Pureflow problem

Read a long, detailed post at another group just now about serious problems a home patient recently had with his new pureflow system. Everything that could possibly go wrong did including a number of faulty pacs, a waste leak on his carpet, and when he thought he finally got everything going, he was awakened by the system beeping in the middle of the night with yet another system failure…many calls back and forth to NxStage and his unit. If anyone could get “permission” to share his post over here, it would be very instructive. He stated NxStage did everything they could to help him, but he really went through the mill with this and I feel we should share technical problems/solutions in case one of us has the problem next. I was looking forward to getting our new pureflow system, but after reading of this person’s ordeal, I am glad we haven’t gotten the system yet.

Ihave been on the NXstagew/Pueflow for a month now, and after having a few problems, it seems to be going OK. Only problem I’m having is timing my treatments to coincide with the 72 hour window that you have when the batch is made. Last night I thought i would have enough time to do my tx before it expired, but i took a little longer getting my needles in , and my batch expired with 19 minutes to go in tx, so i had to end early.

When i make a batch, I try to do 3 txs in a row. I’m on 6 day/week schedule, so I’m going to do 3 on 1 off.

Any probs i’ve had (my water froze one nite at -15) and I got an inlet pressure allarm, were handled with a call to NxStage

So far, every problem that I have had has been something that I did. I had a problem with passing the conductivity on the last 2 batches, but I am hoping to have this solved on the batch that is making now.

IMO Nxstage tried to make the process too easy and now the control unit is too complicated. I think that it would have been much less headache if they hadn’t tried so hard to take out all user involvement. It really is a great system and will be even better when they get all the kinks out of the system.

Just because one person had a problem shouldn’t be a cause for alarm. I believe what billable pointed out - that most problems with Nx Stage whether it be the System One or the Pureflow are user errors. O.k. not all but most. I don’t know how it got on the carpet unless it over flowed from the large stainless container.

Anyway the only problem I’ve had is when I didn’t screw in my waste line to my Pureflow. I thought it was push and cinch not a screw on. I made it through 15 hours before I got an alarm for the Purepak tray being wet. The waste drippled down there. The rest of the waste went into the container. Clearly my fault and of course it hasn’t happened again.

There are early adopters of technology and those that come after it has been completely proven. The early adopters some times have to work the bugs out. In my case I was the bug. I’ve worked myself out.

The Pureflow is incredible and great for the environment since it greatly cuts down on the waste stream.

By the way, for those who exercise by lifting the 10k boxes - you will find time to do push ups, curls or other exercises when you are not tied into the bags.

In lieu of posting the post you refer to why don’t you post the addess of the discussion group. I don’t think that will break any rules. This way people can go to it. Just a suggestion.
Good luck on your decision. Erich

[QUOTE=TheRiverdude;12244]Just because one person had a problem shouldn’t be a cause for alarm. I believe what billable pointed out - that most problems with Nx Stage whether it be the System One or the Pureflow are user errors. O.k. not all but most. I don’t know how it got on the carpet unless it over flowed from the large stainless container.

Anyway the only problem I’ve had is when I didn’t screw in my waste line to my Pureflow. I thought it was push and cinch not a screw on. I made it through 15 hours before I got an alarm for the Purepak tray being wet. The waste drippled down there. The rest of the waste went into the container. Clearly my fault and of course it hasn’t happened again.

There are early adopters of technology and those that come after it has been completely proven. The early adopters some times have to work the bugs out. In my case I was the bug. I’ve worked myself out.

The Pureflow is incredible and great for the environment since it greatly cuts down on the waste stream.

By the way, for those who exercise by lifting the 10k boxes - you will find time to do push ups, curls or other exercises when you are not tied into the bags.

In lieu of posting the post you refer to why don’t you post the addess of the discussion group. I don’t think that will break any rules. This way people can go to it. Just a suggestion.
Good luck on your decision. Erich[/QUOTE]

The post was here: http://ihatedialysis.com/forum/index.php?topic=2460.0

I will be posting my PureFlow review within 24 hours and it’s a big review, stay tuned. I will post here as well.

  • Epoman

Thanks so much for helping me out with the linc to the pure flow post at your site, Epoman! Look forward to reading your review.

