AMS Tools Reprocessing Instructions

Connector Assembly Tool Part number 72400271

Used with: • AMS 700™ Penile Prosthesis with and without InhibiZone™ • AMS 700™ Penile Prosthesis with MS Pump™ • AMS 800™ Urinary Control System with and without InhibiZone™

Insertion Kit (Tubing Passers) Part number 72100005

Used with: • AMS 700™ Penile Prosthesis with and without InhibiZone™ • AMS 700™ Penile Prosthesis with MS Pump™ • AMS 800™ Urinary Control System with and without InhibiZone™

Japan Only Tubing Passer Part number: 720176-01 Used with AMS 800™ Urinary Control System. Quick Connect Tool Part number: 720175-01 Used with AMS 800™ Urinary Control System without InhibiZone™.

WARNINGS

• Ethylene Oxide (EO), gas plasma sterilization, and dry heat sterilization methods shall not be used for sterilization of AMS reusable tools. • Failure to follow instructions could lead to inadequate sterilization. The cleaning procedures contained in this instruction manual must be executed as detailed prior to executing steam sterilization instructions. • Devices that fail functional checks, have identification markings that are not legible, and/or have visible wear, rust, or pitting should be safely disposed of in accordance with standard biohazard practices. Devices that have visible soil after repeated cleaning should be disposed of in accordance with standard biohazard practices.

PRECAUTIONS

• Tape or other material attached to the tool should be removed before reprocessing. • Healthcare facility procedures and precautions should be followed by hospital personnel who work with contaminated or potentially contaminated medical devices. • Caution should be exercised when handling devices with sharp points or cutting edges. • Do not stack tools or place heavy tools on top of delicate devices. • Comply with local laws and ordinances.

4

• The tools may also become contaminated with body fluids containing hepatitis virus, HIV, or other etiological agents and pathogens. • Fresh cleaning detergents should be prepared when existing detergents become grossly contaminated (turbid). • Any physician using this accessory should be thoroughly familiar with and trained in the surgical procedure being performed prior to using these tools. • Do not allow contaminated devices to dry prior to reprocessing. Do not allow blood, body fluids, bone or tissue debris, saline, or disinfectants to dry on used tools. • Articulating devices (devices that open/close, such as the Connector Assembly Tool or Furlow Inserter Tool) should be in the open position or disassembled when being cleaned in an automated or manual process. Failure to open or disassemble devices could result in the retention of tissues or fluids that will prevent the device from being used as intended.

PREPARATIONS

American Medical Systems (AMS) does not sterilize AMS Tools. New and used tools must be thoroughly processed according to these instructions prior to use. Reprocessing includes a manual, ultrasonic, or automated washer/disinfector cleaning, followed by a steam sterilization cycle.

DISASSEMBLY Only the Furlow Inserter Tool requires disassembly prior to cleaning and sterilization. To disassemble, pull the Obturator (round handle) (a) completely out of the Cylinder handle (rectangular handle) (b). Refer to Figure 1. b

a Figure 1. Disassembled Furlow Inserter Tool NOTE: Disassemble by hand. Never use aiding instruments to disassemble tools beyond what is recommended.

REASSEMBLY To reassemble the Furlow Inserter Tool, insert the Obturator into the Cylinder handle.

MATERIALS FOR REPROCESSING • Personal Protective Equipment (PPE) should be worn when handling or working with contaminated or potentially contaminated materials, devices, and equipment. • Legally marketed accessories, when applicable, should be used for performing all reprocessing steps. NOTE: Cleaning agent should be pH neutral. Saline and cleaning agents containing aldehyde, mercury, active chlorine, chloride, bromine, bromide, iodine, or iodide are corrosive and should not be used.

