GAMBRO
Prismaflex ST Set Instructions for Use Dec 2019
Instructions for Use
13 Pages
Preview
Page 1
IFU Insert
Prismaflex ST Set Emergency Use Authorization for the United States The Prismaflex ST Set has been Authorized by the FDA to provide continuous renal replacement therapy (CRRT) to treat patients in an acute care environment during the Coronavirus Disease 2019 (COVID-19) pandemic. The Prismaflex ST Set has neither been cleared or approved to provide CRRT in an acute care environment. The Prismaflex ST Set has been authorized by FDA under EUA200704. The Prismaflex ST Set is Authorized only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of the Prismaflex ST Set under section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner.
Intended Use for Patients with COVID-19 The Prismaflex ST Set is indicated for use only with the Prismaflex control unit or with the PrisMax control unit in providing continuous fluid management and renal replacement therapies in an acute care environment during the Coronavirus Disease 2019 (COVID-19) pandemic. The system is intended for patients who have acute renal failure, fluid overload, or both. Relative contraindications (individual risk/benefit to be determined by treating physician) for the use of Prismaflex ST Sets include: • The inability to establish vascular access • Severe hemodynamic instability • Known hypersensitivity to any component of the Prismaflex ST Set This set is intended for use in the following veno-venous therapies: SCUF; CVVH; CVVHD; CVVHDF. All treatments administered with the Prismaflex ST Set must be prescribed by a physician. The size, weight, metabolic and fluid balance, cardiac status, and general clinical condition of the patient must be carefully evaluated by the prescribing physician before each treatment.
Additional Product Information for the United States The tubing contained in the following product codes are labeled as DEHP-free in the IFU, this means that the product was not made with DEHP plasticizer: 107643, 115308, 107636, 115309, 107640 and 115310. The tubing contained in the following product codes were made using DEHP plasticizer: 955468 and 955596. The following codes do not include reference to the PrisMax control unit; however, all Prismaflex ST Sets may be used with the Prismaflex control unit or with the PrisMax control unit: 115308, 115309, 115310, 955468 and 955596. To access COVID-19 Resources, product details, product use information, and the comprehensive Prismaflex Control Unit Operator’s Manual and PrisMax Control Unit Operator’s Manual please visit the Baxter Healthcare Acute Therapies website at http://www.renalacute.com
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 1 of 92
Colour Reference:
Proofread No.: 1
BLACK
ST60 SET / ST100 SET / ST150 SET
Instructions for use
Oδηγίες χρήσης
Notice d'utilisation
Návod k použití
Gebrauchsanweisung
Uputstvo za upotrebu
Folleto de utilización
Інструкції з використання
Istruzioni per l'uso
Návod na použitie
Handhavandeninstruktioner
Navodila za uporabo
Gebruiksaanwijzing
Használati utasítás
Instruções de use
Upute za uporabu
Bruksanvisning
Kasutusjuhend
Bruksanvisning
Lietošanas instrukcijas
Käyttöä opas
Naudojimo instrukcijos
Instrukcja stosowania
Инструкции за употреба
Kullanma talimatları
Instrucțiuni de utilizare
Инструкция по применению
107643 107636 107640
Made in France
Date of Revision: 2019-12-01
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 3 of 92
Colour Reference:
Proofread No.: 1
BLACK
English...14 Français...16 Deutsch...19 Español...22 Italiano...25 Svenska...28 Nederlands...30 Português...33 Norsk...35 Dansk...37 Suomi...39 Polski...41 Türkçe...44 РУССКИЙ...46 Eλληvικά...49 Český...52 Srpski...54 Українська...57 Slovenčina...59 Slovenščina...61 Magyar...63 Hrvatski...65 Eesti...67 Latviešu...69 Lietuvių k...71 български...73 Română...76 General characteristics...78 Installation guide...87
3
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 5 of 92
Colour Reference:
Proofread No.: 1
BLACK
DEFINITION OF SYMBOLS ENGLISH SYMBOL GRAPHIC & REF NUM / SYMBOLES GRAPHIQUES ET N° RÉF. / SYMBOLGRAFIKUND REFERENZNUMMER
TITLE AND NUMBER OF STANDARD / TITRE ET NUMÉRO DE LA NORME / TITEL UND NUMMER DER NORM
SYMBOL TITLE
SYMBOL DESCRIPTION (EXPLANATORY TEXT)
ISO 15223-11
TITRE DU SYMBOLE
DESCRIPTION DU SYMBOLE (TEXTE EXPLICATIF)
Manufacturer
Indicates the medical device manufacturer, i.e. the natural or legal person with responsibility for the design, manufacture, packaging and labelling of a device before it is placed on the market under his own name.
