions for using these criteria and a Calibration Criteria Chart are included with each procedure to facilitate the decision. The calibration procedures have been divided into subsections that consist of a series of easy-to-follow steps. Always follow the entire procedure unless specifically directed to skip to another section. Worksheets are provided at the end of each procedure to assist in determining which parameters require calibration. For manual calibration, worksheets can be used to assist in making the necessary calculations. These worksheets can be duplicated as needed. NOTE: Always complete the Pre-Calibration procedures before beginning any calibration.
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Guidelines
The CELL-DYN Calibrator must be warmed and mixed according to the directions given in the package insert and run a minimum of six and a maximum of 10 times. NOTE: For instructions on running the calibrator, refer to Auto-Cal Overview, Calibration Requirements for Auto-Cal within this chapter. If performing a reference whole blood calibration: A minimum of five different, fresh, whole blood specimens must be used for this procedure. Each specimen must be assayed a minimum of three times by reference methodology and on the CELL-DYN 3700 System. No more than two hours should elapse between the reference run and the CELL-DYN 3700 System run. NOTE: Refer to Overview, Calibration Materials, Whole Blood Calibration Guidelines within this chapter for detailed information about the requirements for reference whole blood calibration.
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NOTE: Ensure that the worklist is turned off before running samples in QC file CD Mean. 8. Press the [MAIN] key followed by the [QUALITY CONTROL] key and the [VIEW QC LOG] key. 9. To obtain a printout of the data, press the [PRINT QC LOG] key. 10. Press the [RETURN] key followed by the [MAIN] key to display the MAIN MENU screen.
3. Referring to the New Open Mode Cal Factor from the previous step and the Current Open Mode Cal Factor from the printout, use the appropriate chart on the worksheet to compute the factor % difference as follows:
New Open Mode Current Open Cal Factor Mode Cal Factor Current Open Mode Cal Factor
4. Enter the factor % difference for each parameter in the Manual Calibration Criteria chart on the Manual Calibration Worksheet provided at the end of this procedure.
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NOTE: Delete the sign of the factor % difference value before entering it on the worksheet. 5. To determine which parameters require calibration, continue with the next section in this chapter, Determining Which Parameters Need Calibration.
Table 6.3: Calibration Criteria
Calibration Criteria Validation Range (Cal Not Required) WOC WIC RBC HGB MCV PLT <1.5% <1.5% <1.0% <1.0% <1.0% <3.0% Calibration Range (Cal Required) >1.5% but <10% >1.5% but <10% >1.0% but <10% >1.0% but <10% >1.0% but <10% >3.0% but <15% Calibration Limit (Do Not Cal) >10% >10% >10% >10% >10% >15%
If desired, the manual calibration results may be documented in the Auto-Cal Calibration Log. The Auto-Cal Calibration Log is available for comments only when a calibration factor is changed or reentered. Therefore, to document the calibration in the <COMMENTS> line, access the log as follows. 1. From the CALIBRATION screen press the [ENTER FACTOR] key. 2. Retype any existing Cal Factor. Ensure that the cursor is in the <Open Sampler Factor> column. Press the Enter key on the keyboard to save the entry and advance the cursor. 3. Press the [RETURN] key.
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4. When the CALIBRATION LOG screen is displayed, indicate in the <COMMENTS> line that instrument calibration was confirmed and no changes were required. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. Be certain to retain all necessary documentation in the instrument logbook.
Calibration Limit
If the factor % difference for a particular parameter is greater than the following value, there may be a computation error or an instrument problem as the value has exceeded the Calibration Limit. Results greater than the Calibration Limit: WIC/WOC RBC HGB MCV PLT >10% >10% >10% >10% >15%
1. Recheck the numbers entered on the worksheet and then recheck all calculations. 2. Check to see if any component has been changed that could affect the calibration, as this could cause the factor % difference to exceed the above limits. For example: Shear Valve WOC Flow Cell WIC Transducer WIC Aperture Plate RBC/PLT Transducer RBC/PLT Aperture Plate Hemoglobin Flow Cell Syringe(s)
If a component has been changed, then calibrate the instrument as needed according to the directions in this procedure. If no components have been changed, the calculations are correct, and the factor % difference exceeds these limits, do not calibrate. Confirm that all Pre-Calibration procedures were completed, and then call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
Calibration Range
If the factor % difference falls within the following Calibration Range, calibration is required for that parameter. Calibrate the Open Mode as directed in this procedure.
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Results within the Calibration Range: WIC/WOC >1.5% RBC HGB MCV PLT >1.0% >1.0% >1.0% >3.0% but but but but but <10% <10% <10% <10% <15%
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/ / / / / / /
x x x x x x x
= = = = = = =
* Current factor as printed in this Manual Calibration procedure. ** If factor falls outside limits, do not calibrate. Check all calculations and call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Factor % Difference
New Open Mode Factor Current Open Mode Factor x 100 = % Diff Current Open Mode Factor New Open Mode Factor WOC WIC RBC HGB MCV PLT Current Open Mode Factor* Current Open Mode Factor
/ / / / / / /
% Diff
* The Current Open Mode Factor is printed at the start of this calibration procedure.
* Delete the sign of the % Diff value before entering it in the chart. ** Do not calibrate. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Starting Auto-Cal
1. From the MAIN MENU screen, press the [CALIBRATION] key. 2. If necessary, press the [CLOSED SAMPLER] key to display the Closed Mode Calibration Factors. 3. To obtain a printout of the Closed Mode Calibration Factors displayed on the screen, press the [PRINT] key. NOTE: These calibration factors are retained in the Auto-Cal Calibration Log until 10 entries have been made. As each subsequent entry is made, the oldest existing entry will be deleted. 4. Press the [AUTO-CALIBRATE] key to display the AUTOCALIBRATION screen. 5. If necessary, press the [CHANGE SAMPLER] key to select the Closed Mode. 6. Press the [WHOLE BLOOD] key to select Whole Blood Auto-Cal.
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6. Run the first whole blood specimen one time. The reference value, VALUE, and the results of the analysis, RUN1, will be displayed on the WHOLE BLOOD AUTO-CAL, RESULTS FOR SPECIMEN (N) screen. The Auto-Cal program automatically compares the results of the first run of each whole blood specimen with the Parameter Reference Values entered for that specimen, to verify that the difference is within acceptable limits. If the first run passes this internal Reference Check, proceed to step 9. If the first run fails the Reference Check for any parameter, the results are highlighted and the Bulletin Line displays the following message: RESULT IS OUTSIDE THE REFERENCE LIMITS. REPEAT THIS SPECIMEN. Proceed to step 7. 7. The specimen may be repeated at this time by pressing the [REPEAT SPECIMEN] key followed by the [CONFIRM REPEAT] key. NOTE: When the repeat function is used, all the results for that specimen will be automatically deleted. If the run passes the Reference Check, proceed to step 9. If the repeated run also fails the Reference Check, the results will be highlighted and no calibration factor will be calculated for that parameter. Proceed to step 8. If all parameters fail the Reference Check, results of that run are not displayed and the Bulletin Line displays the following message: ABANDON CAL FOR SPECIMEN 1 RESULT NOT INCLUDED IN MEAN. Proceed to step 8. 8. If necessary, repeat the specimen as directed in step 7. NOTE: Check to be sure the correct specimen was run before repeating it. If the run passes the Reference Check, proceed to step 9. If all parameters on the repeated run also fail the Reference Check, discard that specimen and continue with the next calibration specimen. If desired, a replacement specimen may be added after the remaining specimens have been run. 9. After a run has passed the internal Reference Check, run each specimen for the number of runs entered in step 2 of Entering the Reference Values within this chapter.
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Each subsequent run must pass the Reference Check and an additional internal Precision Check. If a run fails either check, the result for that parameter is highlighted and no calibration factor will be calculated for the parameter. Calibration must be repeated for the highlighted parameter. Calibration factors will be calculated for the remaining parameters. 10. When all runs of a specimen have been completed, the Bulletin Line displays the following message: NEW CAL FACTOR COMPUTED. READY FOR NEXT CAL SPECIMEN. 11. Press the [NEXT SPECIMEN] key to run the next specimen.
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To determine which parameters require calibration, continue with the next section in this chapter, Determining Which Parameters Need Calibration.
Table 6.4: Mode to Mode Calibration Criteria
Mode to Mode Calibration Criteria Validation Range Cal Not Required WOC WIC RBC HGB MCV PLT <1.75% <1.75% <1.25% <1.25% <1.25% <3.50% Calibration Range Cal Required >1.75% but <10% >1.75% but <10% >1.25% but <10% >1.25% but <10% >1.25% but <10% >3.50% but <20% Calibration Limit Do Not Cal >10% >10% >10% >10% >10% >20%
If the results for all parameters are less than the values given above, press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key. If desired, the calibration results may be documented in the Auto-Cal Calibration Log. The Auto-Cal Calibration Log is available for comments only when a calibration factor is changed or reentered. Therefore, to document the calibration in the <COMMENTS> line, access the log as follows. 1. From the CALIBRATION screen, press the [ENTER FACTOR] key. 2. Retype any existing Cal Factor. Ensure that the cursor is in the <Closed Sampler Factor> column. Press the Enter key on the keyboard to save the entry and advance the cursor.
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3. Press the [RETURN] key. 4. When the CALIBRATION LOG screen is displayed, indicate in the <COMMENTS> line that instrument calibration was confirmed and no changes were required. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. Be certain to retain all necessary documentation in the instrument logbook.
Calibration Limit
If the factor % difference for a particular parameter is greater than the following value, the value has exceeded the Calibration Limit and there may be an instrument problem. Results greater than the Calibration Limit: WIC/WOC RBC HGB MCV PLT >10% >10% >10% >10% >20%
1. Check to see if any component that could affect the calibration was changed, as this could cause the factor % difference to exceed the above limits. For example: Shear Valve WOC Flow Cell WIC Transducer WIC Aperture Plate RBC/PLT Transducer RBC/PLT Aperture Plate Hemoglobin Flow Cell Syringe(s)
If a component was changed, then calibrate the instrument as needed according to the directions in this procedure. If no components have been changed and the factor % difference exceeds these limits, do not calibrate. Confirm that all Pre-Calibration procedures were completed, and call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US). 2. Press the [QUIT AUTO-CAL] key followed by the [CONFIRM QUIT] key to exit Auto-Cal. 3. Troubleshoot accordingly. Be certain to retain all necessary documentation in the instrument logbook.
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Calibration Range
If the factor % difference falls within the following Calibration Range, calibration is required for that parameter. That is, a new Calibration Factor must be entered. Calibrate the Closed Mode as directed in this procedure, either for all parameters or for specific parameters. Results within the Calibration Range: WIC/WOC RBC HGB MCV PLT >1.75% >1.25% >1.25% >1.25% >3.50% but but but but but <10% <10% <10% <10% <20%
If all parameters require calibration, continue with the next section in this chapter, Calibrating All Parameters. If only specific parameters require calibration, skip to Calibrating Individual Parameters within this chapter.
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The log displays the date, time, operator ID, calibration factors, and a line for comments. NOTE: The letters in parentheses after each factor indicate the method of factor derivation: A = Auto-Cal, F = Factory, E = Enter Factor (manual factor entry). 4. Type any comments in the <COMMENTS> field. Press the Enter key on the keyboard to save the entry and advance the cursor. NOTE: Comments may be added to the Calibration Log only after a calibration factor is changed or reentered. 5. To obtain a printout of the Calibration Log for documentation, press the [PRINT LOG] key.
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If the Post-Calibration factor % difference exceeds these limits, verify that the new calibration factors were entered correctly. If no errors are detected, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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* Delete the sign of the factor % difference value before entering it on the worksheet. ** Do not calibrate. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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6. Press the [QC SPECIMEN] key to display the RUN screen. 7. Run each sample one time into the OPEN MEAN QC file. 8. Press the [MAIN] key followed by the [QUALITY CONTROL] key and the [VIEW QC LOG] key. 9. To obtain a printout of the data, press the [PRINT QC LOG] key. 10. Press the [RETURN] key followed by the [MAIN] key to return to the MAIN MENU screen.
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3. On the worksheet, enter the % difference for each parameter in the Mode to Mode Calibration Criteria Chart (depicted in the following table). NOTE: Delete the sign of the % difference before entering it on the chart. 4. To determine which parameters require calibration, continue with the next section in this chapter, Determining Which Parameters Need Calibration.
Table 6.5: Mode to Mode Calibration Criteria
Mode to Mode Calibration Criteria Validation Range Cal Not Required WOC WIC RBC HGB MCV PLT <1.75% <1.75% <1.25% <1.25% <1.25% <3.50% Calibration Range Cal Required >1.75% but <10% >1.75% but <10% >1.25% but <10% >1.25% but <10% >1.25% but <10% >3.50% but <20% Calibration Limit Do Not Cal >10% >10% >10% >10% >10% >20%
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If desired, the Manual Mode to Mode Calibration results may be documented in the Auto-Cal Calibration Log. The Auto-Cal Calibration Log is available for comments only when a calibration factor is changed or reentered. Therefore, to document the calibration in the <COMMENTS> line, access the log as follows. 1. From the CALIBRATION screen press the [ENTER FACTOR] key. 2. Retype any existing Cal Factor. Ensure that the cursor is in the <Closed Sampler Factor> column. Press the Enter key on the keyboard to save the entry and advance the cursor. 3. Press the [RETURN] key. 4. When the CALIBRATION LOG screen is displayed, indicate in the <COMMENTS> line that instrument calibration was confirmed and no changes were required. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. Be certain to retain all necessary documentation in the instrument logbook.
Calibration Limit
If the factor % difference for a particular parameter is greater than the following values, the value has exceeded the Calibration Limit and there may be a computation error or instrument problem.
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Results greater than the Calibration Limit: WIC/WOC RBC HGB MCV PLT >10% >10% >10% >10% >20%
1. Recheck the numbers entered on the worksheets and then recheck all calculations. 2. Check to see if any component was changed which could affect the calibration, as this could cause the factor % difference to exceed the above limits. For example: Shear Valve WOC Flow Cell WIC Transducer WIC Aperture Plate RBC/PLT Transducer RBC/PLT Aperture Plate Hemoglobin Flow Cell Syringe(s)
If a component was changed, then calibrate the instrument as needed according to the directions in the following sections. If no components have been changed, the calculations are correct, and the % difference exceeds these limits, do not calibrate. Confirm that all Pre-Calibration procedures were completed and then call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
Calibration Range
If the factor % difference falls within the following Calibration Range, calibration is required for that parameter. Calibrate the instrument as directed in the following sections, either for all parameters or for specific parameters. Results within the Calibration Range: WIC/WOC RBC HGB MCV PLT >1.75% but >1.25% but >1.25% but >1.25% but >3.50% but <10% <10% <10% <10% <20%
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If the New Closed Mode Calibration Factor falls within the acceptable range given on the worksheet, calibrate the Closed Mode as directed in the next section of this chapter, Calibrating the Closed Mode. If the New Closed Mode Calibration Factor for a given parameter falls outside the acceptable range, there may be a computation error. Do not calibrate that parameter. Recheck all calculations and then call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
Calibration Chapter 6
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6. Type any comments in the <COMMENTS> field. Press the Enter key on the keyboard to save the entry and advance the cursor. NOTE: Comments may be added to the Calibration Log only after a calibration factor is changed or reentered. 7. To obtain a printout of the Calibration Log for documentation, press the [PRINT LOG] key.
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Calibration Confirmation
1. Run the same whole blood specimens into the CLOSED MEAN file again by repeating the steps in Manual Mode to Mode Calibration, Determining the Closed Mode Mean within this chapter. 2. The Post-Calibration difference must be equal to or less than the following: WIC/WOC RBC HGB MCV PLT <1.75% <1.25% <1.25% <1.25% <3.50%
Calculate the Post-Calibration difference using the Mode to Mode Post-Calibration Difference chart on the Manual Mode to Mode Worksheet. If the Post-Calibration difference exceeds these limits, verify that all calculations were correct and that the new factors were entered correctly. If no errors are detected, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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/ / / / / / /
% Diff
* Delete the sign of the % difference value before entering it on the worksheet. ** Do not calibrate. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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/ / / / / / /
x x x x x x x
= = = = = = =
* Current factor as printed by the operator in the Preparing for Manual Mode to Mode Calibration section within this procedure (Manual Mode to Mode Calibration). ** If factor exceeds limits, do not calibrate. Check all calculations and call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
/ / / / / / /
% Diff
* Mean after calibration. ** If % Diff exceeds limits, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Post-Calibration Procedures
If calibration was changed, complete the procedures in this section.
Quality Control
Confirm calibration changes by running all levels of controls into the appropriate QC files. If any parameters fall outside the limits, proceed as follows: 1. Obtain new vials of the controls. 2. Warm and mix them properly and again run them into the appropriate QC files. If parameters still exceed the limits, proceed as follows: 1. Collect all the calibration documentation including the Pre-Calibration worksheets. (Be certain you have recorded lot numbers where indicated.) 2. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US). NOTE: Inform the Customer Support Specialist if a reagent and/or lot number of reagent was changed just prior to the calibration procedure. 3. Include documentation as to the resolution of the problem in the instrument logbook.
Calibration Backup
The current calibration factors should be saved on the CELL-DYN 3700 Set-Up Disk #1 whenever calibration is changed. Data should also be saved whenever any setup information is changed and after any service work is performed. The backup procedure copies the following setup information from the Data Station to the Set-Up Disk: Calibration Factors QC Limits Patient Limits Analyzer Module Set Points (for example, gains, dil factors the [internal calibration factors] key, thresholds, pressure/ vacuum settings) RBC Editing Ratio Units Selection
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To back up the calibration factors, proceed as follows: 1. Perform the Daily Shutdown Procedure described in Chapter 5: Operating Instructions, Subsection: Routine Operation. 2. Turn the Data Station power switch OFF. 3. Obtain the Set-Up Disk #1 from the diskette box located behind the Upper Front Cover of the Analyzer. 4. Insert the Set-Up Disk #1 in the Data Station disk drive. 5. Turn the Data Station power switch ON. The Data Station screen displays the following: THIS IS THE CD3700 SETUP DISK TO USE, TYPE EITHER SAVE the [ENTER] OR RESTORE [ENTER] AND FOLLOW THE INSTRUCTIONS. NOTE: The restore option copies setup information from the Set-Up Disk to the Data Station hard disk. This option is used when a hardware or software failure occurs and should only be used at the direction of Technical Service or Abbott Diagnostics Customer Service. 6. Type SAVE. Press the Enter key on the keyboard. The screen will display the following: THIS UTILITY WILL SAVE YOUR DATA FILES ONTO YOUR SETUP DISK TO KEEP THEM BACKED UP SAFELY. THE FOLLOWING FILES WILL BE SAVED: (1) NONVOL (2) QC LOG (3) CALIBRATION LOG (4) MAINTENANCE LOG (5) ANIMAL TYPE CONFIGURATION (CD3700 ONLY) PROCEED (Y/N)?
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Post-Calibration Procedures
7. Type Y. Press the Enter key on the keyboard. The setup information is copied from the Data Station hard disk onto the setup disk. Previous setup information that was stored on the disk is overwritten. When the copy process is complete, the a:> prompt will be displayed on the screen. 8. Remove the Set-Up Disk #1 from the disk drive and return it to the diskette box. 9. Turn the Data Station power switch OFF. 10. Wait five seconds and then turn the Data Station power switch ON.
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NOTES
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References
References
1. International Committee for Standardization in Haematology (ICSH). Protocol for Evaluation of Automated Blood Cell Counters. Clinical and Laboratory Hematology 1984; 6:69-84. 2. Clinical and Laboratory Standards Institute/NCCLS. Procedure for Determining Packed Cell Volume by the Microhematocrit Method; Approved Standard Third Edition. CLSI/NCCLS document H7-A3 (ISBN 1-56238-413-9) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2000.
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NOTES
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Chapter 7
Quality Control
Quality Control
Overview
The first section of this chapter describes the functions of the keys in the QC MENU. Interpretation of the QC data is then discussed in the Quality Control Guide. The CELL-DYN 3700 System offers three Quality Control options to monitor and validate instrument performance: QC Files Statistical and graphical analyses of the data in each of 20 QC files calculate the mean, standard deviation, and coefficient of variation. A multi-rule system is applied to the data in each of the QC files. Bulls Moving Average Program is applied to the RBC Indices and a similar moving average calculation is applied to some WBC Differential optical parameters.
The options may be used independently or in combination at the operators discretion. The QC files are discussed in Quality Control Menu, View QC Log Soft Key within this chapter. X-B Analysis and Westgard Rules are discussed in the Quality Control Guide within this chapter. The Quality Control Guide also includes information about Running Controls.
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Chapter 7
X-B SET UP
X-B FILE
VIEW QC LOG
QC LIMITS
SET UP QC FILE
MAIN
TURN ON TURN ON X-B WBC X-B RBC TURN OFF TURN OFF X-B WBC X-B RBC
RETURN
RETURN
RETURN
TOGGLE ONE/ALL
RETURN
WBC GROUP LOT NUMBER REPLICATE ID RANGE ENTRY MEANS/ LIMITS WRITE QC TO DISK TOGGLE ON/OFF
DIFF GROUP
RETURN
PURGE QC LOG
LEVEYJENNINGS
DELETE SPECIMEN
MOVE SPECIMEN
PRINT QC LOG
RETURN
LOAD LOW
LOAD NORMAL
LOAD HIGH
RETURN
CONFIRM PURGE
CANCEL PURGE
CONFIRM UPDATE CONFIRM CANCEL DELETION DELETION MOVE TO FILE CANCEL MOVE
CANCEL UPDATE
GROUP 1
GROUP 2
GROUP 3
GROUP 4
RETURN
WRITE LOW
WRITE NORMAL
WRITE HIGH
RETURN
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Quality Control
QC MENU Ready
File Name 1. Low 2. Normal 3. High 4. FILE 4 5. FILE 5 6. FILE 6 7. FILE 7 8. FILE 8 9. FILE 9 10. FILE 10
# Specimens 11 13 0 0 0 0 0 0 0 0
File Name 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Patient FILE 12 FILE 13 FILE 14 FILE 15 FILE 16 FILE 17 FILE 18 FILE 19 FILE 20
# Specimens 30 0 0 0 0 0 0 0 0 0
Select a QC file with the arrow keys or enter a new file name.
X-B SET UP
X-B FILE
VIEW QC LOG
QC LIMITS
SET UP QC FILE
CUSTOMIZE DISPLAY
CUSTOMIZE PRINTOUT
MAIN
Figure 7.1:
QUALITY CONTROL
QC Menu Screen
The following soft key labels are displayed on the QC MENU screen: X-B SET UP* X-B FILE VIEW QC LOG QC LIMITS* SET-UP QC FILE* CUSTOMIZE DISPLAY* CUSTOMIZE PRINTOUT* MAIN *These keys are discussed in Chapter 5: Operating Instructions, Subsection: Set Up Instructions, QC Set Up Menu Soft Key.
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The following soft key labels are displayed when the [X-B FILE] key is pressed: X-B RBC DATA or X-B RBC GRAPHS X-B WBC DATA or X-B WBC GRAPHS PRINT RETURN (The key label alternates between these two selections.) (The key label alternates between these two selections.)
RETURN
Figure 7.2:
X-B RBC DATA X-B RBC GRAPHS
The [X-B RBC DATA] key is used to display the X-B data for RBC indices on the X-B FILE DISPLAY screen. (See the preceding figure.) This screen displays the results for X-B batches 110 and the lower and upper limits. The date and time that each batch was completed are also displayed. The Page Down key on the keyboard is used to display batches 1120. When batches 1120 are displayed, the Page Up key on the keyboard is used to display batches 110. NOTE: The X-B RBC data can also be viewed as graphs by pressing the [X-B RBC GRAPHS] key.
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The [X-B RBC GRAPHS] key is used to display the X-B graphs for RBC indices on the X-B FILE DISPLAY screen. (See the following figure.) This screen displays the results for X-B batches 120 and the lower and upper limits. NOTE: The X-B RBC data can also be viewed as data in tables by pressing the [X-B RBC DATA] key.
MCHC
RETURN
Figure 7.3:
The [X-B WBC DATA] key is used to display the X-B data for WBC differential optical parameters on the X-B FILE DISPLAY screen. (See the following figure.) This screen displays the results for X-B batches 110 and the lower and upper limits. The date and time that each batch was completed are also displayed. The Page Down key on the keyboard is used to display batches 1120. When batches 1120 are displayed, the Page Up key on the keyboard is used to display batches 110. NOTE: The X-B WBC data can also be viewed as graphs by pressing the [X-B WBC GRAPHS] key.
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X-B FILE DISPLAY Standby PAGE UP/DN FOR MORE DATA X-B WBC DATA BATCH 1 2 3 4 5 6 7 8 9 10 Upper Lower L0D 62 62 62 62 62 62 62 62 64 63 74 50 L10D 64 63 64 62 68 63 63 63 63 62 73 49 N0D 151 151 152 152 151 150 152 154 159 155 176 118 N10D 142 142 144 135 130 136 146 147 149 147 168 112 N90D 111 114 117 117 116 115 115 116 120 119 137 91 N90DEP 17 18 18 18 18 18 17 17 18 18 20 14
NEU-EO 21.2 21.4 21.2 21.1 20.7 20.7 20.4 20.4 20.4 20.4 27.3 14.7
DATE 12/10/98 12/10/98 12/10/98 12/11/98 12/11/98 12/11/98 12/11/98 12/11/98 12/11/98 12/11/98
TIME 14:42 17:21 21:05 04:07 06:02 07:26 08:24 09:29 11:05 11:54
RETURN
Figure 7.4:
The [X-B WBC GRAPHS] key is used to display the X-B graphs for WBC differential optical parameters on the X-B FILE DISPLAY screen. (See the following figure.) This screen displays the results for X-B batches 120 and the lower and upper limits. NOTE: The X-B WBC data can also be viewed as data in tables by pressing the [X-B WBC DATA] key.
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N90D 20 17 14
N90DEP
RETURN
Figure 7.5:
The [PRINT] key is used to print the X-B data and graphs. When this key is pressed, the data and graphs for all 20 batches are automatically printed if the data or graphs are displayed.
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Quality Control Menu
Chapter 7
5
O O
Op 732 732
WBC
REJECT SPECIMEN
DELETE SPECIMEN
MOVE SPECIMEN
Figure 7.6:
VIEW QC LOG
The [VIEW QC LOG] key is used to display the QC Log indicated by the position of the cursor. Each QC Log display shows the following information (see the preceding figure): 1. Upper Left Corner Lot Number and Expiration Date if the file was configured for this type of control. If the file was configured for a Replicate ID, it is displayed here. File name, the number of runs currently in the file, and the file capacity (e.g.: 29/120 indicates that the file contains 29 runs out of a possible 120). The page number of the display and the total number of pages in the file. 2. Status Box Screen name, system status, and USE < OR > FOR MORE DATA. This message indicates that the Left and Right arrow keys on the keyboard should be used to display the other groups of data.
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3. Upper Right Corner The current date, time, and operator ID are displayed along with the last sequence number that was used. 4. The remainder of the screen displays the file information and the data. The Upper and Lower Limits and Target Mean entered are displayed immediately above the parameter names. The sequence number for each result is displayed to the left of the data, and the results are displayed below the parameter. The date, time, and operator ID when the sample was run are displayed to the right of the data. 5. The following QC Log codes are displayed in the column immediately preceding the date. These codes are the same as those used in the Data Log: O Sample was run in the Open Mode C Sample was run in the Closed Mode N Incomplete aspiration in the Open Mode I Incomplete aspiration in the Closed Mode K Metering fault (Clog or Flow Error) M Mixing error on the Sample Loader V Sample was run in the Veterinary Mode B Blood in line 6. The statistics are displayed below the data as follows: N: FILE MEAN: STD DEV: CV (%): The number of runs used in the calculation The mean value for the number of runs used in the calculation The standard deviation for the number of runs used in the calculation The Coefficient of Variation in percent for the number of runs used in the calculation
NOTE: Quality Control results that fall at the boundaries of the selected limit set may be colored differently in the QC and Data Logs. This is possible due to differences in numerical rounding between the two logs. The result that will be displayed, printed and reported is the same in both logs and is accurate. Use the color in the data log view to determine whether the results are outside the entered limits.
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The following soft key labels are displayed on the VIEW QC LOG screen: PURGE QC LOG LEVEY-JENNINGS REJECT SPECIMEN or ACCEPT SPECIMEN DELETE SPECIMEN MOVE SPECIMEN WRITE QC TO DISK PRINT QC LOG RETURN (This key label alternates between these two selections.)
The [PURGE QC LOG] key is used to delete the contents of the QC Log. When the [PURGE QC LOG] key is pressed, the following soft key labels are displayed: CONFIRM PURGE CANCEL PURGE These keys are used to confirm or cancel the [PURGE QC LOG] command.
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QC file: NORM 41 OPEN Seq num: 5597 to 6628 WBC: 8.60 8.00 7.40 RBC: 4.51 4.33 4.15 PLT: 270. 245. 220. 13.6 13.2 12.8 8.60 8.00 7.40
MCV:
GROUP 2
GROUP 3
GROUP 4
RETURN
Figure 7.7:
LEVEYJENNINGS
The [LEVEY-JENNINGS] key accesses the LEVEY-JENNINGS MENU screen, which is used to display the Levey-Jennings graphs of the data in the QC file. (See the preceding figure.) The following soft key labels are displayed on the LEVEY-JENNINGS MENU screen: GROUP 1* GROUP 2 GROUP 3 GROUP 4 PRINT RETURN * The soft key for the group currently shown on the screen is not displayed.
GROUP 1 4
Each of these keys is used to select the graphs for a group of data that corresponds to the groups selected in the Customize QC Display option. Subsequent groups can be selected by pressing the appropriate soft keys.
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The [PRINT] key is used to print the Levey-Jennings graphs. When the [PRINT] key is pressed, all of the graphs are automatically printed. The [RETURN] key is used to return to the VIEW QC LOG screen.
RETURN
Lot Number: N0041 Exp. Date: 12/06/98 Norm 41 OPEN: 29/120 Page 4 of 4 Upper Limits: Lower Limits: Target Mean: Seq 6627 6628 R 8.60 7.40 8.00 WBC 8.12 7.80 8.60 7.40 8.00 WOC 8.12 7.80
270. 220. 245. PLT 225. 231. O O Date 11/20/98 11/20/98 Time 10:10 10:12 Op 732 732
WBC N: File Mean: Std Dev: CV (./.): PURGE QC LOG LEVEYJENNINGS 26 8.02 .111 1.4
ACCEPT SPECIMEN
DELETE SPECIMEN
MOVE SPECIMEN
Figure 7.8:
REJECT SPECIMEN ACCEPT SPECIMEN
The [REJECT SPECIMEN] key is used to exclude the results for the specimen indicated by the cursor position. When the key is pressed, the key label changes to [ACCEPT SPECIMEN], an R is displayed in the column immediately left of the results, and the statistics are recomputed excluding those results. (See the preceding figure.) The data are still displayed and stored in the file but are excluded from the statistical calculation. When the [ACCEPT SPECIMEN] key is pressed, the R is deleted and the statistics are recomputed including those results.
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The [DELETE SPECIMEN] key is used to delete the results for the specimen indicated by the cursor position. When the [DELETE SPECIMEN] key is pressed, the following key labels are displayed: CONFIRM DELETION CANCEL DELETION These keys are used to confirm or cancel the delete command. When the [CONFIRM DELETION] key is pressed, the results are deleted from the file (the data are not displayed or stored in the file) and the statistics are recomputed excluding those results.
The [MOVE SPECIMEN] key is used to move the QC result indicated by the cursor position to another QC file. When the [MOVE SPECIMEN] key is pressed, the QC MENU screen is displayed, allowing the desired file to be selected. When the [MOVE TO FILE] key is pressed from the QC MENU screen, the result is moved to the indicated file.
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The [WRITE QC TO DISK] key enables the download of data from a QC file to a floppy disk.
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Chapter 7
Quality Control
Running Controls
Control Material
Abbott recommends using the CELL-DYN control materials for performing quality control checks on the CELL-DYN 3700 System. These controls should be run: After daily start up procedures are completed. After a reagent lot number change. After calibration (confirmatory step). After a service call or component replacement. In accordance with the laboratorys quality control protocol. According to regulatory requirements. The CELL-DYN controls can be run in any mode of operation: Open Mode, CS Mode, or SL Mode. NOTE: Controls for the Sample Loader and Closed Sampler Modes are packaged in tubes with pierceable caps.
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Store the controls at recommended temperatures. Storage in a central location in the refrigerator, away from the door if it is opened frequently, is advisable. Carefully warm and resuspend the product according to the directions given in the package insert. Proper mixing is essential for accurate results. Check the open-tube stability dating and do not use products longer than is recommended, or results may be compromised. Never subject a tube to excessive heat or agitation.
Assay Verification
New lots of control material should be analyzed in parallel with current lots prior to their expiration dates. This may be accomplished by running the new controls twice a day for five days. The mean of the ten runs is then used to confirm the assay value. A control file is set up for the new lot number to easily establish the mean. If desired, this same control file can then be used to run the control for the remainder of the dating period. Creating another file is not required. The expected ranges published by manufacturers are generally too broad for effective quality control.1 Therefore, each laboratory should establish acceptable ranges. These ranges may be determined by evaluating three to six months of data (data from the Interlaboratory QC Program may be used) for a particular level of control. The individual SD values may be averaged as follows:
Average SD =
(N1 (N2 . (Ni 2 (Ni (N1 12+2 x SD2SD x SD1 22))+. SDi2) SD 2) (N 2 ... )+ SD + . x ) (N1...Ni) -- 1 N2 1 . . (N+ 2+Ni) 1+N + .
N SD i
= = =
number of values in a group Standard Deviation of the values in that group the last group of values
The resultant long-term instrument SD and the laboratoryestablished mean for each lot number should be used to monitor instrument performance. NOTE: Entry of the laboratory-established ranges is restricted by the allowable limits available in the QC Range Entry Screen. An explanation of this screen is provided in Chapter 5: Operating Instructions, subsection: Set Up Instructions, QC Limits Soft Key.
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Westgard Rules
A control rule tests the control result against control limits to determine whether the CELL-DYN 3700 System shows acceptable accuracy and precision. The limits are derived from the mean and standard deviation of control measurements obtained when instrument performance is stable and acceptable. The most common rule used in hematology quality control is the mean 2SD limits. Ninety-five percent of the control results should fall within the 2SD limits. Quality control rules detect random or systematic error. Random error may be defined as an increase in the SD (loss of precision). Systematic error may be defined as a shift in the mean value (loss of accuracy). A multi-rule quality control procedure combines several control rules to improve the detection of both types of error. J. Westgard recommended a multi-rule approach to evaluating quality control results.2 This approach has long been used in the clinical laboratory3. A set of modified Westgard Rules can be used to monitor quality control results on the CELL-DYN 3700 System. NOTE: Do not use the values for mean range provided on the control assay sheet in conjunction with Westgard Rules. Before using Westgard Rules with commercial controls, establish the SD for each parameter on your instrument and enter limits based on these SDs. Refer to Assay Verification within this section for how to establish a long-term SD.
Rule 3 (R4s):
Rule 4 (2 of 32s): Two of three consecutive values outside same 2SD Two consecutive results of the last three results fell outside 2SD on the same side of the mean.
CELL-DYN 3700 System Operators Manual
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Chapter 7
Rule 5 (41s):
Four consecutive values outside same 1SD Four consecutive results fell outside 1SD on the same side of the mean. Ten consecutive values on the same side of mean Ten consecutive results fell on the same side of the mean.
Rule 6 (10x):
The rules may be used singly or in combination, depending on operator preference. Selections are made on the QC FILE SET UP screen. When a rule is selected, a plus sign is displayed to the right of the parameter name on the LEVEY-JENNINGS MENU screens. (See the following figure.) Six plus signs indicate that all six rules are selected in order from left to right. A minus sign is displayed if a rule is not selected.
QC file: Patient Seq num: 14 to 42 WBC:+-+-+6 4.80 4.40 4.40 RBC:+-+-++ 5.14 4.90 4.66 PLT:+-+-++ 248. 226. 204. 16.0 15.3 14.6 4.80 4.40 4.40
GROUP 2
GROUP 3
GROUP 4
RETURN
Figure 7.9:
Whenever a rule is violated, the Bulletin Line displays the following message in the VIEW QC LOG screen: WESTGARD WARNINGS: SEE LEVEY-JENNINGS. The number of the rule that was violated is displayed in place of the plus sign. The preceding figure shows examples of the plus and minus signs and rule-violation indications.