POINT OF USE PROCESSING • Cleaning detergent: pH neutral enzymatic detergent (i.e., Prolystica™ Enzymatic Detergent or equivalent) • Softened tap water

5

• Absorbent, low-lint cloth

MANUAL CLEANING • Cleaning detergent: pH neutral enzymatic detergent (i.e., Prolystica™ Enzymatic Detergent or equivalent) • Lumen brush: 0.118 inch diameter nylon brush • Surface brush: Soft nylon-bristled brush • Soaking container/tub • 20 mL or greater volume syringe • Critical water (RO or ≤ 0.2 micron filtered water) • Softened tap water • Absorbent, low-lint cloth

ULTRASONIC CLEANING • Ultrasonic bath: Capable of frequency 45 kHz minimum at 10 minutes • Cleaning detergent: pH neutral enzymatic detergent (i.e., Prolystica™ Enzymatic Detergent or equivalent) • Lumen brush: 0.118 inch diameter nylon brush • Surface brush: Soft nylon-bristled brush • Critical water (RO or ≤ 0.2 micron filtered water) • Softened tap water • Absorbent, low-lint cloth

AUTOMATED WASHER/DISINFECTOR CLEANING • Cleaning detergent: pH neutral enzymatic detergent (i.e., Prolystica™ Enzymatic Detergent or equivalent) • Critical water (RO or ≤ 0.2 micron filtered water) • Absorbent, low-lint cloth • ISO 15883 washer/disinfector

LUBRICATION • Lubricant that does not interfere with steam sterilization per the manufacturer’s label (i.e., Symmetry Surgical Preserve™ Instrument Lube Concentrate or equivalent)

STERILIZATION • Sterilization pouch • Pre-vacuum type OR Gravity type steam sterilizer

REPROCESSING INSTRUCTIONS POINT OF USE PROCESSING 1.

Disassemble the Furlow Inserter Tool, if used.

2.

Remove gross soil using absorbent, low-lint cloths and thoroughly rinse the surgical tools with softened tap water.

3.

Place devices in a container of distilled water or cleaning detergent, or cover with damp towels.

6

NOTE: Soaking in a cleaning detergent prepared according to the manufacturer will facilitate cleaning especially in tools with crevices, hinged joints, rough surfaces, lumens, and areas with moving components or clips.

CONTAINMENT AND TRANSPORTATION Start the reprocessing steps within 1 hour of surgery completion. For the containment and transportation of the devices during point of use processing, procedures established by the healthcare facility must be followed.

MANUAL CLEANING NOTE: Metal brushes or scouring pads must not be used during manual cleaning procedures. These materials will damage the surface and finish of the tools. NOTE: Manual scrubbing with brushes should always be performed with the tool below the surface of the cleaning detergent to prevent generation of aerosols and splashing, which may spread contaminants. Cleaning agents must be completely rinsed from device surfaces to prevent accumulation of detergent residue. 1.

If not already disassembled, disassemble the Furlow Inserter Tool, if used.

2.

Prepare a cleaning detergent, using softened tap water, at the concentration and temperature specified by the detergent manufacturer.

3.

Submerge tools completely in the cleaning detergent for a minimum of 5 minutes.

With the tools still completely submerged, for an additional 5 minutes scrub surfaces using a surface brush until all visible soil has been removed. NOTE: Minimum submerge and scrub time is 10 minutes. NOTE: All scrubbing should be performed below the surface of the cleaning detergent to minimize the potential of aerosolizing contaminated solution. 4.

Actuate (open and close) moveable mechanisms and flush lumens with a syringe to ensure contact of the cleaning detergent with all surfaces, and to remove trapped bubbles. Particular attention should be given to crevices, hinged joints, rough surfaces, lumens, and areas with moving components or clips.

5.

Insert the lumen brush into the lumen (if applicable) with a twisting motion while pushing in and out at least 3 times.

NOTE: The slot on the distal end of the Furlow Inserter Tool stem should be brushed by pushing the head of the brush against the slot starting at the proximal end and moving outwardly toward the distal end of the device. This allows the bristles of the brush to fit into the slot and push gross debris out of the end of the lumen. 6.

Remove the tools from the cleaning detergent and rinse in critical water 3 times for a total of 1 minute. Actuate (open and close) all moveable and hinged parts while rinsing.

7.