ISO 15223-11
Date of manufacture
ISO 15223-11
SYMBOLBESCHREIBUNG (ERKLÄRENDER TEXT)
Fabricant
Indique le fabricant du dispositif médical, c'est-à-dire la personne physique ou morale responsable de la conception, de la fabrication, du conditionnement et de l'étiquetage d'un dispositif avant sa commercialisation sous son nom propre.
Hersteller
Gibt den Hersteller des Medizinprodukts an, d. h. die natürliche oder juristische Person, die für das Konzept, die Herstellung, die Verpackung und die Etikettierung eines Produkts verantwortlich ist, bevor es unter ihrem Namen auf den Markt kommt.
Indicates the date when the medical device was manufactured. Format should be YYYY-MM-DD.
Date de fabrication
Indique la date de fabrication du dispositif médical. Elle doit respecter le format AAAA-MM-JJ.
Herstellungsdatum
Gibt das Datum an, an dem das Medizinprodukt hergestellt wurde. Das Format sollte JJJJ-MM-TT sein.
Use-by date
Indicates the date after which the medical device is not to be used. Format should be YYYY-MM-DD
Date limite d'utilisation
Indique la date après laquelle le dispositif médical ne doit plus être utilisé. Elle doit respecter le format AAAA-MM-JJ.
Verfallsdatum
Gibt das Datum an, ab dem das Medizinprodukt nicht mehr verwendet werden soll. Das Format sollte JJJJ-MM-TT sein.
ISO 15223-11
Batch code
Indicates the manufacturer’s batch code. Synonyms are “lot number” and “batch number”
Numéro de lot
Indique le code du lot du fabricant. Synonyme : « numéro du lot ».
Chargencode
Gibt den Batchcode des Herstellers an. Synonyme sind „Losnummer“ und „Chargennummer“.
ISO 15223-11
Catalogue number
Indicates the manufacturer’s catalog number. Synonyms are “reference number” and “reorder number”
Référence catalogue
Katalognummer
Sterile fluid path
Circuit de fluide stérile
Indique la présence d'un circuit de fluide stérile dans le dispositif médical dans le cas où d'autres parties du dispositif médical, y compris l'extérieur, ne seraient pas stériles. La méthode de stérilisation doit être indiquée dans la case vide, si nécessaire.
Gibt die Katalognummer des Herstellers an. Synonyme sind „Referenznummer“ und „Nachbestellnummer“.
ISO 15223-11
Indicates the presence of a sterile fluid path within the medical device in cases where other parts of the medical device, including the exterior, might not be supplied sterile. The method of sterilization shall be indicated in the empty box, as appropriate.
Indique le numéro de catalogue du fabricant. Synonymes : « numéro de référence » et « numéro de commande ».
Sterile Flüssigkeitsbahn
Zeigt das Vorhandensein einer sterilen Flüssigkeitsbahn innerhalb eines Medizinproduktes an, in den Fällen wo andere Teile des Medizinproduktes, einschließlich der außen gelegenen Teile, nicht steril geliefert werden können. Sofern geeignet, muss das Sterilisationsverfahren in dem leeren Kästchen angegeben sein.
