Haemonetics MCS+ Analyzer - User Manual PDF
Haemonetics MCS+ Analyzer - User Manual PDF
- Operation Manual -
0123
HAEMONETICS U.K. LTD
5 Ashley Drive, Bothwell
Printed in France EC REP Scotland G71 8BS
Great Britain
Haemonetics Corporation
400 Wood Road P/N 85213-30, Manual revision: B
Braintree, Massachusetts 02184, USA June 2006
©2002, 2006, Haemonetics Corporation. All rights reserved.
iii
CONSUMER INFORMATION
Proprietary rights The contents of this manual are property of the Haemonetics Corporation.
Haemonetics®, MCS®+ and eLynx™ are trademarks or registered trademarks of
the Haemonetics Corporation in the United States, other countries, or both. Any
information or descriptions contained in this manual may not be reproduced and
released to any of the general public, or used in conjunction with any profes-
sional instruction without written consent of Haemonetics Corporation, USA.
Please direct any written inquiries to the appropriate address.
International Headquarters Corporate Headquarters
Haemonetics SA Haemonetics Corporation
Signy Centre, rue des Fléchères 400 Wood Road
P.O. Box 262, 1274 Signy 2, Switzerland Braintree, MA 02184, USA
Tel. [+41 22] 363 90 11 Tel. [+1 781] 848 7100
Fax [+41 22] 363 90 54 Fax [+1 781] 848 5106
Legal disclaimer This manual is intended for use as a guide, uniquely for material as supplied by
the Haemonetics Corporation. It provides the operator with necessary informa-
tion to safely carry out specific procedures and satisfactorily maintain Haemo-
netics produced equipment. The manual is to be used in conjunction with
instruction and training as supplied by qualified Haemonetics personnel.
Haemonetics guarantees its products when correctly used by a properly trained
operator. Any failure to respect the procedures as described could result in
impaired function of the equipment, as well as in injury to the operator and/or
patient/donor. Haemonetics accepts no responsibility for problems resulting from
failure to comply with prescriptions as outlined by the company.
Any modifications estimated as necessary by the customer should be evaluated
by a Haemonetics Clinical Specialist.
Safe utilization of Haemonetics material and equipment requires the operator to
correctly handle and dispose of blood-contaminated material. The operator of
any Haemonetics equipment must fully understand and implement the local
prevailing policies and procedures of each facility in which Haemonetics prod-
ucts are used, concerning blood-contaminated material as well as blood prod-
ucts.
It remains solely the responsibility of the customer to fully assess and ensure the
safety of any products obtained from Haemonetics prescribed procedures, prior
to further application or use.
Haemonetics declines any responsibility for choices made by the consumer
concerning the utilization of these products and by-products.
In addition, it is the responsibility of the apheresis center using Haemonetics
equipment and material to provide information to the donor concerning the risks
involved with any apheresis procedure. Prior to initiating any procedure, the
apheresis center is responsible to verify that the donor understands these risks
and consents to the procedure.
Preface
INTRODUCING THE MCS+ TOTAL APHERESIS DEVICE . . . . . . . . . . . . . . . XI
What is the purpose of this manual? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
What is apheresis technology? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
What is the Haemonetics “Mobile Collection System”? . . . . . . . . . . . . . . xii
What are the characteristics and special features of the MCS+? . . . . . . . xiii
Setting up the device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Symbols found in this document. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Symbols found on the device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Symbols found on disposable packaging . . . . . . . . . . . . . . . . . . . . . . . . xvi
Specifications of the MCS+ device . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii
What is the This manual is intended to supply anyone involved in using Haemonetics apher-
purpose of this esis equipment with the essential tool for safe and successful operation – infor-
mation. Using this tool of information, the operator can acquire knowledge to be
manual? applied throughout all levels of operating experience. This body of information
should be consulted whenever necessary, starting from the initial contact with
Haemonetics technology, in order to attain:
! An awareness of the purpose of the device and the implications of its col-
lection procedures for the donor/patient and the apheresis center.
! An understanding of how to safely operate the Haemonetics system, cor-
rectly install the appropriate disposable material, and troubleshoot any dif-
ficulties.
! An ability to consistently apply the principles behind safe operation, prop-
er maintenance and correct handling to ensure optimal, quality apheresis
results.
This manual covers MCS+ device information for list numbers LN9000-220-E,
LN9000-220-ED, LN9000-220-EW, and LN9000-110-EWC. Information that is
specific to a certain protocol (disposable set installation and how to run the
protocol), is located in the protocol manuals.
What is apheresis Apheresis is the general term used to describe the selective removal and collec-
technology? tion of one or more individual components which together form whole blood.
This term can be subdivided into two categories:
! Cytapheresis: selective removal of one or more of the formed, cellular
components of whole blood. These elements include erythrocytes, throm-
bocytes, leukocytes and stem cells.
! Plasmapheresis: selective removal of plasma, the liquid suspension medi-
um of blood. Plasma contains elements referred to as fractional compo-
nents, such as clotting proteins and immunoglobulins.
Apheresis Technology permits:
! The collection and separation of whole blood.
! The selective removal of specific components.
! The subsequent return of the remaining components
to the donor/patient.
What is the Using updated apheresis technology, Haemonetics has produced the MCS+, a
Haemonetics highly mobile, compact, lightweight total apheresis system which is as easy and
safe to use, as it is technologically advanced.
“Mobile
The MCS+ automated apheresis technology provides the operator with a
Collection maximum degree of flexibility in any type of apheresis location. The components
System”? collected such as platelets, red cells, stem cells, and plasma may be designated
for use in therapeutic transfusion. Plasma collected can also be conserved and
subsequently fractionated into plasma-derived products.
The MCS+ (Haemonetics “Mobile Collection System Plus”), consists of distinctive
“parts” which collectively function as a “whole” to produce a designated final
product. These system elements can be explained using the following distinc-
tions:
! The automated total apheresis device produced by Haemonetics called
the “MCS+”.
! The single-use collection material manufactured by Haemonetics called a
“disposable set”.
! The collection procedure designed by Haemonetics called a “protocol”.
Once the operator has initiated an MCS+ procedure, component collection will
proceed automatically. The appropriate amount of anticoagulant solution will be
mixed in the disposable tubing with whole blood from the donor/patient.
This anticoagulated blood will be drawn into a disposable collection bowl and
separated by centrifugal force into its various components.
When the bowl reaches its collection capacity, the separated components will
exit the bowl and be directed into collection containers for conservation, or
returned to the donor/patient. This cycle is repeated until the desired amount of
selected blood components have been collected.
The choice of the disposable material will depend on the selected MCS+ collec-
tion protocol. The MCS+ technology provides the operator with the option to
infuse saline solution along with the blood components remaining in the bowl at
the end of a procedure.
Haemonetics has designed the MCS+ technology with a degree of automation
which permits the operator to interact with the device. The operator should
remain attentive to the screen messages while monitoring the status of the donor/
patient. It is possible to modify the collection procedures, based on the needs and
requirements of the individual donor/patient, as well as the apheresis center.
What are the MCS+ collection procedures are quick and easy to initiate, requiring the operator
characteristics simply to:
and special " Select a collection protocol among the interchangeable Protocol cards.
Setting up the The following guidelines should be observed when setting up the MCS+ device:
device ! Always place the device on a flat, stable surface.
! Allow the device to equilibrate to room temperature before use.
! Always ensure the IV poles are in the “down” position and the cabinet cov-
er is closed when moving or transporting the device.
Symbols found in The terms Note, Caution and Warning are used in this manual with the following
this document symbols to emphasize certain details for the operator.
Symbols found on The descriptions of the following symbols are based on information provided in
the device the following documents:
! IEC 60601-1 Standard, Medical Electrical Equipment,
Part 1: General requirements for safety.
! IEC 60417-1 Standard, Graphical symbols for use on equipment,
Part 1: Overview and application.
This symbol indicates that the applied portion (i.e. the part which comes in
contact with the donor) of the device is electrically isolated. The device has an
internal electrical power source providing adequate protection against electrical
shock, in particular pertaining to acceptable leakage current and the reliability of
the protective earth connection.
~ Alternating current
Used to indicate on the rating plate that the device is suitable for alternating
current only.
Fuse symbol
Power OFF
Position of the main power switch indicating disconnection from the mains.
Power ON
RS232 connection
Symbols found on The following symbols are used by Haemonetics on disposable set packaging.
disposable
REF CATALOG NUMBER
packaging
EXPIRATION DATE
DO NOT REUSE
80%
8%
8%
50°C
-20°C
Specifications of The approximate weight and dimensions for the MCS+ device are as follows:
the MCS+ device
Values
Characteristics
Cabinet Cabinet
cover open cover closed
Height 68.5 cm 44 cm
Width 56.5 cm
Weight 27.5 kg
Conditions Values
The electrical specifications for operating the MCS+ device are as follows:
Characteristics Values
(relative to input voltage)
Note: Haemonetics will regulate the proper voltage setting upon installation. The
power source used must be properly grounded.