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Rule Violations
Only the directly measured parameters need to be monitored with multiple rules.4 In reference 4 (pp. 190192), Cembrowski suggests a protocol for using the Westgard Rules in hematology. The following is a synopsis of that protocol. Since three levels of control are typically used to monitor a hematology analyzer, it is reasonable to consider all three runs at the same time. In other words, check for rule violations across the three levels, not just within a particular level. If the same rule is violated for more than one level, determine whether the violation indicates a loss of precision or a loss of accuracy, and troubleshoot accordingly. Cembrowski suggests that the results for all three levels first be checked to see if they are within their 2SD limits. If all three levels meet this criterion, the instrument is in control. If any control result exceeds the 2SD limits, check to see if it exceeds the 3SD limits. If a result exceeds 3SD, there are two possibilities. There is either an instrument problem or a problem with the particular level of control. Therefore, if a result exceeds 3SD, run another bottle of that control. If the problem persists, then additional investigation is required. Check to see if either the 2 of 32s or R4s rules have been violated for any level or across levels. If the problem is confined to one level of control, check for a 22s rule violation for that level. Again, if the violations are confined to one level of control, use another bottle and possibly another lot. Check expiration dates and data entry. Check to be sure that the control is run into the correct file. If a combination of rules has been violated across the three levels, determine whether the violations indicate a loss of precision or a loss of accuracy, and troubleshoot accordingly. If necessary, call Abbott Diagnostics Customer Service (at 1-877-4ABBOTT in the US) for assistance. When the problem has been resolved, Cembrowski suggests that all levels be run again in duplicate to confirm that the problem has in fact been corrected.
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Chapter 7
X-B Analysis
Overview
X-B analysis is an automated means of monitoring instrument performance by using the known stability of the red cell indices. X-B is used to indicate XB, which is the symbol for a moving average of hematology values calculated using an algorithm developed by Dr. Brian Bull of Loma Linda University. X-B RBC analysis uses the Bull algorithm to monitor instrument performance by tracking data in the patient population analyzed on the instrument. X-B RBC analysis works well using the data from the RBC indices due to the narrow dynamic range of the indices in human populations. However, it is difficult to use this approach when the algorithm is applied to results that have a wide dynamic range of values, such as the WBC Differential subpopulations. Consequently, there has been no means of monitoring the WBC Differential parameters in a similar manner. A method of X-B analysis for WBC Differential parameters has been developed for the CELL-DYN 3700 System using data obtained with the MAPSSTM technology. This method uses a moving average calculation that is similar to the one used in Dr. Bulls algorithm. For convenience, the method is called X-B WBC, even though it was not developed by Dr. Bull. A detailed description is contained in X-B Analysis for WBC within this chapter.
Target Value
The Target Value for X-B RBC is similar to the assay value for a commercial control. It is derived from the patient population analyzed on the instrument.
Action Limit
The Action Limit is the acceptable limit of variation around the target value.
CELL-DYN 3700 System Operators Manual
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Chapter 7
Each laboratory should establish its own target value for the RBC indices. It is suggested that the process be started by using the default values (preset values from Dr. Bulls earlier studies) displayed on the X-B SET UP screen or by entering the values from Dr. Bulls recent study described above. The 3% action limits may be used or widened to 5% during the study and tightened to 3% when the Target Values are confirmed. The default values for the Lower/Upper Limits may also be used or widened depending on the specimen population analyzed by the laboratory. Collect data from 20 batches of 20 specimens each for a total of 400 specimens. Data collection should be from specimens which represent the typical specimen population that is processed through the instrument. When all 20 batches are complete, print the X-B DATA DISPLAY screen for RBC. Calculate the mean, standard deviation (SD), and coefficient of variation (CV) for MCV, MCH, and MCHC. The CV for each index should be < 1.5%. If the CV for each index meets these criteria, enter the calculated mean value as the target value and set the action limits to 3%. NOTE: Laboratories analyzing specialized patient populations (as described above) may need to widen the action limits slightly to accommodate results from these abnormal patients. If the CV for each index is >1.5%, evaluate another 400 specimens and repeat the calculations. When an acceptable target value has been entered, evaluate data from an additional 400 specimens to confirm the entered values.
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Calibration changes may also cause a shift in results. If a shift cannot be explained as described above, run commercial controls or run a patient selected from a previous batch when X-B results were in control. If values are within acceptable limits, a calibration shift is not the cause of the problem. Trends in X-B results are usually caused by instrument problems. A recent component change may also cause a trend in results. Use the following table to determine the directly measured parameter(s) involved, and troubleshoot accordingly. If a problem is not readily identified, perform routine maintenance and repeat the commercial and patient controls to see if results are acceptable. Since two of the RBC indices are calculated parameters, their interrelationships can be used to assist in troubleshooting. The following table uses the mathematical relationships between the indices to aid in determining which directly measured parameter(s) are involved when X-B is out of control. When the directly measured parameter(s) are identified, refer to Chapter 10: Troubleshooting for troubleshooting assistance with these parameters.
Table 7.1: Troubleshooting X-B RBC
If the MCV X-B Pattern MCV will be MCH will be MCHC will be is increased High N/A Low is decreased Low N/A High
If the RBC is increased N/A Low Low is decreased N/A High High
If the HGB is increased N/A High High is Index decreased Derivation N/A Low Low MCV HGB/RBC HGB/HCT
If all efforts fail to bring results within acceptable limits, contact Abbott Diagnostics Customer Service (at 1-877-4ABBOTT in the US) for assistance.
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7-24
Collect data from 20 batches of 20 specimens each for a total of 400 specimens. Data collection should be from specimens which represent the typical specimen population that is processed through the instrument. When all 20 batches are complete, print the X-B DATA DISPLAY screen for WBC. Calculate the mean, standard deviation (SD), and coefficient of variation (CV) for each parameter. The CV for LYM 0, LYM 10, NEU 0, and NEU 10 should be <2.5%. The CV for NEU 90, NEU 90 depolarized, and NEU-EOS should be <5%. If the CV for each index meets these criteria, enter the calculated mean value as the target value and set the action limits to 5% for LYM 0, LYM 10, NEU 0, and NEU 10, and to 10% for NEU 90, NEU 90 depolarized, and NEU-EOS. NOTE: Laboratories analyzing specialized patient populations (as described above) may need to widen the action limits slightly to accommodate results from these abnormal patients. If the CV for each index is more than the limits described above, evaluate another 400 specimens and repeat the calculations. When an acceptable target value has been entered, evaluate data from an additional 400 specimens to confirm the entered values.
Table 7.2: Default (Preset) X-B WBC Values
Action Limit 7 5 4 5 10 19 13
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Quality Control
References
1. Cembrowski GS, Carey RN. Laboratory Quality Management. Chicago: ASCP Press. 189. 1989. 2. Westgard JO et al. A Multi-Rule Shewhart Chart for Quality Control in Clinical Chemistry. Clinical Chemistry 1981; 27:3:493501. 3. Cembrowski GS, et al. Use of a Multirule Control Chart for the Quality Control of PT and APTT Analyses. Laboratory Medicine June 1989; 418421. 4. Cembrowski GS, Carey RN. Laboratory Quality Management. Chicago: ASCP Press. 190. 1989. 5. Bull BS, Korpman RA. Intralaboratory Quality Control Using Patients Data. Quoted in Cavill I, ed, Quality Control (Edinburgh: Churchill Livingstone, 1982), 121150. 6. Bull BS, Jones AR, Gibson M, Twedt D. A Method for the Independent Assessment of the Accuracy of Hematology Whole Blood Calibrators. American Journal of Clinical Pathology 1992; 98:623-29. 7. Bull BS, Hay KL. Are Red Blood Cell Indexes International? Archives of Pathology and Laboratory Medicine 1985; 109: 604606. 8. Chanarin I, ed. Laboratory Hematology: An Account of Laboratory Techniques. New York: Churchill Livingstone. 3-7. 1989.
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Chapter 7
NOTES
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Chapter 8
Hazards
Hazards
Overview
Hazards
Operation, maintenance, and servicing of automated hematology systems may expose individuals to potential safety and health hazards. All work must be performed as described in the Abbott Laboratories CELL-DYN Operators Manual or as directed by an Abbott Representative. This section provides precautionary warnings and information necessary for the safe use of the CELL-DYN 3700 System. Supplementary warnings are inserted throughout this manual and on the instrument to alert personnel to potential hazards. Whenever hazard symbols are encountered on the instrument, users must consult the Operators Manual to determine the nature of the potential hazard and actions that must be taken. The standard warning conventions including signal words (e.g., caution) and symbols are described below. Safety symbols appear next to signal words that identify hazards.
Warning Conventions
Signal Words
DANGER: WARNING: CAUTION: Denotes an immediate hazard which, if not avoided, could result in serious injury or death. Denotes a hazard which, if not avoided, could result in moderate to serious injury. Denotes potential hazards that could result in a minor injury. Also, used for conditions or activities which could interfere with proper functioning of the instrument. Denotes special operator/service information or standard practices.
NOTE:
8-1
Hazards Overview
Chapter 8
Symbols
The general hazard symbol identifies an activity or area that may present a hazard to personnel or equipment. The electrical hazard symbol alerts personnel to the possibility of electrical shock if procedural or engineering controls are not observed. The biohazard symbol identifies an activity or area where personnel may be exposed to infectious substances if procedural engineering controls are not observed. The laser hazard symbol identifies an activity or area where personnel will be exposed to an eye hazard if procedural or engineering controls are not observed.
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Chapter 8
Biohazards
WARNING: Potential Biohazard. Consider all clinical specimens, reagents, controls, surfaces or components that contain or have contacted blood, serum, or other bodily fluid as potentially infectious. Wear gloves, lab coats, and safety glasses, and follow other biosafety practices as specified in the OSHA Bloodborne Pathogen Rule (29CFR Part 1910.1030) or other equivalent biosafety procedures. WARNING: Potential Biohazard. The aspiration needle and probe are sharp and potentially contaminated with infectious material. Avoid contact with the tips of the probe and needle. Spills of potentially infectious materials should be cleaned up in accordance with established biosafety practices. A generally accepted procedure for cleaning such spills is to absorb the spill with toweling or other absorbent material, wipe the area with an appropriate tuberculocidal disinfectant such as 0.5% sodium hypochlorite solution (refer to formula in Chapter 9: Maintenance, Subsection: Decontamination Procedures).
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Chapter 8
Prior to maintenance, service, or shipping, the instrument should be decontaminated in accordance with the procedures specified in Chapter 9: Maintenance, Subsection: Decontamination Procedures and/or Preparation for Inactivity or Shipping as appropriate. Remove and dispose of contaminated disposables in accordance with local, state, and federal regulations.
Chemical Hazards
Prevent exposure to chemicals used in the operation and maintenance of the CELL-DYN 3700 System (including reagents) by using appropriate personal protective equipment, work procedures, and information on Material Safety Data Sheets (MSDS). Refer to Chapter 2: Installation, for an installation procedure for chemical containers.
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Chapter 8
Electrical Hazards
Basic electrical hazard awareness is essential to the safe operation of any hematology analyzer. Appropriate personnel (including facilities personnel) should practice good habits of electrical safety, which include the following: Periodically inspect electrical cabling into and on the instrument for signs of wear or damage. When moving equipment, lift all power cables clear of all System components. CAUTION: Electrical Hazard. Do not disconnect any electrical connection while the power is on. Follow instructions for correctly powering down the instrument and all connected equipment before performing maintenance on parts which require protective covers to be removed for access. Use only approved power cords and electrical accessories, supplied with the instrument, or provided by Abbott, to protect against electrical shock. CAUTION: Electrical Hazard. Turn off the power to the instrument and disconnect the power cord before removing any instrument panel that is securely fastened in place by screws or prior to replacing fuses. Replace only the externally accessible fuse located immediately above the power cord connector on the rear panel of the instrument. Use replacement fuses only of the specified type and electrical rating. Keep liquids away from all electrical connectors (such as electrical outlets) or communication connectors (such as the LIS connector). Keep the floor dry. The electrical circuit spacing of the CELL-DYN 3700 System is based on pollution degree (1) and altitude [up to 2000 M (6500 ft)] as per IEC 61010-1. Pollution degree 1 is defined as an environment where there is no pollution or only dry, nonconductive pollution. CAUTION: If the instrument is used or modified in a manner not specified by the manufacturer, the protection provided by the instrument may be impaired. For details about power requirements, refer to Chapter 4: System Specifications, Subsection: Power Specifications.
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Chapter 8
Laser Hazards
The CELL-DYN 3700 Analyzer and Sample Loader are Class 1 (Class I) Laser Products per IEC 60825-1. However, the analyzer contains Class 3B and Class 2 lasers as well. CAUTION: Class 3B Laser Light when open Avoid Exposure to Beam. Do not look directly into the laser beam or any reflections of the beam from a mirror-like surface. When the access door, or other inner protective covers are removed, Helium-Neon laser power up to 10 mW continuous wave at 632.8 nm in a beam with 1mR divergence could be accessible in the interior of the optics bench. This amount of energy, with insignificant attentuation with distance, is sufficient to cause eye damage. The laser aperture is located on the left end of the laser head (refer to Figure 8.3). This Class 3B laser system is classified to EN 60825-1/A2:2001, the standard for Safety of Laser Products.
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Chapter 8
CAUTION: Barcode Laser Light Do not stare into beam. Do not stare directly into the barcode laser beam or any reflections of the beam from a mirror-like surface. The laser beam is capable of causing eye damage. When the Left Front Cover or the Tower Cover is removed, Class 2 laser light up to 1 mW continuous wave at 670 nm could be accessible from the bar code reader. The bar code reader is located behind the Tower Unit. The laser aperture is located on the right side of the bar code reader. This Class 2 laser system is classified to EN 60825-1:1994+All:1996, the standard for Safety of Laser Products. The Class 2 Laser Label applies only to the CELL-DYN 3700SL. CAUTION: Use of controls adjustments or performance of procedures other than those specifified herein may result in hazardous laser light exposure. The sample loaders safety cover has an interlock switch that prevents sample loader operation when the cover is not in place. Lifting the cover while the sample loader is operating causes an immediate emergency stop condition. Do not bypass the interlock switch to operate the sample loader without the safety cover. During normal operation the inner protective covers are to remain in place to prevent laser light exposure from the optics bench. The inner protective covers should be removed only during servicing by qualified personnel. The inner protective cover laser warning labels must not be removed and are to remain legible. The protective housing label (Abbott P/N 9230701), shown in Figure 8.1 consists of black lettering against a yellow background.
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Chapter 8
Figure 8.1:
This label is located in two places: on the L-shaped optical baffle cover on the left side of the optical bench (under the Top Cover) (refer to Figure 8.2), and on the upper left side of the Flow Panel (refer to Figure 8.3).
Laser Aperture Protective Cover Laser Warning Label
Figure 8.2:
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Chapter 8
Figure 8.3:
The Class 2 Laser Caution Label (Abbott P/N 9230323) is shown in Figure 8.13. The label consists of black lettering against a yellow background.
CAUTION - CLASS 2 LASER LIGHT WHEN OPEN AND INTERLOCK IS DEFEATED DO NOT STARE INTO THE BEAM PN 9230323
Figure 8.4:
This label is located on the top surface of the sample loader. (Refer to Figure 8.5.
Chapter 8
The Class 1 Laser Product Label (Abbott P/N 9230702) shown in Figure 8.6 consists of black lettering against a yellow background.
Figure 8.6:
The label is located on the left section of the instruments Rear Panel and is positioned in a clearly visible location, as shown in Figure 8.7.
Figure 8.7:
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Chapter 8
Hazards References
References
1. Occupational Safety and Health Administration, Department of Labor. 29 CFR Part 1910.1030. Occupational Exposure to Bloodborne Pathogens. 2. IEC 60825-1, International Electrotechnical Commission World Standards for Electrical and Electronic Engineering, 60825: Safety of Laser Products, 60825-1 (1993) Part 1: Equipment Classification, Requirements, and Users Guide.
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Hazards References
Chapter 8
NOTES
8-12
Chapter 9
Maintenance
Maintenance
Overview
The CELL-DYN 3700 System is designed to require minimal routine maintenance. For example: The fluidics are automatically rinsed between samples. A thorough system rinse is performed automatically when the unit has been idle for five minutes after the last cycle is completed. An automatic Aperture Cleaning Circuit cleans the WIC aperture after each count cycle. The instrument is automatically placed in STANDBY if it has been idle for four hours after the last cycle is completed. The operator is encouraged to routinely perform the scheduled maintenance procedures described in this chapter in order to ensure optimum performance. This chapter also give instructions for preparing the instrument for a prolonged period of inactivity. Many required preventive maintenance procedures have been automated on the CELL-DYN 3700 System. These programs can be accessed by pressing the [SPECIAL PROTOCOLS] key on the Data Station. The SPECIAL PROTOCOLS screen is discussed in the next section. The maintenance schedule outlined on the following page will minimize operational problems with the CELL-DYN 3700 System. The recommended intervals are based on instruments operating in laboratories that process samples from a general patient population. The intervals are affected by the volume of samples processed, the workload schedule, the operating environment and the patient population that is analyzed. Each laboratory must assess its own situation and modify these recommended intervals as necessary. Overdue maintenance is usually indicated by an increase in imprecision of one or more of the directly measured parameters. This increase is due to carryover or dilution/sampling inconsistencies. If this occurs on more than a random basis, the appropriate maintenance should be performed more frequently. A diagram of the Analyzer Flow Panel is included to assist in component identification and location.
9-1
Maintenance
Overview
Chapter 9
Daily
1. Run the Auto-Clean Cycle. 2. Clean the Aspiration Needle.
Weekly
1. Clean the Shear Valve. 2. Replace the Sample Aspiration Peristaltic Pump Tubing. 3. Clean the Sample Loader Tray, Racks, and Safety Cover. 4. Run the Extended Auto-Clean Cycle if routinely running reticulocyte counts.
Monthly
1. Clean the Reagent Syringes. 2. Clean the Analyzer Air Filters. 3. Replace the WOC Transfer Peristaltic Pump Tubing. 4. Run the Extended Auto-Clean Cycle.
Special Procedures
1. Adjust the Closed Sampler Tube Retainer (CS only). 2. Prepare for Inactivity or Shipping. 3. Repackage for Shipment.
Chapter 9
Figure 9.1:
Grounding Wire Clip WOC Mixing Chamber A.C.C. Interlock Switch Grounding Wire Clip Sample Aspiration Peristaltic Pump Mounting Bracket WOC Flow Cell Cover Mounting Bracket Optical Bench Assembly
Mounting Bracket
Overflow Chamber
Aerosol Filter
Mounting Bracket
Waste Chamber 1
Maintenance
Overview
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Maintenance
Overview
Chapter 9
Decontamination Procedures
The OSHA Bloodborne Pathogen Rule (29 CFR Part 1910.1030) requires the decontamination of laboratory equipment prior to servicing or shipment: Decontaminate the instrument by performing the AutoClean cycle. This cycle flushes all of the fluid pathways with reagents to purge any waste from the fluid pathways. The Open Mode Sample Probe and the Closed Sample Needle (CS Model) or Sample Loader Needle (SL Model) are automatically rinsed after every cycle. The surfaces of the instrument should be wiped with a nonabrasive detergent solution to remove any soiling, then wiped with a tuberculocidal disinfectant, such as a 0.5% sodium hypochlorite solution. To calculate the percent (%) sodium hypochlorite concentration desired see the following formula: A = Percent (%) of sodium hypochlorite solution desired B = Percent (%) of sodium hypochlorite stock solution (as purchased) X = Parts of water to be mixed with one part of the sodium hypochlorite stock solution X= B-A A
Example: If you need a 0.5% solution of sodium hypochlorite for a cleaning procedure, and the label on the bottle of bleach states that it is 5.25% sodium hypochlorite, then: X= 5.25 - .5 .5 X = 9.5
Add 9.5 parts deionized water to 1 part bleach to obtain a 0.5% sodium hypochlorite solution, or 9.5 mL of deionized water to 1.0 mL of bleach (5.25% sodium hypochlorite) to obtain 10.5 mL of a 0.5% solution of sodium hypochlorite. If the instrument is to be shipped, it must be decontaminated prior to shipment. This is accomplished by pressing the [PREPARE SHIPPING] key in the SPECIAL PROTOCOLS menu. Instructions for this procedure are given in Special Procedures, Subsection: Preparation for Inactivity or Shipping.
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Maintenance Chapter 9
Special Protocols Menu
EMPTY XDUCERS
REAGENT RESERVOIR
EMPTY WOC
MAINTEN LOG
DISABLE ANALYZER
MORE
MAIN
Figure 9.2:
SPECIAL PROTOCOLS
The SPECIAL PROTOCOLS screen is accessed from the MAIN MENU screen by pressing the [SPECIAL PROTOCOLS] key. The following soft key labels are displayed: EMPTY XDUCERS or FILL XDUCERS REAGENT RESERVOIR EMPTY WOC or FILL WOC (The soft key label alternates between these two selections.) MAINTEN LOG CLEAN SHEAR VAL or RESTORE SHEAR VAL DISABLE ANALYZER or ENABLE ANALYZER MORE MAIN (The soft key label alternates between these two selections.) (The soft key label alternates between these two selections.) (The soft key label alternates between these two selections.)
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Maintenance
Special Protocols Menu
Chapter 9
A brief description of the function of each soft key follows. Instructions for the detailed use of each key are given in the appropriate maintenance procedure.
The [EMPTY XDUCERS] key is used to empty both chambers in the von Behrens WIC Transducer and both chambers in the von Behrens RBC/PLT Transducer prior to removing the Aperture Plates. When the transducers are empty, the key label changes to [FILL XDUCERS]. When the [FILL XDUCERS] key is pressed, the transducers are refilled with reagent.
FILL XDUCERS
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Maintenance Chapter 9
Special Protocols Menu
Press the appropriate EMPTY soft key to empty the reagent reservoir. Stay on this screen until the "FILL" key appears After the appropriate FILL soft key is displayed, remove reagent line from existing container and place in new container. Press the FILL soft key to fill the reagent reservoir. Run 5 background cycles. Confirm background results are acceptable before running samples.
EMPTY DILUENT
EMPTY LYSE
EMPTY SHEATH
EMPTY DETERGENT
RETURN
Figure 9.3:
REAGENT RESERVOIR
The [REAGENT RESERVOIR] key is used to drain the reagent reservoirs located on the Left Side Panel of the Analyzer. When the [REAGENT RESERVOIR] key is pressed, the following soft key labels are displayed: EMPTY DILUENT or FILL DILUENT EMPTY LYSE or FILL LYSE EMPTY SHEATH or FILL SHEATH EMPTY DETERGENT or FILL DETERGENT RETURN The screen displays the message shown in the preceding figure. When the [EMPTY DILUENT], [EMPTY DETERGENT] or [EMPTY SHEATH] key is pressed, the appropriate reagent reservoir is drained. The [EMPTY LYSE] key is used to drain the WIC/HGB Lyse supply tubing. When the reservoir (or tubing) is empty, the appropriate [FILL] key is displayed. When the [FILL DILUENT], [FILL DETERGENT] or [FILL SHEATH] key is pressed, the appropriate reagent reservoir is refilled. When the [FILL LYSE] key is pressed, the lyse supply tubing is refilled.
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Maintenance
Special Protocols Menu
Chapter 9
The [EMPTY WOC] key is used to drain the reagent from the WOC Flow Cell. When the Flow Cell is empty, the key label changes to [FILL WOC]. When the [FILL WOC] key is pressed, the Flow Cell is refilled with reagent.
The [MAINTEN LOG] key is used to set up, review, and print the Maintenance Log. If the Maintenance Log feature is used, the screen displays a Bulletin Line prompt when scheduled maintenance should be performed. The Maintenance Log Set Up Procedure and the Maintenance Log screens are discussed in Maintenance Log Set Up within this chapter. When the [MAINTEN LOG] key is pressed, the following soft key labels are displayed: INTERVAL SET UP UPDATE LOG PRINT & PURGE PRINT LOG RETURN The [INTERVAL SET UP] key is used to configure the maintenance schedule. The [UPDATE LOG] key is used to indicate when maintenance was performed and to add comments to the Maintenance Log. The [PRINT & PURGE] key is used to print the completed log and then delete it. When the [PRINT & PURGE] key is pressed, the following soft key labels are displayed: CONFIRM CANCEL These keys are used to [CONFIRM] or [CANCEL] the Print & Purge command.
INTERVAL SET UP
UPDATE LOG
PRINT LOG
The [PRINT LOG] key is used to print the Maintenance Log. The [RETURN] key is used to return to the main SPECIAL PROTOCOLS screen. A detailed Maintenance Log Set Up Procedure and illustrations of the Maintenance Log screens are presented at the end of this section.
RETURN
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Maintenance Chapter 9
Special Protocols Menu
The [CLEAN SHEAR VAL] key is used to prepare the Shear Valve for cleaning. When the key is pressed, the syringes partially empty, which flushes the reagents out of the Shear Valve and the associated tubing. The Shear Valve then rotates into the position necessary for its removal. When the rotation is complete, the key label changes to [RESTORE SHEAR VAL]. When the [RESTORE SHEAR VAL] key is pressed, the syringes refill the Shear Valve and the associated tubing, and the Shear Valve rotates back to its operational position. When the rotation is complete, the key label changes to [CLEAN SHEAR VAL].
The [DISABLE ANALYZER] key is used to prevent the Analyzer from cycling while certain maintenance procedures are performed. When the Analyzer is disabled, the key label changes to [ENABLE ANALYZER]. When the [ENABLE ANALYZER] key is pressed, the Analyzer is returned to the READY state.
ENABLE ANALYZER
FLUSH SHEATH
AUTO CLEAN
DAILY SHUTDOWN
PREPARE SHIPPING
CLEAN NEEDLE
EXTEND AUTOCLEAN
MORE
MAIN
Figure 9.4:
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Maintenance
Special Protocols Menu
Chapter 9
When the [MORE] key on the SPECIAL PROTOCOLS screen is pressed, the second SPECIAL PROTOCOLS screen and the following soft key labels are displayed: FLUSH SHEATH AUTO CLEAN DAILY SHUTDOWN PREPARE SHIPPING CLEAN NEEDLE EXTEND AUTOCLEAN MORE MAIN
FLUSH SHEATH
The [FLUSH SHEATH] key is used to flush the WOC Flow Cell with Sheath Reagent. The [AUTO CLEAN] key is used to initiate the Auto-Clean Cycle. The Shear Valve, the WOC Mixing Chamber, the WOC Flow Cell, the von Behrens WIC Transducer, the von Behrens RBC/PLT Transducer, the HGB Flow Cell and all of the associated fluidics are automatically cleaned and rinsed during the cycle. When the [AUTO CLEAN] key is pressed, the screen displays the message shown in Figure 9.8 in the Daily Maintenance section. The following soft key labels are displayed: START CANCEL These keys are used to [START] or [CANCEL] the Auto-Clean Cycle.
AUTO CLEAN
DAILY SHUTDOWN
The [DAILY SHUTDOWN] key is used to initiate the Daily Shutdown cycle. During the cycle, the fluidics are automatically drained and rinsed. At the end of the cycle, the Analyzer is placed in STANDBY. The electronic solenoid valves are automatically opened periodically while the Analyzer is in STANDBY to prevent the tubing from becoming pinched. The [PREPARE SHIPPING] key is used to prepare the Analyzer for shipment or a period of inactivity. The cycle drains all of the reagents from the system and then rinses the fluidics with deionized water.
PREPARE SHIPPING
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Maintenance Chapter 9
Special Protocols Menu
CLEAN NEEDLE
The [CLEAN NEEDLE] key is used to clean the needles used in either of the Closed Modes (CS or SL) of operation. When this key is pressed, the needle is forcefully rinsed with diluent. The [EXTEND AUTOCLEAN] key is used to initiate the Extended AutoClean cycle, which is a longer version of the Auto-Clean cycle. When the [EXTEND AUTOCLEAN] key is pressed, the screen displays the message shown in Figure 9.17, Special Protocols: Extended Auto-Clean Screen in the Monthly section within this chapter. The following soft key labels are displayed: START CANCEL These keys are used to [START] or [CANCEL] the Extended AutoClean cycle.
EXTEND AUTO-CLEAN
MORE
The [MORE] key is used to return to the first SPECIAL PROTOCOLS screen.
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Special Protocols Menu
Chapter 9
NOTES
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Chapter 9
Maintenance
Nov 20 1998 Operator ID Sequence # PUMP TUBING ASPR WOC X EXT AUTO
Date Time OpID 10/09/98 08:30 sh Comments: Weekly Maintenance 10/16/98 08:32 jg Comments: Weekly Maintenance 10/23/98 08:33 td Comments: Weekly Maintenance
SYNG
SL X
AUTO OTHER
INTERVAL SET UP
UPDATE LOG
PRINT LOG
RETURN
Figure 9.5:
MAINTEN LOG
The MAINTENANCE LOG screen is accessed from the SPECIAL PROTOCOLS screen by pressing the [MAINTEN LOG] key. When the [MAINTEN LOG] key is pressed and scheduled maintenance is due, a Bulletin Line on the MAINTENANCE LOG screen will display the following message: MAINTENANCE DUE: followed by the name(s) of the components(s) requiring maintenance NOTE: The bulletin message will disappear when any key is pressed.
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Maintenance
Maintenance Log Set Up
Chapter 9
The log displays the following entry fields: <Date>, <Time>, <OpID>, <SHEAR VALVE>, <AIR FILTR>, <SYNG>, <APERTURES> (<WIC> and <RBC>), <PUMP TUBING> (<ASPR> and <WOC>), <SL>, <EXT AUTO>, <AUTO>, <OTHER>, and a line for <Comments>. (Up to 70 characters may be entered in the <Comments> line.) The log holds 40 entries, but the screen displays only the 5 most current. Other entries can be displayed by pressing the Page Up or Page Down keys on the keyboard. Each time an entry is made, the current date, time, and operator ID are automatically entered in the log. When the UPDATE MAINTENANCE LOG screen (illustrated in Figure 9.7, Update Maintenance Log Screen) is displayed, the cursor is automatically positioned in the <Op ID> entry field. If desired, the ID may be edited. Entries are made by moving the cursor with the arrow keys on the keyboard to the desired entry field and pressing the Enter key on the keyboard. An X is displayed to indicate the completed maintenance and the cursor advances to the next entry field. NOTE: Entries can also be made by moving the cursor to the desired location, typing an X, and pressing the Enter key on the keyboard. An incorrectly placed X can be deleted by moving the cursor to it and pressing the Space Bar on the keyboard. Comments may be entered in the <Comments> entry field of the Maintenance Log if entries have been made in the other fields. Comments and maintenance entries (Xs) can also be edited after they have been made. However, once the [RETURN] key has been pressed, the changes are saved and changes can no longer be made. A printout can be made at any time, but when the log is full all entries must be deleted before new ones can be added. When the log is full, a Bulletin Line will display the following message: MAINTENANCE LOG IS FULL, NO MORE ENTRIES CAN BE CREATED The [PRINT & PURGE] key is used to print the log and delete all entries.
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Maintenance Chapter 9
Maintenance Log Set Up
Specify a maintenance interval if you want the instrument to prompt you when it is time to do the maintenance. Enter the maintenance interval (in days) for each of the following: (enter 0 for no interval)
SHEAR VALVE AIR FILTERS SYRINGES WIC APERTURE RBC APERTURE ASPIRATION PUMP TUBING WOC PUMP TUBING SAMPLE LOADER TRAY AND RACKS EXTENDED AUTO-CLEAN AUTO-CLEAN
7 30 30 30 90 90 30 30 30 7
RETURN
Figure 9.6:
NOTE: Before the Interval Setup feature of the Maintenance Log will function, an initial Maintenance Log must be created as a reference for Interval implementation. This log should be accessed, the operators initials entered, and an X placed under every procedure listed at the top of the log by placing the cursor in the first field and pressing the Enter key on the keyboard. The cursor will advance to the next field automatically. By continuing to press the Enter key, the Xs may be placed under each procedure. Once all the procedures have been selected, the log has a reference point for future notification of maintenance that is due. 1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [MAINTEN LOG] key. 2. Press the [INTERVAL SET UP] key to display the INTERVAL SET UP screen. 3. Use the arrow keys on the keyboard to move the cursor to the desired maintenance procedure.
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Maintenance Log Set Up
Chapter 9
4. Type the desired interval in days, and press the Enter key on the keyboard to save the entry and advance the cursor. 5. If desired, press [PRINT] to obtain a printout of the entered intervals. 6. Press [RETURN] twice to return to the SPECIAL PROTOCOLS screen. 7. Press [MAIN] to return to the MAIN MENU screen.
Date Time Op ID OTHER 11/10/98 08:30 sh Comments: Weekly Maintenance 11/10/98 08:32 sh Comments: Weekly Maintenance 11/10/98 08:33 sh Comments: Weekly Maintenance 11/10/98 Comments: 10:30 sh
SHEAR VALVE
X X X
AIR FILTR
SYNG
SL
X X X
AUTO
RETURN
Figure 9.7:
After the maintenance procedure has been performed, access the log as directed in this procedure. 1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [MAINTEN LOG] key. 2. Press the [UPDATE LOG] key. The cursor is positioned in the <OPERATOR ID> entry field. (See the preceding figure.) If necessary, edit the operator ID at this time. 3. Use the arrow keys on the keyboard to move the cursor to the desired entry field.
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Maintenance Chapter 9
Maintenance Log Set Up
4. Press the Enter key on the keyboard. An X will be displayed to indicate the completed maintenance and the cursor will advance to the next entry field. NOTE: An incorrectly placed X can be deleted by moving the cursor to it and pressing the Space Bar on the keyboard. 5. Repeat steps 3 and 4 to make other entries. 6. When all entries have been made, use the arrow keys on the keyboard to move the cursor to the <Comments> entry field. 7. Type any comments (up to 65 characters) and press the Enter key on the keyboard. NOTE: All current entries may be edited before the screen is exited. When the [RETURN] key is pressed, all the entries will be saved and cannot be changed. 8. Press [RETURN] twice to return to the main SPECIAL PROTOCOLS screen. 9. Press [MAIN] to return to the MAIN MENU screen.
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Maintenance
Maintenance Log Set Up
Chapter 9
NOTES
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Chapter 9
Maintenance
Auto-Clean
The Auto-Clean Cycle is a fully automated cycle designed to clean the Shear Valve, the WOC Mixing Chamber, the WOC Flow Cell, the von Behrens WIC Transducer, the von Behrens RBC/PLT Transducer, the HGB Flow Cell, the needle in the CS or SL system, and all the associated fluidics. The forward and reverse action of the peristaltic pumps is used during this cycle to gently scrub and remove any fibrin or debris within the system. The Auto-Clean Cycle takes approximately 11 minutes.
Hold a tube of Cell-Dyn Enzymatic Cleaner under the probe, and press the START key After the auto-clean cycle is completed three or more background counts will be run. This cleaning process takes about 11 minutes.
START
CANCEL
Figure 9.8:
Materials Required
1. CELL-DYN Enzymatic Cleaner (cleaner should be at room temperature) 2. Clean test tube or container 3. Lint-free pads
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Maintenance
Daily Maintenance Procedures
Chapter 9
Procedure
1. Select the Open Sampler Mode. 2. Carefully wipe the outside of the Open Sampler Aspiration Probe and the bottom of the Wash Block with a pad dampened with warm water and a few drops of CELL-DYN Enzymatic Cleaner. 3. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [MORE] key to access the Auto-Clean function. 4. Press the [AUTO CLEAN] key. Instructions for performing the procedure are given on the screen. 5. Dispense approximately 1.5 mL of Enzymatic Cleaner into a clean container and hold the container under the Open Sample Aspiration Probe. 6. Press the [START] key. NOTE: Do not press the Touch Plate. The Auto-Clean Cycle is only initiated by the [START] key. 7. Continue to hold the container under the probe until a beep is heard. Remove the container and discard the remaining Enzymatic Cleaner. 8. When the Auto-Clean cycle is completed, carefully wipe the outside of the Open Sampler Aspiration Probe and the bottom of the Wash Block with a lint-free pad dampened in warm water to remove any traces of enzymatic cleaner. 9. If necessary, use a dry, lint-free pad to remove any water that remains on the Probe or the Wash Block. 10. Press [MAIN] to return to the MAIN MENU screen. Check that the background counts are acceptable before running controls or patient samples. If the counts are unacceptable, troubleshoot accordingly.