ISO 15223-11
Do not use if package is damaged
Indicates a medical device that should not be used if the package has been damaged or opened.
Ne pas utiliser si l'emballage est endommagé
Indique un dispositif médical qui ne doit pas être utilisé si l'emballage a été endommagé ou ouvert.
Bei beschädigter Verpackung nicht verwenden.
Zeigt ein Medizinprodukt an, das nicht verwendet werden sollte, falls die Verpackung beschädigt oder geöffnet sein sollte.
ISO 15223-11
Fragile, handle with care
Indicates a medical device that can be broken or damaged if not handled carefully.
Fragile, à manipuler avec précaution
Indique un dispositif médical pouvant être brisé ou endommagé s'il n'est pas manipulé avec précaution.
Vorsicht, zerbrechlich!
Gibt an, dass ein Medizinprodukt bei unvorsichtiger Handhabung beschädigt werden kann.
ISO 15223-11
Keep dry OR Keep away from rain
Indicates a medical device that needs to be protected from moisture. OR Indicates a medical device that needs to be kept away from rain.
Conserver au sec OU Ne pas exposer à la pluie
Indique un dispositif médical à protéger de l'humidité. OU Indique un dispositif médical à protéger de la pluie.
Vor Nässe schützen! ODER Vor Regen schützen!
Gibt an, dass ein Medizinprodukt vor Feuchtigkeit geschützt werden muss. ODER Gibt an, dass ein Medizinprodukt vor Regen geschützt werden muss.
ISO 15223-11
Temperature Limit
Indicates the temperature limits to which the medical device can be safely exposed.
Limite de température
Indique les limites de température auxquelles le dispositif médical peut être exposé en toute sécurité.
Temperaturgrenzwert
Gibt die Temperaturgrenzwerte an, denen das Medizinprodukt gefahrlos ausgesetzt werden kann.
Do not re-use
Indicates a medical device that is intended for one use, or for use on a single patient during a single procedure. Synonyms for “Do no re-use” are “single use” and “use only once”.
Ne pas réutiliser
Indique un dispositif médical conçu pour une utilisation unique ou une utilisation sur un seul patient pendant une seule procédure. Synonyme : « à usage unique ».
Nicht wiederverwenden
Gibt an, dass ein Medizinprodukt für einen Gebrauch oder für einen Gebrauch an einem einzigen Patienten während eines einzigen Verfahrens vorgesehen ist. Synonyme für „Nicht wiederverwenden“ sind „Für den Einmalgebrauch“ und „Nur einmal verwenden“.
ISO 15223-11
Caution
Indicates the need for the user to consult the instructions for use for important cautionary information such as warnings and precautions that cannot, for a variety of reasons, be presented on the medical device itself.
Attention
Indique qu'il est nécessaire que l'utilisateur consulte le mode d'emploi pour obtenir des informations importantes telles que des avertissements et mises en garde ne pouvant pas, pour des raisons diverses, être mentionnées sur le dispositif proprement dit.
Vorsicht
Gibt an, dass der Anwender die wichtigen Sicherheitsinformationen in der Gebrauchsanweisung, wie Warnhinweise und Vorsichtsmaßnahmen, beachten sollte, die aus unterschiedlichen Gründen nicht auf dem Medizinprodukt selbst angegeben werden können.
NA, European countries only / NA, pays européens seulement / NA, nur europäische Länder
Green Dot Symbol
To indicate the manufacturer of the product contributes to the cost of recovery and recycling
Symbole du point vert
Indique que le fabricant du produit contribue aux frais de récupération et de recyclage
Der Grüne Punkt
Gibt an, dass sich der Hersteller des Produkts an den Kosten der Verwertung und Entsorgung beteiligt.
ISO 70002
This way up
Indicates the correct, upright position of the package
Haut
Indique la position correcte, à la verticale du carton
Diese Seite nach oben
Gibt die korrekte aufrechte Position der Verpackung an.