Warning: Equipment not suitable for use in the presence of a flammable anes-
thetic mixture with air or with oxygen or nitrous oxide.
The shipping/ storage temp are -20C to 50C at 8% to 80% humidity. The
artwork for the carton is only in the old film style.
In addition, the MCS+ device and accessories must not be placed directly adja-
cent to, or top of other equipment, unless specifically approved by Haemonetics.
Any electrical equipment used inside or outside the “patient environment” (as de-
fined in the Standard), whether connected or not connected to the MCS+ device,
must provide a level of safety compliant with relevant IEC and ISO safety stan-
dards. Safe environmental conditions must be maintained for all devices inside
and outside of the patient environment.
When properly operated and maintained, the MCS+ device provides a level of
safety compliant with the IEC 60601-1-1 Standard, both inside and outside the
patient environment.
The operator is responsible for making sure that the final configuration of the
MCS+ device complies with IEC 60601-1-1 Standard, Medical electrical equip-
ment.
Note: Refer to the Postscript to the MCS+ Operation Manual (P/N 85270-30), for
information about Haemonetics approved devices, such as a printer or an exter-
nal network, that can be connected to the MCS+ device.
1. Locking knob 2. 2.
2. Optical sensor
3. Long fluid detector 4.
4. Round fluid detector 3.
5. Mechanical chuck 1. 1.
6. Vacuum chuck
NOTE:
Any system containing one or
two round fluid detector(s) 4.
could be retrofitted with one
long fluid detector.
5. 5.
2. 2.
4. 4.
1. 1.
5. 6.
CENTRIFUGE BASE
The centrifuge base contains a chuck designed to hold a disposable centrifuge
bowl in place during operation. The MCS+ disposable set can contain either a
Latham bowl, or a blow molded bowl (BMB). The type of bowl used will depend
on the final collection product.
The technique used to install a bowl will depend on the design of the centrifuge
chuck. The following variations exist among MCS+ devices in use:
! Centrifuge base with a mechanical chuck/factory origin.
! Centrifuge base with a vacuum chuck/factory origin.
! Centrifuge base with a mechanical chuck, retrofitted from a vacuum
chuck/factory-origin.
Using a If the MCS+ device contains a mechanical chuck, the clips on the centrifuge base
mechanical will hold the bowl in place. When installing a bowl, the operator should exert a
centrifuge chuck downward pressure on the head of the bowl and ensure that the bowl is
completely seated. The operator will hear a “click” after applying the proper
downward force.
To remove the bowl at the end of the procedure, the operator should grasp the
head of the bowl and pull sideways to release the bowl from the clips while lifting
the bowl out of the centrifuge well.
Caution: The mechanical chuck clips must be kept clean, and should be thor-
oughly cleaned after any spills. A dirty or blocked clip may no longer hold the
bowl correctly. If a clip is not functioning properly, the operator must contact an
authorized Haemonetics representative.
Using a vacuum If the MCS+ device contains a vacuum chuck, a vacuum force will be created
centrifuge chuck between the base of the bowl and the chuck to hold the bowl in place. When
installing a bowl, the operator should exert a downward pressure on the head of
the bowl and ensure that the bowl is completely seated. The bowl will be
completely secured once the operator has locked the centrifuge lid.
To remove a bowl at the end of a procedure, the operator should simply pull
upward on the bowl until the vacuum force is disrupted. The bowl can then be
lifted out of the centrifuge well.
Caution: If any residual vacuum force remains and the operator cannot remove
the bowl using this technique, the manual vacuum release button can be used
(refer to Manual vacuum release button in Chapter 2). However, the operator
should not use this mechanism during routine MCS+ function, as this could dam-
age the bowl and/or centrifuge components.
Applications for a When the selected MCS+ protocol uses a blow molded bowl (BMB), a centrifuge
centrifuge chuck chuck adapter is required to secure the BMB in the centrifuge well, designed for
adapter the Latham bowl.
The chuck adapter is designed to be installed and removed using the same tech-
niques as for the Latham bowl. The adapter will be secured by either vacuum
force, or the mechanical clips, depending on the type of centrifuge chuck.
Once the adapter has been securely positioned, the BMB can be installed in the
adapter, using a downward pressure to fully seat the bowl. A suction force will
be created between the base of the adapter and the bowl. To remove a BMB at
the end of a procedure, the operator should simply pull upward on the head of
the bowl. The adapter can be removed from the centrifuge well using the same
technique as when removing the Latham bowl.
Figure 1-5, MCS+ centrifuge with chuck adapter for blow molded bowl
Note: The chuck adapter is not a disposable element and should not be discarded
after use. It is to be re-used for subsequent MCS+ procedures.
CENTRIFUGE WELL
The MCS+ centrifuge well is designed with the following components.
Note: The interface between the optical sensor in the centrifuge well and the con-
tents of the bowl is often referred to as “bowl optics” and will be discussed in fur-
ther detail in each respective MCS+ protocol manual.
1. Optical sensor
2. Long fluid detector
3. Round fluid detectors
2. 3.
1.
Caution: The optical bowl sensor must be kept clean, and should be cleared after
any spills. A dirty or clouded lens will interfere with proper functioning of the
MCS+ device.
Fluid detector(s)
The MCS+ centrifuge well is equipped with an electronic fluid detection system
designed to detect the presence of liquid. Depending on the style of centrifuge in
use, there will be either one long fluid detector, or one or two round fluid
detector(s) mounted on the wall of the centrifuge well. The MCS+ safety system
will automatically stop the centrifuge (and the pumps) if there is contact between
liquid of any sort and the fluid detector(s).
SYSTEM-SEALING MECHANISM
The MCS+ centrifuge contains a split, hinged lid (or cover) and a locking knob.
These components “seal” the system by:
! Securing the contact of the disposable bowl with the centrifuge base.
! Isolating the spinning bowl from the operator.
Centrifuge cover The centrifuge lid, referred to as the cover, has tabs located on the rimmed
portion of each split side. The split halves are attached to the centrifuge rim by a
hinge. As the halves of the lid are lowered to meet the rim, the tabs must be firmly
pressed together in order to completely close the lid and provide a seal around
the stationary head of the disposable bowl.
The split halves of the lid are made from a durable, transparent material, allowing
the operator to observe changes in the bowl contents as the centrifuge spins.
Locking knob The locking knob is positioned on the rim of the centrifuge well.
Two types of locking knobs exist among the MCS+ devices in use.
The second style requires that the operator press the knob to separate the halves
of the split lid when opening the centrifuge. The knob can be engraved with either
the text “PUSH TO OPEN”, or a symbol of a lock.
The centrifuge can be locked once the split halves of the lid have been firmly
pressed together using the tabs. This knob is incorporated into an elevated base.
The knob needs to be turned and aligned with the appropriate symbol on the base
to place it in the locked or unlocked position.
Warning: The MCS+ device is equipped with a safety feature which will not al-
low the centrifuge to spin if the lid has been improperly closed. It is unlikely that
a properly installed centrifuge bowl will become unaligned as it spins. However,
if the operator should notice anything unusual about the bowl, under no cir-
cumstances, should the operator attempt to open the centrifuge lid if the bowl
is still spinning. The operator must ensure that the centrifuge has come to a
complete stop before attempting to open the lid for any reason.
Summarizing the The following table summarizes the combinations of centrifuge components
MCS+ centrifuge which can be found among the MCS+ centrifuge systems in use.
components
Table 1-1, MCS+ Centrifuge component combinations
Centrifuge chuck Mechanical clips secure Vacuum force secures the Mechanical clips secure
the bowl or chuck adapter. bowl or chuck adapter. the bowl or chuck adapter.
Fluid detector(s) One long or two round One round One round
Split hinged lid Designed with semi- Designed with cylindri- Designed with cylindri-
circularly shaped tabs, cally shaped tabs, pressed cally shaped tabs, pressed
pressed to close the sides to close the sides of the lid. to close the sides of the lid.
of the lid.
Locking knob Knob engraved with either: Requires series of turns to Requires series of turns to
“PUSH TO OPEN” sym- lock or unlock the lid. lock or unlock the lid.
bol or text.
Note: Any references made to “left”, “right”, “top”, or “rear” are from the per-
spective of an operator facing the MCS+ device during an apheresis procedure.
1. Top deck
2. Front panel
3. Right side
4. Rear panel (not visible)
1. 3.
4.
2.
14. 15.
3. 4. 5. 6. 7.