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Maintenance Chapter 9
Daily Maintenance Procedures
Materials Required
1. CELL-DYN Enzymatic Cleaner 2. Diluent or deionized water 3. Three empty VACUTAINER tubes 4. Appropriate personal protective equipment
Procedure
1. Aliquot approximately 2 mL of Enzymatic Cleaner into one of the VACUTAINER tubes. 2. Aliquot approximately 2 mL of fresh diluent each into the other two VACUTAINER tubes. 3. If necessary, from the Data Station RUN screen, press the [CHANGE SAMPLER] key to select the Closed Mode. 4. Press the [SPECIMEN TYPE] key followed by the [BACKGROUND] key. 5. Place the Enzymatic Cleaner tube followed by the two diluent tubes in a Sample Loader end rack. 6. Position the rack in the Sample Loader tray and install the Sample Loader Safety Cover. CAUTION: The Sample Loader will not operate unless the Safety Cover is in place. 7. Press the START key on the Sample Loader Control Panel to initiate processing. 8. Audible beeps indicate that processing is completed. 9. Run at least five background counts before running controls or patient samples. If the counts are unacceptable, troubleshoot accordingly.
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Daily Maintenance Procedures
Chapter 9
Materials Required
1. CELL-DYN Enzymatic Cleaner 2. Diluent or deionized water 3. Three empty VACUTAINER tubes 4. Appropriate personal protective equipment
Procedure
1. Aliquot approximately 2 mL of Enzymatic Cleaner into one of the VACUTAINER tubes. 2. Aliquot approximately 2 mL of fresh diluent each into the other two VACUTAINER tubes. 3. If necessary, from the Data Station RUN screen, press the [CHANGE SAMPLER] key to select the Closed Mode. 4. Press the [SPECIMEN TYPE] key followed by the [BACKGROUND] key. 5. Run the Enzymatic Cleaner. 6. Run the diluent tubes. 7. Run at least five background counts before running controls or patient samples. If the counts are unacceptable, troubleshoot accordingly.
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Maintenance
Shear Valve
Center Section Front Section Rear Section
Tubing Loop
Mounting Guide Retaining Screw Rim Notch Figure 9.9: Shear Valve
Regular cleaning of the Shear Valve ensures accurate and precise performance. Any reagent or blood residue may cause the valve to leak or function improperly. The Shear Valve Assembly is depicted in the preceding figure. The Shear Valve is made of a ceramic material and consists of three separate sections front, center, and rear. The rear and front sections are connected to the CELL-DYN 3700 System by tubing that should not be removed. NOTE: The center section is not connected to the Analyzer by tubing and must be handled carefully, as it will break if it is dropped. Care should be taken to avoid chipping, scratching, or otherwise damaging any of the sections.
Materials Required
1. Deionized water 2. Lint-free pads 3. Appropriate personal protective equipment
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Weekly Maintenance Procedures
Chapter 9
Procedure
1. Remove the Left Front Cover to gain access to the Shear Valve. NOTE: It is necessary to also remove the Tower Cover on the SL model to access the Shear Valve. 2. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [CLEAN SHEAR VAL] key. This prepares the Shear Valve for removal and puts the Analyzer into a NOT READY state. 3. Turn the Shear Valve Retaining Screw counterclockwise until it can be removed. 4. Grasp the entire valve assembly firmly and pull it forward with a slight rocking motion until it is free of the Mounting Guide. 5. Rotate the center and front sections in the opposite direction from the rear section to release any suction and free the rear section. NOTE: Be careful to keep a firm grip on the center section, as it is not attached to the front or rear sections and it may break or crack if dropped. Avoid crimping any of the attached tubing in the front and rear ceramic sections. 6. Place the rear section with its attached tubes on a clean lint-free pad in the Shear Valve compartment. 7. Rotate the center and front sections in opposite directions to separate the sections. 8. Place the center section in a container of deionized water and allow it to soak for the remainder of the cleaning procedure. NOTE: Do not soak the center section in bleach as it may damage the ceramic. 9. Place the front section with its attached tubes on a clean lint-free pad in the Shear Valve compartment. 10. Clean the Mounting Guide with lint-free pad dampened with deionized water to remove any blood or residue. Wipe the guide dry. 11. Wipe the inner surfaces of the front and rear sections with a clean lint-free pad dampened with deionized water. Use care to avoid scratching any of the inner surfaces. NOTE: Hold the sections by the edges to avoid getting fingerprints on the inner surfaces.
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Maintenance Chapter 9
Weekly Maintenance Procedures
12. Align the lock notch of the rear section with the back panel of the Shear Valve Assembly. Carefully slide the section back as far as it will go. Avoid crimping any of the attached tubing. 13. Remove the center section from the deionized water, and wipe the surfaces with a lint-free pad dampened in deionized water. Do not dry. 14. View each surface under reflective light to confirm that it is clean, and free of lint and fingerprints. 15. Align the center section so that the Rim Notch in the outer edge faces to the right. CAUTION: Be certain the Rim Notch faces to the right. (See Figure 9.9, Shear Valve for correct center section orientation.) Erroneous results will be obtained if specimens are analyzed when the center section is installed backwards. 16. Carefully slide the center section onto the Mounting Guide and push it back until it touches the rear section. 17. Align the lock notch of the front section with the Mounting Guide. Carefully slide it back until it touches the center section. 18. Firmly hold the three valve sections in place and replace the Shear Valve Retaining Screw. Turn the screw clockwise until it stops. 19. Press the [RESTORE SHEAR VAL] key. The valve automatically rotates several times. The instrument is returned to the READY state when the rotation is finished. 20. Visually inspect the Shear Valve to ensure that the Rim Notch of the center Shear Valve section faces to the right. (Refer to Figure 9.9, Shear Valve for correct center section orientation.) 21. Replace the Left Front Cover. 22. Press the [MAIN] key to return to the RUN screen. 23. Run at least five background counts before running controls or patient samples. If the counts are unacceptable, troubleshoot accordingly as directed in Chapter 10: Troubleshooting.
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Pump Shoe
Materials Required
1. Sample Aspiration Peristaltic Pump Tubing. NOTE: The Sample Aspiration Pump Tubing has a smaller diameter and is identified by the orange collar on each end. 2. Appropriate personal protective equipment
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Procedure
1. From the SPECIAL PROTOCOLS screen, press the [DISABLE ANALYZER] key. 2. Remove the Left and Right front covers to gain access to the Peristaltic Pumps. 3. Locate the Sample Aspiration Pump to the left of the Shear Valve. 4. Hold the Pump Shoe away from the pump wheel and remove the tubing from under the pump wheel by lifting the collars out of the metal brackets that hold them. Pull the tubing completely out from under the pump wheel. (Refer to Figure 9.10) 5. Disconnect the tubing at the plastic connector. 6. Connect the new tubing to the plastic connector. 7. Place the collars on the ends of the pump tubing into the metal brackets as shown in Figure 9.10. Hold the Pump Shoe open and insert the tubing back under the pump rollers. Make sure the tubing is positioned in the center of the rollers. When the tubing is centered, release the Pump shoe. 8. Replace the Front Covers. 9. Press the [ENABLE ANALYZER] key. 10. Press the [MAIN] key to return to the MAIN MENU screen. 11. Run at least five background counts before running controls or patient samples. If the background counts are unacceptable, troubleshoot accordingly.
Materials Required
1. Container (large enough to hold a rack) filled with a mild detergent solution made with warm (not hot) water 2. Clean, warm water for rinse 3. Lint-free pads 4. Appropriate personal protective equipment
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Procedure
1. Remove the racks from the Sample Loader tray. 2. Wash the racks in the detergent solution. Do not allow them to soak in the solution, as the labels will come off. NOTE: When cleaning the racks, do not use an automated washing system that operates at elevated tempertures as this may damage the racks. 3. Rinse the racks with warm water and dry thoroughly with lint-free pads or towels. 4. Wipe the stainless steel tray area with a lint-free pad moistened with water. Dry the tray with a lint-free pad or towel. 5. Wipe the stainless steel plate behind the vent/aspirate and mixing stations with a lint-free pad moistened with water. Dry the plate with a lint-free pad. 6. Clean the mixing heads with a lint-free pad moistened with water. Dry the heads with a lint-free pad. 7. Wash the Safety Cover with the detergent solution, rinse, and dry it.
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Maintenance
Reagent Syringes
The Reagent Syringes need to be cleaned on a regular basis to prevent reagent residue buildup, which may cause leakage or improper functioning. Syringes should be cleaned one at a time to ensure that each syringe is replaced in the correct position. Replace each syringe after it is cleaned and then remove the next one to be cleaned. The Syringe Assembly is depicted in Figure 9.11. The 10-mL Syringe should be cleaned as required; the 0.5mL and 2.5 mL syringe should be cleaned monthly.
Syringe Assembly
Figure 9.11:
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Procedure
1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [DISABLE ANALYZER] key. 2. Remove the front covers to gain access to the Syringe Assembly. 3. Lift the syringe out of the snap-in bracket. Note the liquid level in the syringe so that it can be refilled after cleaning to approximately this same level. (For example, a piece of tape may be attached to the syringe barrel to note the position of the plunger tip.) 4. Grasp the metal Luer Lock fitting at the tip of the syringe that attaches it to the tubing. Carefully turn the syringe clockwise to release it from the fitting. Use lint-free pads to absorb excess reagent. 5. Dispense the reagent into a sink or an appropriate waste container. 6. Aspirate deionized water into the syringe until it is full. Continue to pull on the plunger until it is removed from the barrel. NOTE: Do not push or pull on the plunger when the syringe is dry, as it may damage the plunger. Avoid touching the plunger because oil from the fingers may cause it to move erratically. 7. Rinse the plunger and barrel thoroughly with deionized water. Carefully reinsert the plunger into the wet barrel. 8. Refill the syringe with the appropriate reagent to the level noted in step 3 above. Hold the syringe upright and tap the side gently to dislodge any bubbles that may adhere to the tip of the plunger. 9. Carefully adjust the position of the plunger as necessary to insert it into the pedestal assembly that moves it up and down during the cycle.
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10. Insert the syringe tip into the Luer Lok fitting and turn the syringe counterclockwise until the fitting is finger-tight. Be careful to not overtighten the fitting or crimp the associated tubing. 11. Insert the syringe into the bracket and the end of the plunger into its slot in the pedestal assembly. Position the horizontal flange on the back of the syringe into the slot at the base of the bracket. 12. When the syringe has been reinstalled, press the [ENABLE ANALYZER] key. 13. Press the [MAIN] key to return to the MAIN MENU screen. 14. Run several background counts and observe the action of each syringe during the cycle. The plunger should move smoothly up and down and the syringe should not leak. 15. Replace the front covers after the operation of the syringes has been verified. 16. Run at least five background counts before running controls or patient samples. If the background counts are unacceptable, troubleshoot accordingly.
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Materials Required
1. Running water 2. Lint-free pads 3. Small vacuum cleaner (optional) 4. Appropriate personal protective equipment
Procedure
1. Remove the Front Covers to gain access to the filter holders on the Left Side Panel. (See the preceding figure.) 2. Grasp the upper filter and slide the holder forward to remove it. The lower filter is removed the same way.
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3. Choose one of the following two options: Remove the filters from the frames and rinse with warm water from the inside to the outside to remove the dust. Blot each filter with lint-free pads or towels to dry the filters before replacing them. Clean the filters by vacuuming them. 4. Insert the upper filter holder into its slot (metal frame side toward the instrument). Slide it back into place until the holder is flush with the Front Panel. Repeat this process to install the lower filter holder. 5. Replace the Front Covers.
Pump Rollers
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Materials Required
1. WOC Transfer Peristaltic Pump Tubing. NOTE: The WOC Transfer Pump Tubing has a larger diameter than the Sample Aspiration Pump Tubing (orange collar) and is identified by the clear collar on each end. 2. Appropriate personal protective equipment
Procedure
1. From the SPECIAL PROTOCOLS screen, press the [DISABLE ANALYZER] key. 2. Remove the upper front cover to gain access to the Peristaltic Pumps. 3. Locate the WOC Transfer Peristaltic Pump to the far left of the Flow Panel. 4. Hold the Pump Shoe away from the pump wheel and remove the tubing from under the pump wheel by lifting the collars out of the metal brackets that hold them. Pull the tubing completely out from under the pump wheel. (Refer to Figure 9.13) 5. Disconnect the tubing at the plastic connector. 6. Connect the new tubing to the plastic connector. 7. Place the collars on the ends of the pump tubing into the metal brackets as shown in Figure 9.13. Hold the Pump Shoe open and insert the tubing back under the pump rollers. Make sure the tubing is positioned in the center of the rollers. When the tubing is centered, release the Pump shoe. 8. Replace the Upper Front Cover. 9. Press the [ENABLE ANALYZER] key. 10. Press the [MAIN] key to return to the MAIN MENU screen. 11. Check that the background counts are acceptable before running controls or patient samples. If the background counts are unacceptable, troubleshoot accordingly.
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Extended Auto-Clean
The Extended Auto-Clean Cycle is a fully automated cycle designed to clean the Shear Valve, the WOC Mixing Chamber, the WOC Flow Cell, the von Behrens WIC Transducer, the von Behrens RBC/PLT Transducer, the HGB Flow Cell, the needle in the CS or SL version, and all the associated fluidics. The forward and reverse action of the Peristaltic Pumps is used during this cycle to gently scrub and remove any fibrin or debris within the system. The Extended Auto-Clean cycle takes approximately 2.5 hours to complete. During this time, the instrument is not available to process samples or manipulate data. (When the process is complete, the instrument is automatically put in the STANDBY state.) The cycle may be canceled after 38 minutes by pressing the [CANCEL] key, which is displayed at this time. IMPORTANT: It is not possible to exit the SPECIAL PROTOCOLS screen when the Extended Auto-Clean cycle is in progress. The screen may be exited only after the [CANCEL] key (displayed after 38 minutes) is pressed or when the cycle is complete.
12:25 sh 0630
Hold a tube of Cell-Dyn Enzymatic Cleaner under the probe and press the START key The Extended Auto-Clean process takes 2.5 hours to complete. During this time, the system is unavailable for processing samples or manipulating data. When the Extended Auto-Clean process is complete, the instrument will go into STANDBY. It is important to begin with a sufficient reagent supply and a half empty waste container in order to successfully complete the Extended Auto-Clean process. After 38 minutes a CANCEL key is displayed. Press this key to cancel the Extended Auto-Clean process and return to the operating mode.
START
CANCEL
Figure 9.14:
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Materials Required
1. CELL-DYN Enzymatic Cleaner (should be at room temperature) 2. Clean test tube or container 3. Lint-free pads 4. Warm water 5. Appropriate personal protective equipment
Procedure
1. Select the Open Sampler Mode. 2. Carefully wipe the outside of the Open Sample Aspiration Probe and the bottom of the Wash Block with a lint-free pad dampened with warm water and a few drops of CELL-DYN Enzymatic Cleaner. Wipe any dried reagent or blood off the bottom of the Wash Block. 3. Press the [SPECIAL PROTOCOLS] key followed by the [MORE] key to access the Extended Auto-Clean function. 4. Press the [EXTEND AUTOCLEAN] key. Instructions for performing the procedure are given on the screen. 5. Dispense approximately 1.5 mL of Enzymatic Cleaner into a clean container and hold the container under the Open Sample Aspiration Probe. 6. Press the [START] key. NOTE: Do not press the Touch Plate. The Extended AutoClean cycle is initiated only by the [START] key. 7. Continue to hold the container under the probe until a beep is heard. Remove the container and discard the remaining Enzymatic Cleaner. NOTE: The complete procedure takes 2 hours but may be terminated after 38 minutes by pressing the [CANCEL] key. If the [CANCEL] key is pressed, a rinse cycle is initiated that prepares the instrument for sample processing. Proceed to Step 8. 8. When the rinse cycle finishes, carefully wipe the outside of the Open Sampler Aspiration Probe and the bottom of the Wash Block with a lint-free pad dampened in warm water to remove any traces of enzymatic cleaner. 9. If necessary, use a dry, lint-free pad to remove any water that remains on the Probe or the Wash Block. 10. Press [MAIN] to return to the MAIN MENU screen. NOTE: At the end of the 2 hours, the instrument automatically goes into the STANDBY state. Press the [RUN] key to bring the Analyzer out of STANDBY and prepare it for sample processing. Run at least five background counts before running controls or patient samples. If the backgrounds counts are unacceptable, troubleshoot accordingly.
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As Required
As Required
NOTE: The Auto-Clean cycle described in Daily Maintenance Procedures, Auto-Clean within this chapter should be run after performing any maintenance procedure.
Materials Required
1. A large container filled with approximately 500 mL of deionized water 2. Lint-free pads 3. Deionized water 4. Small container of diluent to refill the clean syringe 5. Appropriate personal protective equipment
Procedure
1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [DISABLE ANALYZER] key. 2. Remove the front covers to gain access to the Syringe Assembly. 3. Grasp the plastic Luer-Lok fitting at the tip of the syringe that attaches it to the tubing. Carefully turn the luer nut on the syringe counterclockwise to release it from the fitting. Use lint-free pads to absorb excess reagent. 4. Grasp the Syringe barrel below the Luer-Lok with one hand. With the other hand, grasp the syringe plunger below the metal band. Pull straight out to remove the syringe from the snap-in bracket. 5. Note the liquid level in the syringe so that it can be refilled after cleaning to approximately this same level. (For example, a piece of tape may be attached to the syringe barrel to note the position of the plunger tip.)
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6. Dispense the diluent into a sink or an appropriate waste container. 7. Immerse the tip of the syringe in a container of deionized water. 8. Aspirate deionized water into the syringe until it is full, and dispnse the water into a sink or an appropriate waste container. NOTE: Do not pull the plunger out of the barrel. Do not push or pull on the plunger when the syringe is dry, as it may damage the plunger. Avoid touching the plunger because oil from the fingers may cause it to move erratically. 9. Repeat step 8 as necessary. 10. Refill the syringe with diluent to the level noted in step 5 above. Hold the syringe upright and tap the side gently to dislodge any bubbles that may adhere to the tip of the plunger. 11. Carefully adjust the position of the plunger as necessary to insert it into the pedestal assembly which moves the plunger up and down during operation. 12. Insert the syringe Luer-Lok nut into the fitting and turn the syringe clockwise until the fitting is finger-tight. Be careful to not overtighten the fitting or crimp the associated tubing. 13. Place the end of the plunger into its slot in the pedestal assembly. Position the horizontal flange on the back of the syringe into the flange slot on the syringe bracket. Align one rib of the syringe in the rib slot on the syringe bracket. Carefully push and twist the syringe into the bracket until it snaps into position. 14. When the syringe has been reinstalled, press the [ENABLE ANALYZER] key. Press the [MAIN] key to return to the MAIN MENU screen. 15. Run several background counts and observe the action of the syringe during the cycle. The plunger should move smoothly up and down and the syringe should not leak. 16. Replace the front covers after the operation of the syringe has been verified. 17. Run at least five background counts before running controls or patient samples. If the background counts are unacceptable, troubleshoot accordingly. Refer to Chapter 10: Troubleshooting. 18. Run Controls and confirm that results are within acceptable limits. If results are outside acceptable limits, follow your laboratorys quality control protocol for out of range results.
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As Required
Aperture Plates
The WIC Aperture Plate and the RBC/PLT Aperture Plate are automatically cleaned during the Auto-Clean cycle. (The WIC Aperture Plate is also cleaned at the end of every count cycle by the Aperture Cleaning Circuit.) However, it may also be necessary to remove them occasionally for cleaning. Refer to the instrument logbook to find the latest baseline count time(s) obtained from a diluent sample with an acceptable background count. Use the baseline count time(s) to determine the frequency of cleaning needed. NOTE: Both count times are displayed on the RUN screen. The WIC count time is displayed below and to the right of the BASO results. The RBC count time is displayed to the right of the MPV result. The count times are also displayed on the RAW DATA SUMMARY screen accessible from the DIAGNOSTICS MENU screen. The WIC Aperture Plate should be cleaned if the count time differs from the baseline value by more than 0.3 seconds or if there are frequent WIC CLOG messages. The WIC Aperture Plate is located in the von Behrens WIC Transducer Assembly and is identified by "WBC" etched on the plate. The RBC/PLT Aperture Plate should be cleaned if the count time differs from the baseline value by more than 0.4 seconds or if there are frequent RBC CLOG messages. The RBC/PLT Aperture Plate is located in the von Behrens RBC/PLT Transducer Assembly and is identified by "R/P" etched on the plate. NOTE: The apertures are different sizes, therefore, the Aperture Plates are NOT interchangeable. The following procedure is applicable to either aperture. A Transducer Assembly is depicted in the following figure.
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Counting Chamber
Mixing Chamber
Aperture Plate
Figure 9.15:
Materials Required
1. Cleaning solutions: Either of the following solutions may be used to clean the Aperture Plate. Because they will deteriorate over time, each solution should be prepared fresh just before use. a. Mix 20 drops of Enzymatic Cleaner and 20 mL of warm water in a container that is large enough to hold the Aperture Plate. b. Make a 25% bleach solution (1.25% sodium hypochlorite) by adding 5 mL of bleach to 15 mL of deionized water in a container that is large enough to hold the Aperture Plate. 2. Aperture brush from the Accessory Kit 3. Squirt bottle of deionized water 4. Lint-free pads 5. Sonic cleaner (optional) 6. Appropriate personal protective equipment
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As Required
Procedure
1. Remove the Front Covers to gain access to the von Behrens WIC or RBC/PLT Transducer Assembly. 2. Confirm that the Analyzer is in the READY state. 3. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [EMPTY XDUCERS] Key. This will drain the liquid from both the Transducer Assemblies. NOTE: DO NOT attempt to remove the Aperture Plates without first emptying the Transducer Assemblies. 4. When the Empty Transducer cycle stops, place a lint-free pad or gauze under the transducer to prevent liquid from dripping onto the solenoids located directly below it. 5. Pull the red Release Lever located in front of the transducer out and to the right to release the Aperture Plate. (See the following figure.)
Counting Chamber
Mixing Chamber
Aperture Plate
6. Pull the Aperture Plate straight out from between the Transducer Chambers to remove it from the assembly. Note the orientation of the plate, as it must be replaced correctly. (See the preceding figure.)
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7. If necessary, clean any debris from the Aperture Plate by rotating the aperture brush in the opening. (The opening is located inside the red jewel embedded in center of the plate). NOTE: DO NOT use anything but the aperture brush provided in the Accessory Kit to clean the aperture. Using other implements may damage the aperture. 8. Place the Aperture Plate into the container of freshly prepared cleaning solution. Submerge the Aperture Plate completely in the solution and rotate the aperture brush in the opening to ensure the cleaning solution penetrates it completely. Allow the plate to soak for five minutes. NOTE: If desired, the container (with the Aperture Plate and cleaning solution) may be placed in a sonic cleaner for two to three minutes instead of cleaning the Aperture Plate with a brush. DO NOT leave the Aperture Plate in the sonic cleaner longer than three minutes as prolonged cleaning may loosen the aperture jewel. 9. When the plate is clean, remove it from the cleaning solution and thoroughly rinse it with a stream of deionized water. 10. Insert the plate between the transducer chambers with the Orientation Notch on the bottom leading edge. Carefully push the Aperture Plate into place. Be sure that it is completely seated between the chambers. 11. Move the release lever back to the left to securely hold the plate in place. (See Figure 9.15, von Behrens Transducer Assembly.) 12. Press the [FILL XDUCERS] key to refill the Transducer Assemblies and the associated tubing. 13. Replace the Upper and Lower Front Covers. 14. Press [MAIN] followed by [RUN] to return to the RUN screen. 15. Run at least five background counts before running controls or patient samples. If the background counts are unacceptable, troubleshoot accordingly. 16. When an acceptable background count has been obtained, record the count time(s) on that diluent sample in the instrument logbook. This is the baseline count time for the instrument. NOTE: The baseline value may only be obtained immediately after the WIC or RBC/PLT Aperture Plate has been cleaned.
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As Required
Mixing Chamber
Counting Chamber
Solenoid 13
Figure 9.17:
The von Behrens WIC Transducer, HGB Flow Cell, and Solenoid 13
Materials Required
1. Cleaning Solution: Make a 25% bleach solution (1.25% sodium hypochlorite) by adding 5 mL of bleach to 15 mL of deionized water. 2. 15-mL syringe with a piece of tubing attached 3. Appropriate personal protective equipment
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Procedure
1. Remove the front covers to gain access to the von Behrens WIC Transducer and HGB Flow Cell Assembly. 2. Be sure that the Analyzer is in the READY state. 3. Manually open Solenoid 13 to completely drain all the liquid from the von Behrens WIC Transducer and HGB Flow Cell. (If necessary, refer to the preceding figure to locate Solenoid 13.) 4. Close Solenoid 13. 5. Press the [SPECIAL PROTOCOLS] key followed by the [DISABLE ANALYZER] key to disable the Analyzer. 6. Disconnect the clear TYGON tubing from the fitting on the top right of the von Behrens WIC Transducer Mixing Chamber. (See the preceding figure.) 7. Fill the syringe with the cleaning solution and connect it to the fitting on the top of the von Behrens WIC Transducer Mixing Chamber. Dispense the cleaning solution into the transducer until it is approximately half full. 8. Remove the syringe and reconnect the TYGON tubing. 9. Manually open Solenoid 13 and allow approximately half of the bleach solution to drain into the HGB Flow Cell. 10. Manually close Solenoid 13 to hold the bleach solution in the Flow Cell. 11. Allow the bleach solution to remain in the transducer and Flow Cell for 5 minutes. 12. When the time has elapsed, manually open Solenoid 13 to drain the bleach solution from the transducer and Flow Cell. 13. Press [ENABLE ANALYZER] followed by [MAIN] to return to the MAIN MENU screen. 14. Rinse the bleach solution out of the system by running a minimum of five background counts. Check the TYGON tubing on the top of the von Behrens WIC Transducer Mixing Chamber during the cycles to be sure it is properly attached and does not leak. 15. Verify that the background counts are acceptable before running controls or patient specimens. If the background counts are unacceptable, troubleshoot accordingly. 16. Replace the Front Covers.
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Figure 9.18:
The Open Sample Aspiration Probe is thoroughly cleaned whenever the Auto-Clean Cycle is performed. If a blockage is suspected, it may be cleared as directed in the following procedure.
Materials Required
1. Wire stylet, gauge #23 (not provided) 2. Empty VACUTAINER tube 3. CELL-DYN Enzymatic cleaner 4. Appropriate personal protective equipment
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Procedure
WARNING: Potential Biohazard. The probe is sharp and potentially contaminated with infectious materials. Avoid any contact with the tip of the probe.
1. Disable the Analyzer. 2. Remove the tubing from the top of the Open Sample Aspiration Probe as indicated in the preceding figure. 3. Carefully insert the stylet into the probe and push it down through the probe until it extends from the end. If a clot has been pushed out of the probe, remove it from the stylet. 4. Remove the stylet from the probe. 5. Reconnect the tubing to the top of the probe. 6. Perform an Auto-Clean Cycle. (If necessary, refer to the directions given earlier within this chapter.) 7. When the Auto-Clean Cycle is complete, run several background counts and a blood sample and check for complete aspiration. (There should be a minimum of one inch of blood on either side of the Shear Valve.) 8. If aspiration is not complete, call Abbott Diagnostics Customer Service (at 1-877-4ABBOTT in the US). 9. Verify that the background counts are acceptable before running controls or patient specimens. If the background counts are unacceptable, troubleshoot accordingly.
Procedure
1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key. 2. From the SPECIAL PROTOCOLS screen, press the [DISABLE ANALYZER] key. 3. Turn OFF the Sample Loader. NOTE: The ON/OFF toggle switch is located on the left end panel of the Sample Loader unit.
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As Required
4. Remove all racks from the Sample Loader tray. 5. Wrap an applicator swab with lens tissue. 6. Moisten the tissue with deionized water. 7. Locate the front Bar Code Reader Window under the Sample Loader Tower and wipe the glass window with a moistened swab. 8. Wipe the window dry with the clean swab that has also been wrapped with lens tissue. 9. Visually inspect the window to be sure debris, smudges, and blood have been removed. 10. Return the 10 racks to the Sample Loader Tray. 11. Turn the Sample Loader to the ON position. 12. Press the [ENABLE ANALYZER] key to bring the CELL-DYN 3700 System to the READY state. And resume normal Sample Loader operation procedures.
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Container for Drainage Figure 9.19: Flow Panel Open/Closed Mode Tubing
Materials Required
1. 10-mL syringe filled with cleaning solution: Make a 25% bleach solution (1.25% sodium hypochlorite) by adding 5 mL of bleach to 15 mL of deionized water. 2. Tubing, two sizes to be used as a temporary drain line: TEFLON, 12"18", small diameter Silicon, 2"12", same diameter as pinch valve tubing 3. Paper towels/gauze 4. Appropriate personal protective equipment
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NOTES
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Special Procedures
Special Procedures
Closed Sampler Tube Retainer Adjustment (CS System Only)
It is necessary to adjust the Tube Retainer on the CELL-DYN 3700CS System to accommodate different sized VACUTAINER tubes. The Closed Sampler Module is depicted in the following figure.
Release Levers
Figure 9.20:
Materials Required
1. An empty VACUTAINER tube 2. Appropriate personal protective equipment
Procedure
1. Squeeze the Release Levers on the sides of the Tube Retainer between the thumb and forefinger to loosen the Tube Retainer, and slide the clamp up. 2. Insert the VACUTAINER tube upside down into the Cap Piercer Well. 3. Slide the clamp down to hold the tube snugly in place. 4. Release the Release Levers when the Tube Retainer has been properly positioned. 5. Check the height adjustment with several VACUTAINER tubes to be certain that it is correct.
CELL-DYN 3700 System Operators Manual
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Figure 9.21:
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Special Procedures
Materials Required
1. Container with approximately 500 mL of deionized water. 2. If the instrument will be shipped, the following are also needed: Shear Valve Dummy Center Section (this is stored in the disk storage container located on the Analyzer Flow Panel to the right of the WOC Flow Cell Access Cover) Four plastic bags to hold the reagent inlet and waste outlet tubes 3. Appropriate personal protective equipment
Procedure
1. From the MAIN MENU screen, press the [SPECIAL PROTOCOLS] key followed by the [MORE] key followed by the [PREPARE SHIPPING] key. 2. Place the reagent lines in the container of deionized water and then press the [START] key. The flow system will be automatically rinsed. (This process takes about 10 minutes.) NOTE: The message CLEAN FOR SHIPPING IS IN PROGRESS is displayed during the rinsing process. 3. When the process is complete, the message CLEAN FOR SHIPPING HAS COMPLETED is displayed. Turn OFF the power to the instrument. 4. Carefully remove the reagent inlet tubes from the Normally Closed Valves under the reagent reservoirs located on the Left Side Panel of the Analyzer. (If necessary, refer to Figure 9.12, Analyzer Left Side Panel for the location of these Normally Closed Valves.) 5. Carefully remove the tubing from the Normally Closed Valves on the Analyzer Flow Panel. There are two Normally Closed Valves located to the right of the Shear Valve (only the lower one is present on the CS Model) and another located above the lower Aperture Cleaning Circuit Interlock Switch. (See the preceding figure for the location of these valves.) NOTE: To gain access to the Normally Closed Valves located by the Shear Valve, loosen one screw and remove the other screw that holds the Status Indicator Panel in place and rotate the panel upward. 6. Remove the Peristaltic Pump tubing from the Sample Aspiration Pump and the WOC Transfer Peristaltic Pump.
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If the instrument is to be shipped, perform the following steps: 7. Obtain the Shear Valve Dummy Center Section from the disk storage container. 8. Clean the Shear Valve as directed in Steps 3-8 in the procedure given in the weekly maintenance section of this chapter. Reassemble the Shear Valve using the Dummy Center Section. 9. Wrap the ceramic center section carefully for protection and place it in the Accessory Kit. 10. Disconnect the power cords and put them in the Accessory Kit. 11. Remove the reagent inlet and waste outlet tubes. Place each tube in a protective plastic bag and put the bags in the Accessory Kit. WARNING: Potential Biohazard. Waste in the outlet tubes may be infectious. Wear powder-free, disposable gloves and follow established, good laboratory working practices when handling this material.
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Troubleshooting
Troubleshooting
Introduction
This chapter gives instructions for troubleshooting. The CELL-DYN 3700 System continuously monitors the status of the system and displays pertinent information in the Status Box or on the bulletin line. If a problem is detected, the Status Box displays the message: FAULT: SEE DIAG or SEE SPECIAL, the bulletin line displays a message, and the word FAULT on the Analyzer status indicator panel is illuminated in red. A description of the fault can be obtained by pressing the [FAULT REPORT] key on the DIAGNOSTICS MENU screen. The first section of this chapter discusses the DIAGNOSTICS MENU soft keys. The remainder of the chapter is devoted to the Troubleshooting Guide. The Troubleshooting Guide is designed to assist the operator in identifying and resolving instrument problems. Instructions are also given for obtaining technical assistance from Abbott Diagnostics Customer Service. The Guide includes Troubleshooting Tips and Techniques, Troubleshooting Procedures, and Instructions for Component Replacement. The last section describes the Instrument Messages and Fault Conditions. The tables in this section include instructions for corrective action. For information about interfering substances, refer to Chapter 5: Operating Instructions, Subsection: Routine Operation, Sample Collection and Handling, Interfering Substances.
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Troubleshooting Introduction
Chapter 10
NOTES
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Troubleshooting
Diagnostics Menu
This section describes the soft keys displayed on the DIAGNOSTICS MENU screens. These keys enable the operator or service representative to obtain information and execute programs that assist in troubleshooting and identify corrective actions. Several keys listed are described as For Service Use Only. The data these keys provide are meaningful only to trained Field Service Representatives and are not useful to the operator. If certain keys are pressed inadvertently, the system may have to be initialized. There are five primary screens in the DIAGNOSTICS MENU. For ease of explanation, the keys are discussed screen by screen.
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FAULT REPORT
EXECUTION TIMES
CLEAR FAULTS
MORE
MAIN
WOC RBC PLT WIC CNT RATE CNT RATE CNT RATE CNT RATE WOC RBC PLT WIC CNT GRAPH CNT GRAPH CNT GRAPH CNT GRAPH
RETURN
INITIALIZATION
MORE
MAIN
CYCLE BANK
STEP SOLENOID
DIAGNOSTICS
DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
VACUUM PRESSURE INHIBIT ON ON PUMPS VACUUM PRESSURE ENABLE OFF OFF PUMPS
VACUUM TEST
PRESSURE TEST
DIAGNOSTICS
HOME MOTORS
EXERCISE MOTOR
SHEAR VAL SHEAR VAL PRINT TIME DISPENSE SHEAR VAL ASPIRATE
DIAGNOSTICS
FINISH SELECT
SELECT
DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
VERIFY GAINS
ENTER SETTINGS
CURRENT SETTINGS
SIGNAL GENERATOR
DIAGNOSTICS
MAM TESTING
SPM TESTING
WIM TESTING
RETURN
WOC DATA
RBC PLT WIC MORE DATA DATA DATA RBC PLT WIC HISTOGRAM HISTOGRAM HISTOGRAM
MAIN
SERIAL TEST
MORE
MAIN
CALC CV
SCATTER GRAPHS
DIAGNOSTICS
STOP TRANSMISS
TRANSMIT MESSAGE
DIAGNOSTICS
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FAULT REPORT
EXECUTION TIMES
CLEAR FAULTS
MORE
MAIN
Figure 10.1:
DIAGNOSTICS
The first DIAGNOSTICS MENU screen (see the preceding figure) and the following soft key labels are displayed when the [DIAGNOSTICS] key is pressed: FAULT REPORT EXECUTION TIMES CNT RATE SUMMARY CLEAR FAULTS RAW DATA SUMMARY MORE PRINT MAIN
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FAULT REPORT
When the [FAULT REPORT] key is pressed, information regarding the pending fault is displayed on the screen. The screen displays the words Operator correctable fault report: (see the following figure) or Fatal fault report: (see Figure 10.3, Fatal Fault Report Screen) and any additional information available. If there is no fault, the screen displays the words No fault pending. (See Figure 10.4, Fault Report No Fault Pending Screen.)
