Thought I would start a new thread on NxStage technical problems/solutions as I notice those on NxStage have technical problems and say they do not always get satisfactory answers from the technical dept. When it comes to NxStage, there are many good patient reports re the fact that NxStage gives top service. But from time to time, I see home patients coming to the boards, because they are stressed out and losing time and sleep due to incomplete training, faulty equipment, or due to technical problems that NxStage technical did not resolve. The following are examples:
"Re: My NxStage machine broke down tonight.
« Reply #12 on: November 11, 2006, 07:12:13 PM »
I havnt had trouble with my machine until the last week or so. Last week I had error 89! Means sensors are bad, had to get a new nxstage machine… Luckiyly i got mine the next day.
Then the following week I had a flood in my pure flow machine! The pur PAK fooded. I replaced it and the bag and the next one flooded also! really a bummer with 2 1/2 hour priming and 6 1/2 hours of filling the dialysaid bag. On the third try I got it. Took me a total of 20+ hours to fix the problem… Other than that, no problems…"
NxStage Alarm #14
« on: November 15, 2006, 12:20:17 PM »
My partner have been on Nxstage for about two months. She gets to sleep while I attend to the alarms. She is on nocturnal (7 hours) treatments. The machine has introduced sleepless nights for me. It keeps alarming yellow #14. Yes, There is air in the dialysate line. it is located at the cartridge in the line between the heater and the cartridge (green clamps). There is a chain of bubbles that goes in and out like it is breathing. These bubbles are present after the prime… so it is there before I do the tubing switching before connection the patient. I am very careful when hooking up the cartridge (green clamp) to the heater (green clamp) I let it drip dialysate into the connection before tightening to make sure there is no air bubble enter the system. Guess there is some bubbles coming from the heater later when the treatment is running… Don’t know as I try to get some sleep and not up until ALARM #14 wakes me up. Is anyone else on Nocturnal having this problem?
NxStage suggest that I increase the dialysate rate to 3.5 to try to pull the bubbles thru the system… When I try to increase the flow to 3.5 from 2.8 it only allows me to increase to 3.2 (clinic set FF max 30) The only way to get it to 3.5 is change the UF rate to a lower rate. Then the treatment time is longer because of the rate change. This is unacceptable as I would like to get the UF and Hemodialysis to end about the same time…Which I now have about 7 hours. I’ve tried to extract the bubbles from the line by using a syringe with some dialysate attached to the line coming out of the cartridge. Would you believe I actually get about .2 cc of air. Some nights this works and other nights I still get the 14 alarm. but it is better. By the way the alarm 14 happens any time after 2 hours into the treatment. usually happens before the #2 alarm. Usually after the 14 alarm is reset within 5 minutes the #2 alarm (Normal Check) comes on…"
Are you following the instructions very carefully about snapping the Arterial and the Venus lines. Starting with the Arterial and tapping the actual dialyser, than releasing any air at the end of the dialyser? Then tapping the Venus line. I do this process 2 times. Just after I get Ralph on I attach a syringe to the blue tail of the dialyser and watch very carefully and draw all the bubbles out of the top. Than replace the syringe to be ready if I need to do this again.
Hope this helps.
Pat
The second message sounds like they’re saying the air is on the dialysate side - green clamps. The air there should not make a differece.
Heather, what is the goal of cross posting from IHD? The original poster is unlikely to see an answer posted here.
You wrote:
I see home patients coming to the boards, because they are stressed out and losing time and sleep due to incomplete training, faulty equipment, or due to technical problems that NxStage technical did not resolve.
Asking questions on Boards does not imply any of those things. Maybe yes, maybe no but what is it to you?
The second message sounds like they’re saying the air is on the dialysate side - green clamps. The air there should not make a differece.
Heather, what is the goal of cross posting from IHD? The original poster is unlikely to see an answer posted here.
>>>Heather-My purpose of crossposting is to show the problems these NxStage users are having. So far, they have not gotten any good answers at their group, because so few patients post to the boards or have the correct answers. By bringing it here they may get more of an answer such as Pat’s response above. They may or may not come here and see what is posted. Either way, others on NxStage may be helped by replies to this post.
You wrote:
I see home patients coming to the boards, because they are stressed out and losing time and sleep due to incomplete training, faulty equipment, or due to technical problems that NxStage technical did not resolve.
Asking questions on Boards does not imply any of those things. Maybe yes, maybe no but what is it to you?
>>>Heather- I disagree. If NxStage users are having these problems and must come to the boards for help, something is probably lacking in training or technical support. If other patients have experienced these technical problems they can help under this thread as Pat did.
Just want to add my two cents. . . I’ve been on Nx Stage for 8 months and the only problems I’ve ever experienced are operator error. Like when my 7 year old is on my computer and I’m getting off and I forget a clamp. I run it myself and as long as I pay attention things sail smoothly.
What I’ve ssen from Gus’s bulletin board, for those that have a defective machine they are replaced next day in most cases.
Erich
“Dialyze for the Prize.”