Valves There are eight valves located on the MCS+ top deck which automatically control
the flow of fluids through the disposable set tubing. The valves are color-coded
and correspond with specific sections of disposable set tubing. Each valve also
contains a light to indicate an open (lit) or closed (not lit) state. The MCS+ safety
system will control the valves during the power-up self-diagnostic tests. Once the
operator has selected a collection protocol, the appropriate valves will open
automatically and be lit, in preparation for loading the disposable tubing.
Note: The function of each valve will depend on the selected MCS+ protocol,
however the red-coded valve (N° 3) is consistently used as the “donor“ valve.
During the different modes of the selected MCS+ protocol, the valves will operate
automatically, opening and closing depending on the passage of fluids. However,
the valves can be opened manually if the disposable tubing should need to be
adjusted during a procedure, by pressing the pinch-lever on each valve toward
the cabinet.
Pump assemblies Located on the left side of the MCS+ top deck are three pumps which use peri-
staltic movements to displace fluids through the disposable set tubing. Each
pump is designated by a color and will function at particular moments during the
apheresis procedure, as determined by the selected MCS+ protocol.
A pump assembly consists of a pump rotor, housed in a well containing the pump
motor. The outer pump housing is designed to secure the correlating pump mani-
fold of the disposable set. During installation of the disposable set, the MCS+ will
perform an autoload of the tubing onto the pumps.
1. Single-pump housing 2.
2. Dual-pump housing
3. Dual-pump
identification window
3.
4. AC pump rotor
5. Transfer pump rotor
4.
6. Blood pump rotor 5.
6.
1.
Note: The Blood pump and the AC pump will rotate at different speeds during
DRAW, depending on the AC/Blood pump ratio parameter setting. Information
related to the function of the pumps during sub states, such as SURGE and
DWELL, will be provided in each relevant MCS+ protocol manual.
Optical line Located on the right side of the MCS+ top deck is the optical line sensor which
sensor monitors the blood components passing through the effluent tubing. This
measurement is important for the MCS+ software in controlling the final collec-
tion product.
Caution: The line sensor will not provide accurate readings if the optical lens is
obstructed in any way; thus the lens must be cleared of any extraneous substanc-
es to ensure proper functioning of the system.
Weigher The “weigher” is the term used by Haemonetics to describe the MCS+ compo-
nent which measures in grams the contents of the collection container(s) placed
on the “weigher arm”.
When the Draw key is pressed to begin a procedure, the weigher will automati-
cally tare, or set the weigher to zero. Thus, the weight of the container will not
be included in the weight displayed on the MCS+ screen.
To ensure optimal accuracy from the weigher during a collection procedure:
! The weigher arm must be fully extended, positioned at a 90 degree angle
to the MCS+ top deck, prior to the system self-tests.
! The collection container must hang freely, without any contact with the
MCS+ cabinet.
Caution: The operator must be careful to not touch the weigher once the weight
of the collection container has been set to zero. This could affect the collection
procedure and a warning will be provided to the operator.
Pressure The electronically controlled pressure monitors function with the correlating
monitors filter on the disposable set to measure pressure in the disposable tubing. The pres-
sure monitors provide feedback to the system about the flow of blood compo-
nents to and from the donor (DPM) as well as the centrifuge bowl (SPM). The
MCS+ programming will automatically regulate the speed of the pumps based on
this information.
Caution: Once the DPM/SPM and the disposable set filters have been connected,
they should not be disrupted at any point to ensure proper pressure readings.
DRAW mode
The pressure readings will vary as blood is drawn from the donor. If a significant
pressure decrease is detected and the DPM readings drop below a programmed
value, the pump speed will automatically decrease until a sufficient pressure
increase is measured.
If the donor-line pressure is measured as insufficient, the pumps will stop, the NO
FLOW indicator lights will be visible and an explanatory screen message will
appear with an alarm. Once pressure is measured to be within normal operating
range, the pumps will resume their programmed speed.
RETURN mode
The pressure readings will vary as blood is returned to the donor. If a significant
pressure increase is detected, and the pressure readings rise above a programmed
value, the pump speed will automatically decrease until a sufficient pressure
change is measured. If pressure readings remain high, the Blood pump will stop,
and an explanatory screen message will appear with an alarm.
When pressure is measured to be within the normal operating range, the pumps
will resume operation until reaching the programmed pump speed.
Warning: The operator must remain aware of the fact that a high pressure warn-
ing can indicate a possible flow obstruction and could cause red blood cell
hemolysis, and/or damage the vein. Corrective action is necessary and the op-
erator should intervene immediately, following the actions listed on the HELP
screen. The operator can also consult Chapter 6 for information about avoiding
flow restrictions.
Air detectors (top The MCS+ is equipped with an assembly of ultrasonic sensors designed to detect
deck) the presence of air, bubbles or foam in the fluids flowing through the disposable
set tubing.
If air is detected outside of the normal range during any mode (PRIME, DRAW or
RETURN), the detectors will:
! Activate the MCS+ safety system.
! Stop the operation in progress.
! Provide the operator with an error message and an audible alarm.
Caution: In the case of any air detection alarm, the operator must respond imme-
diately, note the source and take immediate action, following the actions listed
on the HELP screen.
Warning: If the AC solution is depleted prior to the end of the collection proce-
dure, the operator may receive a NOTICE message and an alarm, signifying that
the ACAD has detected air in the AC line tubing. Haemonetics recommends that
the collection of blood components be discontinued at this point.
Warning: Air detected (or lack of air detection) by the BLAD, outside of normal
limits, will stop the collection procedure and alert the operator.
1. DLAD1 5.
2. DLAD2
3. Blood filter chamber
brackets
4. Re-circulation chamber
brackets
5. Disposable set pins
1.
3. 4.
2.
Warning: In the case of any air detection alarm, the operator must respond im-
mediately, note the source and take immediate action, according to the list on
the HELP screen. During RETURN, if either the DLAD1 and/or DLAD2 produce
an air detection alarm, this could indicate a failure of the BLAD. The operator
should carefully note the source of air detected – no blood should be sent to the
donor until all air bubbles have been removed from the line.
Warning: If, after attempting this procedure to remove any air, the DLAD1 and/
or DLAD2 detect air again, the operator should terminate the procedure, dis-
continue use of the device and contact the authorized Haemonetics represen-
tative.
Disposable set Located on the MCS+ front panel are the following various components used to
element holders secure elements from the disposable set during a collection procedure:
! Blood filter chamber brackets.
! Re-circulation chamber brackets.
! Disposable set pins.
Solution-bag Located on either side of the MCS+ cabinet is a height-adjustable pole. These
poles (2) poles are used to hang the solution bags during the collection procedure. The left
pole should be used to hang the AC solution bag, whereas the right pole should
be used to hang the saline solution and other bags.
Donor flow These color-coded lights indicate donor/patient blood flow status during DRAW
indicator lights mode and RETURN mode. They are used in conjunction with either a text, or a
symbol.
DRAW 1. 2. 3. 4.
1. Green
2. Yellow
3. Red
RETURN
4. Yellow
DRAW mode
! The GREEN LIGHT indicates that donor blood flow is sufficient for the
Blood pump to maintain an adequate speed.
! The YELLOW LIGHT indicates that donor blood flow is decreasing and
may be insufficient to maintain an adequate Blood pump speed.
! The RED LIGHT indicates that blood is not flowing adequately or not flow-
ing at all from the donor/patient.
If the red flow light is lit, the Blood pump will automatically stop. The centrifuge
will continue to spin to ensure continued separation of the collected blood
components. When donor/patient blood flow is restored, the blood pump will
automatically restart. The Transfer pump will continue to function if required by
the selected MCS+ protocol.
RETURN mode
! The YELLOW LIGHT indicates that the non-selected blood components
are being returned to the donor.
Note: If any of the DRAW mode lights are lit, the donor can promote blood flow
by clenching and relaxing the hand below the needle site.
When the RETURN yellow light is lit, the donor should not do this, because the
blood components in the bowl are being returned. The operator should instruct
the donor to observe the differences in the lights and act accordingly.
2.
6.
7.
3.
4.
Anticoagulant The AC drip monitor contains an optical sensor, used to detect the flow of AC
(AC) drip monitor solution as it passes from the AC drip chamber into the AC tubing. If the AC drip
monitor detects a problem with the AC flow, the MCS+ pumps will stop. The
operator will receive an explanatory screen message, as well as an audible alarm.
! During PRIME and DRAW, it monitors the flow of AC solution being drawn
through the tubing by the AC pump.
! During DRAW, the flow corresponds with the programmed AC ratio. The
AC drip monitor works in conjunction with the ACAD to ensure the flow
of AC solution to the donor-line tubing.
! During RETURN, the AC drip monitor functions as a safety feature to en-
sure that no AC solution is passing into the donor-line tubing.