Well, I had high hopes of the 3rd batch passing, but it failed as well. Nxstage is sending a new unit–new controller and chassis (I had a problem with the chassis. When installing the control unit, the holes for the thumbscrews weren’t threaded.) Sending it overnight.

We are still pleased with the system and have nothing but praise for the company and its employees. It would be nice not to have had these problems, but they are on top of the situation when problems occur. That is all you can ask for.

[quote=billable;12260]Well, I had high hopes of the 3rd batch passing, but it failed as well. Nxstage is sending a new unit–new controller and chassis (I had a problem with the chassis. When installing the control unit, the holes for the thumbscrews weren’t threaded.) Sending it overnight.

We are still pleased with the system and have nothing but praise for the company and its employees. It would be nice not to have had these problems, but they are on top of the situation when problems occur. That is all you can ask for.[/quote]

Great attitude! That is what it is all about. Erich

First, here is what I posted on the IHD site that Epoman has also given you. I have also posted an update as of today.

This is my first post. I hate to be negative. There are problems with the PureFlow. I have had my Pureflow since September '06. I too was so excited not to have to hang 5 - 5 liter bags a night. Don’t get me wrong…I love the PureFlow but there are way too many problems with this component.

At first I had only experienced some of the little annoyances such as placing the pure pak in its compartment and finding the Ethernet type connection. My first two paks failed (one due to user error) the other one had a leak which was a slight mess. My next big mess came when I didn’t connect the waste line correctly and had a dialysate tub and carpet full of waste. I know this was my fault but the connection is misleading. You may think it is on tight…but it’s not !! I have had 3 or 4 bags leak in the tub. All and all those things I can live with. I saved the worst for last. On Wednesday of last week I was completing a routine treatment with a little more than an hour to go and I received an alarm that indicated that there was a fluid leak in the dialysate tub. I was unable to clear this alarm and was forced to abandon my treatment with over an hour left to go.

Once I finished my disconnection from the system, I started to investigate. I noticed that there was a significant amount of fluid in the tub. I proceeded to drain the remaining dialysate with no success. I was now forced to lift out over 18 liters of fluid from the tub in a very awkward bag. I cleaned the tub out and called NxStage technical support. We discussed all the possibilities and I was asked to return the Sak for analysis. I did convey that I felt it was not the sak, but the control unit that was leaking because I saw a drip come from the bottom of the control unit after I dried it out. I was told this was highly unlikely and most likely the sak or possibly condensation from the fluid that was in the tub. I agreed to send the sak back to NxStage and the call ended.

I then proceed to load a new PureFlow Pak because I had received the last batch warning while making the last batch. I completed the connection and left to return an hour later to an alarm that indicated a Phase 2 pak failure. Once again I contacted NxStage technical support. I was told that once you get a phase 2 alarm it usually means death to the pak. They suggested I give it one more try and let them know. This time I got a pak leak alarm which I confirmed. I asked for an explanation of what went wrong and was told the “New” pak’s were not having this problem because they were fixed to help eliminate this. Tech support asked me to load another pak and start over. I told Tech support that I did not have another pak because it is NxStage’s policy to only send one pak at a time. Tech support informed me that he would send two out the next day. The call ended.

I contacted my Davita center for support and they said they had an extra pak that I could have if I could get it. I drove into Chicago to fetch the pak and do my monthly check up to save some time. I returned home to load the new pak. I plugged the machine back in and I got a fluid leak alarm in the tub alarm. I thought what’s this??? I proceeded to slide the tub out to find it 1/4 fill of water!!! I again contacted tech support and they assured me that a new control unit would be at my house in the early am the next day. Sure enough, the unit arrived at 7:30 am. I loaded the new control unit and then a new pak waited 2.5 hours and started what I thought was the end of my problems. At 3:30 am I woke to hear a BEEP…BEEP…BEEP and I had a new alarm I believe an A43 which is batch did not pass conductivity. I contacted tech support and woke them up to be told there was nothing I could do but drain the batch and try a new one the next day. I completed the drain and started a new batch around 12 Noon the next day. I let everyone know what was going on and we all waited with our fingers crossed. I came to realize at 7 pm that it was not the saks but the control unit once again. It was the weekend to boot and nothing could be done until Monday morning. I stuck it out with the bags I had on hand and was to receive the unit today at 7 am. Around 10 am I had a delivery but it was only a new pak…where is the control unit? I again contacted NxStage to find out around 4 pm that it did not ship. It will now be delivered by courier at 8 am tomorrow. Pray for me…