Consult instructions for use
Indicates the need for the user to consult the instructions for use. Synonym for “Consult instructions for use” is “Consult operating instructions”.
Consulter le mode d’emploi
Indique que l’utilisateur a besoin de se reporter au mode d’emploi. « Consulter le mode d’emploi » a pour synonyme «Consulter la notice d’utilisation».
Gebrauchsanweisung beachten
Weist darauf hin, dass der Anwender die Gebrauchsanweisung beachten muss. „Gebrauchsanweisung beachten“ ist gleichbedeutend mit „Bedienungsanweisungen beachten“.
5.1.3
5.1.5 5.1.6
5.2.3
5.2.8
5.3.1
DEUTSCH
SYMBOLNAME
5.1.1
5.1.4
FRANÇAIS
5.3.4
5.3.7
5.4.2 ISO 15223-11
5.4.4
0623
5.4.3 ISO 15223-1
1
ISO 15223-1:2016 Medical Devices - Symbols to be used with medical device labels, labelling and information to be supplied Part 1: General Requirements / Dispositifs médicaux : Symboles à utiliser avec les étiquettes, l'étiquetage et les informations à fournir relatifs aux dispositifs médicaux - Partie 1 : Exigences générales / „Medizinprodukte – Bei Aufschriften von Medizinprodukten zu verwendende Symbole, Kennzeichnung und zu liefernde Informationen – Teil 1: Allgemeine Anforderungen“ 2 ISO 7000 Graphical symbols for use on equipment - Registered symbols / Symboles graphiques utilisables sur le matériel - Symboles enregistrés / „Grafische Symbole auf Einrichtungen – Index und Übersicht“ 1
5
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 14 of 92
Colour Reference:
Proofread No.: 1
BLACK
ENGLISH The Prismaflex ST60/ST100/ST150 set is manufactured by GAMBRO Industries, 7 avenue Lionel Terray, BP 126, 69883 MEYZIEU CEDEX, FRANCE.
• inability to establish vascular access, • severe hemodynamic instability, • known hypersensitivity to any component of the Prismaflex set.
Caution: Federal law (USA) restricts this device to sale by or on the order of
CAUTIONS AND WARNINGS
a physician.
Note: refer to the control unit user interface and operator’s manual for additional cautions and warnings.
DEFINITION OF EXPRESSIONS USED IN THIS MANUAL
Cautions
In this document :
1.
Particular attention must be paid to extra corporeal blood volume with respect to patient size. Consider the sum of the Prismaflex set blood volume (refer to “Specifications”) plus the blood volume of any accessory or device if used. The Prismaflex ST60 set should be restricted to patients with a body weight greater than 11kg (24lb). The Prismaflex ST100 set and ST150 set should be restricted to patients with a body weight greater than 30kg (66lb).
2.
If the patient is not immediately connected to the Prismaflex set after priming is complete, flush the set with at least 1 000 mL priming solution [saline or alkaline solution (pH ≥ 7.3), with or without heparin added according to usual institutional practice] prior to connecting the patient. This requires use of a new bag of priming solution.
3.
When not using the pre blood pump infusion line, it is recommended to clamp this line close to its connection to the access blood tubing line; this will prevent the sedimentation of blood into the pre-blood pump infusion line.
4.
Using the Prismaflex set with blood flow rates lower than the recommended minimum values (see “Operating Parameters” section) may impair filter performance due to hemoconcentration, or to increased risk of coagulation.
5.
Since drugs can be removed by the membrane of the filter, the dosage of associated drug treatments may need to be adjusted for patients on continuous renal replacement therapy. Monitoring of blood drug levels of relevant compounds should be performed. The removal of other watersoluble compounds (e.g. vitamins, trace elements) during therapy also requires clinical consideration.