[QUOTE=Heather1;11111]Thought I would start a new thread on NxStage technical problems/solutions as I notice those on NxStage have technical problems and say they do not always get satisfactory answers from the technical dept. When it comes to NxStage, there are many good patient reports re the fact that NxStage gives top service. But from time to time, I see home patients coming to the boards, because they are stressed out and losing time and sleep due to incomplete training, faulty equipment, or due to technical problems that NxStage technical did not resolve. The following are examples:
"Re: My NxStage machine broke down tonight.
« Reply #12 on: November 11, 2006, 07:12:13 PM »
I havnt had trouble with my machine until the last week or so. Last week I had error 89! Means sensors are bad, had to get a new nxstage machine… Luckiyly i got mine the next day.
Then the following week I had a flood in my pure flow machine! The pur PAK fooded. I replaced it and the bag and the next one flooded also! really a bummer with 2 1/2 hour priming and 6 1/2 hours of filling the dialysaid bag. On the third try I got it. Took me a total of 20+ hours to fix the problem… Other than that, no problems…"[/QUOTE]
What is point in this? If people who are using nxstage are having that many problems take it up with your center or with nxstage. Any machine set up is going to minor bugs.
I use nxstage and I’m looking forward to the new set up. From reading Pat and Ralph’s story it sounds like the new set will be a great time saver plus doing it at night. And you know how Gus and EPOMAN feel about nxstage.
bobeleanor,
Why do people come to the boards? One reason is to get answers they don’t get from unit or company. I stated there are many good reports about NxStage service, but some patients are having technical problems they need help with and haven’t gotten that through their unit or NxStage technical in all instances. Pat has solved a number of problems and helped people who are facing same problems. What is wrong with that? If anyone can solve the technical problems I posted here, it may help someone…that’s all.
We had this same problem running nocturnal. The only solution is to increase the dialysate rate – we did not get the #14 alarm at 3.1 L/hour or above, but each machine might be slightly different. When we did this using 20 L. of dialysate it meant that the dialysate would be all gone in 20/3.1 or about 6.5 hours of dialysis. In order to sleep 8 hours we set the ultrafiltration rate at UF goal/8. This means we got 6.5 hours of dialysis and an extra 1.5 hours (or so) of pure ultrafiltration (and 8 hours sleep). To do this you must change the system setting (I don’t have the number in front of me) to turn off a #5 alarm (which tells you either the dialysate or the ultrafiltration have finished which you don’t need to know).
The cartridge design spec lists the minimum dialysate flow as 6.0 L./hour so this problem is not a machine problem – it just reflects that nocturnal rates were not considered in the design. Hopefully, they will be accomodated with future changes.
Mel
[QUOTE=Heather1;11112]"HemoHelper
Newbie
NxStage Alarm #14
« on: November 15, 2006, 12:20:17 PM »
My partner have been on Nxstage for about two months. She gets to sleep while I attend to the alarms. She is on nocturnal (7 hours) treatments. The machine has introduced sleepless nights for me. It keeps alarming yellow #14. Yes, There is air in the dialysate line. it is located at the cartridge in the line between the heater and the cartridge (green clamps). There is a chain of bubbles that goes in and out like it is breathing. These bubbles are present after the prime… so it is there before I do the tubing switching before connection the patient. I am very careful when hooking up the cartridge (green clamp) to the heater (green clamp) I let it drip dialysate into the connection before tightening to make sure there is no air bubble enter the system. Guess there is some bubbles coming from the heater later when the treatment is running… Don’t know as I try to get some sleep and not up until ALARM #14 wakes me up. Is anyone else on Nocturnal having this problem?
NxStage suggest that I increase the dialysate rate to 3.5 to try to pull the bubbles thru the system… When I try to increase the flow to 3.5 from 2.8 it only allows me to increase to 3.2 (clinic set FF max 30) The only way to get it to 3.5 is change the UF rate to a lower rate. Then the treatment time is longer because of the rate change. This is unacceptable as I would like to get the UF and Hemodialysis to end about the same time…Which I now have about 7 hours. I’ve tried to extract the bubbles from the line by using a syringe with some dialysate attached to the line coming out of the cartridge. Would you believe I actually get about .2 cc of air. Some nights this works and other nights I still get the 14 alarm. but it is better. By the way the alarm 14 happens any time after 2 hours into the treatment. usually happens before the #2 alarm. Usually after the 14 alarm is reset within 5 minutes the #2 alarm (Normal Check) comes on…"[/QUOTE]
Heather, Just because a patient asks a question here does not mean the center or NxStage are not responding to them. Haven’t you ever had something go wrong with your car and you asked other people what they think before you talk to the garage? Could be the same deal here.
Hi Heather,
If the posts that you re-post are from message boards on other websites, it would be terrific if you would post the link to Home Dialysis Central let those patients know about our message boards. Rather than have you re-post their question where they won’t see the answer (unless you re-post the answer from here to the other site), they can post their own question where NxStage users can advise them and/or give them other questions to ask their home training staff and/or doctor.
[QUOTE=Pat Colongione Just after I get Ralph on I attach a syringe to the blue tail of the dialyser and watch very carefully and draw all the bubbles out of the top. Than replace the syringe to be ready if I need to do this again.