Detergent Empty FAULT REPORT EXECUTION TIMES CNT RATE SUMMARY CLEAR FAULTS RAW DATA SUMMARY MORE PRINT MAIN
Figure 10.2:
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RBC diluent syringe overpressure FAULT REPORT EXECUTION TIMES CNT RATE SUMMARY CLEAR FAULTS RAW DATA SUMMARY MORE PRINT MAIN
Figure 10.3:
No fault pending
FAULT REPORT
EXECUTION TIMES
CLEAR FAULTS
MORE
MAIN
Figure 10.4:
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Operator correctable faults (for example, Waste Full, Diluent Empty) can be cleared by pressing the [CLEAR FAULTS] key after taking the appropriate corrective action. After the corrective action has been taken for a fatal fault, the system must be initialized.
EXECUTION TIMES
RETURN
Figure 10.5:
CNT RATE SUMMARY
When the [CNT RATE SUMMARY] key is pressed, the following soft key labels (see the preceding figure) are displayed: WOC CNT RATE or WOC CNT GRAPH* RBC CNT RATE or RBC CNT GRAPH* PLT CNT RATE or PLT CNT GRAPH* WIC CNT RATE or WIC CNT GRAPH* PRINT RETURN * These key labels alternate between the two selections when the soft key is pressed.
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WOC : TOTAL COUNT: 5934 TIME: 0.50 1.05 1.55 2.07 2.57 3.08 3.62 4.12 COUNT: 361 808 1183 1576 1989 2359 2799 3225 RATE: 714.85 827.78 742.57 755.77 826.00 725.49 822.43 843.56 TIME: 4.63 5.14 5.67 6.21 6.73 7.24 7.50 COUNT: 3666 4074 4500 4924 5342 5743 5934 RATE: 864.71 800.00 811.43 777.98 803.85 794.06 720.75
RETURN
Figure 10.6:
Each key displays kinetic data for the selected parameter from the last cycle run. When each key is pressed, the count rate data is displayed (see the preceding figure) and the key label changes to [CNT GRAPH] for that parameter. Count rate data from the last cycle is displayed in a tabular format. The total count, time segments, and rate per second are displayed for multiple data points from that cycle. (See the preceding figure.) When the [CNT GRAPH] key for a particular parameter is pressed, the rate-per-second data is displayed as a graph. (See the following figure.) The kinetic data and graph are useful when troubleshooting problems related to these parameters.
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864.7 756.6 648.5 540.4 432.4 324.3 216.2 108.1 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0 7.5
RETURN
Figure 10.7:
CLEAR FAULTS
When the [CLEAR FAULTS] key is pressed, the Analyzer returns to the Ready state if the corrective action taken resolved the problem. If the corrective action did not correct the problem, the fault status does not change.
NOTE: Only operator correctable faults can be cleared
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List Mode WOC: 4350 RBC: 23598 PLT: 2682 WIC: 2956 Raw Count WOC: 4206 RBC: 31166 PLT: 2741 WIC: 3038 WIC Bubble: 94
RBC Times Upper: 3.53 WIC Times Upper: 1.53 HGB Sample HGB Ref WOC Alg RBC Alg PLT Alg % Tot : 98.6% RER : 33.9% Adj cnt: 2728 1: 1218 2255
Lo thr: 40 Lo thr: 8
FAULT REPORT
EXECUTION TIMES
CLEAR FAULTS
MORE
MAIN
Figure 10.8:
RAW DATA SUMMARY
When the [RAW DATA SUMMARY] key is pressed, detailed information pertaining to the last cycle run is displayed. An example of the RAW DATA SUMMARY screen is shown in the preceding figure. The most useful information for the operator, the metering times and the HGB Reference and Sample readings, is highlighted on the screen shown in the preceding figure. The information on metering times may be used to assist in troubleshooting chronic Clog or Flow Error messages. The HGB Reference and Sample readings may be used to assist in troubleshooting erratic or imprecise HGB results.
MORE
When the [MORE] key is pressed, the second DIAGNOSTICS MENU screen is displayed. The [MORE] keys on the remaining screens to be discussed always display the next DIAGNOSTICS MENU screen. Consequently, they are discussed last in each section. When the [PRINT] key is pressed, a Diagnostic Report is printed. This report contains information pertinent to the data displayed on the screen at the time the key is pressed. If no data is displayed on the screen, the report prints the current fault status.
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The [PRINT] key functions in this way on each screen. Therefore, it will not be discussed again in this section.
MAIN
The [MAIN] key is used to return to the MAIN MENU screen. The [MAIN] key appears on each primary DIAGNOSTICS MENU screen and works the same way on each screen. Consequently, it will not be discussed again in this section.
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MOTOR OPERATION
SOLENOID OPERATION
PUMP OPERATION
DRAIN ACCUMULAT
INITIALIZATION
MORE
MAIN
Figure 10.9:
MORE
When the [MORE] key on the first DIAGNOSTICS MENU screen is pressed, the second DIAGNOSTICS MENU screen (see the preceding figure) and the following soft key labels are displayed: MOTOR OPERATION SOLENOID OPERATION PUMP OPERATION DRAIN ACCUMULAT INITIALIZATION MORE MAIN
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MOTOR OPERATION
This key is for service use only. The system must be initialized after this key is pressed. This key is for service use only. The system must be initialized after this key is pressed.
SOLENOID OPERATION
VACUUM ON
PRESSURE ON
VACUUM TEST
PRESSURE TEST
DIAGNOSTICS
Figure 10.10:
PUMP OPERATION
When the [PUMP OPERATION] key is pressed, the following soft key labels (see the preceding figure) are displayed: VACUUM ON or VACUUM OFF PRESSURE ON or PRESSURE OFF INHIBIT PUMPS* VACUUM TEST PRESSURE TEST DIAGNOSTICS * This key is displayed after either key listed above it is pressed. (The key label alternates between these two selections.) (The key label alternates between these two selections.)
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Vacuum is on
VACUUM OFF
PRESSURE ON
INHIBIT PUMPS
VACUUM TEST
PRESSURE TEST
DIAGNOSTICS
Figure 10.11:
VACUUM ON VACUUM OFF
When the [VACUUM ON] key is pressed, the key label changes to [VACUUM OFF], the vacuum pump is turned ON, and the screen displays the message: Vacuum is on. (See the preceding figure.) Press the [VACUUM OFF] key to turn the pump OFF.
NOTE: The pump is automatically turned OFF and control
of the pump is returned to the instrument when the screen is exited. This key is useful for troubleshooting vacuum problems. If the pump does not turn ON when the key is pressed, the vacuum pump may be the cause of the vacuum problem.
NOTE: The system must be initialized after this key is pressed.
PRESSURE ON PRESSURE OFF
When the [PRESSURE ON] key is pressed, the key label changes to [PRESSURE OFF], the pressure pump is turned ON, and the screen displays the message: Pressure is on. Press the [PRESSURE OFF] key to turn the pump OFF.
NOTE: The pump is automatically turned OFF and control
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This key is useful for troubleshooting pressure problems. If the pump does not turn ON when the key is pressed, the pressure pump may be the cause of the pressure problem.
NOTE: The system must be initialized after this key is pressed.
VACUUM OFF
PRESSURE OFF
ENABLE PUMPS
VACUUM TEST
PRESSURE TEST
DIAGNOSTICS
Figure 10.12:
INHIBIT PUMPS ENABLE PUMPS
When the [INHIBIT PUMPS] key is pressed, the key label changes to [ENABLE PUMPS], operation of the pumps is inhibited (no vacuum and pressure are produced), and the screen displays the message: Pressure and vacuum are inhibited. (See the preceding figure.) Press the [ENABLE PUMPS] key to enable pump operation.
NOTE: The pumps are automatically enabled and control of them is returned to the instrument when this screen is exited.
This key is useful when performing maintenance or troubleshooting procedures that require a vacuum or pressure line to be removed.
NOTE: The system must be initialized after this key is pressed.
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Figure 10.13:
VACUUM TEST
When the [VACUUM TEST] key is pressed, the system releases the vacuum into the atmosphere and then determines the amount of time required for it to return to the correct level. The key labels disappear and the incrementing time is displayed on the screen. (See the preceding figure.) When the test is complete, the time stops incrementing and the key labels are displayed. A vacuum recovery time greater than 5 seconds may indicate a vacuum problem.
NOTE: The system must be initialized after this key is pressed.
PRESSURE TEST
When the [PRESSURE TEST] key is pressed, the system releases the pressure into the atmosphere and then monitors the amount of time required for it to return to the correct level. The key labels disappear and the incrementing time is displayed on the screen. When the test is complete, the time stops incrementing and the key labels are displayed. A pressure recovery time greater than 4 seconds may indicate a pressure problem.
NOTE: The system must be initialized after this key is pressed.
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After draining the accumulators, press the INITIALIZATION key, prime, run 5 Background Counts and confirm that the background results are acceptable before running samples.
MOTOR OPERATION
SOLENOID OPERATION
PUMP OPERATION
DRAIN ACCUMULAT
INITIALIZATION
MORE
MAIN
Figure 10.14:
DRAIN ACCUMULAT
When the [DRAIN ACCUMULAT] key is pressed, the internal vacuum accumulators are drained of accumulated fluid. This key is used to correct the Vacuum Accumulator Wet fault. (See the preceding figure.) When the process is completed, the system must be initialized and primed. A prime cycle and background are automatically run whenever the [RUN] key is pressed after the system is initialized. Run an additional five background counts.
INITIALIZATION
When the [INITIALIZATION] key is pressed, the Analyzer is initialized. This is necessary when a fatal fault has occurred. When the Analyzer is initialized, a prime cycle must be run.
NOTE: A prime cycle and background are automatically run whenever the [RUN] key is pressed after the system is initialized.
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DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
Figure 10.15:
MORE
When the [MORE] key is pressed, the third DIAGNOSTICS MENU screen (see the preceding figure) and the following soft key labels are displayed: DIGITAL READINGS VOLTAGE READINGS GAIN ADJUSTMNT MORE PRINT MAIN
DIGITAL READINGS
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Arrow keys to move around, SELECT key to select, FINISH SELECT key to go DCM: slf-tst f/DAC:0.00 99mv refrence:0.08 15v/2 pwr sp :7.49 5v pwr sp :5.14 slf-test ramp:9.99 9.901v refrnc:9.86 -15v/2 pwr sp:-7.55 SPM: WOC threshold:0.85 SPM tst f/DAC:0.00 WOC ch 1 peak:0.00 RBC peak :0.00 RBC threshold:0.57 5v supply :5.12 WOC ch 2 peak:0.00 RBC intgrl:0.00 PLT L thrshld:0.53 10v refrence :9.97 WOC ch 3 peak:0.00 PLT peak :0.04 PLT H thrshld:9.97 -10v refrence:-10.0WOC ch 4 peak:0.00 MAM: ch 1 offset :0.20 ch 5 offset :-2.06electrode v/2:0.41 laser ref :0.00 ch 2 offset :0.97 ch 6 offset :-3.00apt crrnt set:-0.05 ch 3 offset :0.64 ch 3-Vdyn/100:6.14 tstpuls H set:-0.05 ch 4 offset :0.27 ch 4-Vdyn/100:5.65 tstpuls L set:-0.00 VPM: press 1 psi :12.0 press 3 psi :4.88 vac 1 in. Hg :11.8 pos rf prs:5.00 press 2 psi :9.01 vac 2 in. Hg :11.7 pos rf prs:-5.07 FCM: HGB output :5.53 WIC: WIC offset v :-3.26WIC H thrshld:7.30 WIC apt cr st:0.00 WIC peak :0.00 WIC elctd v/2:0.66 WIC L thrshld:1.54 WIC test puls:0.00
FINISH SELECT
SELECT
DIGITAL READINGS
VOLTAGE READINGS
GAIN ADJUSTMNT
MORE
MAIN
Figure 10.16:
VOLTAGE READINGS
When the [VOLTAGE READINGS] key is pressed, the voltage and vacuum/pressure value from a test point, measured at the moment when the key was pressed, is displayed. (See the preceding figure.) The following additional soft key labels are displayed: FINISH SELECT* SELECT* *These two keys are for service use only. The data provided by the VOLTAGE READINGS screen can be useful in determining if a problem is caused by a hardware malfunction.
GAIN ADJUSTMNT
This key is for service use only. The system may have to be initialized after this key is pressed.
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WOC DATA
RBC DATA
PLT DATA
WIC DATA
MORE
MAIN
Figure 10.17:
MORE
When the [MORE] key is pressed, the fourth DIAGNOSTICS MENU screen (see the preceding figure) and the following soft key labels are displayed: WOC DATA RBC DATA PLT DATA WIC DATA MORE PRINT MAIN These keys are for service use only.
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AUTO-SAMP VERSION
SERIAL TEST
MORE
MAIN
Figure 10.18:
MORE
When the [MORE] key is pressed, the fifth and last DIAGNOSTICS MENU screen (see the preceding figure) and the following soft key labels are displayed: AUTO SAMP VERSION* BAR CODE ALIGNMENT* BAR CODE VERIFY* SERIAL TEST MORE PRINT MAIN *These keys are displayed on the CELL-DYN 3700SL System only.
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AUTO-SAMP VERSION
SERIAL TEST
MORE
MAIN
Figure 10.19:
AUTO-SAMP VERSION
This key is used to display the software version currently installed in the Sample Loader. The Sample Loader must be ON before the key is pressed. When the [AUTO-SAMP VERSION] key is pressed, the screen displays the following message (see the preceding figure): Auto-Sampler Software: [followed by the version information]
NOTE: This key is displayed on the CELL-DYN 3700SL System only.
This key is for service use only and is displayed on the CELL-DYN 3700SL System only. This key is for service use only and is displayed on the CELL-DYN 3700SL System only.
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Serial Interface Test 1. See Interface Specification. 2. If transmission in progress, press STOP TRANSMISS key first 3. Attach Loop-back connector to the serial interface connector on back of the Data Station. 4. Press the TRANSMIT MESSAGE key to start the test.
STOP TRANSMISS
TRANSMIT MESSAGE
DIAGNOSTICS
Figure 10.20:
SERIAL TEST
The [SERIAL TEST] key is used to test the functionality of the RS232 port (referred to as the serial interface connector) at the rear of the Data Station. This test is designed to assist in troubleshooting problems related to interfacing with a Laboratory Information System (LIS). The loop-back connector must be connected to the Data Station RS232 port before performing the test.
NOTE: If the laboratory does not have an LIS, the loopback connector may remain connected to the RS232 port for convenience, as it does not interfere with routine operation. If an LIS is usually connected, the loop-back connector should be stored near the instrument when the connector is not in use.
When the [SERIAL TEST] key is pressed, the following soft key labels (see the preceding figure) are displayed: STOP TRANSMISS TRANSMIT MESSAGE DIAGNOSTICS The DIAGNOSTICS MENU screen for Serial Test displays the following message:
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Serial Interface Test 1. See Interface Specification. 2. If transmission in progress, press STOP TRANSMISS key first. 3. Attach Loop-back connector to the serial interface connector on back of the Data Station. 4. Press the TRANSMIT MESSAGE key to start the test.
STOP TRANSMISS
The [STOP TRANSMISS] key is used to abort any transmission that is in progress to an LIS.
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STOP TRANSMISS
TRANSMIT MESSAGE
DIAGNOSTICS
Figure 10.21:
TRANSMIT MESSAGE
When the [TRANSMIT MESSAGE] key is pressed, the message: CELL-DYN serial interface test is transmitted from the Data Station to the RS232 port, through the loop-back connector and back to the Data Station. The DIAGNOSTICS MENU screen then displays the message (see the preceding figure): Message sent: CELL-DYN serial interface test If the test is successful, the screen displays the message: Message received: CELL-DYN serial interface test This message indicates that the Data Station is communicating properly. If the test is not successful, no message will be displayed.
DIAGNOSTICS
The [DIAGNOSTICS] key is used to return to the previous DIAGNOSTICS MENU screen.
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NOTES
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Troubleshooting
Troubleshooting Guide
Overview
Good troubleshooting skills are learned by using a logical, stepby-step approach to problem solving. The first step in the process is understanding normal instrument operation and preventive maintenance. A good working knowledge of the instrument is essential for identifying and resolving operational problems. Logical troubleshooting may be divided into three steps: 1. Problem Identification 2. Problem Isolation 3. Corrective Action Step 1, Problem Identification, involves not only identifying what is wrong but also noting what is right. The investigator should identify the problem area and eliminate areas that are working correctly. Once this is done, the troubleshooting process moves quickly to the next step. Step 2, Problem Isolation, further classifies the problem. Instrument problems are generally divided into three categories: Measurement related to sample analysis Software computer program related Hardware component related Measurement problems are generally operator correctable. This category is further subdivided into problems related to sample handling, maintenance, or calibration. Typically, software and hardware problems are corrected by an authorized service representative. Step 3, Corrective Action, involves taking appropriate action to correct the problem. If the operator can correct the problem, with or without technical assistance, normal operation can quickly resume. This Troubleshooting Guide is designed to enhance the troubleshooting process by providing information to assist in problem identification, isolation, and corrective action.
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Troubleshooting Procedures
The procedures in this section are for troubleshooting purposes only. A specific procedure should be performed when indicated in this chapter or at the request of an Abbott Customer Support Specialist.
Power ON Procedure
IMPORTANT: If the power has been OFF more than five minutes, the laser must be allowed to warm up for 15 minutes once the power is turned back ON. Do not process samples during this warm-up period. 1. Verify that all components are properly installed (for example, syringes, Shear Valve, etc.). 2. Verify that all reagents are properly installed. 3. Verify that all necessary cables and power cords are properly connected. 4. Verify that the Analyzer covers are properly installed. If the instrument is a CELL-DYN 3700SL System, verify that the Sample Loader safety cover is in place. 5. If applicable, verify that the cause of the power OFF situation has been corrected. 6. Turn the power switches ON in the following order: a. Analyzer b. Data Station c. Sample Loader, if present d. Printer 7. When the INITIALIZED message appears in the Status Box on the Data Station screen, prime the system by pressing [PRIME] or [RUN], whichever is displayed.
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1. Perform any required maintenance that is due. 2. Perform an Auto-Clean Cycle. (If necessary, refer to the directions given in Chapter 9: Maintenance, Subsection: Daily Maintenance Procedures, Auto-Clean.) 3. When the Auto-Clean cycle is complete, press [DAILY SHUTDOWN]. When the Daily Shutdown cycle is complete, the Status Box displays the message: Standby.
NOTE: If the instrument will be inactive for more than seven days, perform the Preparation for Inactivity or Shipping cycle instead of the Daily Shutdown cycle. Refer to the instructions given in Chapter 9: Maintenance, Subsection: Special Procedures, Preparation for Inactivity or Shipping.
4. Turn the power switches OFF in the following order: a. Data Station b. Analyzer c. Sample Loader, if present d. Printer
NOTE: In an emergency situation, turn OFF the power switches, in any order, as quickly as possible. Follow the Power ON procedure as described earlier in this section when the emergency is over.
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The reagent priming step is necessary after any initialization. This is accomplished by pressing [RUN] or [PRIME], whichever is displayed. All reagents are primed automatically, a background cycle is performed, and the results are displayed on the RUN screen. After the reagents are primed and auto background is performed, the message Ready is displayed in the Status Box. On the CELL-DYN 3700SL System, the Sample Loader may be initialized by pressing the INT key on the Sample Loader operation keyboard. It may also be initialized by turning the Sample Loader power switch OFF and ON. (The Sample Loader is automatically initialized every time the power switch is turned ON.)
Replacing Reagents
If a reagent (or reagents) is suspected as the cause of a particular problem, replace the container. However, the Analyzer has reservoirs that contain a small amount of reagent to maintain the supply within the system. This supply must be depleted before installing the new reagent.
NOTE: There is no reservoir for the WIC/HGB lyse reagent. The amount of lyse contained in the lyse supply tubing is sufficient to maintain the systems supply. The lyse tubing is drained and filled with the [EMPTY LYSE] and [FILL LYSE] keys displayed on the REAGENT RESERVOIR screen, using the procedure described below.
To ensure that only new reagent is in the system, proceed as follows: 1. From the first SPECIAL PROTOCOLS screen, press [REAGENT RESERVOIR]. 2. From the REAGENT RESERVOIR screen, follow the instructions given on the screen. 3. Wipe the reagent line with a lint-free wipe before placing it in the new container. Place the line in the container and secure the cap. 4. To refill, follow the instructions given on the screen. 5. Run five background counts before assessing the results.
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Replaceable Components
Procedures are given in this section for those components that may be replaced by the operator. All other components must be replaced by an Authorized Service Representative.
WARNING: Potential Biohazard. Components may be contaminated with infectious materials. Wear appropriate personal protective equipment and follow biosafety practices as specified in the OSHA Bloodborne Pathogen Rule (29 CFR 1910.1030) or equivalent biosafety procedures.
Fuse Replacement
The CELL-DYN 3700 System has a fuse located above the Power Cord Connector on the Rear Panel. It should only be replaced with the following types of fuses: For 220-volt operation, a 4-amp T (slow-blow) fuse For 110-volt operation, an 8-amp T (slow-blow) fuse Replacement fuses are provided in the Accessory Kit.
Materials Required
Flathead screwdriver
Procedure
WARNING: Electrical Shock Hazard. Always turn the
System OFF and disconnect the Power Cord from the receptacle before checking or changing the fuse. 1. Turn the Analyzer power switch OFF and disconnect the power cord from the receptacle. 2. Insert a flathead screwdriver into the Fuse Holder Slot on the Rear Panel of the Analyzer. 3. Push in and turn the Fuse Holder counterclockwise to remove it. 4. Pull on the fuse to remove it from the holder. 5. Check the fuse. If it has obviously failed, replace it. If it has not obviously failed, verify that it is the correct type of fuse.
NOTE: If you are not sure if the fuse has failed, replace it and see if the problem is corrected.
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6. Check that the fuse is fully inserted into the Fuse Holder and replace the holder. 7. Insert a flathead screwdriver into the Fuse Holder Slot and push in, turning clockwise to lock it in place. 8. Reconnect the power cord to the receptacle and turn the Analyzer power switch ON.
Pulley Belt
Mounting Block
Vent Reservoir
Figure 10.22:
The Sample Loader Vent/Aspiration Needle should be replaced if it is bent, or if it cannot be unclogged. The Sample Loader Vent/ Aspiration Needle Assembly tubing connections are depicted in the preceding figure. The Vent and Aspiration Tubing connections are shown in the following figure.
WARNING: Potential Biohazard. The needles are sharp and
are potentially contaminated with infectious materials. Handle with extreme caution.
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Vent Tubing V
Figure 10.23:
Materials Required
1. Sample Loader Vent/Aspiration Needle, L/N 03H99-01 (provided in the Accessory Kit) 2. Enzymatic Cleaner in a VACUTAINER tube 3. Gauze 4. A 2.5-mm Allen wrench 5. Two VACUTAINER tubes approximately half full of Diluent 6. Small needle nose pliers or similar tool.
Procedure
1. Perform the Auto-Clean procedure as directed in Chapter 9: Maintenance, Subsection: Daily Maintenance Procedures, Auto-Clean. When the cycle is complete, turn the Sample Loader power switch OFF. 2. Remove all racks from the tray. 3. Place some gauze under the Vent/Aspiration Needle to catch any liquid.
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4. Disable the Analyzer by pressing the [DISABLE ANALYZER] key on the SPECIAL PROTOCOLS screen. 5. Disconnect the Sample Aspiration Tubing from the Analyzer.
NOTE: The tubing connection is located below the Status Panel to the left side of the Open Sample Aspiration Probe.
6. Remove the Sample Loader Tower Cover. 7. Manually rotate the Pulley Belt counterclockwise until the needle is fully bottomed. 8. Mark the sets of tubing connected to the top of the vent and aspirate parts of the needle V and A to aid in proper reconnection.
NOTE: The needle is divided into the aspiration section (straight) and the vent section (slanted).
9. Disconnect the A tubing from the needle. Slide the silicon tubing sleeve onto the aspiration tubing before disconnecting it. (See the preceding figure.) Disconnect the V tubing from the Vent/Aspiration Needle. 10. Use the Allen wrench to remove the locking screw on the mounting bracket. (See Figure 10.22, Sample Loader Vent/ Aspiration Needle Assembly.) 11. Using the needle nose pliers, grip the holding clip on the mounting block and carefully pull it forward until it clears the block. 12. Remove the needle by pulling it up through the Wash Block and the mounting block.
WARNING: Potential Biohazard. The needles are sharp and are potentially contaminated with infectious materials. Handle with extreme care. CAUTION: Use care when removing or inserting the needle
to avoid skin puncture. 13. Insert the new needle through the mounting bracket and down through the Wash Block until the wide collar at the top of the needle is flush with the top of the mounting bracket.
NOTE: Be sure that the vent section (slanted) is facing the analyzer.
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14. Slide the holding clip back onto the mounting block and push in until it is snug against the block. 15. Using the Allen wrench, replace and tighten the locking screw in the mounting bracket. 16. Reconnect the vent tubing and the aspiration tubing.
NOTE: When connected, the aspiration tubing must be placed at least 1/4 inch over the top of the needle to cover it. The silicon tubing sleeve must slide over this connection for a proper seal.
when reconnecting it. Do not use excessive force. 18. Replace the tower cover and check all tubing to ensure it is not pinched or crimped. 19. Reinstall all Sample Loader Racks. Prepare the first rack to run two diluent tubes. Install Safety Cover. 20. Enable the Analyzer by pressing the [ENABLE ANALYZER] key on the SPECIAL PROTOCOLS screen. 21. Turn the Sample Loader power switch ON. 22. Run the two diluent tubes and verify proper needle movement. Check to be sure the background count is acceptable on the last cycle.
NOTE: If the background count is unacceptable, clean the aspiration needle as directed in Chapter 9: Maintenance, Subsection: Daily Maintenance Procedures and repeat the background count. If any problems are encountered, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
Apertures
It may be necessary to replace the WIC Aperture Plate and/or the RBC/PLT Aperture Plate if no other solution to a related problem is found. WIC apertures are identified by WBC etched on the Aperture Plate. RBC/PLT apertures are identified by R/P etched on the Aperture Plate.
NOTE: The Aperture Plates are NOT interchangeable.
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Procedure
1. Remove the old Aperture Plate as directed in the aperture cleaning procedure described in Chapter 9: Maintenance, Subsection: As required, Aperture Plates. 2. Confirm that the replacement Aperture Plate is the correct one. 3. Clean the new Aperture Plate and install it as directed in the aperture cleaning procedure described in Chapter 9: Maintenance, Subsection: As Required, and follow the remaining steps in that procedure.
CAUTION: Changing the Aperture Plate may alter the
instrument calibration. Therefore, confirm the calibration by running commercial controls before processing samples. If necessary, recalibrate the instrument as directed in Chapter 6: Calibration. 4. Repeat the samples that were running when the problem was detected to determine if it has been resolved. If the problem is not resolved, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
Syringes
It may be necessary to replace a syringe to correct a problem, for example, if a syringe is cracked or broken.
Procedure
1. Remove the syringe in question as directed in the appropriate syringe cleaning procedure described in Chapter 9: Maintenance and set it aside. 2. Remove the screw from the base of the plunger on the old syringe. Install the screw on the base of the new syringe before installing the syringe on the instrument. 3. Install the new syringe as directed in the appropriate syringe cleaning procedure and follow the remaining steps in that procedure. 4. Repeat the samples that were in process when the problem was detected to determine if it has been resolved. If the problem is not resolved, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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List of Symptoms
Troubleshooting Background Counts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-39 Platelet background out of specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-40 WOC background out of specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-41 WIC background out of specification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-42 RBC background out of specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-43 Hemoglobin background out of specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-44 Multiple background counts out of specification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-45 Troubleshooting Incomplete Aspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-46 Sampling Error Incomplete Aspiration: Open Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . .10-47 Sampling Error Incomplete Aspiration: Closed Mode (Cap Piercer System) . . . . . . . . 10-48 Sampling Error Incomplete Aspiration: Closed Mode (Sample Loader System) . . . . . . .10-49 Troubleshooting Clog and Flow Error Messages for RBC/PLT and WIC . . . . . . . . . . . . . . . . . . . . 10-50 RBC/PLT clog or flow errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-51 WIC clog or flow errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-52 Troubleshooting WOC Flow Errors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-53 WOC flow errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-54 Troubleshooting Imprecise or Inaccurate Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-55 RBC/MCV/PLT data are imprecise or inaccurate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-56 WOC data are imprecise or inaccurate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-58 WIC data are imprecise or inaccurate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-59 Hemoglobin data are imprecise or inaccurate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-60 >>>> appear in place of the result for WBC, RBC, HGB, or PLT . . . . . . . . . . . . . . . . . . . . .10-61 Observable Fault Conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Analyzer or Data Station will not power ON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No screen display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The MAIN MENU screen is not displayed after initialization . . . . . . . . . . . . . . . . . . . . . The word FAULT on the Analyzer Status Indicator Panel is illuminated in red . . . . . . . . Instrument will not stop cycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Data Station keyboards, membrane (including soft keys) and external, are not operational . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Sample Loader does not power ON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Sample Loader beeps and the Start key is not illuminated . . . . . . . . . . . . . . . . . . . . Shear Valve problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-62 10-62 10-62 10-63 10-63 10-64 10-64 10-65 10-65 10-65
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Note the lot number of the reagent. Is it a new lot? Configure the RUN screen to display the appropriate graph for the parameter(s) for which the background count exceeds the system specifications and print the appropriate graph. Parameter WIC WOC RBC PLT HGB Appropriate Graph WIC histogram Size/Complexity scatterplot and the NWBC-LYM-MONO histogram RBC and PLT histograms RBC and PLT histograms WIC, RBC and PLT histograms
NOTE: Instructions for customizing the RUN screen display are given in Chapter 5: Operating Instructions.
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NOTE: After performing any maintenance or troubleshooting procedures, run at least 5 background counts. Ensure that the controls are in range.
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NOTE: After performing any maintenance or troubleshooting procedures, run at least 5 background counts. Ensure that the controls are in range.
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NOTE: After performing any maintenance or troubleshooting procedures, run at least 5 background counts. Ensure that the controls are in range.
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NOTE: After performing any maintenance or troubleshooting procedures, run at least 5 background counts. Ensure that the controls are in range.
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Contaminated Reagent
NOTE: After performing any maintenance or troubleshooting procedures, run at least 5 background counts. Ensure that the controls are in range.
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3. The reagents are cold. NOTE: If reagents were frozen discard. 4. There is liquid in the Vacuum Accumulator.
5. There are bubbles in the Diluent Syringe. 6. The Shear Valve is dirty.
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Troubleshooting Clog and Flow Error Messages for RBC/PLT and WIC
The following list contains some general guidelines for troubleshooting RBC/PLT and WIC clog and flow errors. Determine which metering process exhibits the problem, WIC or RBC/PLT. Remove the front covers and observe the appropriate metering tube while a cycle is in progress. (Refer to the following figure.) Approximately 1015 seconds after the start of the cycle, the metering tube should be flushed of all liquid. Observe that the liquid is completely flushed from the tube. After flushing, a liquid column with a meniscus at the leading edge should travel down the tube. Observe that the meniscus is visible at the leading edge. A complete flush of the tube and a uniform meniscus are important to correct metering.
Meniscus
Count Time
Print the RUN screen to record the metering times. The upper metering time and the count time are both important in troubleshooting clogs or flow errors. The metering times are automatically stored in the Data Log. Configure the Data Log to display and print the appropriate upper metering time and count time. (If necessary, refer to the directions given in Chapter 5: Operating Instructions.)
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Additional information regarding the count times from the previously run cycle can be found on the RAW DATA SUMMARY screen. NOTE: The information is only available immediately after the cycle is completed. Therefore, the screen should be printed immediately after the clog or flow error occurs. From the first DIAGNOSTICS MENU screen, press [RAW DATA SUMMARY] followed by [PRINT] to obtain a printout. Information pertaining to the vacuum level in the Analyzer can be found on the VOLTAGE READINGS screen. From the third DIAGNOSTICS MENU screen, press [VOLTAGE READINGS] followed by [PRINT] to obtain a printout.
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Check the specimen for clots and/or the stained blood smear for platelet clumps. Recollect the specimen using proper technique. Rerun the specimen.
Electrical interference
If Analyzer covers have been removed, replace them and reconnect the ground wires. Perform an electrical background count. Clean the Fan Filters (as directed in Chapter 9). Check for any equipment near the CELL-DYN 3700 System that may be causing electrical interference.
Contaminated Reagent
Empty the RBC/PLT Diluent Reservoir. Replace the reagent with a new box of reagent. NOTE: To prevent contamination, place the Reagent tubing on a clean surface.
Dirty RBC/PLT Aperture Plate The RBC/PLT Diluent Syringe contains salt crystals
Clean the RBC/PLT Aperture Plate (as directed in Chapter 9). Clean the RBC/PLT Diluent Syringe (as directed in Chapter 9).
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Certain red blood cells (for example, hypochromic RBC or RBC containing large amounts of HGB S, C, or F) may not be completely lysed by the Sheath Reagent and cause interference with the WOC count. Laser light is not on
Check MAM 1, 2, 3, and 4 Offset readings on the VOLTAGE READING SUMMARY screen in the DIAGNOSTICS MENU. If the readings are 0.0, the laser or laser power supply has malfunctioned.
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>>>> appear in place of the result for WBC, RBC, HGB or PLT
NOTE: When the WOC or WIC result is replaced with >>>>, the HGB result is suppressed. <<<< displays to indicate that the HGB is affected by the elevated WOC or WIC value. Cause of Inaccurate Result Data exceed linear range for that parameter Corrective Action For RBC or HGB: Dilute a 0.5-mL aliquot of well-mixed whole blood with 0.5 mL of diluent (1:2 ratio). Close the container and invert it 10 to 15 times to mix. Run the specimen as usual. Multiply the RBC or HGB result by 2 to obtain a reportable value.
For WBC or PLT: Dilute a 0.5-mL aliquot of well-mixed whole blood with 0.5 mL of diluent (1:2 ratio) or 1 mL (1:3), 1.5 mL (1:4), or 4.5 mL (1:10) of diluent as required. Close the container and invert it 10 to 15 times to mix. Run the specimen as usual. Multiply each WBC or PLT result by 2, 3, 4, or 10 (per ratio of diluent to blood used above) to obtain a reportable value.
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Observable Fault Conditions Analyzer or Data Station will not power ON.
Probable Cause 1. Power source is defective. Corrective Action 1. Verify that the power switch is turned OFF and connect the system to a different power source. 2. Ensure that the power cord is securely connected to the Analyzer or Data Station and verify that it is connected to the power outlet. 3. The Analyzer fuse is located above the power cord connector on the rear panel. Check the fuse as directed in Troubleshooting Procedures within this chapter. WARNING: Electrical Shock Hazard. Always turn the Analyzer power switch OFF and disconnect the power cord from the receptacle before checking or replacing any fuse. 4. Defective power switch or other system malfunction. 4. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
2. Power cord is not securely connected to the Analyzer or is not connected to the power outlet. 3. Analyzer fuse is blown or incorrect.
No screen display.
Probable Cause 1. Monitor power switch is turned OFF. 2. Data Station power switch is turned OFF. 3. Brightness control is turned down. 4. Defective Data Station or other component. Corrective Action 1. Turn the monitor power switch ON. 2. Turn the power switch ON. 3. Adjust the brightness control on the Data Station until the image is visible. 4. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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The word Fault on the Analyzer Status Indicator Panel is illuminated in red.
Probable Cause 1. The Analyzer has detected a fault situation and has inhibited operation. Corrective Action 1. From the first DIAGNOSTICS MENU screen, press [FAULT REPORT]. Print a copy of the report and perform the indicated corrective action. When the action is completed, initialize the Analyzer by pressing the [INITIALIZATION] key on the second DIAGNOSTICS MENU screen. 2. If the fault report does not indicate a message or action, document the situation and initialize the Analyzer by pressing the [INITIALIZATION] key on the second DIAGNOSTICS MENU screen.
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The Data Station keyboard and the soft keys are not operational.