The Furlow Inserter Tool lumen, if used, should be flushed with critical water 3 times using a 20 mL to 50 mL syringe.

8.

Visually inspect the tools with sufficient magnification and light to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

9.

Dry tools with an absorbent, low-lint cloth, or clean, filtered compressed air.

10.

Visually inspect the tools with sufficient magnification and light to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

ULTRASONIC CLEANING NOTE: Separate stainless steel tools from other metal tools during ultrasonic cleaning to avoid electrolysis. NOTE: Fully open hinged tools and use wire mesh baskets or trays designed for ultrasonic cleaners.

7

1.

If not already disassembled, disassemble the Furlow Inserter Tool, if used.

2.

Rinse the tools, including lumens (if applicable) with softened tap water to remove any visible soil or detergent residue from all areas (lumen and surface) of the tools using lumen and cleaning brushes.

3.

Prepare an ultrasonic bath with a cleaning detergent, using softened tap water, at the concentration and temperature specified by the detergent manufacturer.

NOTE: Ensure devices are fully opened and dissembled. Failure to open devices (e.g., Connector Assembly Tool) could result in the retention of tissues or fluids that will prevent the device from being used as intended. 4.

Immerse the device in the ultrasonic bath for a minimum of 10 minutes at a frequency of 45 kHz.

5.

Remove the tools from the ultrasonic bath and rinse in critical water for a minimum of 1 minute or until there is no sign of soil or detergent residue. Actuate (open and close) all moveable and hinged parts while rinsing.

6.

The Furlow Inserter Tool lumen, if used, should be flushed with critical water 3 times using a 20 mL to 50 mL syringe.

7.

Visually inspect the tools with sufficient magnification and light to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

8.

Dry tools with an absorbent, low-lint cloth, or clean, filtered compressed air.

9.

Visually inspect the tools with sufficient magnification and light, to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

AUTOMATED CLEANING WASHER/DISINFECTOR PRECAUTION: Chemical disinfection programs should not be used due to the potential for chemical residues to remain on the tools. These residues could interfere with sterilization efficacy. NOTE: Follow the washer/disinfector manufacturer’s instructions for use. NOTE: Use a washer/disinfector with demonstrated efficacy. NOTE: Increase the dry time as the load size increases. Follow the washer/disinfector manufacturer’s instructions. NOTE: Low-level disinfection must be used as part of a washer/disinfector cycle, but the devices must also be sterilized before use. NOTE: Use critical water for the final rinse. 1.

If not already disassembled, disassemble the Furlow Inserter Tool, if used.

2.

Place tools in a washer/disinfector basket. Observe the manufacturer’s loading requirements. Follow the cycle parameters given in Table 1.

3.

Avoid contact between devices as movement during washing could cause damage and washing action could be obstructed.

4.

Arrange the Furlow Inserter Tool lumens (if applicable) vertically to assist drainage.

5.

The Connector Assembly Tool (if applicable) should be in the open position.

The following minimum wash cycle parameters are recommended: Table 1. Minimum Automated Washer/ Disinfector Cycle for Surgical Tools Step

Description

1

4 minutes; 50-55° C enzymatic wash

2

2 minutes; 50-55° C wash

3

2 minutes; 50-55° C final rinse

8

Step

Description

4

10 minutes; 70° C Thermal disinfection

5

15 minutes 80° C air dry

6 (optional)

If a lubrication cycle is available that applies a water soluble lubricant, it is acceptable to use on the tools.

NOTE: If the washer/disinfector does not have a lubrication cycle, refer to “Lubrication.” 6.

Upon completion, unload the washer/disinfector.

7.

Visually inspect the tools with sufficient magnification and light to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

8.

If needed, dry tools with an absorbent, low-lint cloth, or clean, filtered compressed air.

9.

Visually inspect the tools with sufficient magnification and light to verify that all soil and detergent residue has been removed. If it has not, repeat the cleaning process.

WARNING: Failure to properly clean could lead to inadequate sterilization. The cleaning procedure outlined in these instructions must be performed as stated prior to steam sterilization.