Caution: The lens of the optical sensor must be kept clean so that the AC drip
monitor can provide accurate readings.
Power entry The power entry module (PEM) is located on the left side panel of the device.
module Externally, the module consists of an ON/OFF switch and a power input recep-
tacle for the power cord. Internally, the module contains the fuse panel. It will
interrupt power supply to the system in the event of an electrical current
surcharge.
The design of the power entry module also provides a filter-effect for the MCS+
device against the effects of a power surge.
In the case of an emergency, the ON/OFF switch can be used to stop all MCS+
function.
2.
Power cord The power cord provided is designed to connect the MCS+ device with an
external power source via the power input receptacle, located on the power entry
module on the left side panel.
Bar-code reader The bar-code reader is mounted on the left panel of the MCS+ device and can be
used to enter the following types of data directly into the data storage memory.
! Disposable set lot and list number.
! Anticoagulant and solution bag codes.
! Donation number, donor number and operator code.
Note: The Postscript to the MCS+ contains further information on the use of the
bar-code reader when entering data, as well as the role of the communication
box (discussed later in this chapter), in the transfer of this data to an external de-
vice or to HaemoNet, the Haemonetics communication network.
Warning: The class II bar-code reader emits laser radiation. Do not look directly
into the beam.
Handles Handles for lifting the MCS+ device are located on the side panels.
Platelet filter Located on the right side of the MCS+ device are brackets used to secure the filter
holder contained on the MCS+ disposable sets designed for platelet collection.
Disposable set The MCS+ right side panel contains pins designed to secure disposable bags from
pins the disposable collection set.
Protocol card An MCS+ collection procedure is performed using the operating instructions
port provided on the MCS+ protocol card. Prior to powering on the device, the
protocol card should be inserted into the card port located on the lower right side
of the MCS+ device.
Once the protocol card has been correctly inserted, the door of the card port can
be closed and should remain closed during the entire collection procedure. To
remove the card at the end of a procedure, the operator should open the door and
press the release tab above the card.
A.
1. Pins
2. Protocol card insertion
into card port 1. 4.
B.
3. Release tab
4. Platelet filter holder
5. Tubing guide
2.
3.
5.
A. B.
3.
Pressure cuff The tourniquet-style pressure cuff is used to maintain an optimal venous blood-
flow from the donor during specific phases of the collection procedure. The cuff
should be attached to the MCS+ cuff connection located on the rear panel of the
MCS+ cabinet. The cuff meets the ANSI/AAMI SP-9 & SP-10 standards for accu-
racy and performance.
Communication Note: The communications box may not be present on all MCS+ devices. Refer
box to the Postscript to the MCS+ Operation Manual (P/N 85270-30), for further in-
formation on the communication box and other communication options such as
the data card reader or wireless antenna.
The communication box (either internal or external) transfers data via a serial
connection from the MCS+ device to an external device such as a printer, or to
HaemoNet, the Haemonetics communication network. A Haemonetics trained
technician must configure the communication box to communicate with a
specific device. Refer to the Postscript for information about Haemonetics
approved devices that can be connected to the MCS+ device.
HaemoNet provides any establishment using Haemonetics equipment with the
possibility of linking several Haemonetics apheresis devices to a central moni-
toring computer. Using HaemoNet, procedure data can be exchanged and stored
in a database and/or viewed directly.
Note: The MCS+ communication box has been tested according to standards re-
quired by EN 60601-1-2 (EMC of medical electrical equipment). The measured
error rate of data communicated to HaemoNet at certain specific electromagnetic
frequencies rises above the standards. However, there is no impact on the integ-
rity of the procedure information stored in the database. HaemoNet communica-
tion is designed with CRC error checking, performed upon the reception of all
data.
Wireless Note: The wireless antenna may not be present on all MCS+ devices. Refer to the
antenna Postscript to the MCS+ Operation Manual (P/N 85270-30), for further information
on the wireless feature and other communication options such as the data card
reader or communication box.
The antenna, located on the rear panel and protected by a hard plastic cover,
allows the transmission of procedure data to a wireless access point connected
to a handheld device, internal PC or network, the eLynx communication system,
or to an external computer network over the Internet.
Figure 2-13, Example of the wireless antenna located on the device rear panel
Manual vacuum Any MCS+ device with a vacuum centrifuge contains this mechanism which can
release button interrupt the vacuum effect on the bowl. An MCS+ protocol functioning with the
vacuum centrifuge is designed to automatically release the vacuum force at a
specific point in the procedure. However, it may be necessary for the operator to
do this manually, as in the case of a power failure. In this type of situation, the
operator can depress the button to interrupt the vacuum force and release the
bowl, once the centrifuge and bowl have come to a complete stop.
2.
Caution: The operator must not use the manual vacuum release button during
routine MCS+ function, unless specifically warranted, as this could damage the
bowl and/or the centrifuge components.
Biohazard waste The biohazard waste bag is designed to collect any biologically contaminated
bag material from the centrifuge well in the rare case of a spill or leak. Two biohazard
waste bags are supplied with the delivery of each MCS+ device.
A bag must be attached at all times to the centrifuge drain tube, located at the
rear of the device. The bag must hang freely, with the clamp open, visible to the
operator.
Warning: The biohazard waste bags are not to be used to collect or store aph-
eresis products. When a bag contains evacuated waste products, it must be
clamped, removed and properly disposed of, according to the local standard op-
erating procedure concerning biologically contaminated material. A new bag
must be placed before resuming operation.
A. 2.
3. 4.
5. 6.
B. 7.
Donor flow There is a set of flow indicator lights located on the top of the MCS+ control
indicator lights panel, above the display screen. These lights provide the same information about
donor/patient blood flow status during the apheresis procedure as the other sets
of flow indicator lights located on the MCS+ cabinet side panels.
The lights are arranged as follows:
DRAW 1. 2. 3. 4.
1. Green
2. Yellow
3. Red
RETURN
Figure 3-2, MCS+ control panel flow indicator lights (text version)
4. Yellow
Note: The design of the fourth set of flow indicator lights, located on the exterior
of the MCS+ cabinet cover, is identical to those located on the control panel. All
of the lights provide the same information simultaneously throughout the MCS+
procedure.
Display screen The MCS+ screen will display different types of information to the operator
throughout a collection protocol. All MCS+ protocols will use the same screen
layouts and provide the operator with the same types of information on the
display screen. This information will concern:
! MCS+ self-testing protocol option selection.
! Disposable set installation.
! Procedure parameter modification.
! Haemo Calculator and Haemo Update information.
! MCS+ anticoagulant priming sequence.
! MCS+ operating mode and sub state.
! NOTICE messages and related HELP messages.
Explaining the The information and data, updated throughout the procedure, is displayed on
screen layout specific areas of the MCS+ display screen. The following screen illustrates the
MCS+ display screen as it could appear during an apheresis procedure.
The upper screen area will provide information for the operator identifying the
selected MCS+ protocol, as well as describe the mode of operation in progress.
The center screen area contains an icon (to represent the donor), the current
mode of operation, the relevant pump speed and a visual representation of the
pressure reading in the donor-line tubing, depicted by the DPM bar graph (when
visible).
Note: The contrast between filled and non-filled area in the DPM bar graph col-
umn will vary to depict the fluctuations registered in the donor-line pressure read-
ings.
The lower screen area communicates data to the operator concerning the cycle
in progress, as well as the volume of blood processed during the MCS+ proce-
dure. Other protocol-specific measurements will made be by the system and will
be displayed in this procedure statistics portion of the screen.
Note: There will also be slight variations present with the display screen layout
when the Haemo Update and Haemo Calculator messages appear. The proce-
dure statistics from the lower portion of the screen will be visible with the upper
portion information, when an operator-action HELP menu is displayed.
Understanding An MCS+ mode can be described as the operating state of the device during
an operating specific phases of the apheresis process. Each MCS+ protocol will:
mode ! Prepare the disposable set with AC solution during PRIME.
! Collect donor whole blood, mix the whole blood with AC solution and
spin the anticoagulated blood in the centrifuge bowl, then selectively re-
move the desired components during DRAW.
! Re-infuse the non-collected blood components to the donor during RE-
TURN.
Defining the These symbols, located on the left side of the center screen area, provide a picto-
screen icons rial representation of the MCS+ mode in progress.
Draw key
This key is used to initiate the first DRAW cycle, or resume the DRAW mode of
operation. The DRAW mode will move anticoagulated whole blood from the
donor through the donor-line tubing into the centrifuge bowl, where apheresis
will be initiated.
Return key
This key is used to initiate, or resume, the RETURN mode of operation. During
RETURN, the MCS+ device will return the non-selected blood components in the
disposable set to the donor. During standard protocol function, a RETURN cycle
will automatically be initiated. However, the operator can press this key if it
becomes necessary to return of the contents of the bowl to the donor before the
end of a cycle.