Probable Cause 1. The computer is performing a function that inhibits the keys. 2. There is an incomplete operator entry. 3. A data transmission to the printer or laboratory computer is in progress. 4. Keyboard entry is not possible on the displayed screen. 5. Data Station computer, keyboard and/ or circuitry malfunction. Corrective Action 1. No action required. Refer to the screen for the current Status Box message. 2. Complete the operator entry or press the Esc key on the keyboard. 3. No action required. Refer to the screen for the current Status Box message. 4. No action required. Refer to the screen for the current Status Box message. 5. Initialize the Analyzer by pressing the [INITIALIZATION] key on the second DIAGNOSTICS MENU screen. If necessary, call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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The Sample Loader beeps and the Start key is not illuminated.
Probable Cause 1. The cable that connects the Sample Loader to the Analyzer is loose or disconnected. Corrective Action 1. Check that each end of the cable is securely connected. If necessary, remove the cable and reconnect it. Press the INT key on the Sample Loader operation keyboard to initialize the Sample Loader. 2. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
2. Circuitry malfunction.
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General Fault Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-76 Auto-Sampler alarm, condition <x,x>; see DIAG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-76 Auto-Sampler command negatively acknowledged . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-76 Auto-Sampler consecutive data faults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-77 Auto-Sampler/Data fault . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-77 Bad checksum in nonvolatile RAM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-78 Bad monitor command . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-78 Blood in Auto-Sampler Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-78 Blood in Shear Valve Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-79 Data acquisition overlap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-79 Detergent empty: See Diluent, Lyse, Sheath, or Detergent empty . . . . . . . . . . . . . . . . . . 10-80 Diluent empty: See Diluent, Lyse, Sheath, or Detergent empty . . . . . . . . . . . . . . . . . . . . 10-80 Diluent, Lyse, Sheath, or Detergent empty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-80 External waste full. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-81 Flow sequence time out <x,x>. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-81 Initalization Failed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-82 List mode data phase error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-82 Lyse empty: See Diluent, Lyse, Sheath, or Detergent empty . . . . . . . . . . . . . . . . . . . . . . . 10-80 Message acknowledgment time out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-82 Message reception time out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-83 Mixing Error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-83 Not Ready: See Diag or Not Ready: See Special. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-84 Printer (Graphics or Ticket) unavailable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-84 RBC diluent syringe overpressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-85 RBC Metering fault clog or flow error. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-85 Sampling Error Incomplete Aspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-86 Shear Valve position fault . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-86 Sheath empty: See Diluent, Lyse, Sheath, or Detergent empty . . . . . . . . . . . . . . . . . . . . . 10-80 Uninitalized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-87 Vacuum accumulator wet (1 or 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-87 WIC Metering fault clog or flow error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-88 WOC Metering fault flow error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-88
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Auto-Sampler Initializing
This message is displayed in the Bulletin Line. Explanation/Action The Sample Loader hardware initialization cycle is in progress. Wait for the cycle to be completed.
Auto-Sampler Off
This message is displayed in the Bulletin Line. Explanation/Action Power to the Sample Loader is turned OFF. Turn ON the Power Switch and wait for the initialization cycle to be completed.
CELL-DYN 3700 System Operators Manual
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Auto-Sampler Pause
This message is displayed in the Bulletin Line. Explanation/Action The Sample Loader PAUSE key was pressed during operation and therefore, operation is suspended. Press the Sample Loader START key to initiate processing.
Auto-Sampler Ready
This message is displayed in the Bulletin Line. Explanation/Action The Sample Loader initialization cycle is complete and samples may be processed. Press the Sample Loader START key to initiate processing.
Bar Code flag not allowed to change unless Work List is purged
This message is displayed in the Bulletin Line. Explanation/Action The [BAR CODE ON] or [BAR CODE OFF] key was pressed and there is an existing Work List. Delete all samples from the Work List before turning the bar code ON or OFF.
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Clearing Apertures
This message is displayed in the Status Box Explanation/Action The [CLEAR APERTURES] key was pressed or the instrument automatically performed the Clear Apertures function in response to a clog or flow problem. Wait until the READY message is displayed in the Status Box and repeat the sample.
Clearing Fault
This message is displayed in the Status Box Explanation/Action The [CLEAR FAULT] key was pressed after an operator correctable fault was detected. Resume operation when READY is displayed in the Status Box and the word READY on the Status Indicator Panel is illuminated in green.
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Entering Standby
This message is displayed in the Status Box Explanation/Action The instrument has been idle for four hours and therefore is automatically performing a cleaning cycle before entering the STANDBY state. (The [DAILY SHUTDOWN] key also initiates this message.) When the cycle is complete, press [PRIME] or [RUN] to initiate the priming cycle and return the instrument to the READY state. Resume operation when the cycle is complete.
Extended Count
This message is displayed in the Status Box Explanation/Action A low value has been detected for the WBC and/or PLT count. The Analyzer is automatically extending the cycle to count more cells. The Extended Count message is displayed while running a specimen in the Auxiliary Mode. Resume processing when the READY message is displayed in the Status Box.
Initialized
This message is displayed in the Status Box Explanation/Action The Analyzer hardware initialization is complete. Press [PRIME] or [RUN] to initiate the priming cycle and return the instrument to the READY state. Resume operation when the cycle is complete.
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No entry found
This message is displayed in the Bulletin Line. Explanation/Action The number (Sequence Number or specimen ID number) entered on the DATA LOG SEARCH screen is not present in the Data Log. Check that the entry was correct. If appropriate, enter the correct number.
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Ready
This message is displayed in the Status Box Explanation/Action The Analyzer is ready to process samples.
Samples Completed
This message is displayed in the Bulletin Line. Explanation/Action The Sample Loader has completed processing samples in the End Rack and has stopped automatically.
Standby
This message is displayed in the Status Box Explanation/Action The instrument has entered the STANDBY state. Press [PRIME] or [RUN] to initiate the priming cycle and return the instrument to the READY state. Resume operation when the cycle is complete.
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Unpinching Valves
This message is displayed in the Status Box Explanation/Action The Analyzer was idle for a predetermined time period and therefore the valves are being exercised to be sure that tubing is not pinched shut. Resume processing when the READY message is displayed in the Status Box.
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CAUTION: If the Sample Loader needle does not retract properly from the specimen vacutainer, discard this specimen, collect a new one, and repeat the test to ensure accurate patient results.
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Auto-Sampler/Data fault
This message is displayed in the Bulletin Line. Probable Cause 1. Four sequential clog or flow messages occurred during Sample Loader operation. Corrective Action 1. Follow the instructions given in Symptom Identification and Resolution within this chapter for troubleshooting clog, flow, or incomplete aspiration messages.
2. Four sequential incomplete aspiration messages occurred during Sample Loader operation.
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NOTE: If necessary, samples can be processed in the Open Mode, as it is not affected by this problem. To run samples in the Open Mode, first initialize the system as directed in the initialization procedure provided in Troubleshooting Procedures within this chapter. When initialization is complete, the Open Mode is automatically selected and samples can then be processed.
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NOTE: The error may occur when several tasks are requested in rapid sequence. For example, print data log, transmit result, sample processing, print ticket, print report, etc.
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5. Circuitry malfunction.
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2. Waste sensor connector is loose or disconnected. 3. Shorted wire(s) or electrode(s) on the waste cap.
4. Circuitry malfunction.
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Initialization Failed
This message is displayed at the bottom of the screen. (MAIN MENU is not displayed.) Probable Cause 1. The Data Station was unable to initialize. The CELL-DYN software does not display the MAIN MENU screen. Corrective Action 1. Initialize the Analyzer by following the instructions in Power OFF Procedure and Power ON Procedure in Troubleshooting Procedures within this chapter. If the Data Station does not initialize, press the Print Screen key on the computer keyboard to document any screen messages and call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Troubleshooting Chapter 10
Mixing Error
This message is displayed in the Bulletin Line. MIX ERROR is displayed on the RUN screen to the right of the MCH result. MIXING ERR is printed on the graphics report. A mixing error is always accompanied by a sampling error; therefore, SAMPLING ERR is printed on all reports. Probable Cause 1. The Sample Loader mixing head(s) detected resistance when attempting to mix a sample. Therefore, no sample was aspirated and results appear to be a background count. 2. One or both mixer motors is binding and generating resistance. Corrective Action 1. Check to be sure that the sample tube can spin freely in the Sample Loader rack. If necessary, remove excess labels or obstructions. Repeat the sample. 2. Call Abbott Diagnostics Customer Service for assistance (at 1-877-4ABBOTT in the US).
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Troubleshooting Chapter 10
10-84
Troubleshooting Chapter 10
Troubleshooting Chapter 10
10-86
Troubleshooting Chapter 10
Uninitialized
This message is displayed in the Status Box. Probable Cause 1. Data Station has power but the Analyzer is not responding. Corrective Action 1. Ensure that the Analyzer power cord is connected to the Analyzer and that the cord is connected to the power outlet. Initialize the Analyzer by pressing the [INITIALIZATION] key on the second DIAGNOSTICS MENU screen. 2. Check the cable that connects the Analyzer to the Data Station. If necessary, secure the connections. Initialize the Analyzer by pressing the [INITIALIZATION] key on the second DIAGNOSTICS MENU screen.
10-87
Troubleshooting Chapter 10
2. Replace the WOC Transfer Peristaltic Pump Tubing as directed in Chapter 9. 3. Clean the WOC Metering Syringe as directed in Chapter 9.
10-88
Chapter 11
Printers
Overview
The CELL-DYN 3700 system is configured with a color Graphics Printer (known in this manual as the Graphics Printer). The printer is set up to print reports, including complete graphic information, on 8.5" X 11" paper. The printer may be set up to print graphic information in color or black only. If ticket printing is desired for the CELL-DYN 3700, a second printer (known as the Ticket Printer) can also be connected to the system at the same time as the Graphics Printer. Results are automatically printed at the completion of each run cycle or are printed on command by the operator. The Ticket Printer can be used to print reports with graphic information in black only, but the connection to the Data Station must be changed. IMPORTANT: The CELL-DYN 3700 System has been configured for and tested with specific printers, such as the printer shipped with the analyzer. For additional information about specific printer capability with the CELL-DYN 3700 System, US Customers, please contact the Customer Service Center at 1-877-4ABBOTT (1-877-422-2688). Customers outside the US should contact your local Customer Service representative. Use of printers other than those recommended by Abbott Laboratories may lead to erroneous printer functionality. Refer to Chapter 2: Installation; Subsection: Printer Installation for instructions on installing both printers. Complete directions for customizing the printout type and format are given in Chapter 5: Operating Instructions, Subsection: Set Up Instructions.
11-1
Printers
Overview
Chapter 11
NOTES
11-2
Chapter 11
Printers
Routine Operation
Graphics Printer
The CELL-DYN 3700 software automatically controls and adjusts most print conditions, including page width. If printing is not what you expect, refer to the printer manual for guidance in making adjustments. If you have additional questions or experience any problems, call Abbott Diagnostics Customer Service for assistance.
Ticket Printer
For detailed information about loading continuous-feed tickets or paper and changing the ribbon in the Ticket Printer, refer to the manuals that accompany the printer. In particular, note the important safety instructions. This section gives information about ticket printing and instructions for loading individual preprinted tickets in the Ticket Printer. The Ticket Printer can be used to print a complete graphics report on continuous tractor-feed paper or to print result data on blank or pre-printed tickets. (Blank tickets are available in continuous tractor-feed sheets. Pre-printed tickets are loaded individually.) To print the graphics report, the printer cable must be connected to the Graphics Printer connector on the back of the Data Station.
Printing Tickets
To print tickets, the printer cable must be connected to the Ticket Printer connector on the back of the Data Station. (See Figure 2.5 for the location of these connectors.) Refer to Chapter 5: Operating Instructions, Subsection: Set Up Instructions for instructions for customizing either type of printout.
11-3
Printers
Routine Operation
Chapter 11
2. Set the ribbon cartridge headgap lever to adjust for the thickness of the tickets. Refer to the printer manual for the location of the headgap lever and for detailed instructions. 3. Move the paper selection lever to the rear position to select single-feed paper. 4. Open the access cover and be sure the guide wire on the paper separator is pushed back into the locked position. 5. Raise the separator to its upright position. 6. Place a ticket on the paper separator and adjust the guides so that they barely touch the edges of the ticket. 7. Pull the bail lever forward. The ticket will automatically feed into place. Release the paper bail lever. 8. Be sure the printer is deselected (Sel indicator is not illuminated) and set the Top of Form by pressing and holding the TOF/Quiet key and pressing the Form Feed key to move the ticket up or pressing the Line Feed key to move the ticket down. (The ticket moves in very fine increments so it can be precisely positioned.) NOTE: The ticket will only move down to a certain point to prevent potential ticket jams. Do not move the top of the page below the paper bail. 9. Position the ticket so that the lower red line on the paper shield (located between the print head and the paper) is positioned where the first line of printing should occur. NOTE: When the Top of Form is set, the position is retained in the printer memory until it is reset. 10. Press the Sel key to select the printer. The printer is now ready to print.
11-4
Printers Chapter 11
Maintenance and Troubleshooting
Cleaning
Every six months (or after about 300 hours of operation) turn the printer OFF and use a clean, dry cloth to dust the area around the carriage shaft and platen. Be sure to remove any loose particles of paper. Do not use solvents or strong detergents on the cabinet.
Troubleshooting
Refer to the printer manuals for a list of the most common printer problems and how to solve them. If the problem is not resolved, contact the Abbott Diagnostics Customer Service Center for assistance. If, during routine system operation, the message PRINTER UNAVAILABLE is displayed on the bulletin line, check to see that the printer cable is securely connected to the Data Station, the printer power switch is turned ON, and that the printer status is on-line. Press the [PRINT] key. If the message is still displayed, turn the printer power OFF, wait about five seconds, turn the power ON again and press the [PRINT] key. If the message is still displayed, there may be an internal printer error. Contact Abbott Diagnostics Customer Service for assistance.
11-5
Printers
Maintenance and Troubleshooting
Chapter 11
NOTES
11-6
Chapter 12
Sample Loader
Sample Loader
Overview
The Sample Loader for the CELL-DYN 3700SL System is an automated microprocessor-based sample-handling system designed to fit directly in front of the Analyzer. (See the following figure.) The Analyzer communicates electronically with the Sample Loader and vice versa. The Sample Loader delivers blood samples (and their identification information) to the CELL-DYN 3700SL System for analysis. The sample tubes are transported in racks that keep the tubes in an upright position. The Sample Loader processes up to 100 samples at a time with or without bar code labels.
Figure 12.1:
12-1
Sample Loader
Overview
Chapter 12
When the START key on the Sample Loader is pressed, the tube racks advance to move each tube through the three processing stations located in the base of the tower: Station 1: Pre-Mixing. The tube is sensed and the sample is pre-mixed by counter-rotation for approximately 30 seconds.* The bar code label is read (if present) and the sample is mixed again for approximately 30 seconds.* The plunger positions the tube, the tube stopper is punctured, the tube is vented, and the sample is aspirated.
Station 2: Mixing.
Station 3: Vent/Aspiration.
* The first tube in a series skips Station 1 and is advanced to Station 2 for complete mixing (for approximately 60 seconds).
Station 2: Mixing
Station 1: Pre-Mixing
As illustrated in the preceding figure, the tube racks move from the right side of the tray, through the three tower stations, and over to the left side of the tray. Consequently, the rack on the right side at the back of the tray is the first to be processed. When the last tube in this rack is at Station 2, the next rack is moved into position for processing. Racks are continuously moved to ensure that tubes are always present in the three tower stations. Fluids travel between the Analyzer and the Sample Loader through four tubes. These tubes carry blood and waste to the Analyzer and diluent to the Sample Loader for cleaning. A cable is connected to the Analyzer to provide bidirectional communication.
12-2
CELL-DYN Q Labels
Special bar code labels are available to identify QC specimens. These Q labels (numbers Q1 Q20) automatically select QC files 1 to 20 and, therefore, should be used to process only QC specimens.
Clear Tape
Exposed Bottom
IMPROPERLY LABELED TUBES 16.5 mm Dia. Width Limit for Multiple Labels Edges Peeled Loose
High Collar
Flap
Tail
Figure 12.3:
12-3
Sample Loader
Bar Code Labels
Chapter 12
The bar code label should be placed on the tube just below the stopper, with the bars perpendicular to the length of the tube, so that the entire bar code can be viewed through the slot in the rack as the tube rotates. See the preceding figure for proper placement. NOTE: Refer to Appendix A: Bar Codes for complete information on Bar Codes, Check Digits, and specifications.
12-4
Chapter 12
Sample Loader
Tower Unit
Safety Cover
Operation Keyboard
Figure 12.4:
Sample Loader
Main Module
The Main Module contains: Power ON/OFF Switch Operation Keyboard Safety Cover Tray to hold the Tube Racks
12-5
Sample Loader
Sample Loader Components
Chapter 12
Primary Keys
Figure 12.5:
Operation Keyboard
Primary Keys
The red and yellow Primary Keys on the Sample Loader are: INIT (Yellow) START (Yellow) PAUSE (Yellow) (Initialize.) Activates the initialization cycle. Initiates processing whenever the CELL-DYN 3700SL System is in the READY state. Pauses the processing after the current cycle is completed. This key can be used any time the processing needs to be interrupted.
REPEAT Does not function. (Yellow) RESET (Red) Resets the Sample Loader and activates the INT key, usually in conjunction with an activated alarm situation.
E/STOP (Emergency Stop.) Terminates the processing (Red) immediately. Any sample being processed when this key is pressed must be repeated.
12-6
Tower Unit
The Tower Unit illustrated in the following figure contains the following: Two Mixing Heads Vent/Aspiration Needle and Vent/Aspiration Needle Wash Block Tube Detector Vial Positioning Mechanism (referred to as the Plunger) Bar Code Reader Window NOTE: A detailed functional description of all components is given in Operating Principles, Functional Description within this chapter.
Blood Sensor
Station 3: Needle (Vent/Aspiration) Wash Block Bar Code Reader Window Cover Plate Vial Positioning Mechanism
Station 1: Mixing Head 1 (Pre-Mixing) Tube Detector Bar Code Reader Window
Figure 12.6:
Tower Stations
12-7
Sample Loader
Sample Loader Components
Chapter 12
NOTES
12-8
Chapter 12
Sample Loader
Operating Principles
Functional Description
The Sample Loader is attached to the Analyzer as shown in Figure 12.1, Analyzer with Sample Loader. Three stations located at the base of the Sample Loader Tower are used to pre-mix, mix, and vent/aspirate each specimen tube. (See Figure 12.6, Tower Stations.) The mixing process is performed by counter-rotation of the tubes at the first two stations. A Mixing Head extends to pre-mix the specimen at Station 1 for approximately 30 seconds. A second Mixing Head extends to mix the specimen for approximately 30 seconds more at Station 2. (The first tube in a series skips Station 1 and is advanced to Station 2 for complete mixing for approximately 60 seconds.) A Mixing Monitor checks to ensure that both mixers are operating properly. If the tube cannot spin properly, a MIX ERROR is displayed. The Vent/ Aspiration Needle then extends to puncture the tube stopper, vent the tube, and aspirate the mixed specimen at Station 3. When the tube is at the Vent/Aspiration Station, a Plunger (a vial positioning mechanism) positions the tube vertically in the rack and holds it while the tube is vented and the sample aspirated. This enables the tube stopper to be pierced in the center and the rack to accommodate tubes with varying numbers of labels. Ten Tube Racks must be in place for Sample Loader operation. The End Rack is marked with black dots on top and a black mark on the left end of the rack. (See the following figure.) The End Rack is used to indicate the last rack of a specific run. The Sample Loader automatically stops after the last tube in the End Rack is processed. A clear plexiglass Safety Cover fits on top of the main Sample Loader Module. It covers the processing stations to prevent aerosol contamination, and to prevent operator exposure to the bar code reader laser and the needle while the Sample Loader is processing specimens. NOTE: The Sample Loader has an Interlock Switch that prevents operation when the Safety Cover is not in place. The operator must press the PAUSE key and wait for the Sample Loader to stop processing before lifting or removing the cover. Lifting the cover while the Sample Loader is operating causes an immediate Emergency Stop condition.
12-9
Sample Loader
Operating Principles
Chapter 12
CAUTION: If a Sample Loader fault occurs that necessitates initialization of the Sample Loader, remove all samples that have been processed before restarting the Sample Loader. If these samples are not removed, misidentification of the remaining samples will occur. When the Sample Loader sensors detect the End Rack, the Sample Loader emits audible beeps for three seconds to alert the operator. The message SAMPLES COMPLETED appears in the Data Station Bulletin Line. If continuous processing is desired, an unmarked rack should be substituted for the End Rack.
Black End Rack Visual Indicator Label (END RACK ONLY) Rack ID Number Label
Tube Rack
Figure 12.7:
Tube Racks
The tube racks are identified by a bar code label which must be in place between the first and second tube position. (See the preceding figure.)
12-10
12-11
Sample Loader
Operating Principles
Chapter 12
Function Sequence
The following sequence is a basic description of the events that occur from the time that the Sample Loader power is turned ON through the complete processing cycle. During the cycle, the position of the Tube Racks is monitored by four reflective sensors in the corners of the Sample Loader tray. Another sensor detects the non-reflective black mark on the End Rack. 1. Each time the Sample Loader is switched ON, it completes an Initialization cycle. 2. When the Sample Loader is initialized and ready, the START key on the Sample Loader Keyboard flashes and the message AUTO SAMPLER READY appears in the Data Station Bulletin Line. 3. When the START key is pressed, the Sample Loader begins moving the right rear rack under the tower. As the rack advances, the sensor at the Pre-Mixing Station searches for a tube. When the sensor detects a tube, the rack advances it to the Mixing Station. The second tube in the rack is positioned at the Pre-Mixing Station. 4. The Mixing Head moves down until the height sensor senses the tube at the Mixing Station. Mixing begins at the same time that the bar code label is read. If no bar code label is present, the sample is identified by rack number and tube position or by a Work List entry. (For instructions on using the Work List, refer to Chapter 5: Operating Instructions.) 5. The first specimen is then mixed by counter-rotation for approximately 60 seconds. When approximately 30 seconds have elapsed, the second tube begins mixing. The total mixing time for each sample is approximately 60 seconds. NOTE: Tubes must be able to spin freely while in the tube racks. Tubes with excessive numbers of labels or with label flaps sticking out will not spin properly and may cause the Sample Loader to stop. (Refer to Figure 12.3, Tube Labeling Requirements.) The Bulletin Line will display the following message: SAMPLING ERROR INCOMPLETE ASPIRATION. The RUN screen will display the MIXING ERROR and SAMPLING ERROR messages.
12-12
The Sample Loader does not attempt to aspirate an improperly mixed sample. Therefore, the SAMPLING ERROR INCOMPLETE ASPIRATION message is displayed along with the MIXING ERROR message, and results look like background counts. In addition, results from tubes that cannot spin properly (and therefore are not mixed) also look like background results. If the tube cannot spin, the Sample Loader emits three beeps, the Mixing Head motor stops (to prevent damage to the motor), and the sample is not aspirated. The message MIXING ERROR is displayed and printed to the right of the MCH result, and the message SAMPLING ERROR is displayed and printed to the right of the MCHC result. An M appears in the column preceding the date in the Data Log and the QC Log. 6. Rack movement resumes, and the first tube is moved to the Vent/Aspiration Station. When the Vent/Aspiration Needle begins to move down, the Plunger moves forward to position the tube so the stopper is pierced near the center. The needle continues to move down and pierces the stopper to vent the tube. The needle moves down to the bottom of the tube and the Sample Loader signals the Analyzer to aspirate the sample. The sample is pulled into the Shear Valve by the Sample Aspiration Pump. The Analyzer then begins a normal count cycle. NOTE: If the Sample Loader detects four consecutive metering faults or incomplete aspirations, the Sample Loader stops and the Bulletin Line message alternates between SAMPLING ERROR INCOMPLETE ASPIRATION and AUTO SAMPLER CONSECUTIVE DATA FAULTS and AUTO SAMPLER BUSY. The message SAMPLING ERROR is displayed and printed to the right of the MCHC result. Troubleshoot metering faults appropriately for clogs and other likely causes. 7. While Tube #1 is being aspirated, the Bar Code Reader identifies Tube #2, either by reading the bar code label on the tube or by reading the rack number and tube position. Tube #2 is then mixed for 30 seconds.
12-13
Sample Loader
Operating Principles
Chapter 12
8. Tube #3 is sensed by the tube sensor and pre-mixed for approximately 30 seconds. NOTE: Whenever there is an empty space in a rack, mixing timing returns to that of the first tube in the first rack. When an empty space is detected, the Sample Loader automatically advances the next tube directly to the mixing station and mixes it for approximately 60 seconds. This has only a minor effect on overall throughput but may become significant if there are numerous empty spaces. 9. After the sample is aspirated, the Vent/Aspiration Needle is retracted and washed. The plunger retracts when the needle has been fully withdrawn from the tube. 10. Steps 49 are repeated until all the tubes in the rack have been processed. 11. When the last tube in the rack is at the Mixing Station, the rack sensor senses that the rack has moved far enough to the left side of the Sample Loader Tower. The second rack is moved into position on the right side of the tower and the first tube is positioned at the Pre-Mixing Station. 12. These sequences are repeated until the End Rack sensor detects the End Rack. When all tubes in this rack are processed, the Sample Loader automatically stops and audible beeps alert the operator that processing is completed. The message SAMPLES COMPLETED is displayed in the Bulletin Line. NOTE: If no End Rack is used, processing continues until the Sample Loader is manually stopped by pressing the PAUSE key, or until a fault occurs.
12-14
Chapter 12
Sample Loader
Operating Tips
1. All samples which have been sitting for an extended period of
time must be properly mixed before they are placed in the Sample Loader racks.
2. Spaces must be left between tubes with rubber stoppers when they are placed in the Sample Loader rack. If the tubes are placed side by side, mixing errors will occur because the rubber stoppers will touch each other when the tubes spin. 3. If a tube has multiple labels on it, spin the tube by hand after it is put in a rack to be sure it will spin freely and mix properly.
12-15
Sample Loader
Routine Operating Procedures
Chapter 12
NOTES
12-16
Chapter 12
Sample Loader
Set Up
For detailed instructions on how to set up the Sample Loader, refer to Chapter 2: Installation.
Troubleshooting
If a Sample Loader fault, error, or other problem is detected, an alert message is displayed on the Bulletin Line of the screen. For a list of messages, descriptions of possible problems, and recommended actions, refer to Chapter 10: Troubleshooting.
12-17
Sample Loader
Other Chapters to Reference
Chapter 12
NOTES
12-18
Chapter 13
Veterinary Package
Veterinary Package
Introduction
The Veterinary Package software enables the CELL-DYN 3700 System to analyze animal samples. When the Vet Package is selected, the instrument can be configured to process veterinary samples. The software stores instrument settings for up to 60 different types of animals in a configuration file unique to each animal type. A database in the Vet Package, called the Animal Catalog, contains manufacturer-developed settings for common species. Additional species may be added at the discretion of the user. By pressing the appropriate soft keys, the operator can switch between species or return to the original instrument (human) settings. In this chapter you will find the information needed to configure the system to run animal samples. Access the Vet Package from the Set Up Menu Add a new animal specie and enter normal ranges for that animal Run the animal samples and make changes to the gain settings for appropriate CBC and differential results Calculate and calibrate the MCV for each new animal Adjust the Baso Box The following information regarding the use of the Veterinary Package is included in this chapter: Principles of Operation Performance Characteristics Operating Instructions Calibration Quality Control Adding New Animal Types Turning the Vet Package OFF (including instructions for configuring additional species) (including a description of the soft keys)
13-1
Veterinary Package
Introduction
Chapter 13
NOTES
13-2
Chapter 13
Veterinary Package
Principles of Operation
The Vet Package is designed to configure the instrument to process up to 60 different animal types. The configuration file for each animal type can be customized for the following: Electronic set-points Calibration factors (MCV and MPV) Limits Sets When a particular species is selected, the instrument will automatically choose the appropriate configuration file and adjust the instrument settings to the values contained in the file. This configuration is retained until another species is selected or the Vet Package is turned OFF. When the Vet Package is turned OFF, the instrument automatically returns to the original settings for human samples. Adjustments to the instrument settings (for calibration or alignment) are always made in the human mode. Therefore, a special animal type called Default is maintained in the Animal Catalog (described in the next section) and in the Animal Type Set Up Table. The settings for the default animal are identical to the settings for humans and all animal settings are maintained relative to these settings. When the instrument is calibrated or any procedures are performed which alter the default animal (human) settings, the settings contained in all of the animal type files are automatically adjusted according to the altered default settings. Consequently, the animal configurations are always current and no adjustments are required.
13-3
Veterinary Package
Principles of Operation
Chapter 13
The Default animal type stored in the catalog cannot be modified or deleted. It is a duplication of the original human settings, with their calibration and dilution factors, that were established for the Analyzer. To run samples for the first time, a configuration file must be copied from the catalog to the Animal Type Set Up Table. This table is displayed on the ANIMAL TYPE SET UP screen. Once the file is stored in this table, it can be reviewed, modified, or deleted. Modifications to the file are stored in the Animal Type Set Up Table and do not alter the settings stored in the catalog. Consequently, a Master File is always maintained in the catalog for each species. CAUTION: Do not modify the alignment and calibration factors for the default animal on the DIAGNOSTICS SET POINT ENTRY screen. Any changes to these settings would also modify the settings used for human sample testing and the Bulletin Line would display the following message to alert the operator: WARNING: Any change to the DEFAULT settings also affects the HUMAN settings. After the Vet Package is exited, the human settings would then reflect these modifications made while in the Vet Package. Once the file is copied to the Animal Type Set Up Table, it may be accessed by pressing the [ANIMAL TYPE] key displayed on the RUN screen. When the key is pressed, the settings for that species are transferred to the Analyzer. (It takes approximately 10 seconds for the transfer to occur.) When the Status Box displays the READY message, samples may be processed. Samples from other species may be processed by again pressing the [ANIMAL TYPE] key and selecting the desired animal.
13-4
Chapter 13
Veterinary Package
Performance Characteristics
Introduction
Instrument performance specifications are included in Chapter 4: System Specifications. The Performance Characteristics included in this section illustrate instrument performance for the species indicated.
Precision
Precision results are derived from paired difference analysis of a minimum of 100 data pairs from normal animal samples. The results are stated as a coefficient of variation (CV).
Table 13.1: Precision
Parameter Dog WBC RBC HGB MCV PLT 3.8% 2.3% 1.5% 3.5% 8.5%*
Result (CV) Cat 3.8% 2.3% 1.5% 3.0% 11.3%* Rat ** 2.4% 2.0% 1.5% 2.2% 4.2% Mouse1 3.8% 2.5% 1.5% 2.8% 6.0%*
* The PLT result was derived from a data set which includes samples exhibiting overlap between the RBC and PLT populations. Platelet precision is improved if these samples are eliminated from precision determinations. **Rat precision was calculated with n=31; pooled blood of four healthy rats.
13-5
Veterinary Package
Performance Characteristics
Chapter 13
Accuracy
Accuracy is expressed as a correlation coefficient based on a minimum of 50 pairs of samples. The data are correlated to a reference methodology. Dog and cat hemogram parameters are compared to a Coulter S+IV and differential parameters are compared to a manual 100-cell differential. Rat and mouse hemogram parameters are compared to Contraves AL820 and differential parameters are compared to a manual 100-cell differential.
Table 13.2: Accuracy
Parameter Dog WBC RBC HGB MCV PLT % Neutrophils % Lymphocytes % Monocytes % Eosinophils % Basophils > 0.96 > 0.98 > 0.95 > 0.75 > 0.91 > 0.76 > 0.70 NA > 0.70 NA
Correlation Coefficient Cat > 0.92 > 0.98 > 0.96 > 0.75 > 0.77 > 0.77 > 0.70 NA > 0.70 NA Rat1 > 0.99 > 0.99 > 0.99 > 0.85 > 0.94 > 0.89 > 0.77 NA NA NA Mouse1 > 0.99 > 0.92 > 0.98 > 0.86 > 0.97 > 0.96 > 0.93 NA NA NA
13-6
Linearity
Linearity was evaluated by testing specimens with high values for the parameters indicated in the table. The highest values tested and correlated to a Coulter S+IV or Contraves AL820 are listed in the following table.
Table 13.3: Linearity
Parameter Dog WBC RBC HGB MCV PLT 70.0 K/L 9.56 M/L 21.5 g/dL 150 fL 950.0 K/L
Highest Value Tested Cat 43.0 K/L 9.98 M/L 16.0 g/dL 150 fL 800 K/L Rat1 20.2 K/L 26.8 g/dL NA Mouse1 19.4 K/L 20.9 K/L NA
NOTE: There are no preset limits for parameters that would generate out-of-range flags like those generated with the human settings. The maximum values that can be displayed for the hemogram parameters are: WBC RBC HGB MCV PLT 9999 K/L 9999 M/L 9999 g/dL 9999 fL 9999 K/L
Carryover
Carryover is determined by running samples with high concentrations of WBCs, RBCs, HGB, and PLTs. Each sample is run in triplicate followed by three background cycles. The percent carryover is calculated using the following formula: % Carryover =
Table 13.4:
x 100
Carryover
Carryover Cat < 1% < 1% < 1% < 3.5% Rat1 < 1% < 1% < 1% < 3.5% Mouse1 < 1% < 1% < 1% < 3.5%
13-7
Veterinary Package
Performance Characteristics
Chapter 13
Flagging
The following Suspect Population Flags, and Suspect Parameter Flags are active in the Vet Package software: WBC DFLT (NLMEB) NWBC FWBC NRBC RRBC PLTR Descriptors: WIC WOC The interpretive messages described in Chapter 3: Principles of Operation, Subsection: Operational Messages and Data Flagging are also active in the Vet Package. Samples may be flagged by entering up to four sets of limits for each animal type. Limits may be normal range, panic values, etc. Values that fall outside these limits are displayed and printed as they are for human samples. When a result exceeds the maximum value that the system can display, >>>> (over-range) are displayed and printed in place of the result.
13-8
Chapter 13
Veterinary Package
Operating Instructions
The operation of the Vet Package is discussed in the remaining sections of this chapter. There are four main sections: Vet Package Keys Routine Operation Calibration Adding New Animal Types A description of the Vet Package set up procedures and how to access the various Vet Package functions is given in the first section. The Routine Operation section includes instructions for Sample Analysis and brief descriptions of the Work List and the Data Log. Calibration procedures are discussed in the Calibration section, and the steps required to add new species are described in the Adding New Animal Types section.
COMPUTER SET UP
RETURN
Figure 13.1:
13-9
Veterinary Package
Operating Instructions
Chapter 13
The [TURN ON VET PKG] key is located on the OPERATION SET UP MENU screen (see the preceding figure), which is accessed from the SET UP MENU screen. When the [TURN ON VET PKG] key is pressed, the key label will change to [TURN VET PKG OFF] and the Vet Package software will be enabled. This key is used to enable or disable the Vet Package. When the Vet Package is ON, the Vet Package keys described on the following pages are accessible.
13-10
DATE/ TIME
ANIMAL SET UP
REAGENT LOG
QC SET UP MENU
OPERATION SET UP
UNITS SELECTION
CUSTOMIZE REPORT
MAIN
Figure 13.2:
ANIMAL SET UP
The [ANIMAL SET UP] key is displayed on the SET UP MENU screen (see the preceding figure) when the Vet Package is ON. When the [ANIMAL SET UP] key is pressed, the ANIMAL TYPE SET UP screen (see the following figure) and the following soft key labels are displayed: ADD NEW ANIMAL DELETE ANIMAL VIEW ANIMAL ANIMAL LIMITS BROWSE CATALOG RETURN
13-11
Veterinary Package
Operating Instructions
Chapter 13
DELETE ANIMAL
VIEW ANIMAL
ANIMAL LIMITS
BROWSE CATALOG
RETURN
Figure 13.3:
ADD NEW ANIMAL
The [ADD NEW ANIMAL] key is used to add a new animal type to the Animal Type Set Up Table. This key is discussed and directions for adding new animals are given in the Adding New Animal Types section of this chapter. The [DELETE ANIMAL] key is used to delete the file indicated by the cursor position from the Animal Type Set Up Table. The following soft key labels are displayed when the [DELETE ANIMAL] key is pressed: CONFIRM DELETION CANCEL DELETION These keys are used to confirm or cancel the Delete Animal command.