Hope this helps.
Pat[/QUOTE]
Hi Pat,
What is the reason for this step…is it to get air out of the system? If this step is not done in the set up what would happen?
[QUOTE=Beth Witten MSW ACSW;11134]Hi Heather,
If the posts that you re-post are from message boards on other websites, it would be terrific if you would post the link to Home Dialysis Central let those patients know about our message boards. Rather than have you re-post their question where they won’t see the answer (unless you re-post the answer from here to the other site), they can post their own question where NxStage users can advise them and/or give them other questions to ask their home training staff and/or doctor.[/QUOTE]
Absolutely, Beth. I am not registered over there so could not bring it to the posters’ attention. But next chance I get I will. Until I do, this thread is helpful to anyone on NxStage who may be having the same problems. I know since my family member is in line to get on NxStage I collect all posts I see which deal with solutions to technical problems. We want to avoid being up in the middle of the night or having other problems we can’t solve. Having a thread on technical problems/solutions should be of help to all.
Personaly this thread seems kinda counter productive. It sound like more of an attack on NxStage then anything. Sure it was mentioned that people have been happy with NxStage, but then to say that there are problems that are not being addressed by tech support or the training team. Sure sounds more like an attack on NxStage to me. I have been with NxStage since May this year. I have had problems with the equipment. These problems have been directly dealt with by tech support in an extremely timely fashion, as in on the phone the minute the problem occurs. I had a newer machine with the new nocturnal cartridges, at first. There were some #14 alarms that would not reset. After some trial and error, the cartridge was upgraded and the problem was fixed. While they were working on the upgrade I just used an older model cartridge for three days. Seems like they performed a stand up job in my book. I have encountered some other issues that they sent me a post paid box to send the faulty cartridges back to them. The training is very thorough at my clinic, six weeks worth of thorough. So I have to ask how is this thread valid? Has NxStage dropped the ball? My answer to that question is, not once for me. I would be interested in knowing why the person who posted on the other board can not get the answers they need from their nurses or from NxStage. For some reason I don’t think they are asking or they are not pleased with the responses they are getting. I myself am one of the hardest patients to deal with and I have no problems with the NxStage people. I tried to answer the #14 alarm post that was also on this board. I hope that helps someone, all though I am not sure it will.
LSB
Two year anniversary doing dialysis at home for me this month. In all that time I have not had any major tech problems or complaints…just recently, my cycler started overheating with yellow 50/51…all I did is terminate treatment early and then logon to the internet and send NxStage a message, and also sent a Fax message…by next day at noon I recieved my new replacement machine.
I don’t think posting and seeking for NxStage tech help on public forums is the way to go. Only NxStage or your clinic must give the tech support.
I totally agree! What ever small problem I have had Nxstage has taken care of. They are fast, and always super nice even when me the operator does a stupid thing by hitting the wrong button! They did not laugh at me, they even said it has happened to them.
Our center did a super job training. We only trained for a week. I was pretty nervous. But they were a phone call away. They were even willing to come to the house the first night. I wanted to do it alone.
Pat
Pat, might I ask why yours and Ralph’s training session was only a week? Is this because you were familiar with another type of dialysis machine and you just needed a refresher course on how to use the NxStage or were there other circumstances that shortened your training time?
Richard, Yes we had been doing nocturnal for 2.5 years on the Freni, And let me say that week was pretty intensive. I was pretty nervous the first couple of nights at home but it is really a lot easier now. I still read each step to be sure I am doing it right. I probably will for months.
Hope that answers your questions.
Pat
[QUOTE=Pat Colongione;11114]Are you following the instructions very carefully about snapping the Arterial and the Venus lines. Starting with the Arterial and tapping the actual dialyser, than releasing any air at the end of the dialyser? Then tapping the Venus line. I do this process 2 times. Just after I get Ralph on I attach a syringe to the blue tail of the dialyser and watch very carefully and draw all the bubbles out of the top. Than replace the syringe to be ready if I need to do this again.
Hope this helps.
Pat[/QUOTE]
Thanks for the suggestion but the air bubbles are in the line that is hooked to the heater… (Green/white clamp on priming spike). It is air in the dialysate line that causes the #14 alarm. The air bubbles are there after the prime is complete after #23 and snap and tap is completed. Even after the system recirculates for 15 minutes before I attach the patient.
HemoHelper:
… until ALARM #14 wakes me up. Is anyone else on Nocturnal having this problem?
NxStage suggest that I increase the dialysate rate to 3.5 to try to pull the bubbles thru the system… When I try to increase the flow to 3.5 from 2.8 it only allows me to increase to 3.2 (clinic set FF max 30) The only way to get it to 3.5 is change the UF rate to a lower rate. Then the treatment time is longer because of the rate change. …
Can you provide the rest of your treatment details? Amount of dialysate and blood pump speed. I was trying to figure this out - there may be a way just from the information given but I “git lost in the figuring”, I was coming up with a 200 Qb and 22 liters of dialysate.
I assume you’re making sure there is just a half inch of air at the top of the warmer bag when you set up the machine, is that amount of air the same when you see the #14 alarm?