STOP key This key is used to immediately stop the centrifuge and pumps.
Caution: If the STOP key has been used, the bowl contents should be returned
to the donor before resuming the collection procedure. Stopping the procedure
could affect the separation of the blood components in the bowl. This could
eventually interfere with the quality of the final collection product (and/or the
collection procedure).
Pump control These keys can be used by the operator to manually change the programmed
keys pump speed during a collection procedure.
Caution: The operator should observe the DPM bar graph and flow indicator
lights in order to correctly asses for “low” donor blood flow. However, before us-
ing the arrow keys to adjust for “low” donor flow, it is important that the operator
allow the MCS+ device to first reach the target pump speed.
Caution: If the pumps have been stopped using this key, and remain stopped for
longer than two to three minutes during DRAW later, the bowl may become over-
packed with red cells, because the centrifuge will continue to spin. This can cre-
ate a potential flow problem during RETURN. The operator should return the
bowl contents to the donor before proceeding with DRAW.
Cuff control key During normal MCS+ operation, the cuff will automatically inflate during DRAW
and deflate during RETURN. The operator can use the cuff key to manually
control the pressure cuff prior to a procedure when performing the venipuncture,
or during READY or DRAW mode to modify cuff pressure. The cuff cannot be
inflated during RETURN.
LDP STOP
Cycle 0 0 Platelet Weight 0 ml Processed
MODIFY PARAMETERS
Cuff Pressure 50 mmHg Min Plt Weight 0 g
Draw Speed 90 ml/min AC Ratio 1: 9
Return Speed 120 ml/min
NaCl Vol/Cycle 0 ml
Note: This key can be used to access the Modify Parameter screen and adjust the
program parameters, or to scroll through the parameters when listed on the
Haemo Calculator screen.
Note: Once the program parameters have been consulted and/or modified, the
operator can return to the screen depicting the current mode of operation by
pressing the respective MODE key, without interruption to the collection proce-
dure.
AC Volume Used
HAEMO UPDATE
28 ml Plasma Weight 0 g
Elapsed Time 0 min Platelet Weight 0 g
Target Cycles 8 Estimated Yield 0.0 10e11
NaCl Volume Used 0 ml Target Yield 5.0 10e11
" Consult the Haemo Calculator display screen by pressing this key twice.
LDP STOP
Cycle 0 0 Platelet Weight 0 ml Processed
Sex
HAEMO CALCULATOR
M Target Plasma Wgt 0 g
Height 170 cm Target Yield 5.0 10e11
Weight 65 kg *Process Volume 4000 ml
Blood Volume 4800 ml Target Cycles 8
HCT 40 % Time (estimated) 80 min.
Plt Pre-Count 250 10e3
Press MODIFY to select, +/- to change values.
Press SAVE to save all values.
Press HELP to return to Main display.
If the operator receives a NOTICE display screen due to an error detection by the
MCS+ safety system, the operator can press this key to receive the HELP screen
display.
The HELP screen will contain the most likely source of error and a list of the
appropriate operator actions.
Note: A complete listing of all MCS+ operating NOTICE messages and related
HELP messages is provided in the Section 1 of the Postscript to the MCS+.
Closed set This type of disposable set will contain the basic elements required for blood
component collection as well as a pre-attached needle and a bacteriological filter
on each solution line tubing section. These factory-attached elements will guar-
antee an extra measure of sterility and security for the final collection product(s).
Bundled set A bundled set contains disposable material with a pre-connected bowl. Various
pre-assembled combinations of elements can be used, depending on the type of
final plasma product to be collected.
Note: Certain disposable sets used for MCS+ plasmapheresis applications will re-
quire the use of pump manifold adapters, ordered separately from Haemonetics.
Donor-/Blood- This section will deliver blood from the donor to the centrifuge bowl. Donor
line section whole blood is drawn through the needle into a single lumen section to a junc-
tion where the tubing splits into two sections: one for donor blood, the other for
anticoagulant solution.
Donor whole blood is mixed with AC from the AC tubing section and continues
up to the blood filter. On the opposite side of the blood filter are two sections of
tubing. One section leads to the DPM filter. The other section contains the blood
drawn into the centrifuge bowl by the Blood pump.
1. Pre-attached needle
2. Ratchet clamp (x 2) 3.
2. 4.
3. Needle connector 5.
4. Three-way connector
5. Injection port 1.
6. Donor-line sample pouch
2.
6.
Pre-attached needle/tubing
This section of tubing will contain a 16G needle, a ratchet clamp and a female
luer connection. The established sterile needle connection can eliminate a
certain degree of potential contamination and contribute to the storage life of the
collection product.
Needle connector
This male luer connector attaches the needle tubing, containing a female luer
connector, to the rest of the donor/blood-line tubing.
Y-connector/three-way connector
These connectors create the junction in which the single lumen needle tubing
section can branch into multiple sections.
Injection port
This branch of the three-way connector should only be used for the emergency
administration of medication or fluids, as the “closed” system can be altered.
Caution: The sample pouch tubing must clamped, then sealed before drawing the
sample, in order to isolate it from the rest of the disposable tubing and maintain
a “closed” system.
Blood filter/chamber
The 170 µm blood filter is contained in a chamber located between the needle
adapter and the disposable bowl. The filter will eliminate aggregates; the
chamber will serve as a reservoir for blood being drawn into the bowl.
Note: This provides a safety feature for the operator. It is not possible to install a
disposable set containing a dual-pump manifold which does not correspond with
the inserted MCS+ protocol card, without receiving a NOTICE message.
Note: Pump tubing can be easily distinguished because it is more elastic. This
elasticity helps to reduce twists and occlusions when the tubing is thread around
the pump rotors.
Note: These elements should not be discarded after use, but saved for subsequent
MCS+ collection procedures.
Bowl connector
This element on the harness-in section attaches the donor-line tubing assembly
to the inlet port of the centrifuge bowl.
DPM line section The 0.22 µm hydrophobic filter on this section links the disposable set to the
MCS+ donor pressure monitor. The filter also provides a bacteria-free connection
between the disposable set and the DPM.
There is a slide clamp on the tubing leading to the DPM filter. The clamp is used
when connecting and disconnecting the filter from the DPM.
AC line section This section of the disposable tubing will deliver AC solution to the section of
tubing containing donor whole blood. The elements found on the AC line section
can vary according to the selected disposable set.
Anticoagulant spike
This element permits the operator to attach the AC solution bag to the disposable
set.
Bacterial filter
This element can be found on a “closed” set. The 0.22 µm filter can eliminate
bacteria from entering the system, due to spiking the AC solution bag.
Note: Pump tubing can be easily distinguished because it is more elastic. This
elasticity helps to reduce twists and occlusions when the tubing is thread around
the pump rotors.
CENTRIFUGE BOWL
The Haemonetics disposable centrifuge bowl is the central element of any MCS+
disposable set. Two types of disposable bowls exist for the various MCS+ proce-
dures: the bell-shaped Latham bowl and the cylindrically-shaped blow molded
bowl (BMB).
An MCS+ disposable centrifuge bowl is comprised of the following sections:
! The stationary section referred to as the “head” of the bowl.
! The rotating section referred to as the “body” of the bowl.
! The seal between these two sections.
Explaining the The head of the bowl, containing an inlet port and an outlet port, provides a
general design of shield for the seal of the bowl. When the bowl is held upright, the inlet port is
the bowl located above the outlet port.
Note: When installing a bowl, the inlet port should be positioned facing the left
side of the centrifuge, and the outlet port should be positioned facing the right
side of the centrifuge.
The inlet port is used for attaching the donor-line disposable tubing. The inlet port
leads to the feed tube which passes through the core and transports blood into
the processing chamber.
The feed tube also allows non-selected elements to exit the inlet port as they are
returned to the donor. The outlet port provides the exit for the collected blood
components and connects to the effluent tubing of the disposable set.
The body of the bowl contains a core and the processing chamber for the blood
components.
The rotary seal of the bowl is attached to the body of the bowl by a ceramic
section. A properly functioning rotary seal is essential to MCS+ operation.
Caution: The functional characteristics of the rotary seal can be altered if the pres-
sure in the bowl becomes excessive. This can cause the seal to be raised like a
pressure valve. The operator must remain attentive to avoid twists or occlusions
in the effluent tubing, which could obstruct either the flow of air or fluids in the
effluent pathway.
1. 2.
3.
4.
5.
8.
6.
7.
1. Inlet port
2. Outlet port
3. Header shield Figure 4-6, Latham centrifuge bowl
4. Bowl seal
5. Processing chamber
6. Bowl core
7. Feed tube
8. Bowl body 1. 2.
3.