DELETE ANIMAL
13-12
3. Press the [DELETE ANIMAL] key followed by the [CONFIRM DELETION] key. Verify that the selected animal is deleted from the list. NOTE: The animal type to be deleted must not be the current animal type selected in the RUN screen. The default animal type cannot be deleted.
VIEW ANIMAL TYPE SET UP Ready DEFAULT SET UP Gains: WBC WBC WBC WBC RBC PLT WIC WBC RBC PLT PLT WIC WIC 0D 10D 90D 90DEP 1408 1267 1401 1465 1817 2147 3307 360 240 230 4095 640 3000
Current
THRESH:
lo hi lo hi
RETURN
Figure 13.4:
VIEW ANIMAL
The [VIEW ANIMAL] key displays the configuration file for the animal type indicated by the cursor position on the ANIMAL TYPE SET UP screen. The VIEW ANIMAL TYPE SET UP screen is shown in the preceding figure.
13-13
Veterinary Package
Operating Instructions
Chapter 13
Animal: DOG
Lower Limits WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT PDW LIMIT SET 2 6.7 3.6 0.7 0.1 0.1 0.0 5.50 12.6 36.9 62.0 22.0 33.0 11.6 80. 0.0 0.00 0.0 K/uL K/uL K/uL K/uL K/uL K/uL M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD) LIMIT SET 3 60.0 12.0 3.0 2.0 0.0 %N %L %M %E %B 18.3 12.5 6.0 1.7 1.8 0.1 8.20 19.4 55.0 70.0 25.0 36.0 14.8 560. 99.9 9.99 99.9
K/uL K/uL K/uL K/uL K/uL K/uL M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
%N %L %M %E %B
LIMIT SET 4
RETURN
Figure 13.5:
ANIMAL LIMITS
The [ANIMAL LIMITS] key is used to enter upper and lower flagging limits for each animal in the Animal Type Set Up Table. Four different sets of limits may be entered for each animal type. The animal type is displayed on the upper left corner of each Limit Set. The following soft key labels are displayed (see the preceding figure) when the [ANIMAL LIMITS] key is pressed: LIMIT SET 1* LIMIT SET 2 LIMIT SET 3 LIMIT SET 4 PRINT RETURN *The key label for the Limit Set displayed on the screen is not shown.
13-14
Whenever a parameter result exceeds an entered limit, the result is displayed in color on the screen to alert the operator. Results displayed in yellow are below the limit and results displayed in purple are above the limit. The flagged result is underlined on the graphics report and the blank ticket report. The flagged result is marked with an asterisk (*) on the pre-printed ticket report. NOTE: To avoid data entry errors, limits can only be entered for the animal type that is currently displayed on the RUN screen.
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Veterinary Package
Operating Instructions
Chapter 13
12. Press the appropriate soft key to select another Limit Set and repeat steps 811 to enter the desired limits. 13. Press the [RETURN] key to return to the ANIMAL TYPE SET UP screen. 14. Repeat this procedure to enter limits for a different species.
VIEW SET UP
EXPECTED RANGES
ADD TO SET UP
RETURN
Figure 13.6:
BROWSE CATALOG
The [BROWSE CATALOG] key is used to view the Animal Catalog. The Animal Catalog stores the files for up to 60 different animal types. Information for the animal types currently supported by existing data is stored in the catalog. To run samples from a specific animal, the file must be moved from the catalog to the Animal Type Set Up Table. When the [BROWSE CATALOG] key is pressed, the ANIMAL TYPE CATALOG screen and the following soft key labels are displayed (see the preceding figure): VIEW SET UP EXPECTED RANGES ADD TO SET UP RETURN
13-16
CATALOG CONTENTS Ready ANIMAL TYPE SET UP CAT SET UP Gains: WBC WBC WBC WBC RBC PLT WIC WBC RBC PLT PLT WIC WIC 0D 10D 90D 90DEP 1948 1397 2866 2998 3388 2258 3307 400 240 257 4095 520 3000
Current
THRESH:
lo hi lo hi
RETURN
Figure 13.7:
VIEW SET UP
When the [VIEW SET UP] key is pressed, the CATALOG CONTENTS, ANIMAL TYPE SET UP screen (see the preceding figure) for the animal type indicated by the cursor position and the following soft key labels are displayed: PRINT RETURN NOTE: The file cannot be modified from this screen, only displayed and printed.
RETURN
The [RETURN] key is used to return to the ANIMAL TYPE CATALOG screen.
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Veterinary Package
Operating Instructions
Chapter 13
Animal: DEFAULT
Lower Limits WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT MPV PCT PDW 4.60 2.00 .600 0.00 0.00 0.00 4.04 12.2 37.7 80.0 27.0 31.8 11.6 142. 0.00 0.00 0.00 K/uL K/uL K/uL K/uL K/uL K/uL M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD) 37.0 10.0 0.00 0.00 0.00 %N %L %M %E %B 10.2 6.90 3.40 .900 .700 .200 6.13 18.1 53.7 97.0 31.2 35.4 14.8 424. 100. 9.99 100.
K/uL K/uL K/uL K/uL K/uL K/uL M/uL g/dL % fL pg g/dL % K/uL fL % 10(GSD)
%N %L %M %E %B
RETURN
Figure 13.8:
EXPECTED RANGES
Expected Ranges
The [EXPECTED RANGES] key is used to display the preprogrammed ranges for the animal type indicated by the cursor position. (See the preceding figure.) NOTE: When a file is transferred from the Animal Catalog to the Animal Type Set Up Table, the expected ranges stored in the catalog become Limit Set 1.
ADD TO SET UP
The [ADD TO SET UP] key is used to move the configuration file indicated by the cursor position from the Animal Catalog to the Animal Type Set Up Table.
13-18
3. Press the [ADD TO SET UP] key to move the file to the Animal Type Set Up Table. NOTE: If the selected file has already been moved to the Animal Type Set Up Table, the Bulletin Line will display the message: Animal type was added to set up already. The file with the same name must be deleted from the Animal Type Set Up Table before the selected file can be added. 4. Press the [RETURN] key to return to the ANIMAL TYPE SET UP screen. The added file is entered in the list and displayed in alphabetical order.
PRINT
The [PRINT] key is used to print a list of the files contained in the Animal Catalog. The [RETURN] key is used to return to the ANIMAL TYPE SET UP screen. The [RETURN] key on the ANIMAL TYPE SET UP screen is used to return to the SET UP MENU screen.
RETURN
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Veterinary Package
Operating Instructions
Chapter 13
NOTES
13-20
Chapter 13
Veterinary Package
Routine Operation
This section gives instructions for running veterinary samples. A brief discussion of the Data Station RUN screen is included to explain the different keys displayed when the Vet Package is ON.
Next ID CAT/10533/03 Auto Animal: CAT Sex(M/F):M DOB:01/09/92 Dr FELINE, DVM Param: 1 Limits: 1 WBC 7.24 K/uL NEU 4.75 65.6 %N LYM 1.63 22.5 %L MONO .566 7.82 %M EOS .168 2.33 %E BASO .129 1.79 %B RBC HGB HCT MCV MCH MCHC RDW 4.18 13.1 37.4 89.5 31.4 35.1 14.9 M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST
S I Z E WCT:4.33 COMPLEXITY
10 deg
PLT MAIN
Figure 13.9:
Run Screen
The RUN screen for animals differs slightly from the RUN screen for humans. The preceding figure shows the RUN screen for animals. On this screen, the <PATIENT> field is replaced by the <ANIMAL> field. The selected animal type is automatically displayed in this field. The [SPECIMEN TYPE] key is replaced by the [ANIMAL TYPE] key. However, the [SPECIMEN TYPE] key is available from the ANIMAL TYPE SELECTION screen. NOTE: Animal type and specimen type are two independent characteristics of the sample. For example, Dog QC, Cat Background, etc.
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Veterinary Package
Routine Operation
Chapter 13
SELECT ANIMAL
SPECIMEN TYPE
RETURN
Figure 13.10:
ANIMAL TYPE
When the [ANIMAL TYPE] key on the RUN screen is pressed, the ANIMAL TYPE SELECTION screen (see the preceding figure) and the following soft key labels are displayed: SELECT ANIMAL SPECIMEN TYPE RETURN
The [SELECT ANIMAL] key is used to adjust the instrument to the animal settings determined by the cursor position. When the key is pressed, the Status Box briefly displays the message Setting gains to indicate that the adjustments are in process. This message is immediately followed by the Ready message indicating the adjustments are complete.
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File Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. LOW 44 SL NORM 44 SL HIGH 44 SL LOW 45 OPEN NORM 45 OPEN HIGH 45 OPEN LOW 44 HSL NORM 44 HSL HIGH 44 HSL PRECSL01/28
# Specimens 3 3 3 3 3 3 0 0 0 31 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
File Name PRECOP02/01 PRECSL02/01 PRECSL01/29 LOW RD 13 OP NOR RD 13 OP HI RD 13 OP PRECOP01/27 PRECSL01/27 PRECOP01/29 PRECOP01/28
# Specimens 31 31 31 71 71 69 31 31 34 31
PATIENT
QC SPECIMEN
BACKGROUND
ELECTRICL BACKGRND
LATEX
RESISTANT RBC
RETURN
Figure 13.11:
When the [SPECIMEN TYPE] key is pressed, the SPECIMEN TYPE screen (see the preceding figure) and the following soft key labels are displayed: PATIENT QC SPECIMEN BACKGROUND ELECTRICL BACKGRND LATEX RESISTANT RBC RETURN The functions of these keys are discussed in Chapter 5: Operating Instructions.
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Veterinary Package
Routine Operation
Chapter 13
Animal: DOG Type BACKGROUND Param Set: 1 WBC 0.12 NEU LYM MONO EOS BASO RBC .001 HGB 009 HCT MCV MCH MCHC RDW PLT 0.00 MPV CLEAR APERTURES K/uL %N %L %M %E %B M/uL g/dL % fL pg g/dL % K/uL fL WORK LIST ANIMAL TYPE
S I Z E WCT:4.57 COMPLEXITY
LOBULARITY
PLT MAIN
Figure 13.12:
When the Vet Package is ON, the screens differ in that the selected animal type is always displayed in the upper left corner of each of the specimen type RUN screens. See the preceding figure for an example of a BACKGROUND screen for a dog.
Sample Analysis
Veterinary samples may be run in the Open Mode or the Closed Mode (SL or CS) on the CELL-DYN 3700 System. Once the animal type is selected, these samples are processed in the same manner as human samples. Daily Start Up Procedures and Quality Control checks should be performed before processing samples. For instructions for these procedures, refer to Chapter 5: Operating Instructions, Subsections: Daily Start Up Procedure, Daily Quality Control Procedures, and Sample Analysis.
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13-25
Veterinary Package
Routine Operation
Chapter 13
Data Log
All veterinary samples are entered in the Data Log in the order in which they are processed. All samples run with the Vet Package ON are stored with the Data Log code V to indicate veterinary samples.
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Chapter 13
Veterinary Package
Calibration
With the Vet Package ON, calibration of the directly measured parameters is linked to the calibration factors set for human (Default animal type) samples. When the calibration factors for human (Default animal type) samples are changed, the calibration factors contained in the configuration files stored in the Animal Type Set Up Table are automatically updated. Calibration factors for WBC, RBC, HGB, and PLT always remain identical to the factors for the default animal type. This is true for all species listed in the Animal Type Set Up Table. CAUTION: The calibration factors for these parameters are always identical to those for human samples. Dont modify the alignment and calibration factor settings for the default animal on the Animal Type Set Up Table. Any changes to these settings would also modify the settings used for human sample testing and the Bulletin Line would display the following message to alert the operator: WARNING: Any change to the DEFAULT settings also affects the HUMAN settings. After the Vet Package is exited, the human settings would then reflect these modifications made while in the Vet Package. Calibration factors for MCV and MPV may differ from those for the default animal type. These calibration factors may also differ among the species. If a calibration factor is not entered in the configuration file for these parameters, the factors for the default animal type will be used. If calibration factors are entered for these parameters, they will be linked to the factors for the default animal type. Whenever the default factors are changed, these factors will be automatically updated. When the calibration factors for MCV and MPV have been computed, they are entered manually from the ENTER CALIBRATION FACTOR screen (see the following figure) in the Calibration menu as directed on the following pages.
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Veterinary Package
Calibration
Chapter 13
RESTORE FACTORS
RETURN
Figure 13.13:
Pre-Calibration Procedures
Be certain to complete the procedures outlined in the Pre-Calibration Procedures section of Chapter 6 before beginning the calibration procedure. Human blood should be used to verify specifications.
13-28
If platelet gains or set point entry was changed, an new MPV Calibration Factor must be calculated as follows:
Default PLT Gains New MPV x Current Default MPV Cal Factor = Animal PLT Gains Factor
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Veterinary Package
Calibration
Chapter 13
4. Use the arrow keys on the keyboard to move the cursor to the appropriate factor and type in the new factor. Press the Enter key on the keyboard to save the entry and advance the cursor. 5. When the new factor(s) have been entered, press the [RETURN] key to display the CALIBRATION LOG screen. 6. Document the calibration as directed in the calibration procedure. NOTE: It is important to include the name of the species in the Calibration Log, as it includes records for all calibrations.
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Chapter 13
Veterinary Package
Quality Control
Quality Control procedures are identical to those described in Chapters 5: Operating Instructions and Chapter 7: Quality Control.
13-31
Veterinary Package
Quality Control
Chapter 13
NOTES
13-32
13-33
Veterinary Package
Adding New Animal Types
Chapter 13
New Animal name: NEW ANIMAL NAME Do you wish to copy this animal from an existing animal?
RETURN
Figure 13.14:
NOTE: The name of the new species must be different from other animal names that are already in the Animal Type Set Up Table. 1. From the MAIN MENU screen, press [SET UP] key followed by the [ANIMAL SETUP] key. 2. Press the [ADD NEW ANIMAL] key to display the ADD NEW ANIMAL TYPE screen shown in the preceding figure. 3. Type in the name of the new species to be added. The screen displays the following message: Do you wish to copy this animal from an existing animal? If you do not wish to copy this animal from an existing animal, type N and press the Enter key on the keyboard to save the entry and advance the cursor. The default settings will be used to create the new configuration file.
CELL-DYN 3700 System Operators Manual
13-34
If you do wish to copy this animal from an existing animal, it must be a species that has similar cellular properties. Type Y and press the Enter key on the keyboard to save the entry and advance the cursor. The screen displays the message: Animal name to copy from: Type the exact name of the animal whose configuration file you wish to copy. Press the Enter key on the keyboard to save the entry. 4. Run the specimens from the new species.
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Veterinary Package
Adding New Animal Types
Chapter 13
Next ID ----------- Auto Animal: HORSE Sex(M/F):-M DOB:--/--/-Dr --------------------Param: 1 Limits: 1 WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT 0.00. MPV K/uL %N %L %M %E %B M/uL g/dL % fL pg g/dL % K/uL fL
S I Z E
COMPLEXITY
LOBULARITY
RBC CLEAR APERTURES WORK LIST ANIMAL TYPE CUSTOMIZE REPORT CHANGE SAMPLER PRINT TICKET COLOR PRINT
PLT MAIN
Figure 13.15:
13-36
Next ID ----------- Auto Animal: HORSE Sex(M/F):-M DOB:--/--/-Dr --------------------Param: 1 Limits: 1 WBC NEU LYM MONO EOS BASO RBC HGB HCT MCV MCH MCHC RDW PLT 0.00. MPV
CLEAR APERTURES
S I Z E
G R A N L R T Y
COMPLEXITY LOBULARITY
PLT MAIN
Figure 13.16:
Gains Template
13-37
Veterinary Package
Adding New Animal Types
Chapter 13
13-38
0 S I Z E
Target Box
Figure 13.17:
The ideal position of the Neutrophil population is shown in Figure 13.17. Increasing or decreasing the WOC 0 gain setting moves the population up and down on the 0 axis. Decreasing or increasing the WOC 10 gain setting moves the population left and right on the 10 axis. For example, if the Neutrophil population is located below the Target Box, increase the WOC 0 gain setting until the population is centered over the box. If the Neutrophil population is located above the Target Box, decrease the WOC 0 gain setting until the population is centered over the box. If the Neutrophil population is located to the left or right of the Target Box, increase or decrease the WOC 10 gain setting to move the population in the desired direction on the 10 axis. NOTE: Remember that the Lymphocyte population will also move up and down on the 0 axis and left and right on the 10 axis when the gain settings are increased or decreased.
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Veterinary Package
Adding New Animal Types
Chapter 13
13-40
13-41
Veterinary Package
Adding New Animal Types
Chapter 13
RBC and PLT Histogram Adjustments To estimate the amount of gain adjustment that may be necessary to center the population, do the following: NOTE: Retain the sign for the adjustment and the final variance. 1. Using the first printout, observe the peak of the RBC histogram in relation to the vertical center of the rectangle. (See Figure 13.16.) The RBC histogram peak should be centered on the vertical center of the rectangle. 2. Using the marks on the x-axis as a guide (each mark = 50 channels) determine the present channel and the desired channel. Use the following formula to estimate the percent needed to move the peak of the histogram left (-) or right (+) to center it in the rectangle. Formula: Variance = Desired Channel - Present Channel X 100 Present Channel Write this number in the appropriate column on the worksheet. 3. Repeat steps 1 and 2 above for the second printout (and any additional printouts) obtained under Running Samples above. 4. Average the RBC estimated adjustment. The resulting figure is the percent of adujstment (variance) necessary to center the RBC histogram. Write this number in the appropriate column on the worksheet. 5. Repeat steps 1 through 4 above for the PLT histogram. 6. For a description of the procedure for adjusting gain settings, refer to Entering New Gain Settings later this section.
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Veterinary Package
Adding New Animal Types
Chapter 13
Animal: CAT
Gains:
WOC WOC WOC WOC RBC PLT WIC WOC RBC PLT PLT WIC WIC
1769 1369 3069 2825 2684 4095 3765 320 240 396 4095 480 4095
Current
THRESH:
lo hi lo hi
SET ANALYZER
RETURN
Figure 13.18:
296 B 4
13-44
If the platelet gain or set point entry was changed, a new MPV Calibration Factor must be calculated as follows:
Default PLT Gain X Current Default MPV Cal Factor = New MPV Factor Animal PLT Gain
4. If all gain adjustments were successful, continue processing animal samples. If additional adjustments are necessary, repeat the appropriate procedure for identifying and correcting variances for WOC, RBC, or PLT as described above.
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Veterinary Package
Adding New Animal Types
Chapter 13
N M
B as o
S I Z E
2 3
L 4
Legend: N = L = M = E = Baso =
13-46
Chart 1: Variance Estimation Sample ID# WOC 0 Estimated Adjustment WOC 10 Estimated Adjustment WOC 90D Estimated Adjustment WOC 90 Estimated Adjustment RBC PLT Estimated Estimated Adjustment Adjustment
13-47
Veterinary Package
Adding New Animal Types
Chapter 13
13-48
Mice
Since only small amounts of specimen are available, make a dilution with diluent in order to have enough specimen for processing. Multiply the results by the dilution factor to obtain correct values.
Goats, Sheeps, Llamas, and Other Mammals with Red Blood Counts over 10,000
Since the linearity of impedance counts may be questionable for species with extremely high RBC counts, the RBC count may be underestimated unless a dilution is made. For example, a 1:2 dilution with diluent may yield more accurate RBC counts and RBC indices. The results must be multiplied by the dilution factor.
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Veterinary Package
Vet Package Suggestions
Chapter 13
13-50
Animal Ostrich Ostrich Ostrich Ostrich Pig Pig Pig 1Pigeon Prairie Chicken Quail Rabbit Rabbit Rabbit Rat Rat Rhesus Sea Turtle Sheep-Goat Snake Squirrel Monkey SPECIES African Grey Budgerigar Cockatoo Conure Great Horned Owl Gyrfalcon Macaw Meyers Parrot Owl Red Tailed Hawk Rhea Swainsons Hawk
0 1.461019 1.461019 1.461019 1.461019 1.383905 1.415292 1.723388 2.307346 1.874063 1.51715 1.154354 1.504913 1.43928 1.384565 1.554723 1.87335 1.535982 1.931784 1.542729 1 0 2.74 2.14 1.63 1.81 2.56 1.63 1.81 2.19 1.63 2.56 1.60 2.56
10 1.029441 1.029441 1.029441 1.029441 1 1.159961 1.668302 1.439647 1.569185 1.253584 0.984767 1.373557 1.049068 1.164875 1.139352 0.983871 1.519136 1.544652 1.668302 1 10 2.24 1.49 1.44 1.44 1.79 1.44 1.44 1.49 1.44 1.79 1.00 1.79
90 1.52039 1.52039 1.52039 1.52039 1.477824 2.04504 2.04504 1.800365 1.52039 1.418687 1.301005 1.273664 1.455265 2.364873 1.339014 1.063868 2.310408 1.946439 2.190505 1 90 2.39 1.71 1.20 1.80 2.73 1.20 1.80 1.71 1.20 2.73 1.50 2.73
90D 0.567537 0.567537 0.567537 0.567537 1.462529 2.26958 2.26958 0.748581 0.567537 0.468384 0.789813 1.163177 0.575482 2.34192 2.270148 1 2.26958 0.681044 2.433962 1 90D 0.63 0.99 0.75 0.75 1.26 0.75 0.75 0.75 0.75 1.26 0.60 1.26
RBC 0.757527 0.763441 0.760215 0.760215 2.184 1.770968 1.769892 0.672043 0.757527 1 1 1.594609 1.378495 1.6 1.666667 1 1 2.15 1 1 RBC 0.77 0.50 0.50 0.67 0.75 0.50 0.67 0.50 0.50 0.75 0.70 0.75
PLT 1 1 1 1 1.194539 1.737619 1.737619 1 1 1 1 1.797191 1.099913 2.97619 1 1 1 1.443962 1 1 PLT 0.77 1.00 1.00 0.97 1.00 1.00 0.97 1.00 1.00 1.00 1.00 1.00
WIC 1 1 1 1 1 1.133846 1.133846 1 1 1 1 0.992073 1 1 1 1 1 1 0.692308 1 WIC 1.41 1.41 0.97 0.94 0.97 0.97 0.97 0.94 0.97 0.97 1.00 0.97
MCV 1.42 1.55 1.55 1.42 not calc 0.564 0.564 1.488 1.26 not calc 0.616 not calc 0.726 1 0.6 1 1 1 1
MPV WBC Threshold 1 1 1 1 not calc. 0.576 0.575 1 1 not calc 0.62 not calc 0.909 1 0.72 1 1 1 1 499 360 360 360 650 320 320 360 349 360 360 360 360 360 360 360 360 360 240
MCV CAL 1.304 2.047 1.853 1.364 1.374 1.364 1.364 20.47 1.364 1.209 1.307 1.209
WBC THRES 1.59 1.66 1.66 1.66 0.83 1.66 1.66 1.66 1.66 0.83 1.00 0.83
RBC THRES 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00
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Veterinary Package
Vet Package Suggestions
Chapter 13
NOTES
13-52
Chapter 13
Veterinary Package
13-53
Veterinary Package
Turning The Vet Package Off
Chapter 13
NOTES
13-54
Chapter 13
Veterinary Package
References
1. Specifications for rats and mice were obtained from a study conducted between December 1993 and May 1994 by Dr. H. Lutz at the Facility of Veterinary Medicine, University Zurich, Zurich, Switzerland.
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Veterinary Package
References
Chapter 13
NOTES
13-56
Chapter 14
Reticulocyte Package
Overview
The Reticulocyte Package software enables the operator of the CELL-DYN 3700 System to analyze a whole blood specimen for reticulocytes. The Reticulocyte specimen is prepared by using reticulocyte reagent to produce a diluted, stained sample. Reticulocyte specimens can be run as batches up to two hours after preparation, or they can be run on a STAT basis. The Reticulocyte Package is enabled by pressing [TURN ON RETIC PKG] from the OPERATION SET UP MENU screen. Each menu and function is modified when used in the Reticulocyte Package. Therefore, some of the soft keys that are displayed in the Standard Hematology Mode will be available from the different Reticulocyte screens, and some will not. A Reticulocyte Data Log and a Reticulocyte QC Log are available for samples and controls run within the Reticulocyte Package. Descriptions of all Reticulocyte soft keys are included in this chapter. The prepared specimen run with the Reticulocyte Package on the CELL-DYN 3700 System will measure results as a reticulocyte percentage. The reticulocyte absolute number is automatically calculated when the RBC value is made available from the Standard Hematology Data Log or entered by the operator. The Immature Reticulocyte Fraction (IRF) is calculated from the Reticulocyte % and displayed below the Reticulocyte absolute number. The CELL-DYN 3700 System can be returned to the Standard Hematology function by pressing [TURN OFF RETIC PKG] from the OPERATION SET UP MENU screen.
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Chapter 14
Chapter Contents
This chapter contains the following subsections: Principles of Operation Retic Menu Options Turning the Reticulocyte Package ON and OFF All Retic Menus Except the Retic Run Menu Routine Operation Retic Run Menu Reticulocyte Specimens Quality Control Guide Maintenance Troubleshooting
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Chapter 14
Flowchart Conventions
Menus are shown as square-cornered rectangles in the flowcharts, and soft keys are shown as round-cornered rectangles:
MAIN MENU Ready
SET UP
RUN
DATA LOG
QUALITY CONTROL
When procedures are depicted in flowcharts, shaded boxes and bold lines indicate which soft keys to press:
MAIN MENU Ready
SET UP
RUN
DATA LOG
QUALITY CONTROL
PATIENT LIMITS
REAGENT LOG
QC SET UP MENU
OPERATION SET UP
Flowcharts
The Reticulocyte Package master menu flowchart on the following page was designed to help guide the operator quickly and easily through the menu levels and soft key functions used in the Reticulocyte Package. A segment of this flowchart is included at the beginning of each submenu description to guide the operator through the levels and functions of each submenu and back again to the MAIN MENU. The master menu flowchart can be used as a pull-out guide.
14-3
Chapter 14
NOTES
14-4
Chapter 14
RETIC RUN
RETIC SPECIAL PROTOCOLS Ready RETIC RUN Ready FLUSH SHEATH PATIENT SPECIMEN BACKGROUND RETIC DIAGNOSTICS Ready QC SPECIMEN RETIC MAIN EMPTY WOC FILL WOC CLEAN DISABLE RETIC MAIN SHEAR VLV ANALYZER ENABLE RESTORE SHEAR VLV ANALYZER
RETIC PT LIMITS
TOGGLE ON/OFF
RANGE ENTRY
MEANS/ LIMITS
LIMIT SET 1
LIMIT SET 2
LIMIT SET 3
14-5
Chapter 14
NOTES
14-6
Chapter 14
Principles of Operation
The Reticulocyte Package software is designed to configure the instrument to process stained, diluted specimens. When the Reticulocyte Package is turned ON, the instrument automatically selects the appropriate configuration file and adjusts the instrument settings to the values in this file. This configuration is retained until the Reticulocyte Package is turned OFF. The instrument then returns to the Standard Hematology settings. Reticulocytes are defined by the Clinical and Laboratory Standards Institute (formerly NCCLS) as transitional red cells, between nucleated red cells and the so-called mature erythrocytes1. In contrast to mature RBCs, reticulocytes contain ribosomal RNA. This RNA can be seen with certain supravital, cationic dyes that simultaneously stain and precipitate the polyanion to form a network or reticulum. The CELL-DYN 3700 System reticulocyte method uses the thiazine dye New Methylene Blue N. The reticulocyte assay is performed in the WOC channel of the instrument. Sample preparation is performed manually by diluting 20 L of blood into a tube of CELL-DYN Reticulocyte Reagent. At room temperature, staining of reticulum is complete within approximately 15 minutes. The stained sample is aspirated in the Open Mode. After the stained sample is aspirated, it is diluted approximately 50-fold with Sheath Reagent. Once diluted with Sheath, the RBCs sphere due to the influence of the nonionic detergent incorporated into the staining solution. Sphering is necessary to eliminate optical orientational noise that would otherwise be introduced into the scatter measurements. The usual lytic action of the Sheath is prevented by electrolytes contained in the staining solution and the lack of the usual incubation period used in this channel during WBC analysis. In addition, the high New Methylene Blue concentration in the staining reagent exerts a stabilizing effect on RBCs. During data acquisition, 10 degree and 90 degree scatter are collected for up to 30,000 events. The 0 degree threshold is set high enough to exclude most platelets. Histogram data are used to differentiate reticulocytes, mature RBCs, platelet clumps, and nucleated cells. Reticulocytes have 10 degree scatter that are similar to the scatter for mature RBCs, but differ from them by exhibiting greater 90 degree scatter. Reticulocytes are reported in percent. The instrument will automatically calculate the Reticulocyte Absolute value if an RBC count is entered.
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Chapter 14
The RBC value may be obtained from the Standard Hematology Data Log, or it may be entered by the operator directly on the RETIC PATIENT SPECIMEN screen. Immature reticulocytes contain more RNA and absorb more stain than mature reticulocytes; therefore, they exhibit greater 90 degree scatter. On the CELL-DYN 3700, immature reticulocytes are classified as the population of reticulocytes that exceed a predetermined scatter threshold. Consequently, it is possible to determine the Immature Reticulocyte Fraction (IRF) from the scatter measurements. The IRF was initially designated as the Reticulocyte Maturation Index (RMI), and defined by CLSI/NCCLS H44-A21 as a quantitative expression of the maturation state of the entire reticulocyte population in the peripheral blood. Since automated reticulocyte methods allow the enumeration of immature reticulocytes as a subfraction of the total reticulocyte population, the preferred nomenclature is Immature Reticulocyte Fraction (IRF). The immature reticulocytes are then reported as a fraction (or percent) of the reticulocytes. The clinical utility2 of the IRF is widely recognized as follows: Monitor hemopoietic regeneration after bone marrow transplant, hemopoietic stem cell transplantation, or intensive chemotherapy Monitor bone marrow toxic insults from drugs (for example, AZT) Monitor erythropoietin therapy in renal failure, AIDS, infants, myelodysplastic syndromes, and blood donations Classify anemia Monitor efficacy of anemia therapy (Fe, B12, Folate)
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The [TURN ON RETIC PKG] key is located on the OPERATION SET UP MENU screen (see the following figure), which is accessed from the SET UP screen. The Reticulocyte Package software is enabled when the [TURN ON RETIC PKG] key is pressed, and the soft key label changes to [TURN OFF RETIC PKG]. When the Reticulocyte Package is ON, the soft keys are displayed as described in this chapter.
16:10 sy 123
To turn on the RETIC PKG you must enter the operator ID and the instrument must be in Open mode. To turn on the VET PKG you must exit the RETIC PKG.
COMPUTER SET UP
RETURN
Figure 14.1:
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Chapter 14
SET UP
RUN
DATA LOG
QUALITY CONTROL
CALIBRATION
DIAGNOSTICS
SPECIAL PROTOCOLS
DATE/ TIME
PATIENT LIMITS
REAGENT LOG
QC SET UP MENU
OPERATION SET UP
UNITS SELECTION
CUSTOMIZE REPORT
MAIN
COMPUTER SET UP
RETURN
RETIC PT LIMITS
RETIC QC SET UP
OPERATION SET UP
RETIC UNITS
RETIC MAIN
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Chapter 14
The [TURN OFF RETIC PKG] key is located on the RETIC OPERATION SET UP MENU screen (see the following figure), which is accessed from the RETIC SET UP screen. The Reticulocyte Package software is disabled when the [TURN OFF RETIC PKG] key is pressed, and the soft key label changes to [TURN ON RETIC PKG]. When the Reticulocyte Package is OFF, the soft keys are displayed as described in Chapter 5: Operating Instructions.
14:10 sy R123
COMPUTER SET UP
RETURN
Figure 14.2:
When the Reticulocyte Package is turned OFF, the instrument automatically runs three wash cycles before returning to the Standard Hematology Mode. CAUTION: If the instrument has been idle for four hours, it enters the STANDBY state and automatically returns to the Standard Hematology mode without running a cleaning cycle. If this happens, perform an Auto-Clean cycle before using the instrument again.
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RETIC SET UP
RETIC
RUN
DATA LOG
RETIC QC LOG
RETIC DIAGNOSTC
RETIC SP PROTOCOLS
RETIC PT LIMITS
RETIC QC SET UP
OPERATION SET UP
RETIC UNITS
RETIC MAIN
COMPUTER SET UP
RETURN
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Version 1.1
14:10 sy R123
RETIC SET UP
RETIC RUN
DATA LOG
RETIC QC LOG
RETIC DIAGNOSTC
RETIC SP PROTOCOLS
Figure 14.3:
The upper left-hand corner of the RETIC MAIN menu screen shows the current revision of the instrument system. The upper righthand corner shows the current date and time, the current operator ID, and the Reticulocyte Sequence Number. The information in the upper right-hand corner is displayed on every screen during operation of the Reticulocyte Package. The Status Box is displayed in the top center of the screen. This box appears on every screen to show the following information: Menu in use (such as RETIC MAIN) Analyzer status (such as Ready) Other applicable information (such as report or file identity and any existing fault conditions)
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The cursor is positioned at the <OPERATOR ID> field when the RETIC MAIN menu screen is displayed. An operator ID of up to three alphanumeric characters can be entered. Press the Enter key on the keyboard to accept this operator ID. This operator ID will be displayed on all other Reticulocyte Package screens and printed on all reports. The following soft key labels are displayed on the RETIC MAIN menu screen: RETIC SET UP RETIC RUN RETIC DATA LOG DATA LOG RETIC QC LOG RETIC DIAGNOSTC RETIC SP PROTOCOLS The RETIC RUN menu is described in Routine Operation later in this chapter.
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RETIC PT LIMITS
RETIC QC SET UP
OPERATION SET UP
RETIC UNITS
RETIC MAIN
RETIC QC LIMITS
RETIC SET UP QC
COMPUTER SET UP
MEANS/ LIMITS
RANGE ENTRY
14:10 sy R123
RETIC PT LIMITS
RETIC QC SET UP
OPERATION SET UP
RETIC UNITS
RETIC MAIN
Figure 14.4:
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Chapter 14
The following soft keys are displayed on the RETIC SET UP menu screen: RETIC PT LIMITS RETIC QC SET UP OPERATION SET UP RETIC UNITS RETIC MAIN These soft keys are described in this section as they appear from left to right on the screen.
The [RETIC PT LIMITS] key is used to display the RETIC PATIENT LIMITS screen (see the following figure). The following soft key labels are displayed on the RETIC PATIENT LIMITS screen: LIMIT SET 1* LIMIT SET 2 LIMIT SET 3 LIMIT SET 4 PRINT RETURN *The soft key label for whichever limit set is displayed on the screen is not shown.
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LIMIT SET 1 Lower Limits RETIC% RETIC ABS RBC IRF 1.06 10 4.04 0.01 % K/uL M/uL Upper Limits 2.64 140 6.13 0.25 % K/uL M/uL
LIMIT SET 2
LIMIT SET 3
LIMIT SET 4
RETURN
Figure 14.5:
The [RETIC PT LIMITS] key is used to enter upper and lower flagging limits for groups of patient samples. (For example, limits may be entered for adult males, adult females, neonates, etc.) Four sets of limits may be entered. Whenever a result falls outside an entered limit, the result is displayed in color on the screen to alert the operator. Results displayed in yellow are below the limit and results displayed in purple are above the limit. The flagged result is underlined on the graphics report and in the Reticulocyte Data Log when printed. Patient results that exceed the linearity specifications will be suppressed and chevrons (>>>>) will be displayed and printed.
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2. Use the arrow keys on the keyboard to move the cursor to the desired limit entry field and type the desired number. Press the Enter key on the keyboard to save the entry. 3. Repeat step 2 until all desired entries have been made. 4. If desired, press the [PRINT] key to obtain a printout of the Limit Set being displayed. NOTE: Retaining a hard copy of each Limit Set is recommended, as the screens do not display names or categories for the Limit Sets. 5. Press the appropriate soft key to select another Limit Set and repeat steps 2 4 to enter the desired limits. 6. Press the [RETURN] key to return to the RETIC SET UP menu.