“Warning” indicates a hazardous situation which, if not avoided, could result in death or serious injury. “Caution” indicates a hazardous situation which, if not avoided, could result in minor or moderate injury; “Note” to give additional information. SCUF: Slow Continuous UltraFiltration. CVVH: Continuous Veno-Venous Hemofiltration. CVVHD: Continuous Veno-Venous HemoDialysis. CVVHDF: Continuous Veno-Venous HemoDiaFiltration. Predilution: addition of replacement fluid to the blood stream upstream to the filter. Postdilution: addition of replacement fluid to the blood stream downstream to the filter. "Control unit" refers to the PrismaFlex control unit, or to the PrisMax control unit (in countries where PrisMax is cleared or registered).
PRODUCT DESCRIPTION • T he Prismaflex ST60 / ST100 / ST150 set is a disposable, extracorporeal circuit for use with the PrismaFlex control unit or with the PrisMax control unit (in countries where PrisMax is cleared or registered).
Warnings
• The Prismaflex ST60 / ST100 / ST150 set consists of a AN69 ST hollow fiber hemofilter/dialyzer* and tubing lines ; refer to the control unit operator manual drawing for details.
1.
Carefully read these instructions for use and the control unit operator's manual before using this product.
• The blood return line (blue-striped) is equipped with a Luer-lock connection near the deaeration chamber, dedicated to the connection of authorized devices and accessories described in the control unit operator's manual.
2.
The use of operating procedures other than those published by the manufacturer or the use of accessory devices not recommended by the manufacturer can result in patient injury or death.
• All line connectors are compatible with the ISO 594-1 and ISO 594-2 international standards concerning conical fittings.
3.
Store the Prismaflex set in a dry place, between 0° C (32° F) and 30° C (86° F).
4.
Do not use this set if the packaging is damaged, if the sterilization caps are missing or loose, or if any of the lines in the set are kinked.
5.
To prevent contamination, this Prismaflex set must be used as soon as its packaging and sterilization caps are removed.
6.
Do not try to remove the filter from the cartridge plate.
7.
Use aseptic techniques when handling all blood and fluid lines in the set.
8.
Prismaflex sets are compatible with the usual disinfection agents used for aseptic setup; however solvents and other chemicals, if used in contact with the product, could damage the set.
9.
During priming and operation, observe closely for leakage at joints within the set, and connections to other approved accessories and bags. Leakage can cause blood loss, fluid imbalance or air embolism. If a leakage is detected at a Luer connection and cannot be stopped by tightening the connections, or if leakage occurs at any other location, replace the set.
• The fluid pathways of the Prismaflex set are guaranteed sterile and non pyrogenic. • T he Prismaflex ST60 / ST100 / ST150 set is sterilized by ethylene oxide (EtO). Deaeration is such that EtO residuals comply with the standards in ISO 10993. • Expiration date: please refer to product label. * In this document the hemofilter/dialyzer will be referred to as “filter”.
INTENDED USE / INDICATIONS The Prismaflex set is indicated for use only with the PrismaFlex control unit or with the PrisMax control unit (in countries where PrisMax is cleared or registered) in providing continuous fluid management and renal replacement therapies. The system is intended for patients who have acute renal failure, fluid overload, or both.
10. Tightening Luer connections with an excessive force can damage the connectors. 11. Once priming is complete the set's blood circuit will still contain heparinised saline solution. Depending on the level of the patient's bleeding risk the physician must decide if an additional priming using 500 mL non heparinised saline solution is necessary.
This set is intended for use in the following veno-venous therapies : SCUF ; CVVH ; CVVHD ; CVVHDF.
12. Do not allow air to enter the blood compartment of the filter after priming is started. If a large amount of air enters, the set must be replaced.
All treatments administered via the Prismaflex set must be prescribed by a physician. The size, weight, state of uremia, cardiac status, and general physical condition of the patient must be carefully evaluated by the prescribing physician before each treatment.