4.
5.
8.
6.
7.
Understanding Both types of centrifuge bowls will function during the first part of the DRAW
bowl operation cycle in the following way:
! The head of the bowl remains stationary during operation. The body of the
bowl, held in the centrifuge chuck by the system-sealing mechanism will
be spun between 3000 and 7000 rpm, depending on the selected MCS+
protocol. The header shield covers the rotary seal between the head and
body of the bowl and slightly compresses the seal when the bowl is in-
stalled.
! Anticoagulated whole blood arrives from the donor-line tubing, passes the
inlet port, moves through the feed tube and enters the processing chamber
at the base of the bowl.
! As the bowl spins, the centrifugal force inside of the bowl separates the
products into the cellular components and plasma. The denser cellular
components move to the outside of the bowl, while the lighter compo-
nents move toward the center.
! When the bowl is full, plasma, the lightest of the separated blood compo-
nents, will exit the bowl first through the outlet port, pass through the ef-
fluent tubing and be collected. The red blood cells, being the densest of
the cellular components, will exit the bowl last.
Managing the The disposable bowl contains sterile air which is displaced into a collection
bowl air container as the bowl is filled during a DRAW cycle. This same air returns to the
inventory bowl when the non-collected components are returned to the donor during a
RETURN cycle. It is important that this air return to the bowl from the collection
container in order to avoid negative pressure in the bowl.
B. Collecting plasma
1. Anticoagulated whole
blood
2. Plasma 3.
C. Surge (elutriation)
1. Plasma
2. Platelets and plasma 4.
3. Buffy coat
D. Returning
components C. D.
1. Non-collected blood
components 1. 1.
2. Air from plasma 2. 2.
bag
3.
B. Collecting plasma
1. Anticoagulated whole
blood
2. Plasma
C. Returning
components
1. Non-collected blood
components
2. Air
C.
1.
2.
Effluent line This section of disposable tubing extends from the centrifuge bowl to the collec-
section tion container(s). It will transport centrifuged blood components through the line
sensor before being collected. The following elements will be present on the
MCS+ effluent tubing section.
Bowl connector
This element on the harness-out section attaches the effluent tubing assembly to
the outlet port of the centrifuge bowl.
Y-connector/three-way connector
These connectors create the junction in which the single-lumen needle tubing
section can branch into multiple sections.
Collection bags
The blood components can be collected in a variety of sizes and forms of bags,
depending on the MCS+ protocol requirements.
SPM line section The hydrophobic 0.22 µm filter on this section links the disposable set to the
MCS+ system pressure monitor. It is located on the harness-out section of a
“closed” set and provides a bacteria-free connection between the disposable set
and the SPM.
Solution line These sections of disposable harness tubing are designed for use with MCS+
section(s) protocol-specific additives and solutions.
A solution line on a “closed” set will contain a bacteriological filter separating
the spike, or solution bag connector, from the rest of the disposable set. This filter
will eliminate bacteria from entering the collection system as the operator
connects the solution/additive bag(s).
A saline solution line section can also be included in the preparation of an
unbundled set, if the selected MCS+ plasmapheresis application uses saline
compensation.
Note: The saline solution line designed for an MCS+ unbundled set does not con-
tain a bacteriological filter.
Closed sets
Latham bowl closed set
1. Centrifuge bowl 6.
2. Collection bags 5.
3. Blood filter chamber
4. DPM line 1. 13.
5. Dual-pump manifold 12.
6. Solution line with filter
7. Single-pump manifold 2.
8. AC line with filter
9. Pre-connected needle
10. Sample pouch 4. 2.
11. Recirculation chamber
3. 10.
12. Leukocyte reduction filter
13. SPM line 8. 11.
2. 2.
9.
7.
10.
9.
Bundled set
Bundled set with NaCl 7.
spike
1. Centrifuge bowl
2. Collection bag 3. 5 9.
3. Blood filter
4. DPM line 1.
4.
5. Blood pump “stops”
6. AC pump “stops”
7. AC solution line 6.
8. Needle connector
9. NaCl spike
2.
8.
Unbundled set
sections
Commonly used set
elements
1. Centrifuge bowl (Latham
LN5810 & BMB LN625B)
Harness-in
2. Plasma collection set
(LN799)
2. 5.
3. Plasma collection set
(LN620) 1.
4. Plasma collection set 3. 8.
(LN620E)
Harness-out 6. 9.
5. PPP collection bag
(vented cap) (LN690)
6. Collection set - EVA
(LN691)
7. Collection bag with NaCl
adapter (LN692) 4. 7. 10.
8. Saline adaptor (LN695)
9. Effluent line adaptor
(LN697)
10. Effluent line with bottle
spike (LN698)
CLEANING PROCEDURES
The MCS+ device has been designed to require minimal maintenance for the
operator. To maintain the precision function of the MCS+ device, the operator
needs to primarily perform routine cleaning procedures of certain key compo-
nents. A record of routine cleaning schedule can be kept along with any routine
or preventive service maintenance performed by a Haemonetics representative.
The frequency of cleaning each individual MCS+ device will depend on the
number of procedures performed. Special cleaning needs may arise and should
be dealt with promptly. Haemonetics recommends the following routine
cleaning schedule for each MCS+ device, based on an average of three collec-
tion procedures per day, or approximately sixty per month.
! Daily: Clean the exterior surfaces as well as the pressure monitors.
! Weekly: Clean the air detectors, the optical sensors (line sensor and optical
bowl sensor), the fluid detector, and the inside of the centrifuge well.
! Monthly: Clean the pump rotors and the pump wells.
! Quarterly: Clean the filter screens.
The following list describes the basic material required for routine cleaning.
! Disinfectant cleaning solution, specific for blood-born pathogens.
! Warm water.
! 70% Isopropyl alcohol.
! Lint-free gauze or cloth (for cleaning and drying).
! Cotton swabs.
! Protective gloves.
! Hexagonal-head wrench #10 (provided with the device).
! Silicon lubricant (for the “L” gasket of the centrifuge vacuum chuck).
! Phillips-head screwdriver.
Cabinet and The exterior cabinet, valves, keypad and display screen should be wiped daily,
control panel (as well as following any spill), using the cleaning solution.
Pressure The pressure monitors (DPM/SPM) should be cleaned daily in the following
monitors manner:
" Depress and hold the white ring (as if installing the disposable filter).
" Wipe the silver rod thoroughly with a damp, lint-free cloth, using a circular
motion. Cloth may be dampened with water, disinfectant solution or alco-
hol per the site’s local standard operating procedures.
" Dry the rod and release the pressure on the ring.
Caution: Ensure that the pressure monitor is allowed to dry completely before in-
stalling the disposable set.
Air detectors The air detectors are designed with a groove to hold the disposable tubing. The
contents of the tubing are monitored by the sensors, which are located internally
on either side of this groove.
The operator should use warm water and lint-free gauze to clean and dry in
between the tubing groves. The groove should be kept free of any particles, such
as powder residue from disposable gloves, since this could lead to an erroneous
detection of air.
Note: If a procedure is interrupted due to an air detector alarm and no air bub-
ble(s) are visible, the operator should remove the tubing and clean the groove be-
fore continuing the collection procedure.
Optical sensors The lenses of the optical sensors must be kept completely free of particles or
debris, which could produce inaccurate readings and influence the MCS+ perfor-
mance. The operator should use only water and lint-free gauze to clean and dry
the lenses.
Caution: If any cleaning solution should come into contact with the optical sen-
sor lenses, they should be immediately cleaned with lint-free gauze and warm
water, then thoroughly dried. Cleaning solution can leave a “opaque” film on the
lens.
Line sensor
The line sensor, located on the MCS+ top deck, contains two very small lenses
which are centered on either side of the disposable tubing groove. The operator
should carefully pass the gauze through this groove to clean and dry the lenses.
Fluid detector(s) The fluid detector(s) is/are located inside of the centrifuge well. The surface of the
detector should be cleaned using a cotton swab moistened with 70% alcohol.
Centrifuge Except for the optical sensor and fluid detector(s), the other centrifuge compo-
components nents can be wiped routinely using the cleaning solution and a lint-free cloth.
This includes the centrifuge well and chuck, chuck adapter, hinged lid and
locking knob.
Haemonetics Technical Services provides silicon lubricant for the “L” gasket,
located at the base of the vacuum centrifuge chuck. After a major cleaning, the
operator should apply a small amount of the lubricant to the gasket to prevent it
from cracking. It is not necessary to remove the gasket when applying the lubri-
cant.
If a fluid spill should occur, the operator should:
" Power off the device and disconnect it from the external power source be-
fore cleaning.
" Ensure that the biohazard waste bag is attached to the drain tube and hang-
ing freely.