This is what made me tell you why I feel like I do. I do not want to discourage anyone from NxStage because I love this company for what they have done for my life. They are truly innovating the home dialysis market with products that allow me to do things like go on a cruise and vacations. I know that I have to realize that this is such a new product and there are going to be glitches. I will say that the staff at NxStage has done the best they could with the most courteous support available. I Just want people to realize that it not a cake walk…

Sorry for being so long…

Here is the update:

It has been a couple of days since I made my last post here. I did receive the new control unit for the PureFlow. I however still have not been able to make a successful batch. I also had a terrible time getting a good pak to prime. I had another conductivity failure this morning and I think I have figured it out. I hope I have figured it out. I think it is the lot of saks that I was using. I realized after I made this batch that it was the same lot as the two previous. I verified that was correct and now I am in process of making a new batch with an old lot number sak. I am really hoping that this works. I really hate hanging those bags, but at least I can.

As you can see it has been a very frustrating time for me. I have not and do not want to make out NxStage or home hemo to be a bad thing. I have been treated very well by the folks at NxStage and Davita. I love my System one and Pureflow. I am an advocate of home hemo.

This is NOT user error. I can tell you that NxStage agrees with that statement. For those who think this is an isolated occurance, you could not be more wrong. I have spoken with several higher ups at NxStage this week and they assure me there are many flaws that need to be fixed and “you are not the only one having these problems”.

I’m sorry some feel this is negative. It’s not. It’s fact.

You don’t have to apologize for the post being negative. It isn’t your fault. There are bugs with the pureflow. There are negatives regarding all machines and as patients we do each other a service when we give the facts. Thank you for your post and update.

MartyI

It had been a few months since I saw the PurFlow with my own eyes, so I didn’t want to comment, but I’m in Seattle right now (I saw Bill P & will see him a couple more times before I leave) and saw it again. As I thought, it has a giant metal tub that holds the entire contents of the dialysate batch. So, the only way to get a waste leak on the carpet is to make a mistake and not hook up one of the external lines.

This isn’t a problem with the Pureflow, it’s user error, as others have pointed out. Alarms & such may be due to things that need fixing–or to user error. Faulty pacs? Or user error? Tough to say; could be either. This is new technology that may need some tweaking at first, though it’s very well designed, but it can also take some mistakes to learn how to use something the right way.

[QUOTE=Dori Schatell;12277]It had been a few months since I saw the PurFlow with my own eyes, so I didn’t want to comment, but I’m in Seattle right now (I saw Bill P & will see him a couple more times before I leave) and saw it again. As I thought, it has a giant metal tub that holds the entire contents of the dialysate batch. So, the only way to get a waste leak on the carpet is to make a mistake and not hook up one of the external lines.

This isn’t a problem with the Pureflow, it’s user error, as others have pointed out. Alarms & such may be due to things that need fixing–or to user error. Faulty pacs? Or user error? Tough to say; could be either. This is new technology that may need some tweaking at first, though it’s very well designed, but it can also take some mistakes to learn how to use something the right way.[/QUOTE]

When a Purification PAK “NOT the SAK”, leaks it is NOT user error, NxStage admits that due to manufacturing defects that the Purification PAK can and has leaked and creates quite a mess for the users. Sometimes the floor can be soaked before the purification pak leak detector goes off. The pureflow has TWO leak detectors. One for the PAK and one for the SAK. So I would like to reiterate that when the Purification paks leaks from “inside” due to the first load it encounters, it is NOT user error. It is indeed a manufacturing defect. An outside company manufactures the Purification paks. This has been confirm to me by NxStage tech support. And it’s very simple to understand since there is no “Metal Tub” that the purification pak sits in. As does the “SAK”. I have talked to a couple people who have indeed set up their pureflow correctly and they still have SOAKED carpet.