14:10 sy R123
# Specimens 0 0 0 0 0 0
RETIC QC LIMITS
RETIC SET UP QC
RETURN
Figure 14.6:
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Chapter 14
RETIC QC SET UP
The [RETIC QC SET UP] key is used to display the QC files and the RETIC QC SET UP screen (see the preceding figure). The following soft key labels are displayed on the RETIC QC SET UP screen: RETIC QC LIMITS RETIC SET UP QC RETURN This section discusses the procedures that are used to set up the Reticulocyte QC files. The keys are discussed in the order in which they are used to set up the QC files. Use the arrow keys on the keyboard to move the cursor to the desired QC file shown on the RETIC QC SET UP screen, then type in the desired alphanumeric file name. (Up to 12 characters may be entered.) Press the Enter key on the keyboard to save the entry and advance the cursor to the next QC file. Use the arrow keys to move the cursor back into the selected file. Then press the [RETIC QC LIMITS] key or the [RETIC SET UP QC] key to continue to set up the QC file.
The [RETIC QC LIMITS] key is used to display the RETIC QC RANGE ENTRY screen or the RETIC QC MEANS/LIMITS screen, and the following soft key labels: MEANS/LIMITS or RANGE ENTRY PRINT RETURN (This key label alternates between these two selections.)
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MEANS / LIMITS
RETURN
Figure 14.7:
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14:10 sy R123
RANGE ENTRY
RETURN
Figure 14.8:
QC Limits are entered by selecting the QC file from the RETIC QC SET UP screen (by moving the cursor to the desired QC file) and pressing the [RETIC QC LIMITS] key. The RETIC QC MEANS/LIMITS screen is now displayed. Two types of QC limits are available: Range Entry This option is used to enter the upper and lower flagging limits as absolute numbers. This option is used to enter the mean value and a + range value that defines the upper and lower flagging limits.
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RANGE ENTRY
If Range Entry is selected by pressing the [RANGE ENTRY] key, the current upper and lower limits for the selected file are displayed as shown in Figure 14.7, Retic QC Range Entry Screen. If Means/Limits Entry is selected by pressing the [MEANS/LIMITS] key, the current means and limits for the selected file are displayed as shown in Figure 14.8, Retic QC Means/Limits Screen.
MEANS/ LIMITS
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5. If desired, press the [PRINT] key to obtain a printout of the entered values. 6. Press the [RETURN] key to save the entries and return to the RETIC QC SET UP screen.
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The [TOGGLE ON/OFF] key is used to configure the QC file. The file can be used for commercial controls. The lot number and expiration date may be entered into the appropriate areas on the RETIC SET UP QC screen (see the following figure) and saved by pressing the Enter key on the keyboard. The following soft key labels are displayed on the RETIC SET UP QC screen: TOGGLE ON/OFF PRINT RETURN
TOGGLE ON/OFF
The Westgard Rule selections can be toggled ON or OFF using the [TOGGLE ON/OFF] key. The Westgard Rules are discussed in detail in Chapter 7: Quality Control.
14:10 sy R123
WESTGARD RULE SELECTION: ON OFF ON OFF ON OFF RULE 1: RULE 2: RULE 3: RULE 4: RULE 5: RULE 6: Value outside 3 SD. Two consecutive values outside SAME 2 SD. Two consecutive values outside OPPOSITE 2 SD. Two of three consecutive values outside SAME 2 SD. Four consecutive values outside SAME 1 SD. Ten consecutive values on SAME side of mean.
TOGGLE ON/OFF
RETURN
Figure 14.9:
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14:10 sy R123
COMPUTER SET UP
RETURN
Figure 14.10:
OPERATION SET UP
The [OPERATION SET UP] key on the RETIC SET UP menu is used to display the OPERATION SET UP MENU screen. The OPERATION SET UP MENU screen in the Reticulocyte Package displays the following soft keys: TURN OFF RETIC PKG BAR CODE SET UP COMPUTER SET UP RETURN The [TURN OFF RETIC PKG] key is discussed earlier in this chapter (in Retic Menu Options, Turning the Reticulocyte Package ON and OFF). The [BAR CODE SET UP] and [COMPUTER SET UP] keys are described in Chapter 5: Operating Instructions.
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14:10 sy R123
SI % G/L T/L
USA UNITS
SI UNITS
SI MOD UNITS
SET 1 UNITS
SET 2 UNITS
SELECT UNITS
RETURN
Figure 14.11:
RETIC UNITS
The [RETIC UNITS] key on the the RETIC SET UP screen is used to display the RETIC UNITS SELECTION screen (see the preceding figure). The RETIC UNITS SELECTION screen shows the report units
for the indicated parameters. Units may be selected for each parameter individually, or a set of units may be selected by pressing the appropriate soft key. The following soft key labels are displayed on the RETIC UNITS SELECTION screen: USA UNITS SI UNITS SI MOD UNITS SET 1 UNITS SET 2 UNITS SELECT UNITS RETURN
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EDIT ID
DISPLAY SPECIMEN
FIND SPECIMEN
TRANSMIT DATA
RETIC MAIN
PREVIOUS SPECIMEN
NEXT SPECIMEN
EDIT SPECIMEN
TRANSMIT SPECIMEN
PRINT REPORT
RETURN
The [RETIC DATA LOG] key on the RETIC MAIN menu screen is used to display the RETIC DATA LOG screen. The Reticulocyte Data Log stores all data (Reticulocyte percentage, RBC value, Reticulocyte Absolute Number, IRF, and Reticulocyte Flags) and all patient demographic information in a log format for each of the most current 2,000 Reticulocyte cycles run on the CELL-DYN 3700 System. The record information is stored chronologically by Reticulocyte Sequence Number. Each Reticulocyte Sequence Number will have an "R" prefix (R0 to R1999). This will distinguish the Reticulocyte Sequence Numbers from the Standard Hematology Data Log sequence numbers. Scatterplots and histograms are stored for all 2,000 records. The RBC value will be identified on the RETIC DISPLAY SPECIMEN screen to show whether it was obtained from the Standard Hematology Data Log or entered by the operator. This section discusses the RETIC DATA LOG screen first, then it discusses how to review data from the Reticulocyte Data Log. The current date, time, and operator ID and the last Reticulocyte Sequence Number that was used are displayed in the upper righthand corner of the RETIC DATA LOG screen.
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Mar 22 1998 Operator ID Retic Seq# COUNT Date O 09/29/00 O 09/29/00 O 10/02/00 O 10/02/00 O 10/03/00 O 10/03/00
14:10 123 R300 Time Op 08:10 08:30 09:05 09:27 08:38 09:07 987 964 657 864 987 964
RTC% RABS 34 0.68 176 4.40 74 2.10 48 1.76 418 13.40 40 0.96
RBC
IRF
Figure 14.12:
NOTE: Press the F12 key followed by the F1 key on the keyboard to toggle between this Retic Data Log screen and the Data Log screen.
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The following letters are displayed on the RETIC DATA LOG screen in the column immediately preceding the date. (See the preceding figure.) O K Sample was run in the Open Mode. Flow Error or Fragile RBCs.
NOTE: Reticulocyte results are not suppressed for Fragile RBCs but are suppressed for Flow Errors. The RETIC DATA LOG screen contains the following soft keys: EDIT ID (This key label is displayed only when the cursor is positioned next to a patient record.)
DISPLAY SPECIMEN FIND SPECIMEN TRANSMIT DATA PRINT DATA LOG RETIC MAIN
The [EDIT ID] key on the RETIC DATA LOG screen is used to edit only the Specimen ID. When the [EDIT ID] key is pressed, the cursor moves into the <SPECIMEN ID> field and all soft key labels are blank. Each edit is saved by pressing the Enter key on the keyboard. NOTE: The [EDIT ID] key is displayed only when the cursor is positioned next to a Reticulocyte Patient Record. It is not displayed for Reticulocyte Background or Reticulocyte QC records. When using the Edit Specimen ID feature in the Data Log, set up a laboratory procedure to verify any Specimen ID that has been manually edited in the Data Log by showing the content of the Specimen ID before and after editing. Such verification could be: Printouts of the Data Log summary reports that show the edited ID. These printouts should be signed, dated and saved to ensure tracking of any changes to specimen identification within your laboratory. OR Re-running any specimen unintentionally identified with a Rack and Tube Number, via Open or Closed Mode, to confirm that the correct Specimen ID is applied.
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Spec ID AA12345 Patient: Sex(M/F): Dr. LIMITS: 1 RETIC% RBC IRF 0.91 % 4.00 M/uL 0.10 DOB
PREVIOUS SPECIMEN
EDIT SPECIMEN
TRANSMIT SPECIMEN
COLOR PRINT
RETURN
Figure 14.13:
DISPLAY SPECIMEN
The [DISPLAY SPECIMEN] key is used to display the results for the record indicated by the cursor position. The following soft keys are displayed on the RETIC DISPLAY SPECIMEN screen: PREVIOUS SPECIMEN (This key label is not displayed when the first specimen in the RETIC DATA LOG is on the screen.) (This key label is not displayed when the last specimen in the RETIC DATA LOG is on the screen.)
NEXT SPECIMEN
EDIT SPECIMEN TRANSMIT SPECIMEN PRINT REPORT or COLOR PRINT (This key alternates between these two selections depending on whether the Color print option is turned ON.)
RETURN
CELL-DYN 3700 System Operators Manual
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The [PREVIOUS SPECIMEN] key is used to display the results for the Reticulocyte Sequence Number preceding the one currently displayed without returning to the main RETIC DATA LOG screen.
The [NEXT SPECIMEN] key is used to display the results for the Reticulocyte Sequence Number following the one currently displayed without returning to the RETIC DATA LOG screen.
The [EDIT SPECIMEN] key is used to edit patient demographic information for the selected record. It may also be used to edit and display the results with a Parameter Set or Patient Limit Set different from the one currently displayed. The following soft key labels are displayed when the [EDIT SPECIMEN] key is pressed: CONFIRM CANCEL These keys are used to [CONFIRM] or [CANCEL] the edits. The bulletin line displays the message PRESS CONFIRM TO SAVE CHANGES OR CANCEL TO CANCEL CHANGES. When the [CONFIRM] key is pressed, the edited record is displayed.
The [TRANSMIT SPECIMEN] key is used to transmit the displayed report to a Laboratory Information System or on-line computer.
The [PRINT REPORT] key is used to print a graphics report for the displayed report. NOTE: The ticket printer is not supported in the Reticulocyte mode. The [COLOR PRINT] key will be displayed if the Color Print option is turned on in the Standard Hematology Mode.
The [RETURN] key is used to return to the RETIC DATA LOG screen.
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Seq # : R Spec ID : Name : Seq R284 R285 R286 R287 R288 R289 Specimen ID 123456 234567 345678 456789 567890 678901
Mar 22 1998 Operator ID Retic Seq# Date O 09/29/00 O 09/29/00 O 10/02/00 O 10/02/00 O 10/03/00 O 10/03/00
14:10 jmb R326 Time Op 08:10 08:30 09:05 09:27 08:38 09:07 987 964 657 864 987 964
RTC% RABS 34 0.68 176 4.40 74 2.10 48 1.76 418 13.40 40 0.96
COUNT
Seq Specimen ID
RTC% RABS
RBC
IRF
COUNT
Date
Time Op
Figure 14.14:
FIND SPECIMEN
The [FIND SPECIMEN] key is used to locate a particular record by entering the Reticulocyte Sequence Number, the Reticulocyte Specimen ID, or the patients name for the desired record. When the [FIND SPECIMEN] key is pressed, the RETIC DATA LOG SEARCH screen is displayed. (See the preceding figure.) The Reticulocyte Specimen ID, the Reticulocyte Sequence Number, or the patients name may be entered in the appropriate area. The cursor will be flashing in the Reticulocyte Specimen ID area, but it can be moved to the other areas by using the arrow keys on the keyboard. If the requested reticulocyte record is available, the page of the RETIC DATA LOG that contains that record will be displayed on the screen. The cursor will be flashing next to the Reticulocyte Sequence Number that was requested. The reticulocyte record can be displayed by pressing the [DISPLAY SPECIMEN] key. If the record is not found in the Reticulocyte Data Log, the bulletin line displays the message NO ENTRY FOUND. NOTE: If the patient name is used, the name must be typed exactly as it was originally entered.
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When the [TRANSMIT DATA] key is pressed, the screen prompts the operator to enter the starting and ending Reticulocyte Sequence Numbers (from the lowest to the highest) for the desired transmission. Records may be transmitted to a Laboratory Information System or on-line computer singly or in batches as designated by the Reticulocyte Sequence Number(s).
The [PRINT DATA LOG] key is used to print the Reticulocyte Data Log. When the [PRINT DATA LOG] key is pressed, the screen prompts the operator to enter the starting and ending Reticulocyte Sequence Numbers (from the lowest to the highest) for the desired printout. (See the following figure.)
Starting Sequence # : R _ _ _ _ _
Mar 22 1998 Operator ID Retic Seq# COUNT Date O 09/29/00 O 09/29/00 O 10/02/00 O 10/02/00 O 10/03/00 O 10/03/00
20:44 883 R23 Time Op 08:10 08:30 09:05 09:27 08:38 09:07 987 964 657 864 987 964
RTC% RABS 34 0.68 176 4.40 74 2.10 48 1.76 418 13.40 40 0.96
Seq Specimen ID
RTC% RABS
RBC
IRF
COUNT
Date
Time Op
Figure 14.15:
Reticulocyte Data Log Screen Showing the Starting Reticulocyte Sequence Number Field
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Displaying a Record
A copy of the RETIC RUN RESULT screen can be displayed for the most current 2,000 records in the Reticulocyte Data Log. A record is displayed by positioning the cursor at the record you desire in the Reticulocyte Data Log listing and pressing the [DISPLAY SPECIMEN] key. The Status Box indicates RETIC DISPLAY SPECIMEN on results displayed (or printed) from the Reticulocyte Data Log record. (See following figure.)
Spec ID AA12345 Patient: Sex(M/F): Dr. LIMITS: 1 RETIC% RBC RETIC ABS IRF 0.91 % 4.00 M/uL 36 K/uL 0.09 DOB
13:50 SH 1125
PREVIOUS SPECIMEN
EDIT SPECIMEN
TRANSMIT SPECIMEN
COLOR PRINT
RETURN
Figure 14.16:
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14-38
Chapter 14
VIEW QC LOG
RETIC QC LIMITS
RETIC SET UP QC
RETIC MAIN
PURGE QC LOGS
LEVEYJENNINGS
DELETE SPECIMEN
MOVE SPECIMEN
PRINT QC LOG
RETURN
RETURN
14:54 lym R4
# Specimens 0 0 0 0 0 0
VIEW QC LOG
RETIC QC LIMITS
RETIC SET UP QC
RETIC MAIN
Figure 14.17:
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Chapter 14
RETIC QC LOG
The [RETIC QC LOG] key on the RETIC MAIN menu screen is used to display the RETIC QC LOG screen. The Reticulocyte Package on the CELL-DYN 3700 System offers six QC Logs with statistical and graphical analysis of the data. The statistical analysis includes the mean, standard deviation, and coefficient of variation. The results in each QC Log can be displayed as a Levey-Jennings chart. Westgard Rules can be applied to each QC Log. The rule options can be used independently or in combination, at the operators discretion. NOTE: The [RETIC QC LIMITS] key and the [RETIC SET UP QC] key are used to set up the QC files. The following soft keys are displayed on the RETIC QC LOG screen: VIEW QC LOG (Move the cursor with the arrow keys on the keyboard to the QC file desired, then press this soft key.)
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Lot Number : 0123ABCD4 Exp. Date: 09/24/00 LEVEL I: 2/120 Page 1 of 1 Upper Limits: Lower Limits: Target Mean: Seq R31 R32 2.24 0.64 1.44 RTC% 1.38 1.42 0.77 0.47 0.62 IRF 0.60 0.61
Auto-Sampler Pause PURGE QC LOG LEVEYJENNINGS REJECT SPECIMEN DELETE SPECIMEN MOVE SPECIMEN PRINT QC LOG RETURN
Figure 14.18:
VIEW QC LOG
The [VIEW QC LOG] key is used to display the QC Log indicated by the position of the cursor. Each QC Log display includes the following information (see the preceding figure): 1. The lot number and expiration date are displayed in the upper left corner. The file name, the number of runs currently in the file, and the file capacity are also in the upper left corner. (For example, 35/120 indicates that the file contains 35 runs out of a possible 120.) The page number of the display and the total number of pages in the file are also displayed in the upper left corner. 2. The current date, time, and operator ID and the last Reticulocyte Sequence Number to be used are all displayed in the upper right-hand corner. 3. The remainder of the screen displays the file information and the data. The Upper and Lower Limits and Target Mean entered are displayed immediately above each parameter name. The Reticulocyte Sequence Number for each result is displayed to the left of the data. The date, time, and operator ID when the reticulocyte sample was run are displayed to the right of the data.
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4. The following QC Log codes are displayed in the column immediately preceding the date. These codes are the same as those used in the Reticulocyte Data Log. O K Sample was run in the Open Mode. Flow Error or Fragile RBCs.
NOTE: Reticulocyte results are not suppressed for Fragile RBCs but are suppressed for Flow Errors. 5. The statistics are displayed below the data as follows: N: The number of runs used in the calculation.
FILE MEAN:The mean value for the number of runs used in the calculation. Std Dev: CV%: The standard deviation for the number of runs used in the calculation. The coefficient of variation, in percent, for the number of runs used in the calculation.
The following soft keys are displayed on the VIEW RETIC QC LOG screen: PURGE QC LOG LEVEY-JENNINGS REJECT SPECIMEN or ACCEPT SPECIMEN (This key label alternates between these two selections when the soft key is pressed.)
DELETE SPECIMEN MOVE SPECIMEN PRINT QC LOG RETURN These soft keys are discussed in the order in which they appear on the screen from left to right.
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The [PURGE QC LOG] key is used to delete the contents of a designated file in the QC Log. When the [PURGE QC LOG] key is pressed, the following soft key labels are displayed: CONFIRM PURGE CANCEL PURGE These soft keys are used to confirm or cancel the [PURGE QC LOG] command. When the [CONFIRM PURGE] key is pressed, all the results are deleted from the designated file (the data are no longer displayed nor stored in the file). When the [CANCEL PURGE] key is pressed, the results are not deleted.
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IRF: - - - - - -
PREVIOUS 10
NEXT 10
RETURN
Figure 14.19:
LEVEYJENNINGS
The [LEVEY-JENNINGS] key is used to display the Levey-Jennings graphs of the data in the QC Log. (See the preceding figure.) Up to 30 data points can be displayed on the screen at one time. If there are more than 30 data points in the QC Log, the [PREVIOUS 10] and [NEXT 10] keys can be used to scroll through the graphs. The following soft key labels are displayed when the [LEVEY-JENNINGS] key is pressed: PREVIOUS 10 NEXT 10 PRINT RETURN (This key is not displayed when the first 10 data points are displayed.) (This key is not displayed when the last 10 data points are displayed.)
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RETURN
The [RETURN] key is used to return to the VIEW RETIC QC LOG screen.
Lot Number : 0123ABCD4 Exp. Date: 09/24/00 LEVEL I: 2/120 Page 1 of 1 Upper Limits: Lower Limits: Target Mean: Seq R31 R32 2.24 0.64 1.44 RTC% 1.38 1.42 0.77 0.47 0.62 IRF 0.60 0.61
Auto-Sampler Pause PURGE QC LOG LEVEYJENNINGS REJECT SPECIMEN DELETE SPECIMEN MOVE SPECIMEN PRINT QC LOG RETURN
Figure 14.20:
The [REJECT SPECIMEN] key is used to exclude the results for the specimen indicated by the cursor position. When the soft key is pressed, the key label changes to [ACCEPT SPECIMEN], an R is displayed in the column immediately left of the results, and the statistics are recalculated excluding those results. (See the preceding figure.) The data are still displayed and stored in the file, but they are excluded from the statistical calculations. When the [ACCEPT SPECIMEN] key is pressed, the R is deleted and the statistics are recalculated including those results.
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The [DELETE SPECIMEN] key is used to delete the results for the specimen indicated by the cursor position. When the [DELETE SPECIMEN] key is pressed, the following soft key labels are displayed: CONFIRM DELETION CANCEL DELETION These soft keys are used to confirm or cancel the Delete Specimen command. When the [CONFIRM DELETION] key is pressed, the results are deleted from the file (the data are no longer displayed nor stored in the file) and the statistics are recalculated excluding those results.
The [MOVE SPECIMEN] key is used to move the QC result indicated by the cursor position to another QC file. When the [MOVE SPECIMEN] key is pressed, the RETIC QC LOG screen is displayed, allowing the desired file to be selected. When the [MOVE TO FILE] key is pressed, the result is moved to the indicated file.
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PRINT QC LOG
RETURN
FAULT REPORT
CLEAR FAULT
INITIALIZATION
RETIC MAIN
RETURN
RETURN
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14:10 lym R4
FAULT REPORT
CLEAR FAULT
INITIALIZATION
RETIC MAIN
Figure 14.21:
RETIC DIAGNOSTC
The [RETIC DIAGNOSTC] key is used to display the RETIC DIAGNOSTICS screen. The soft keys displayed on this screen enable the operator or service representative to obtain information and execute programs that assist in troubleshooting and in identifying the corrective action needed. The RETIC DIAGNOSTICS screen displays a subset of the soft keys displayed on the main DIAGNOSTICS menu. The following soft keys are displayed on the RETIC DIAGNOSTICS screen: FAULT REPORT RETIC CNT RATE SUMM CLEAR FAULT RAW DATA SUMMARY INITIALIZATION RETIC MAIN These soft keys are discussed in the order in which they appear on the screen from left to right.
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Chapter 14
When the [FAULT REPORT] key is pressed, information regarding any pending fault is displayed on the screen. The screen displays the words OPERATOR CORRECTABLE FAULT REPORT: or FATAL FAULT REPORT and any additional information available. If there is no fault, the screen displays the words NO FAULT PENDING. Operator-correctable faults (for example, Waste Full, Diluent Empty) can be cleared after the corrective action has been taken by pressing the [CLEAR FAULT] key. After corrective action has been taken for a Fatal Fault, the system must be reinitialized.
TOTAL COUNT: 72861 0.53 1.06 4672 9567 8899.05 9235.85 4.77 5.30 46231 51353 10054.71 9756.20
RETURN
Figure 14.22:
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When the [RETIC CNT RATE SUMM] key is pressed, the following soft key labels are displayed: RETIC CNT GRAPH PRINT RETURN The data displayed on the screen are the kinetic data for the Reticulocyte specimen from the last run, displayed in a tabular format. (See the preceding figure.) The total count, data acquisition intervals, and rate per second are displayed.
When the [RETIC CNT GRAPH] key is pressed, the rate per second data are displayed as a graph. (See the following figure.) The kinetic data and graph information are useful when troubleshooting problems with the reticulocyte parameter. A printout of the Reticulocyte Count Rate Summary may be obtained by pressing the [PRINT] key when the desired format is displayed on the screen.
10479.2 9169.3 7859.4 6549.5 5239.6 3929.7 2691.8 1309.9 0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0 7.5 RETIC CNT GRAPH
RETURN
Figure 14.23:
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When the [CLEAR FAULT] key is pressed, the Analyzer returns to the READY state if the corrective action that was taken has resolved the problem. If the corrective action did not correct the problem, the fault status does not change. NOTE: Only operator-correctable faults can be cleared with the [CLEAR FAULT] key.
RETURN
Figure 14.24:
RAW DATA SUMMARY
When the [RAW DATA SUMMARY] key is pressed, information pertaining to the last cycle run in the Reticulocyte Package is displayed.
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When the [INITIALIZATION] key is pressed, the system is reinitialized. The system exits the Reticulocyte Package and returns to the Standard Hematology mode.
When the [PRINT] key is pressed, a Diagnostics Report is printed. This report contains information pertinent to the data displayed on the screen at the time the key is pressed. If no data are displayed on the screen, the printed report contains the current fault status.
The [RETIC MAIN] key is used to return to the RETIC MAIN menu screen. The [RETIC MAIN] key appears on each primary RETIC DIAGNOSTICS screen and works the same way on each screen.
FLUSH SHEATH
RETIC MAIN
RETIC SP PROTOCOLS
The [RETIC SP PROTOCOLS] key is used to display the RETIC SPECIAL PROTOCOLS menu. The following soft key labels are displayed on the RETIC SPECIAL PROTOCOLS menu: FLUSH SHEATH EMPTY WOC or FILL WOC (This key label alternates between these two selections.)
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CLEAN SHEAR VLV or RESTORE SHEAR VLV DISABLE ANALYZER or ENABLE ANALYZER RETIC MAIN
(This key label alternates between these two selections.) (This key label alternates between these two selections.)
A brief description of the function of each soft key follows. Instructions for the detailed use of each function are given in the appropriate maintenance procedure in Chapter 9: Maintenance.
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FLUSH SHEATH
EMPTY WOC
DISABLE ANALYZER
RETIC MAIN
Figure 14.25:
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The [FLUSH SHEATH] key is used to flush the WOC Flow Cell with Sheath Reagent.
The [EMPTY WOC] key is used to drain the reagent from the WOC flow cell. When the flow cell is empty, the soft key label changes to [FILL WOC]. When the [FILL WOC] key is pressed, the flow cell is refilled with reagent. When the flow cell is filled, the soft key label changes back to [EMPTY WOC].
The [CLEAN SHEAR VLV] key is used to prepare the shear valve for cleaning. When the soft key is pressed, the syringes will partially empty, which flushes the reagents out of the shear valve and the associated tubings. The shear valve then rotates into the position necessary for its removal. When the rotation is complete, the soft key label changes to [RESTORE SHEAR VLV]. When the [RESTORE SHEAR VLV] key is pressed, the syringes refill the shear valve and the associated tubings and the shear valve rotates back to its operational position. When the rotation is complete, the soft key label changes back to [CLEAN SHEAR VLV].
The [DISABLE ANALYZER] key is used to prevent the Analyzer from cycling while certain maintenance procedures are performed. When the Analyzer is disabled, the soft key label changes to [ENABLE ANALYZER]. When the [ENABLE ANALYZER] key is pressed, the Analyzer is returned to the operational state and the soft key label changes back to [DISABLE ANALYZER].
The [RETIC MAIN] key is used to return to the RETIC MAIN menu screen.
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Routine Operation
Overview
This section contains information and procedures that are recommended for the routine operation of the Reticulocyte Package for the CELL-DYN 3700 System. This section contains the following subsections: Retic Run Menu Flowchart Retic Run Menu Reticulocyte Specimens Specimen Requirements Running Specimens Background Quality Control Patient Interfering Substances Specimen Preparation For instructions on turning the Reticulocyte Package ON and OFF, refer to Retic Menu Options, Turning Reticulocyte Package On and OFF within this chapter.
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PATIENT SPECIMEN
QC SPECIMEN
BACKGROUND
RETIC MAIN
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# Specimens 0 0 0 0 0 0
PATIENT SPECIMEN
QC SPECIMEN
BACKGROUND
RETIC MAIN
Figure 14.26:
RETIC RUN
The [RETIC RUN] key on the RETIC MAIN menu screen is used to display the RETIC RUN screen. (See the preceding figure.) This screen allows the operator to decide which type of Reticulocyte specimen will be analyzed. The upper right-hand corner of the screen contains the current time and date, the operator ID, and the next Reticulocyte Sequence Number. The following soft keys are displayed on the RETIC RUN screen: CLEAR FAULT PATIENT SPECIMEN QC SPECIMEN BACKGROUND RETIC MAIN These soft keys will be discussed as they appear on the RETIC RUN screen from left to right. (This key label appears whenever a system fault occurs.)
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The [CLEAR FAULT] key is displayed on the RETIC RUN screen whenever a system fault occurs (for example, Diluent Empty). This key is used after corrective action has been taken, to clear the fault message and return the Analyzer to the Ready state. NOTE: A message describing the fault is displayed on the bulletin line. A list of fault conditions and corrective action is given in Chapter 10: Troubleshooting.
The [PATIENT SPECIMEN] key on the RETIC RUN screen is used to display the first RETIC PATIENT SPECIMEN screen. (See the following figure.) The patient specimen ID (up to 12 alphanumeric characters) is entered here. Type the information and press the Enter key on the keyboard to confirm the entry. The Standard Hematology Data Log will then be searched for the entered specimen ID. NOTE: If the patient name is used for the specimen ID, the name must be typed exactly as it was originally entered in the Standard Hematology Data Log. NOTE: Specimen IDs must match exactly and are case sensitive.
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CANCEL
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PATIENT ID : PATIENT ID :
Patient: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Sex (M/F): _ _ DOB: 00/00/00 Dr. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ RBC 5.48 M/uL Use demographics and RBC value? - (Y/N)
CANCEL
Figure 14.28:
The Second Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID is Found) 14-59
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If the ID located is from a specimen run more than 8 hours ago, the third RETIC PATIENT SPECIMEN screen is displayed. (See the following figure.)
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ENTER SPECIMEN ID: 365127 Press ENTER to confirm. SPECIMEN ID: 365127 was found in HEMATOLOGY DATA LOG but specimen data are more than 8 hours old . . .
CANCEL
Figure 14.29:
The Third Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID Found is More Than Eight Hours Old)
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If the Specimen ID is not found in the Standard Hematology Data Log, the fourth RETIC PATIENT SPECIMEN screen is displayed. (See the following figure.) This screen displays a place for the operator to enter the RBC value. If an entry error is made in the fourth RETIC PATIENT SPECIMEN screen, the operator may press the [CANCEL] key to return to the first RETIC PATIENT SPECIMEN screen. If the operator presses the Enter key to confirm the RBC value, the RETIC RUN RESULT screen is displayed.
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PATIENT ID : PATIENT ID :
CANCEL
Figure 14.30:
The Fourth Reticulocyte Patient Specimen Screen (Displayed When the Specimen ID Is Not Found)
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1 Spec ID AA12345 2 Patient: 3 Sex(M/F):5 Limits: 1 RETIC% RBC RETIC ABS IRF 0.91 4.00 36 0.10 % M/uL K/uL DOB:--/--/-4 Dr.--------------------
11:44 SH R4
NEXT RETIC
COLOR PRINT
Figure 14.31:
Upper Left Corner The numbers in the upper left-hand corner of the RETIC RUN RESULT screen (shown in the preceding figure) correspond with the following numbered data entry fields: 1. <Specimen ID> This data entry field automatically displays the specimen ID (up to 12 characters), which was previously entered on the RETIC PATIENT SPECIMEN screen. This data entry field automatically displays the patients name if it was found in the Standard Hematology Data Log when the patient specimen ID was entered into the first RETIC PATIENT SPECIMEN screen. If the information was not found in the Standard Hematology Data Log, the patient name can be entered here (up to 16 characters).
2. <Patient>
NOTE: If an entry error is made in the second RETIC PATIENT SPECIMEN screen, the operator may press the [CANCEL] key to return to the first RETIC PATIENT SPECIMEN screen.
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3. <Sex (M/F):/DOB>
This data entry field automatically displays the sex and birth date of the patient if it was found in the Standard Hematology Data Log. If the information was not found in the Standard Hematology Data Log, the sex and birth date of the patient can be entered here. This data entry field automatically displays the name of the patients doctor if it was found in the Standard Hematology Data Log. If the information was not found in the Standard Hematology Data Log, the name of the patients doctor can be entered here (up to 22 characters). This data entry field automatically displays the number of the Limit Set that will be applied to the sample results.
4. <Dr.>
5. <Limits>
NOTE: The Limit Set applied to the reticulocyte sample may be changed after the specimen has been run. Refer to the description for the [EDIT SPECIMEN] key given in Reticulocyte Menu Options, Reticulocyte Data Log Menu, Display Specimen Soft Key within this chapter. These demographics can be entered or changed before the Reticulocyte specimen is processed, or while the EDIT SPECIMEN screen in the Reticulocyte Data Log is displayed.
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Top Center The Status Box is displayed in the top center of the RETIC RUN RESULT screen. This box appears on every screen to show the following information: The menu in use (such as RETIC RUN RESULT). The status of the Analyzer (such as Ready, Not ready, and FAULT messages). Status and instructive messages. During the Reticulocyte Run cycle these are: Aspirating Remove Specimen Dispensing Rinsing Processing Data Ready Upper Right Corner The upper right-hand corner of the RETIC RUN RESULT screen displays the following information: The current date and time. The operator ID (which identifies the current operator). The Reticulocyte Sequence Number. ("R _ _ _ _ ," which automatically increments as reticulocyte samples are run.) Center The center section of the RETIC RUN RESULT screen displays the results. The list of the parameters and results is displayed on the left side. The information on RBC value entry is also displayed on the left side. The scatterplot and the histograms are displayed on the right. The red blood cells are shown in red, the reticulocytes are shown in blue, the nucleated cells are shown in white (black on the color printout), the immature Reticulocytes are shown in cyan (light blue), and coincidence passage events are shown in green and the noise is shown in yellow. Any alert messages will appear in the lower left-hand corner of the screen. The following soft key labels are displayed on the RETIC RUN RESULT screen: NEXT RETIC (This soft key label appears when the Reticulocyte specimen run has been completed.) (This key is used to return to the RETIC RUN screen.)
CELL-DYN 3700 System Operators Manual
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IRF
Figure 14.32:
QC SPECIMEN
When the [QC SPECIMEN] key on the RETIC RUN screen is pressed, the QC file where the cursor is positioned is opened and the RETIC RUN RESULT screen for QC specimens is displayed. (See the preceding figure.) Results from the QC run option are stored in the selected reticulocyte QC file and in the Reticulocyte Data Log.
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Figure 14.33:
BACKGROUND
When the [BACKGROUND] key on the RETIC RUN screen is pressed, the RETIC RUN RESULT screen for background counts is displayed. (See the preceding figure.) Results from this run option are identified by the designation BACKGROUND on the RETIC RUN RESULT screen and in the Retic Data Log.
When the [RETIC MAIN] key is pressed, the RETIC MAIN menu screen is displayed.
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Reticulocyte Specimens
Overview
This subsection discusses routine operation of the Reticulocyte Package. Guidelines and procedures are provided for running background counts, quality control, and patient specimens. The Reticulocyte Package is only available for use in the Open Sampler Mode. For background counts, a tube of reticulocyte reagent is run without an aliquot of whole blood, to check for particulate material in the reagent and system. Control material should be properly warmed and mixed according to the manufacturers recommendations. Patient reticulocyte controls should be handled according to the laboratorys protocol. Quality control checks (which verify Reticulocyte Package performance) should be performed on each shift that reticulocyte samples are run. Each reticulocyte sample is run by starting from the RETIC RUN screen. The operator selects the type of Reticulocyte specimen to be run (Patient, QC, or Background) and proceeds through the screen(s) displayed for that specimen type. When the reticulocyte sample is completed, the [NEXT RETIC] key is displayed. When the [NEXT RETIC] key is pressed, the operator can then select the specimen type for the next specimen. Specific instructions for each specimen type are given in this section of this chapter. CAUTION: When using the reticulocyte reagent, avoid contact with skin and clothing. This reagent contains New Methylene Blue, which will stain skin, clothing, and many other surfaces. WARNING: Potential Biohazard. Consider all clinical specimens and controls that contain human blood or serum as potentially infectious. Use established, good laboratory working practices when handling these specimens. Wear appropriate personal protective equipment and follow other biosafety practices as specified in the OSHA Bloodborne Pathogen Rule or other equivalent biosafety procedures.
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Specimen Requirements
Do not run hemolyzed specimens, as they may result in inaccurate reticulocyte values. Specimens may be run up to 8 hours after collection time without refrigeration. NOTE: Studies have shown that reticulocytes continue to mature at room temperature. Increased flagging can occur when using specimens more than 8 hours old. If a specimen is more than 8 hours old and the CBC was processed on the CELL-DYN 3700 System more than 8 hours ago, obtain the RBC value from the Standard Hematology Data Log before entering the Reticulocyte Package. The Reticulocyte Package will select RBC values only for specimens processed within the last 8 hours. To ensure optimal flagging, perform the CBC run within 8 hours prior to the Retic run on the same analyzer using the same specimen. NOTE: Specimen IDs must match exactly and are case sensitive. It is recommended that the RBC value used to determine the reticulocyte absolute number be selected from the results for the same specimen that will be used for the reticulocyte count.