" Wipe the centrifuge lid with cleaning solution.
" Clean the centrifuge chuck and well, (avoiding the optical bowl sensor
lens), using the disinfectant solution and a lint-free cloth until all traces of
blood components are removed.
" Lubricate the “L” gasket with a small amount of the silicon lubricant.
Pumps The pump rotors should be removed from the well with the hexagonal head
wrench.
Debris should be removed from the rotors and the pump wells on a routine basis,
as well as after any spills, to contribute to efficient MCS+ operation.
For routine cleaning, the operator should:
" Remove the pump rotor from the housing, using the hexagonal head
wrench to remove the pump screw.
" Wipe the rotor and remove all debris from the rollers, using warm water
and lint-free cloth or gauze.
" Dry with lint-free cloth (or compressed air, if is available).
" Clean and dry the pump well using the same method.
" Ensure that all of the rollers spin freely and replace the pump rotor in the
well, aligning the cross pin in the rotor with the pump shaft.
" Replace and tighten the hexagonal head screw.
In the case of a fluid spill, the same cleaning method should be followed;
however, disinfectant cleaning solution should be used, followed by a clear
water rinse. The pump rotor should not be immersed in water.
Filter screens The MCS+ device is equipped with filter screens on the bottom of the cabinet,
which eliminate dust from incoming cool air. The filters should be cleaned
routinely, especially if dust becomes visible on the screens.
To clean the filters, the operator should:
" Remove the retainer plates using a Phillips-head screwdriver.
" Remove the filter screens from the panel.
" Rinse the screens under running water – DO NOT use any cleaning agents.
" Gently squeeze the screens to remove excess water.
" Place the screens on a clean, dry cloth and allow to dry completely.
" Reinsert the screens into the panel, ensuring that all openings are com-
pletely covered by the filter.
" Replace the retainer plates and tighten the screws.
Warning: To avoid electrical shock, the filter screen should be completely dry
before it is reinstalled on the MCS+ cabinet.
Bar-code reader The bar-code reader window should be wiped using a lint-free cloth or gauze
and water, then dried. It should be cleaned whenever there is an accumulation
of dust or spilled fluid. For optimal cleaning, the operator should remove the
protector around the window and replace it once the window has been cleaned.
Pressure cuff If it is determined that the cuff has been contaminated, clean the affected area
with a 10% bleach solution (or equivalent). If this cleaning is determined to be
insufficient based on the severity of the contamination, a replacement cuff may
be ordered and installed by the user.
CUSTOMER SERVICE
Clinical training Haemonetics employs a staff of Clinical Specialists to provide training for apher-
esis personnel concerning the use of the MCS+ equipment. The local Haemo-
netics representative will schedule staff training upon delivery of MCS+ equip-
ment and should be contacted to organize further instruction when needed.
Returned Goods Haemonetics seeks to provide the apheresis customer with equipment and mate-
Authorization rial which respects the highest established standards of quality in design and
system manufacturing. If for any reason merchandise must be returned to the company,
the customer should refer to the Haemonetics Returned Goods Authorization
(RGA) system procedure to ensure proper handling and subsequent analysis of
the material.
First, the customer should contact the local Haemonetics representative [or the
Haemonetics Customer Service Department] and provide the following informa-
tion:
! Product list number, lot number and manufacture date.
! Number of articles to be returned.
! Description of defect.
! Number of parcels being shipped.
The Haemonetics representative may ask for additional details, depending on the
nature of the problem. The customer should be prepared to provide a thorough
description of the problem encountered, as well as the product information listed
above.
If a contaminated disposable set must be returned by courier services, the
Haemonetics representative may provide specific instructions concerning prepa-
ration for shipping blood-contaminated products. In addition to the Haemonetics
guidelines, the consumer should strictly follow the local standard operating
procedure related to the shipment of blood-contaminated materials and thus
minimize any potential health hazards involved.
Disposal Follow all local standard regulations for the disposal of medical equipment when
disposing of the MCS+ device.
Action Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.
Maintenance performed by
(date and initials)
Reviewed by
(date and initials)
Annual preventive maintenance should be scheduled by a supervisor when appropriate and performed by a Haemonetics service representative
or a qualified biomedical engineer.
Storing the The MCS+ device must not be operated or stored in an area where flammable
device and gases or vapors are present. The MCS+ disposable set material should be kept in
material a dry, well-ventilated area and isolated from any chemical vapors. The operator
should handle the disposable set elements with clean, dry hands or gloves
The ranges for storing the material should be within 8% to 80% rh and –20° C to
+50° C. The recommended temperature for the working environment is between
18° C to 27° C.
Inspecting the Prior to installation, the operator should complete a visual inspection of the
material disposable set elements and control for twisted or flattened sections.
After installing the disposable set, the operator should verify the correct place-
ment of the individual elements, prior to initiating a collection procedure. It is
important that the tubing remain free of any twists or occlusions which could
cause a flow obstruction.
Transporting the Use caution when lifting and transporting the device. Lift the device only by the
device handles. Always ensure that the IV poles are in the “down” position and the
cabinet cover is closed before transporting or moving the device. Do not hold or
lift the device by the IV poles or weigher arm. Two people should lift the device
in order to avoid injury.
Understanding Hemolysis involves the destruction of red blood cell membranes, with the release
the risk of of free hemoglobin into the plasma portion of the blood. Free hemoglobin does
hemolysis not have the capacity to transport oxygen and can produce serious problems. The
remnants of the red cell can stimulate clot formation and damage the vascular
nature of the lungs and the kidneys. This could lead to respiratory complications
and/or renal failure.
Hemolysis of red cells can occur during an apheresis procedure in the rare event
of a mechanically induced situation, such as overheating, or excessive pressure.
Warning: Forcing a pump to work against a severe flow restriction can lead to
hemolysis, and thus, consequently high levels of free hemoglobin in the plasma.
It is important that the operator remain attentive to this fact in the case of any
“high return pressure alarms” during MCS+ operation.
If there is any suspicion that hemolysis has occurred, the operator should not
return the contents of the bowl to the donor. The local Haemonetics representa-
tive should be informed of the problem to provide the operator with further
instruction.
Avoiding the During DRAW, a flow restriction in the effluent tubing can create pressure on the
consequences of outlet port of the disposable bowl. This unrelieved pressure can deform the rotary
flow restriction seal of the disposable bowl. If the functional characteristics of the rotary seal are
altered, the increased friction and excessive heat can make the contents of the
bowl unsuitable for return to the donor.
During RETURN, a flow restriction in the effluent tubing can cause the pressure
in the centrifuge bowl to drop severely. This sudden drop in pressure could poten-
tially produce hemolysis.
To eliminate these potential problems, the operator should:
" Ensure against inadvertent clamping of the effluent tubing.
" Observe the following changes in flow rate (possible indications of a flow
restriction):
! Decreased donor flow rate during DRAW.
! Abnormally increased time required to return the disposable bowl con-
tents to the donor.
Avoiding bowl An improperly installed disposable bowl can become misaligned as it spins. This
misalignment can create excessive friction, and consequently overheat the bowl contents. The
operator should verify the alignment of the bowl at the time of installation.
Note: In certain MCS+ protocols, the programming will instruct the centrifuge to
spin the bowl during PRIME, as a control for proper bowl placement.
Warning: The operator must not use any bowl which cannot be properly seated
in the centrifuge chuck. Overheating can occur (subsequently leading to hemol-
ysis) and make any blood being processed unsafe for re-infusion. During MCS+
operation, the operator should interrupt the collection procedure if an abnor-
mal or excessive noise appears, related to the spinning bowl.
Controlling for Red Cell Overrun is the term used to describe the presence of erythrocytes in the
red cell overrun effluent tubing and/or product collection container during an apheresis proce-
dure. It is important that the operator observe the appearance of the plasma as it
is collected. A pink or reddish hue could indicate a possible red cell spillage
which should be investigated immediately.
If the cause of the reddish hue cannot be determined to be a normal result of the
selected MCS+ protocol, the procedure should be discontinued immediately and
the blood components in the bowl must not be returned to the donor/patient.
Electrical shock The operator should always use the MCS+ device with clean dry hands, or gloves.
hazards The internal parts of the MCS+ device contain various electrical components.
Contact with any of these components, when the device is connected to an
external powered source, could result in an electrical shock to the operator and/
or donor/patient.
The operator should never remove any of the MCS+ cabinet panels. Maintenance
requiring access to the inner cabinet remains the responsibility of a Haemonetics-
trained technician.
The operator should not touch any internal parts of a non-medical device that,
after the removal of covers, connectors, etc., without a tool, could result in an
electrical shock. Likewise, the operator should not simultaneously touch the
donor/patient and any internal parts of a non-medical device that, after the
removal of covers, connectors, etc., without a tool, could result in an electrical
shock to the operator and/or donor patient.