I am actually surprised by your post Dori, since you do not have first hand experience with the machine and you are quick to totally relate all leaks to user error. I understand NxStage is a corporate sponsor to this site but come on lets be fair and balanced. Hell I run/own http://www.ilovenxstage.com but I will be posting my review there as well and it will be entitled “PureFlow: The Good, The Bad, and The Ugly.”
Fair and balanced.

This comment of yours is completey wrong :

“As I thought, it has a giant metal tub that holds the entire contents of the dialysate batch. So, the only way to get a waste leak on the carpet is to make a mistake and not hook up one of the external lines.”

That are other places that the Pureflow can ruin carpet. Other than the SAK leaking.

  • Epoman

I can see several potential places for leaks. I am a little leary of the stiff plastic line that provides water to the unit.

  1. The compression connections are usually pretty secure, but I have seen them leak in other applications. That is possible here as well.

  2. The pressure relief valve on top of the sediment filter can malfunction. It bleeds air out of the system during the initial hookup and when the sediment filter is changed. They can malfunction.

  3. The sediment filter screws to a bracket on the back of the unit. It has a gasket that seals the cartridge connection. I have seen defects in similar situations.

  4. After that, it enters the control unit. I’m not sure what is inside the unit, but there could be a leak potential there.

  5. As Epoman pointed out, the purification pack (pak) has numerous connections that can leak I haven’t torn one apart (yet), but I assume there is an RO setup in there and there are numerous connections that can fail. All of this is before it ever gets to the sak in the metal tub.

The point is, it is a fairly complicated machine with numerous, intricate connections. Any of these can fail.

[QUOTE=Dori Schatell;12277]It had been a few months since I saw the PurFlow with my own eyes, so I didn’t want to comment, but I’m in Seattle right now (I saw Bill P & will see him a couple more times before I leave) and saw it again. As I thought, it has a giant metal tub that holds the entire contents of the dialysate batch. So, the only way to get a waste leak on the carpet is to make a mistake and not hook up one of the external lines.

This isn’t a problem with the Pureflow, it’s user error, as others have pointed out. Alarms & such may be due to things that need fixing–or to user error. Faulty pacs? Or user error? Tough to say; could be either. This is new technology that may need some tweaking at first, though it’s very well designed, but it can also take some mistakes to learn how to use something the right way.[/QUOTE]

I really can’t beleive that you wrote this. Please read my account and tell me that this is use error. I’m sure that is why NxStage is flying out there chief engineer this weekend to fix my problems. As Epoman and Billable have clearly stated, there are plenty of ways that failure can occur and has occured for many of us. I suggest you contact Scott Barnwell at NxStage. Scott is a member of their technical support team and i’m sure he will tell you these items are not user error. The only ONE accurate observation you made is that the waste line leak can possibly be considered user error. If the waste line connection were properly located for the patient, this woud have never happened. I think it is also amazing that virtually every patient with the PureFlow has experienced a waste leak. Is that user error is it bad design. I guess you would have to be a patient to really know.

Mike

Don’t use it. Seems simple enough. Don’t like. . . don’t use it.

I like it. So I use it.

Good luck! Erich

You obviously have not read my posts. It’s not that I do not like it. IT DOES NOT WORK. I can’t and have not been able to make a successful batch in over a week. As I said before I LOVE the PureFlow! I can’t get it to work and I am not an idiot who does not know how to set up the machine. I had a great 5 month run with the PureFlow without any serious problems but now I have encountered one. I’m sorry that you cannot see the gravity of the situation. I hope this does not happen to you.

I like it…I CANT USE IT!!!

Mike

I got the replacement pureflow in this morning via UPS. As I am posting this I have 30 minutes left on priming/flushing the purification pak.

Will start a batch to be used in the morning. I am sure that this one will work, but there is that little thought in the back of my mind wondering if I got everything right. Well, I guess I will know in the morning.

You’re right Bill! I was confused by the “Sak” vs. “Pak,” and was thinking about fluid on the prepared dialysate side, not the water filtration side. At least it would be water and not dialysate that would get out (the carpet is still wet, but shouldn’t be sticky…). Could be a fair amount of water, though.

Will NxStage ship you a different PureFlow unit, like they would for a defective System One?

The new pureflow made a batch with zero alarms. The other one made 2 successful batches, but first gave A43 codes first before making a batch.

Hopefully (fingers crossed) this one is going to work for a while.