Interfering Substances
The CELL-DYN 3700 Reticulocyte method is a nucleic acid staining method. Therefore, other substances that contain nucleic acids could potentially be enumerated by the instrument as reticulocytes. If these interfering substances are present in sufficient numbers, they may interfere with the dynamic thresholds used to obtain the CELL-DYN 3700 reticulocyte count. Consequently, these specimens should be flagged by the instrument. Refer to Troubleshooting, Instrument Alert Conditions within this chapter for a complete description of the Reticulocyte flags. The information in the following table, based on CLSI/NCCLS Document H44-A21 indicates substances that are known or potential interferents. The CELL-DYN 3700 Reticulocyte procedure is designed to minimize some common interferents, including high WBC counts and NRBCs.
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Table 14.1:
Pappenheimer bodies Cold agglutinins Leukocyte fragments Nucleated erythrocytes >200 NRBC/100 WBC Parasites (malaria, babesia) Platelet/erythrocyte coincidence Hemolysis
Running Specimens
This section contains information and procedures recommended for routine operation of the Reticulocyte Package. Proper start-up procedures should be performed prior to processing patient specimens. These include the background counts and daily quality control checks described in the following sections.
Background Counts
The reticulocyte background count must be included in the daily start-up procedures to check for particulate matter in the reticulocyte reagent and the CELL-DYN 3700 System. The background count is determined from the total counts that occur in the reticulocyte scatter area on the 10/90 scatterplot.
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5. Be sure that the word READY is illuminated on the Analyzer Status Indicator Panel and the word Ready is displayed in the Status Box on the RETIC RUN RESULT screen. 6. Open the tube labeled "Retic Background" and immerse the Open Sample Aspiration Probe in the reagent. 7. Press the Touch Plate located behind the probe to start the cycle. The word BUSY will be illuminated in yellow on the Analyzer Status Indicator Panel. The Status Box on the RETIC RUN RESULT screen will display messages indicating the various stages of the cycle. 8. Remove the tube when the beep sounds. The Wash Block will move down the probe and clean it. 9. When the cycle is complete, the Wash Block moves back to the top of the probe and the Ready message is displayed in the Status Box. NOTE: No message is illuminated on the Analyzer Status Indicator Panel until the [NEXT RETIC] key is pressed and the operator has selected the specimen type for the next specimen to be processed. 10. The screen displays the background count results as Background Count Found in Retic Area. 11. Verify that the background count is within the acceptable limit of less than 100 counts. NOTE: Results that are outside the acceptable range are displayed in purple. 12. If the background count is unacceptable, repeat it. If the repeated count is still unacceptable, follow the directions for troubleshooting background count problems given in the Troubleshooting section of this chapter.
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Quality Control
Quality control checks should be performed daily according to the laboratorys protocol. Control material should be properly warmed and prepared according to the manufacturers recommendations. Patient controls should be handled according to the laboratorys protocol. For customizing the QC files, see Chapter 5: Operating Instructions, Subsection: Set Up Instructions, QC Set Up Menu.
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12. When the cycle is completed, the Wash Block moves up the probe. NOTE: The word Ready appears in the Status Box. No message is illuminated on the Analyzer Status Indicator Panel until the [NEXT RETIC] key is pressed on the RETIC RUN RESULT screen and the operator has selected the specimen type for the next specimen to be processed from the RETIC RUN screen. 13. Repeat steps 8 through 12 for all prepared control specimens. 14. Verify that the control results are acceptable. NOTE: Out-of-range results are displayed in color. Data invalidating alerts, such as Fragile RBCs, are not valid when running commercial controls. 15. If the results are unacceptable, repeat the run. If the results are still unacceptable, run the other levels of the control material. If the results are still unacceptable, prepare another stained dilution of that level of the control material. If the results on all levels are unacceptable, troubleshoot accordingly. See Chapter 10: Troubleshooting. 16. When the control results are acceptable, patient samples may be analyzed.
Patient Specimens
CAUTION: When using the reticulocyte reagent, avoid contact with skin and clothing. This reagent contains New Methylene Blue, which will stain skin, clothing, and many other surfaces. WARNING: Potential Biohazard. Consider all clinical specimens and controls that contain human blood or serum as potentially infectious. Use established, good laboratory working practices when handling these specimens. Wear appropriate personal protective equipment and follow other biosafety practices as specified in the OSHA Bloodborne Pathogen Rule or other equivalent biosafety procedures.
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Specimen Preparation 1. The Reticulocyte Package is available for use only in the Open Sampler Mode. 2. Use reticulocyte reagent and verify the expiration date. Store the stock reagent in the dark at room temperature. 3. Label a tube of reticulocyte reagent for each patient. 4. Verify that the whole blood specimen is warmed to room temperature and well mixed prior to sampling. 5. Pipette 20 L of the whole blood specimen into each labeled tube of reticulocyte reagent. 6. Incubate the stained Reticulocyte specimens on the rotator or in a rack, after fully inverting the stained specimens 5 times. Incubation is performed according to Reagent Package Insert. NOTE: The timing stated in the Reagent Package Insert allows Reticulocyte specimens to be processed for either STAT requests or grouped and run in batches. Running Patient Samples NOTE: To ensure optimal flagging, perform the CBC run within 8 hours prior to the Retic run on the same analyzer using the same specimen. NOTE: Specimen IDs must match exactly and are case sensitive. 1. Press the [RETIC RUN] key to display the RETIC RUN menu. Press the [PATIENT SPECIMEN] key to display the RETIC PATIENT SPECIMEN screen. 2. From the RETIC PATIENT SPECIMEN screen enter the Patient ID and press the Enter key on the keyboard to start the search process. The Standard Hematology Data Log for the last 8 hours will be searched for this Patient ID. 3. If the Patient ID is found, the second RETIC PATIENT SPECIMEN screen is displayed. All the available patient demographic information, and the RBC value, are shown on the screen. Proceed to step 4. If the Patient ID is found but is more than 8 hours old, the third RETIC PATIENT SPECIMEN screen is displayed and the operator may enter an RBC value in this screen. Skip to step 5.
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If the Patient ID is not found, the fourth RETIC PATIENT SPECIMEN screen is displayed and the operator may enter an RBC value in this screen. Skip to step 5. NOTE: If an RBC value is entered manually, the Retic run will have incomplete flagging analysis for Excessive RBC Loss (ERL) and Excessive Nucleated Count (ENC). 4. Press Y on the keyboard to save this demographic information. NOTE: If the Enter key was pressed in error, or if the patient demographic information is incorrect, press the [CANCEL] key to return to the first RETIC RUN screen, press the [PATIENT SPECIMEN] key, then reenter the Patient ID. If the Patient ID is found, skip to step 6. If not, proceed to step 5 after entering the RBC value. 5. Press the Enter key on the keyboard to confirm and accept this information. 6. The RETIC RUN RESULT screen is now displayed. The area in the upper left-hand corner displays the patient demographic information. NOTE: The patient demographic data can be added or edited on this screen before the specimen is run, or from the EDIT SPECIMEN screen in the Reticulocyte Data Log after the reticulocyte run is complete. 7. The prepared dilution(s) of the patient reticulocyte sample(s) can be run after the control and background count results have met the laboratorys criteria. 8. Open the well-mixed, prepared patient reticulocyte sample tube and immerse the Open Sample Aspiration Probe in the sample. 9. Press the Touch Plate located behind the probe to start the cycle. The word Busy on the Analyzer Status Indicator Panel will be illuminated in yellow. The Status Box on the RETIC RUN RESULT screen will display messages to indicate the various stages of the cycle. 10. Remove the sample tube when the beep sounds. The Wash Block moves down the probe and cleans it. 11. When the rinse cycle is complete, the Wash Block moves up the probe. The [NEXT RETIC] key is now displayed, and the Touch Plate is no longer active. The results of the reticulocyte run are displayed on the screen.
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12. If automatic report printing has been specified, a report is printed according to the options selected in the SET UP MENU. If automatic report printing has not been specified, a report may be printed by pressing the [PRINT REPORT] key. Repeat this procedure for each subsequent reticulocyte sample. NOTE: To obtain a color printout, the color printing option on the CUSTOMIZE PRINTED REPORT screen must be turned ON before entering the Reticulocyte Package. 13. Reticulocyte patient sample results can also be printed from the RETIC DISPLAY SPECIMEN screen, available from the RETIC DATA LOG screen.
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NOTES
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Westgard Rules
Each of these options is discussed in detail in Chapter 7: Quality Control. All QC data should be reviewed according to your laboratorys protocol.
Control Material
Abbott Diagnostics recommends using the CELL-DYN control material for performing quality control checks on the CELL-DYN 3700 System. These controls should be run: After daily start-up procedures are completed. After a reagent lot number change. After a service call or component replacement. After calibrating the Standard Hematology Mode. In accordance with the laboratorys quality control protocol. According to regulatory requirements. NOTE: Data invalidating alerts, such as Fragile RBCs, are not valid when running commercial controls.
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Reagent
Use Reticulocyte Reagent prepared only by Abbott Diagnostics. Verify the expiration date. Store the Reticulocyte Reagent in the dark at room temperature. Use one Reticulocyte Reagent tube for each CELL-DYN control or patient specimen.
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Troubleshooting
Overview
This section provides instructions for identifying, troubleshooting, and correcting instrument alerts and conditions in the Reticulocyte Package. All instrument conditions which adversely affect the Standard Hematology Mode of the CELL-DYN 3700 System will also apply to the Reticulocyte Package. These instrument conditions may be found in Chapter 10: Troubleshooting. This section is divided into the following subsections: Operational Messages and Data Flagging Dispersional Data Alerts Instrument Alert Conditions Alert Messages with Suppressed Reticulocyte Results Data Invalidating Alerts High Background Counts NOTE: For a list of interfering substances, refer to Routine Operation, Reticulocyte Specimens, Interfering Substances within this chapter.
Result displayed as >>>> Result(s) outside limits underlined when printed Result(s) outside limits underlined when printed Result(s) outside limits underlined
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Flow Error Note: Alert occurs when the average count rate rapidly increases during the Reticulocyte count cycle. Too Few Events Note: Alert occurs when fewer than 3000 events are counted during the Reticulocyte count cycle. >>>> (Chevrons)
1. Run a background count to cycle air through the system. 2. Rerun the Reticulocyte specimen.
Hardware malfunction
Inadequate whole blood sample mixing
3. If alert still occurs, refer to Chapter 10: Troubleshooting, Subsection: Troubleshooting Flow Errors. 1. Prepare another dilution verifying proper specimen preparation as discussed in Routine Operation, Reticulocyte Specimens, Running Specimens, Patient, Specimen Preparation within this chapter. 2. Verify Reticulocyte results by an alternate method. 1. Verify Reticulocyte results by an alternate method.
Cold Agglutinin
The Reticulocyte
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Alert Fragile RBCs NOTE: Alert occurs when the average count rate rapidly decreases during the Reticulocyte count cycle.
Corrective Action 1. Run a background count to cycle air through the system. Rerun the Reticulocyte specimen. 2. Prepare another dilution verifying proper specimen preparation as discussed in Routine Operation, Reticulocyte Specimens, Running Specimens, Patient, Specimen Preparation within this chapter. Run the dilution after adequate incubation as indicated in the Reagent Package Insert. 3. Verify Reticulocyte results by an alternate method. 1. Prepare another dilution verifying proper specimen preparation as discussed in Routine Operation, Reticulocyte Specimens, Running Specimens, Patient, Specimen Preparation within this chapter, and run after adequate incubation as indicated in the Reagent Package Insert. 2. Rerun the specimen. 3. If the flag persists, verify the reticulocyte results by an alternative method.
Fragile RBCs Excessive RBC Loss (ERL) Specimen staining time too long in the reticulocyte reagent Rapid degeneration of RBCs. High concentration of platelets, platelet aggregates, or other interfering substances. Microcytic RBCs Improper instrument settings Too much blood added to reagent tube. High concentration of WBCs and/or NRBCs.
CAUTION: The (ERL) alert is functional only when CBC results have been run on the same analyzer.
Excessive Nucleated Cells (ENC) CAUTION: The (ENC) alert is functional only when CBC results have been run on the same analyzer.
1. Prepare another dilution using 20lL of blood. 2. Rerun the specimen. If this alert persists, verify Reticulocyte results by an alternate method.
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References
1. Clinical and Laboratory Standards Institute/NCCLS. Methods for Reticulocyte Counting (Automated Blood Cell Counters, Flow Cytometry, and Supravital Dyes); Approved Guideline Second Edition. CLSI/NCCLS document H44-A2 (ISBN 1-56238-5275) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2004. 2. Davis, BH. Immature Reticulocyte Fraction (IRF): by any name a useful clinical parameter of erythropoietic activity. Laboratory Hematology 2:2-8, 1996. 3. Clinical and Laboratory Standards Institute/NCCLS. Method Comparison and Bias Estimation Using Patient Samples; Approved Guideline Second Edition. CLSI/NCCLS document EP9-A2 (ISBN 1-56238-472-4) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2002. 4. Clinical and Laboratory Standards Institute/NCCLS. Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach; Approved Guideline. CLSI/ NCCLS document EP6-A (ISBN 1-56238-498-8) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2003. 5. International Committee for Standardization in Haematology (ICSH). The Assignment of Values to Fresh Blood Used for Calibrating Automated Cell Counters. Clinical and Laboratory Hematology 1988; 10:203-212. 6. Clinical Applications of Flow Cytometry. ASCP National Meeting. Spring 1990. 7. Shapiro Howard. Practical Flow Cytometry. New York: LISS. 1985.
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NOTES
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Bibliography
American Society of Clinical Pathologists (ASCP). Clinical Applications of Flow Cytometry. ASCP National Meeting. Spring 1990. Bull BS, Hay KL. Are Red Blood Cell Indexes International? Archives of Pathology and Laboratory Medicine; 109:604606; 1985. Bull BS, Jones AR, Gibson M, Twedt D. A Method for the Independent Assessment of the Accuracy of Hematology Whole Blood Calibrators. American Journal of Clinical Pathology; 98:623-29; 1992. Bull BS, Korpman RA. Intralaboratory Quality Control Using Patients Data. Quoted in Cavill I, ed, Quality Control Edinburgh: Churchill Livingstone; pp. 121150, 1982. Cembrowski GS, Carey RN. Laboratory Quality Management. Chicago: ASCP Press, p. 189, 1989. Cembrowski GS, et al. Use of a Multirule Control Chart for the Quality Control of PT and APTT Analyses. Laboratory Medicine. pp. 418 421; June 1989. Chanarin I, ed. Laboratory Hematology: An Account of Laboratory Techniques. New York: Churchill Livingstone, pp. 3-7, 1989. International Committee for Standardization in Haematology (ICSH). The Assignment of Values to Fresh Blood Used for Calibrating Automated Cell Counters. Clinical and Laboratory Hematology; 10:203-212; 1988. International Committee for Standardization in Haematology (ICSH). Protocol for Evaluation of Automated Blood Cell Counters. Clinical and Laboratory Hematology; 6:69-84; 1984. Clinical and Laboratory Standards Institute/NCCLS. Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard Fifth Edition. CLSI/NCCLS document H3A5 (ISBN 1-56238-515-1) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2003.
Bibliography-1
Bibliography
Clinical and Laboratory Standards Institute/NCCLS. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens; Approved Standard Fifth Edition. CLSI/NCCLS document H4-A5 (ISBN 1-56238-538-0) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2004. Clinical and Laboratory Standards Institute/NCCLS. Procedure for Determining Packed Cell Volume by the Microhematocrit Method; Approved Standard Third Edition. CLSI/NCCLS document H7A3 (ISBN 1-56238-413-9) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2000. Clinical and Laboratory Standards Institute. Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods; Approved Standard. CLSI/NCCLS document H20-A (ISBN 1-56238-131-8) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 1992. Clinical and Laboratory Standards Institute/NCCLS. Methods for Reticulocyte Counting (Automated Blood Cell Counters, Flow Cytometry, and Supravital Dyes); Approved Guideline Second Edition. CLSI/NCCLS document H44-A2 (ISBN 1-56238-527-5) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2004. Clinical and Laboratory Standards Institute/NCCLS. Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach; Approved Guideline. CLSI/NCCLS document EP6-A (ISBN 1-56238-498-8) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2003. Clinical and Laboratory Standards Institute/NCCLS. Method Comparison and Bias Estimation Using Patient Samples; Approved Guideline Second Edition. CLSI/NCCLS document EP9-A2 (ISBN 1-56238-472-4) 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898, 2002. Shapiro Howard. Practical Flow Cytometry. New York: LISS. 1985. Westgard JO et al. A Multi-Rule Shewhart Chart for Quality Control in Clinical Chemistry. Clinical Chemistry, 27:3:493 501, 1981.
Bibliography-2
Appendix A
Bar Codes
Overview
This section gives a brief overview of what bar coding is, how bar code labels are used for data entry and the different types of bar codes that may be used with the CELL-DYN 3700 System. Bar coding is an automated method of gathering alphanumeric information and transmitting it to a computer. Because it eliminates typing and associated errors, bar coding offers speed, increased accuracy and efficiency. The following are the major elements in a bar coding system: The computer, and its software, which interpret and store bar code data. For the CELL-DYN 3700 System, this is accomplished by the Data Station and its software. The scanning device, which decodes the information on the bar code labels. (The Sample Loader of a CELL-DYN 3700SL System has an integrated reader.) The bar code labels, which supply the specimen identification codes.
Appendix A-1
Bar Codes
Overview
Appendix A
Appendix A-2
Appendix A-3
Bar Codes
Overview
Appendix A
NOTES
Appendix A-4
Appendix A
Bar Codes
Specifications
Bar Code Label Formats
The Sample Loader Bar Code Reader can read Code 39, Interleaved 2 of 5, Codabar and Code 128 formats interchangeably, provided the check digit option is disabled. Code size, collection tube length, and cap style limit the number of digits to the following maximum numbers: Code 39 9 digits Interleaved 2 of 5 10 or 12 digits only Codabar 10 digits The maximum number of digits includes any check digits within the code. For example, if one check digit is used in Code 39, then there are 8 digits left for the rest of the code. Code 128 11 digits
NOTE: If a specific check digit option is selected and enabled, the Sample Loader will read only bar codes in that specific format. If there is more than one format to be read, it is recommended that the check digit option be disabled.
Appendix A-5
Bar Codes
Specifications
Appendix A
Minimum Bar Length 0.5 inches Figure A.1: Bar Code Label Specifications
Appendix A-6
CELL-DYN Q Labels
Special bar code labels are available to identify QC specimens. These Q labels (numbers Q1Q20) automatically select QC files 1 to 20, and therefore should be used to process only QC specimens.
Appendix A-7
Bar Codes
Specifications
Appendix A
Exposed Bottom
Tail
Appendix A
Bar Codes
Acknowledgment
The authors wish to acknowledge Computype, Inc. of St. Paul, Minnesota for providing their booklet Bar Coding and Productivity to assist in the writing of this chapter.
Appendix A-9
Bar Codes
Acknowledgment
Appendix A
NOTES
Appendix A-10
Appendix B
Parts List
Overview
This section lists the part numbers of components, accessories, controls, reagents, and consumables associated with the CELL-DYN 3700 System for user convenience when placing orders. To place an order for these products or obtain technical assistance for your CELL-DYN System, contact Abbott Diagnostics Customer Service at 1-877-4ABBOTT (1-877-422-2688).
20005-01 21704-01
*2400502 *3001008 *5100165 *5100201 *5406754
54305-01
*5100164
70048-01 91482-01
Appendix B-1
Parts List
Overview
Appendix B
Table B.1
CELL-DYN 3700 Accessories Kit (List Number 06H88-01) (Continued) Quantity 2 1 1 1 1 1 1 1 Description Peristaltic Pump Tubing- Small Peristaltic Pump Tubing- Medium Sample Aspiration Tubing (Sample Loader) Serial Loop Back Device CD 3700 SL Needle Solenoid Ring Pull Data Station Cable Waste Bottle Cable
Part/List Number 91484-01 91485-01 9212230 92532-01 03H99-01 03H96-01 95519-01 03H98-02 Table B.2
CELL-DYN 3700 Sample Loader Accessories Kit Quantity 1 set Name Sample Loader Racks Comments Set of 11 Sample Loader racks prelabeled with tube position numbers and rack number label
Appendix B-2
25860-01 99650-01 99652-01 04H34-01 28561-01 28560-01 03H99-01 06H89-01 03H76-01 99644-01 99624-01
1 1 1 1 1 1 1 1 1 1
Bar Code Label Dispenser Bar Code Tube ID Labels, 1 roll QC Bar Code Labels Syringe, 10 mL Syringe, 2.5 mL Syringe, 500 L Needle, Vent/Aspiration Operators Manual CELL-DYN 3700 Shear Valve Center Section Enzymatic Cleaner Pre-Printed Tickets
Dispenser for Bar Code Label rolls Tube ID Bar Code Labels (1000 labels per roll) QC Bar Code Labels (Numeral 120), in Code 39 (without check digit) For dispensing Diluent reagent For dispensing WIC/HGB Lyse reagent For injecting diluted sample into optical flow cell For venting/aspirating samples in Closed Mode English Version Ceramic Center Section for CELL-DYN 3700 Blood Shear Valve
Appendix B-3
Parts List
Overview
Appendix B
Table B.4
CELL-DYN 3700 Calibrators and Controls Quantity 1 1 1 1 1 1 1 1 1 1 Name CELL-DYN 22 CALIBRATOR CELL-DYN HemCal Calibrator CELL-DYN 22 Tri-Level Control CELL-DYN 22 Tri-Level Control, half pack CELL-DYN 22 Normal Level Control CELL-DYN 22 Control Assay Disk CELL-DYN 29 Plus Control (with Retic) CELL-DYN 29 Plus Control (with Retic), half pack Description 2 x 2.5 mL tubes 2 x 3.0 mL vials 12 x 2.5 mL tubes 6 x 2.5 mL tubes 6 x 2.5 mL tubes Diskette 12 x 3.0 mL vials 6 x 3.0 mL vials
List Number 99120-01 08H57-01 93111-01 99106-01 99103-01 01H91-01 08H58-01 08H58-02 08H64-01 08H62-01
CELL-DYN 29 Plus Control (with Retic), Assay Disk Diskette CELL-DYN Retic Plus Control 10 x 3.0 mL vials
Table B.5
CELL-DYN 3700 Reagents Quantity 1 1 1 1 1 1 Name Diluent Reagent Sheath Reagent CN free HGB/WIC Lyse Reagent HGB/WIC Lyse Reagent Detergent Reagent Reticulocyte Reagent Single Container Size 20 L cubitainer 9.6 L cubitainer 3.8 L cubitainer 3.8 L cubitaner 20 L cubitainer 5.0 mL tubes, each tube Kit of 100 containing 3.7 mL of reagent QTY/ Case 1/case 1/case 1/case 1/case
Appendix B-4
Appendix C
Appendix C
This table provides a detailed list of interfering substances. Note that some of the substances listed may not interfere with CELL-DYN 3700 results. Refer to the list of interfering substances provided in this manual in Section 3: Principles of Operation, Subsection: Operational Messages and Data Flagging and in Section 5: Operating Instructions, Subsection: Sample Collection and Handling, for the substances that commonly interfere with CELL-DYN 3700 results. Parameter
White Cell Count (WBC)
Cold agglutinins Clotted specimen (microclot) Hemolysis (in vitro) Polycythemia (increased RBC coincidence) Microcytic red cells Clotted specimen (microclot)
Hemoglobin (HGB)
Carboxyhemoglobin (> 10%) Cryoglobulin, cryofibrinogen Hemolysis (in vivo) Elevated white cell count (>30,000/L Hyperbilirubinemia, severe Lipemia Abnormal plasma proteins
Hematocrit Hyponatremia (Packed Cell Volume Manual Method) Plasma trapping Mean Cell Volume Autoagglutination High white cell count (>50,000/L) Hyperglycemia Reduced red cell deformability Swollen red cells High white cell count (> 50,000/L) Spuriously high hemoglobin Spuriously low red cell count Autoagglutination Clotting Hemolysis (in vivo and in vitro) Spuriously high hemoglobin Spuriously low hematocrit Cryoglobulin, cryofibrinogen Hemolysis (in vivo and in vitro) Microcytic red cells Red cell inclusions White cell fragments
Excess EDTA Hemolysis (in vitro) Hypernatremia Cryoglobulin, cryofibrinogen Giant platelets Hemolysis (in vitro) Microcytic red cells
High white cell count (> 50,000/L) Spuriously low hemoglobin Spuriously high red cell count Clotting Giant platelets Heparin Platelet clumping Platelet satellitosis
Platelets (PLT)
Source: Cornbleet J. Spurious Results from Automated Hematology Cell Counters. Laboratory Medicine 1983; 14:509-514.
CELL-DYN 3700 System Operators Manual
Appendix C-1
Appendix C
NOTES
Appendix C-2
Index
Numerics
10-mL Reagent Syringe 9-37
C
Calibrating All Parameters 6-43, 6-54, 6-80 Calibrating Individual Parameters 6-44, 6-55, 6-81 Calibrating the Closed Mode 6-90 Calibrating the Open Mode 6-65 Calibration Backup 6-95 Calibration Factor Calculation 6-40, 6-50, 6-77, 6-90 Calibration Factor Calculations 6-62 Calibration Guidelines 6-27 Calibration Log Soft Key 6-18 Calibration Materials 6-3 Calibration Menu 6-13 Calibration Menu Flowchart 6-13 Calibration Methods 6-3 Calibration Procedural Summary 6-11 Calibration Requirements for Auto-Cal 6-35 Calibration Screen 6-14 Calibration 13-27 Calibrator 1-27 Carryover 13-7 Cell Populations and Flagging 3-45 CELL-DYN 3700 Accessories B-1 CELL-DYN 3700CS System Specifications 4-3, 4-9 CELL-DYN Bar Code Labels 12-3, A-7 CELL-DYN Controls 7-27 CELL-DYN Q Labels 12-3, A-7 Chemical Hazards 8-4 Closed Mode Calibration Confirmation 6-72 Closed Sampler Aspiration Needle 9-22 Closed Sampler Tube Retainer Adjustment (CS System Only) 9-51 Coincidence Passage Correction 3-27 Collecting the Calibration Data 6-38, 6-48, 6-75 Combined Specifications for the SL and CS Systems 4-13 Completing Manual Calibration 6-66 Completing Mode to Mode Calibration 6-82, 6-91 Completing Open Mode Calibration 6-44
A
Abbott Instrument Warranty iii Accessing the Maintenance Log 9-8 Accessing the Shear Valve 9-9 Accuracy 13-6 Acknowledgment A-9 Adding a New Configuration File 13-34 Adding New Animal Types 13-33 Analyzer Air Filters 9-32 Analyzer Flow Panel Components Diagram 9-2 Analyzer 1-6 Aperture Plates 9-39 As Required 9-37 Auto-Cal Calibration Criteria Worksheet 6-45, 6-57 Auto-Cal Methodology 6-34 Auto-Cal Mode to Mode Calibration 6-71 Auto-Cal Overview 6-33 Auto-Cal Sample Capacity 6-34 Auto-Cal Using Calibrator 6-37 Auto-Cal Using Whole Blood 6-47 Auto-Calibrate Soft Key 6-19 Auto-Clean 9-19
B
Bar Code Check Digit Formats A-5 Bar Code Label Formats A-5 Bar Code Label Placement 12-3, A-8, Bar Code Label Specifications A-6 Bar Code Labels 12-3 Bar Code Reader Window 9-46 Bar Code Specifications 4-7 Bar Code Types and Characteristics A-3 Bar Coding Function A-1 Baso Box Setup 13-46 Bibliography Bibliography-1
Index - 1
Completing Whole Blood Open Mode Calibration 6-55 Control Material 14-77 Controls and Calibrator 1-27 Controls 1-27 Conventions Used in this Chapter 6-11 Conventions Used in This Manual xiv, 5-5 Customer Support i Customize Report Soft Key 5-51 Customizing the Display 13-36
F
Flagging Diagnostics Screen 3-57 Flagging Summary 3-49 Flagging 13-8 Flushing the Y Fitting Open and Closed Modes 9-47 Foreword i Function Sequence 12-12 Functional Description 12-9
D
Daily Maintenance Procedures 9-19 Data Log Menu 5-122 Data Log Set Up Procedures 5-135 Data Review from the Data Log 5-140 Data Review from the Retic Data Log 14-37 Data Station Program Overview 5-2 Data Station 1-19 Date/Time Soft Key 5-14 Decontamination Procedures 9-4 Determining Reference Values 6-73 Determining the Calibration Factors for MCV and MPV 13-29 Determining the Closed Mode Mean 6-86 Determining the Open Mode Mean 6-61, 6-85 Determining the Variance 13-39 Determining Which Parameters Need Calibration 6-41, 6-52, 6-63, 6-78, 6-88 Diagnostics Menu Flowchart 10-4 Diagnostics Menu 10-3 Disabling/Enabling the Analyzer 9-9 Draining the Reagent Reservoirs 9-7
G
General 8-3 Graphics Printing 11-3 Guidelines 6-60
H
Handling and Disposing of Biohazardous Materials 8-4 Hazard Information and Precautions 8-3 Hemoglobin Analysis 3-6, 3-35 Hemoglobin Flow Cell Manual Cleaning 9-43 Hemoglobin Measurement Process 3-35 HGB Parameters 3-36 High Background Counts 14-82
I
Initial Preparation 2-3 Installation 2-7 Instrument Disclaimer ii Instrument Fault and Status Messages 3-37 Instrument Installation 2-13 Instrument Labeling viii Instrument Logbook 5-1 Instrument Rinsed 3-7 Instrument Start Up 5-92 Intended Use i, 1-3 Interpretive Messages 3-58 Interval Set Up Procedure 9-15 Introduction to WBC Flagging 3-41 Introduction 10-1, 3-37, 13-1, 13-5 Inventory 2-3
E
Electrical Hazards 8-5 Electrical Impedance Measurements 3-27 Emptying the Transducers 9-6 Enter Factor Soft Key 6-16 Entering the Calibration Factor 13-29 Entering the Reference Values 6-37, 6-48, 6-74 Examples of Customer-Defined Default Codes 13-50 Extended Auto Clean 9-28, 9-35
Index - 2
L
Laser Hazards 8-6 Linearity 13-7 List of Messages and Fault Conditions 10-66 List of Symptoms 10-38 Loading Blank (Continuous-Feed) Tickets 11-8 Loading Individual Tickets 11-7
P
Package Inspection 2-3 Parameter Flagging Messages 3-38 Patent Statement ii Patient Limits Soft Key 5-16 Percent Difference Calculation 6-87 Performance Characteristics 4-20, 13-5 Performance Specifications 4-15 Physical and Mechanical Hazards 8-6 Physical Specifications 4-3, 4-9 Pictorial Disclaimer ii Platelet Flagging 3-34 PLT Measurement Process 3-32 PLT Parameters 3-33 Post-Calibration Procedures 6-95 Power Requirements 2-5 Power Specifications 4-4, 4-10 Pre-Calibration Procedures Checklist 6-29 Pre-Calibration Procedures 6-27, 13-28 Precision 13-5 Preparation for Inactivity or Shipping 9-52 Preparing for Manual Calibration 6-61 Preparing for Manual Mode to Mode Calibration 6-85 Preparing the Samples 13-38 Preventive Maintenance Schedule 9-2 Principles of Operation 13-3, 14-7 Print Soft Key 6-15 Printer Installation 2-7 Printer 1-23 Procedure: MCV or MPV Calibration 13-28 Proprietary Statement ii
M
Main Module 12-5 Main Soft Key 6-16 Maintenance 11-11, 12-17 Maintenance Log Set Up 9-13 Manual Calibration Overview 6-59 Manual Calibration Procedure Open Mode 6-61 Manual Calibration Worksheet 6-68 Manual Mode to Mode Calibration (CS or SL) 6-85 Manual Mode to Mode Calibration Worksheet 6-93 Manual Mode to Mode Calibration 6-72 Measurement Specifications 4-13 Menu Flowcharts 5-6 Messages and Fault Conditions 10-68 Mixing and Handling 14-78 Mode To Mode Auto-Cal Calibration (Closed Sampler Only) 6-73 Mode to Mode Auto-Cal Calibration Criteria Worksheet 6-83 Mode To Mode Calibration Overview 6-71 Mode to Mode Calibration Preparation 6-72 Monthly Maintenance Procedures 9-29
Q
QC Set Up Menu Soft Key 5-21 Quality Control Guide 7-15, 14-77 Quality Control Menu Flowchart 7-2 Quality Control Menu 7-3 Quality Control 6-95, 13-31
O
Open and Closed Modes 6-2 Open Sampler/Closed Sampler Soft Key 6-15 Operating Instructions 13-9 Operating Principles 12-9 Operating Tips 12-15 Operation Set Up Soft Key 5-43 Operational Messages and Data Flagging 3-37, 14-79 Operational Specifications 4-6, 4-11 Optional Calibration Confirmation 6-82, 6-91 Other Chapters to Reference 12-17
Index - 3
R
RBC Flagging 3-31 RBC Parameters 3-30 RBC/PLT Analysis 3-6, 3-27 RBC/PLT Measurement Process 3-29 Reagent Log Soft Key 5-19 Reagent Syringes 9-29 Reagent System 1-23 References 3-61, 4-25, 5-143, 6-99, 7-29, 8-11, 13-55, 14-83 Related Symbols xiii Relocation 2-17 Repackaging for Shipment 9-54 Replaceable Components 10-32 RER 3-28 Results Displayed 3-7 Retic Data Log Menu 14-30 Retic Main Menu 14-14 Retic Menu Options 14-9 Retic QC Log Menu 14-39 Retic Run Menu 14-57 Retic Run Menu Flowchart 14-56 Retic Set Up Menu 14-16 Retic Special Protocols Menu 14-52 Reticulocyte Analysis 3-6 Reticulocyte Reagent System 1-26 Reticulocyte Specimens 14-67 Reticulocytes 3-32 Revision Log xviii Revision Status xvii Routine Operating Procedures 12-15 Routine Operation 5-67, 13-21, 14-55 Run Menu 5-68 Run Screen Soft Keys 5-74 Run Screen 13-21 Running Controls 7-15 Running the Samples 13-38
Sample Aspiration 3-3 Sample Collection and Handling 5-87 Sample Loader Aspiration Needle 9-21 Sample Loader Components 12-5 Sample Loader Set Up 2-10 Sample Loader Tray, Racks, and Safety Cover 9-27 Sample Loader 1-23 Selecting the Animal 13-22 Self-Test Printouts 11-4 Set Up Instructions 5-13 Set Up 12-17 Shear Valve 9-23 Space Requirements 2-4 Special Procedures 9-51 Special Protocols Menu 9-5 Special Protocols Screen #2 9-10 Specifications A-5 Starting Auto-Cal 6-37, 6-47, 6-74 Suspect Parameter Flags 3-50 Suspect Population Flags 3-53 Symbols v Symptom Identification and Resolution 10-39 System Components 1-5
T
The Animal Catalog 13-3 Ticket Printing 11-5 Tower Unit 12-7 Trademark Statements iv Troubleshooting Guide 10-27 Troubleshooting Procedures 10-29 Troubleshooting 11-13, 12-17, 14-79 Turning on the Gains Template 13-37 Turning the Reticulocyte Package ON and OFF 14-10 Turning The Vet Package Off 13-53
S
Safety Agency Approvals iv Safety xvi Sample Analysis Cycle Overview 3-5 Sample Analysis Using the CS Model 5-99 Sample Analysis Using the SL Model 5-92 Sample Analysis Using the Work List 5-114 Sample Analysis 5-89 Sample Aspiration Peristaltic Pump Tubing 9-26
Index - 4
U
Unclogging the Open Sample Aspiration Probe 9-45 Understanding the Label Code A-2 Units Selection Soft Key 5-49 Update Maintenance Log Procedure 9-16 Using The Data Log 5-121 Using The Work List 5-103
V
Vet Package Keys 13-10 Vet Package Suggestions 13-49 View QC Log Soft Key 7-8 Volumetric Metering 3-28
W
Warning Conventions 8-1 Waste Requirements 2-5 WBC Analysis 3-5, 3-9 WBC Descriptors 3-49 WBC Differential Analysis 3-19 WBC Flagging 3-26
WBC Parameters 3-25 Weekly Maintenance Procedures 9-23 Westgard Rules 7-17 When to Calibrate 6-1 WIC Measurement 3-10 WIC/WOC Interaction 3-9 WOC Analysis 3-13 WOC Transfer Peristaltic Pump Tubing 9-33
X
X-B Analysis 7-20 X-B File Soft Key 7-4
Index - 5
NOTES
Index - 6