13. Should acute allergic reactions (first-use syndrome) occur in patients receiving treatment, immediately stop the treatment and administer appropriate intervention. Pay special attention to patients receiving ACE inhibitors and/ or having already shown similar allergic reactions (see “Hypersensitivity Reactions” section).
CONTRAINDICATIONS
14. Use a 21-gauge or smaller needle to obtain blood/fluid samples or remove trapped air from the Prismaflex set. Use of larger needles can cause holes in the sample sites, resulting in external leak or air intake.
There are no known absolute contraindications to continuous renal replacement therapies.
15. External blood leakage may not be immediately identified by monitoring equipment and could result in significant blood loss. Check the filter and all connections of the disposable tubings during treatment to minimize the risk of leakage.
For the following conditions a careful assessment of the individual risk/benefit ratio has to be made by the treating physician (relative contraindications):
14
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 15 of 92
Colour Reference:
Proofread No.: 1
BLACK
Hypersensitivity Reactions
16. To assure adequate filter performance, it is recommended that the set be changed every 24 hours of use. However, the set must be changed after 3 days (72 hours). Continued use beyond this limit could result in rupture of the pump segments, with risk of patient injury or death.
Note: see Warning no. 13. Should acute allergic reactions (first use syndrome) occur within the first few minutes of the treatment, it is important to react immediately by discontinuing the session and administering appropriate treatment.
17. Destroy this set after single use, using aseptic technique for potentially contaminated equipment and following local regulation for disposal. Do not re-sterilize. The Prismaflex set is intended for single use only. Re-using the Prismaflex set may cause serious damage to the product resulting in patient injury or death.
Adverse reactions may occur due to the complex interaction between blood and the artificial surfaces of the entire extracorporeal circuit. These reactions may also be precipitated and/or exacerbated by other external factors involved with the individual patient’s specific disease process and the treatment of renal insufficiency. Certain types of adverse reaction may occur due to operational factors associated with the treatment. Therefore, proper management of the fluid removal, electrolyte balance, anticoagulation and blood flow rate as well as monitoring of the overall treatment parameters are essential to avoid side-effects which may be associated with hemodialysis/hemofiltration therapies.
18. Use only drugs compatible with plastics listed in the specifications section. Some plastics can be incompatible with drugs when in contact with solutions with pH > 10.
SPECIFICATIONS
Hypersensitivity reactions have been observed during dialysis. Symptoms of a hypersensitivity reaction may be gastrointestinal, mucocutaneous, respiratory, cardiovascular or systemic in nature and range from very mild to severe. Such symptoms have been described as anaphylactic-like reactions within the first few minutes. Manifestations include nausea, malaise, weakness, a sensation of burning or heat throughout the body, profuse perspiration, respiratory distress and in some instances hypotension and cardiopulmonary arrest. Should a combination of such symptoms appear, particularly at the start of the treatment session, it is important to react immediately by discontinuing the session and administering appropriate treatment. Blood in the extracorporeal circuit must not be returned to the patient.
See Tables at end of document.
SET MATERIALS AN69 ST hollow fiber : Acrylonitrile and sodium methallyl sulfonate copolymer + Polyethylene Imine (surface treatment agent) Housing and headers :
Polycarbonate
Potting compound
:
Polyurethane
Tubing material
:
Plasticized polyvinyl chloride (PVC)
Cartridge
:
Polyethyleneterephtalate Glycol
Extra care must be taken when treating patients who have exhibited possible hypersensitivity symptoms during previous treatments, or patients who have a history of being highly sensitive and allergic to a variety of substances. A physician must be consulted to evaluate the risk and prescribe the appropriate precautions if a possible sensitivity is suspected.
Note : the following information is available from the manufacturer upon request : • information about test methods used to obtain performance characteristics, • the number and range of particles in the effluent from the dialyzer prepared as recommended for clinical use, • the types and amounts of residue from the sterilization process.