PRE-STERILIZATION INSTRUCTIONS LUBRICATION The Connector Assembly Tool must be lubricated. Lubrication of other tools is optional. WARNING: Mineral oil or silicone lubricants should not be used because they prevent proper steam sterilization. 1.

Refer to the lubricating agent labeling for preparation and use instructions.

2.

Disassemble the Furlow Inserter Tool before lubricating.

3.

Dip the tools in the prepared lubricant or spray the prepared lubricant on per manufacturer’s instructions, paying special attention to crevices and joints.

4.

Remove any excess lubricant with absorbent, low-lint cloth.

INSPECTION AND FUNCTIONAL CHECK Visually inspect each device for completeness, damage, and excessive wear. When inspecting devices, look for the following: • Jaws and teeth should align properly. • Movable parts should operate smoothly throughout the intended range of motion. • Long, thin tools should be free of bending or distortion. • Where tools form part of a larger assembly, all components should be available and should assemble readily. • The identification marking should be readable. • There should be no reddish brown rust on the tool. If damage or wear is observed that might compromise the function of the tool, dispose of product and packaging in accordance with hospital, administrative, and/or local government policy and contact your AMS representative for a replacement.

9

PACKAGING 1.

Before use, packaging materials should be held at room temperature (20°C - 23°C and RH of 30% - 60%) for a minimum of 2 hours.

2.

Tool Preparation: a.

For the Furlow Inserter Tool, disassemble the tool with both parts together in the same pouch.

b.

The Connector Assembly Tool shall be in the open position when placing in the pouch.

3. The cleaned and inspected tools should be double pouched. To double pouch: a.

Place the tool in a smaller pouch and seal the pouch.

b.

Place the smaller sealed pouch in a larger pouch and seal it.

STEAM STERILIZATION WARNING: Do not use rigid containers for steam sterilization. This configuration could limit steam penetration and prevent effective sterilization of the tools. Do not wrap the tools with tape. PRECAUTION: Do not use flash sterilization for reusable tools. Load trays per the sterilization equipment manufacturer’s instructions. Table 2. Steam Sterilizer Parameters Sterilization Method

Exposure time (minutes)

Exposure Temperature

Dry time (minutes)

Pre-vacuum*

3

134°C

30

Pre-vacuum

4

132°C

20

Gravity

30

121°C

30

*This (Pre-vacuum: 3 minutes at 134°C and dry time of 30 minutes) sterilization cycle is not considered by the United States Food and Drug Administration (US FDA) to be a standard sterilization cycle. Users should only use sterilizers and accessories (such as sterilization wraps, sterilization pouches, chemical indicators, biological indicators, and sterilization containers) that have been cleared by the US FDA for the selected sterilization cycle specifications (time and temperature).

STORAGE CONDITIONS Sterile packaged tools should be stored in a designated, limited access area that is well ventilated, dry, and provides protection from dust, moisture, and temperature/humidity extremes. NOTE: Inspect every package before use to ensure that the sterile barrier is not torn, perforated, shows signs of moisture, or appears to be tampered with. If any of those conditions are present then the contents are considered non-sterile and should be completely re-processed.

All trademarks are the property of the respective owners.

10

Australian Sponsor Address Boston Scientific (Australia) Pty Ltd PO Box 332 BOTANY NSW 1455 Australia Free Phone 1800 676 133 Free Fax 1800 836 666 Brazil Local Contact Para informações de contato da Boston Scientific do Brasil Ltda, por favor, acesse o link www.bostonscientific.com/bra

ONLY

American Medical Systems, Inc. 10700 Bren Road West Minnetonka, MN 55343 U.S.A. U.S. Toll Free: 800 328 3881 Tel: 952 930 6000

American Medical Systems Europe B.V. Haarlerbergweg 23 G 1101 CH Amsterdam Zuid-Oost The Netherlands ©2017 Boston Scientific Corporation or its affiliates. All rights reserved. 1017012-01-MH (2017-09)

1017012-01-MH