The following factors are considered essential to minimize the risk of hypersensitivity reaction and other side effects: • Strict adherence to the set-up, priming and rinsing procedures detailed in the manufacturer’s instructions for use. • Setting up and monitoring the treatment operating parameters according to the manufacturer’s recommendations specified for each type of Prismaflex set and to the patient’s needs and tolerance. • Strict adherence to all WARNINGS and CAUTIONS given by the manufacturer in the instructions for use.
Note: the Prismaflex set is not made with rubber natural latex. Note: all fluid pathways in direct or indirect blood contact are DEHP-free.
INSTRUCTIONS FOR USE
Patients receiving angiotensin converting enzyme (ACE) inhibitors as medication can develop, within the first few minutes of a treatment, symptoms similar to acute allergic reactions i.e bronchospasm, edema of airways or larynx, dyspnea, angioedema, urticaria, nausea, vomiting, diarrhea, respiratory arrest, abdominal cramping, hypotension, hypovolemic shock and death.
Note: use the set by following the detailed on-line instructions provided by the control unit. Additional information is available in the control unit operator’s manual.
Load Set Install the set onto the control unit using the photographs on the inside cover as a guide - the same procedure applies for both Prismaflex and PrisMax control units (in countries where PrisMax is cleared or registered).
However, for these patients, administration of antihistamines often does not alleviate the symptoms. In this case, treatment must be stopped and a more aggressive first-line therapy for an anaphylactoid reaction should be initiated immediately after the onset of symptoms.
Prepare and Connect Solutions
Therefore, the prescribing physician must pay special attention to patients receiving ACE inhibitors and/or having already shown similar reactions.
In order to gain full benefit from the AN69ST in terms of improvement of hemocompatibility, it is recommended to add 5000IU of unfractionated heparin per liter of priming/rinsing solution. This procedure allows the adsorption of active heparin onto the AN69ST before the start of extracorporeal circulation.
WARRANTY AND LIMITATION OF LIABILITY a) T he manufacturer warrants that the Prismaflex set has been manufactured in accordance with its specifications and in compliance with good manufacturing practices, other applicable industry standards and regulatory requirements.
Consequently, the systemic anticoagulation strategy during treatment will be adapted with respect to patient specificity. In the cases where priming/rinsing without addition of unfractionated heparin, we recommend infusing the loading dose of heparin to the patient 2 to 5 minutes before connection to the filter.
I f provided with the lot/serial number of the defective product, the manufacturer will, by replacement or credit, remedy manufacturing defects in the Prismaflex set becoming apparent before the expiration date. b) T he warranty under paragraph a) above is in lieu of, and to the exclusion of, any other warranty, whether written or oral, express or implied, statutory or otherwise, and there are no warranties of merchantability or other warranties, which extend beyond those described in paragraph a) above. The remedy set out above for manufacturing defects is the sole remedy available to any person due to defects in the Prismaflex set and the manufacturer shall not be liable for any consequential or incidental loss, damage, injury or expense arising directly or indirectly from the use of the Prismaflex set, whether as a result of any defect therein or otherwise.
ang bag of priming solution [saline or alkaline solution (pH ≥ 7.3) with added H 5000IU unfractionated heparin/liter according to usual institutional practice, correctly homogenised] on priming hook. Connect access (red)/effluent (yellow) Y-line to priming solution bag.
SPECIAL PROCEDURES IN CASE OF COMPLICATION
c) T he manufacturer shall not be liable for any misuse, improper handling, noncompliance with warnings and instructions, damage arising from events after the manufacturer’s release of the Prismaflex set, failure or omission to inspect the Prismaflex set before use in order to ensure that the Prismaflex set is in proper condition, or any warranty given by independent distributors or dealers.
External Blood Leaks Note: see Warning no. 15.
d) T he manufacturer is GAMBRO Industries, 7 avenue Lionel Terray, BP 126, 69883 MEYZIEU CEDEX, FRANCE.
If an external blood leakage is observed, immediately stop the blood pump. Initiate corrective action by securing connections or replacing the Prismaflex set.
Indonesia - Distributor : PT. Tawada Healthcare, Rukan Permata Senayan Blok A No. 18-19, Jl. Tentara Pelajar No. 5, Grogol Utara, Jakarta Selatan Indonesia
If necessary, administer adequate replacement solution to the patient to compensate for blood loss.
KEMENKES RI AKL 20805713569
15
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 86 of 92
Colour Reference:
Proofread No.: 1
BLACK
Prismaflex PHYSICAL CHARACTERISTICS
ST60 SET
ST100 SET
ST150 SET
0.6 m2
1 m2
1.5 m2
(1)
Membrane effective surface area Fiber internal diameter (wet)
240 µm
Fiber wall thickness
50 µm
Blood volume in set
97 mL
155 mL
193 mL
Overall dimensions • Length • Width • Height
27 cm 22 cm 9 cm
Weight
772 g
828 g
894 g
OPERATING PARAMETERS Maximum TMP
450 mmHg 60 kPa
Maximum blood pressure
500 mmHg 66.6 kPa
Minimum blood flow rate Maximum blood flow rate
PERFORMANCE SPECIFICATIONS
50 mL/min
75 mL/min
100 mL/min
180 mL/min
400 mL/min
450 mL/min
(2)
Maximum ultrafiltration rate (mL/min) (3) (bovine blood, Hct 32%, Cp 60 g/L, 37°C) QB (mL/min) Max.QUF (± 20%)
100
180
100
200
300
400
100
200
300
450
39
56
45
70
91
109
52
82
106
136
Sieving cœfficient (bovine plasma, Cp 60 g/L, 37°C) QB = 100 mL/min, QUF = 20 mL/min • Urea
1
• Vitamin B12
1
• Inulin
0.96
Sieving cœfficient (human plasma, Cp 60 g/L, 37°C) QB = 100 mL/min, QUF = 20 mL/min • Myoglobin
0.70
• Albumin
< 0.0045
Clearance (mL/min) (saline solution ; 37°C) Parameters: QB/QS
100 mL/min
150 mL/min
200 mL/min
QUF
0 mL/min
0 mL/min
0 mL/min
QD (L/h)
1
2.5
4
1
2.5
4
8
1
2.5
4
8
QD (mL/min)
17
42
67
17
42
67
133
17
42
67
133
Urea (± 10%)
17
40
56
17
41
63
97
17
42
66
117
Vitamin B12 (± 20%)
15
26
30
16
32
41
50
17
38
51
68
Inulin (± 20%)
13
19
22
15
26
30
35
16
33
40
49
(1)
Nominal values - given for indication
(2)
Typical mean values obtained from laboratory testing of post-sterilization sample lots. Results may vary depending on patient and clinical conditions.
(3)
Ultrafiltration is controlled by the control unit and is independent of the ultrafiltration cœfficient (KUF). Note : a TMP > 40 kPa (300 mmHg) does not allow a higher ultrafiltration.
86
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 87 of 92
Colour Reference:
Proofread No.: 1
BLACK
Prismatherm
87
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 88 of 92 BLACK
INSTALL SET DIRECTLY ONTO THE CONTROL UNIT
Colour Reference:
Proofread No.: 1
88
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 89 of 92 BLACK
Patented ready to use PrismaFlex set packaging.
Colour Reference:
Proofread No.: 1
89
BAXTER CONFIDENTIAL - INTERNAL USE ONLY Part Number: 1000014795
Date: 22-JAN-2020
Designer: CDS
Page: 92 of 92
Colour Reference:
Proofread No.: 1
BLACK
Baxter, AN69, Prismaflex, Prismatherm and Prismax are trademarks of Baxter International Inc. or its subsidiaries.
92