Equipment in which protection against electric shock relies on basic insulation
only should not be used with the MCS+ device.
Leakage current Each MCS+ device receives a careful inspection for leakage current prior to
control leaving the factory. Haemonetics recommends that a control be performed for
current leakage by an authorized representative as part of the annual preventative
maintenance. It remains the responsibility of the apheresis center to ensure that
this control is performed.
In the event of any major spill in which fluid may enter the cabinet, or an impor-
tant voltage surge, the operator is responsible to ensure that a leakage current test
is performed before re-using the device. The control is necessary to avoid the risk
of electrical shock and should be conducted by an authorized Haemonetics
representative.
The operator is responsible for making sure that the leakage current of the final
configuration (the MCS+ device and any ancillary equipment attached to the
MCS+ device), comply with IEC 60601-1-1 Standard, Medical electrical equip-
ment in normal and single fault conditions.
Mechanical As with any equipment containing rapidly rotating parts, the potential for severe
hazards/rotating injury exists if personal contact is made, or if clothing becomes entangled with
parts the moving parts. The MCS+ device contains a safety feature, designed to prevent
the centrifuge from spinning if the system has not been properly secured.
However, the operator should respect the usual precautions taken when working
with equipment containing rotating mechanical parts.
Power outlet To comply with the IEC 60601-1-1:2000 Standard for Medical Electrical Equip-
connection ment, general requirements for safety do not connect more than one multiple
portable socket outlet or extension cord to the system. In addition, do not power
the MCS+ device using a power cord other than the one originally supplied by
Haemonetics for your instrument. Always ensure the power cord is connected to
an appropriately grounded power source.
Communicable Despite testing and screening to detect communicable diseases such as hepatitis,
disease syphilis or HIV, the risk remains that the blood being processed may be infected.
precautions The operator must take the appropriate precautions when handling blood prod-
ucts and disposing of blood-contaminated material, to ensure personal safety as
well as the safety of others who may come in contact with the material.
PROCEDURE RECOVERY
The POWER has been OFF for a short time.
Note: If the operator presses the No key to begin a new procedure, rather than
the Yes key to attempt a Procedure Recovery, new disposable material must be
installed.
Power failure Policies may vary among apheresis centers concerning the procedure to follow
procedure in the event of a power failure.
It is important for the operator to remember that during DRAW, the blood in the
needle tubing is not anticoagulated. All needles should be considered as
containing non-anticoagulated blood, in the event that processing should be
interrupted during DRAW.
The operator can bring anticoagulated blood to the needle site by the following
actions:
" Place the power ON/OFF switch in the OFF position.
" Press the donor valve lever to hold the valve open.
" Manually turn the blood pump in a counter-clockwise direction, providing
5 full, slow rotations.
This will bring approximately 5 ml of anticoagulated blood through the needle
tubing to the venipuncture site. If power has not been restored within 5 minutes,
the operator should begin to manually return the blood components in the bowl
and tubing to the donor using the “Manual Gravity Infusion” procedure.
If power is restored, and the original venipuncture has been maintained open for
blood to flow freely, the operator can re-install the tubing in the valves and
attempt to recover the procedure and continue component collection.
Manual gravity During an apheresis procedure, an unusual circumstance may arise (such as a
infusion power failure or other technical reason) in which the MCS+ device cannot pump
procedure the contents of the disposable bowl and tubing back to the donor. Haemonetics
suggests a technique using gravity to manually infuse the remaining contents.
This can eliminate unnecessary blood loss for the donor.
This procedure is applicable for all of the MCS+ protocol options. Policies may
vary among apheresis centers concerning the return of cells by gravity. The oper-
ator should consult and apply the local standard operating procedure for gravity
infusion of cells if variation in procedure exists.
Without an external power source, the MCS+ valves must be opened manually
to release the tubing. To do this, the operator must press the lever of the pinch
valve toward the cabinet until the tubing can be removed.
Warning: The operator should carefully monitor the venipuncture site. If infil-
tration of the vein is observed at any point, the procedure should be discontin-
ued.
Caution: Turn the pump rotors clockwise until the groove on each pump rotor is
aligned with the tubing guide, then pull the tubing upward. The operator should
verify that the tubing remains in the groove as the pump rotor is turned, in order
to avoid pinching or tearing the tubing.
" Remove the tubing from the DLAD1, DLAD2 and the tubing guide.
Caution: The operator should hold the disposable bowl and blood filter upright
and higher than the donor at all times.
" Unclamp the donor line tubing. Allow gravity force to infuse the entire
contents of the bowl up to the point of the needle connector.
" Re-clamp the double lumen tubing approximately 5 cm from the Y- con-
nector to prevent blood from returning in the direction of the bowl.
Repeat If a vein becomes infiltrated at any point during a collection procedure, and
venipuncture blood can no longer flow through the needle, Haemonetics recommends that the
procedure uncollected blood components in the bowl and tubing be returned to the donor
using a new intravenous pathway.
The MCS+ operator should be familiar with the local standard operating proce-
dures when repeating a venipuncture, as well as product storage-duration
requirements when changing a needle.
This procedure as described by Haemonetics must be performed using strict
aseptic technique or a sterile connection device.
" Press the STOP key on the control panel.
" Hermetically seal the donor-line tubing by clamping both sides of the nee-
dle connector as follows:
! Close the ratchet clamp on the needle tubing.
! Place a second clamp on the double-lumen tubing on the opposite side
of the Y-connector.
! Remove the needle from the donor, cut the contaminated needle and
dispose of correctly.
! Place the donor-line tubing aside to prevent contamination.
Caution: At this point, the operator should remove the pressure cuff from the do-
nor and appropriately treat the vein, if infiltrated.
" Prepare and perform a new venipuncture, securing the new needle and
tubing.
" Prime the new needle tubing with donor blood and close the ratchet
clamp.
" Disconnect the old needle tubing (minus the needle) from the disposable
set and dispose of correctly.
" Connect the new needle tubing to the disposable harness and unclamp at
both sites.
If aseptic technique has been used, any air in the tubing is considered as sterile,
and the collection product will remain viable. Any air in the tubing can be
displaced toward the blood filter or disposable bowl by the following actions:
" Press the Draw key to advance any air present from the needle through the
DLAD1 and DLAD2 into the blood filter.
Note: Depending on the quantity of blood already present in the bowl, the oper-
ator may receive the NOTICE message “DRAW not allowed, press RETURN to
continue”. If this should occur, the operator should press the STOP key, followed
by the Draw key. The MCS+ DRAW mode will then be initiated automatically.
Once any air from the needle has reached the bowl, the operator should:
" Press the Return key to re-infuse the blood components in the bowl.
The operator can attempt to return any blood components remaining in the bowl
using manual gravity infusion.
% AC in Product
AC Volume in Product = x Product Volume
100
Donor
Hematocrit % Anticoagulant in the plasma or platelet product
Calculating the The volume of AC solution infused to the donor/patient can be calculated as
AC volume follows:
infused to the " Consult the “Haemo Update” or “Procedure Complete Screen” to deter-
donor/patient mine the volume of AC solution used (AC Used) during the collection pro-
cedure.
" Determine the total volume of AC solution in the final plasma and platelet
products referring to the previous table.
" Subtract the volume of AC solution volume in the final products from the
volume of AC solution used during the procedure to determine the volume
of AC solution infused to the donor/patient.
Estimating total The MCS+ device displays the estimated total blood volume of the donor/patient,
blood volume according to the method provided by the AABB Technical Manual (13th edition,
appendix 5, page 757). The equations used by the MCS+ device are as follows:
! For males:
! For females:
Estimating the The maximum Extra Corporeal Volume (ECV) for each donor/patient per proce-
expected extra dure can be estimated by subtracting the volume of AC solution used from the
corporeal volume blood volume processed, then dividing by the number of cycles performed.
Note: The most accurate estimation is obtained during the first RETURN cycle.
Prior to a collection procedure, the maximum ECV can be estimated by using the
following equation:
17,000
Estimated Maximum ECV=
Donor Hematocrit x {1– AC Ratio}
To determine if the 15% ECV limit may be exceeded, the estimated maximum
ECV should be divided by the Estimated Total Blood Volume of the donor/patient.
A donor/patient with a hematocrit of less than 38% and an estimated blood
volume of less than 3600 ml can be expected to reach the 15% ECV limit during
the procedure.
Determining final The MCS+ device is designed to determine final product volume(s) either by:
product ! Counting the number of pump revolutions.
volume(s) or
! Weighing the product.
In certain MCS+ protocols, the plasma and platelet product volumes are deter-
mined by the weigher. To convert the product weight to a volume, the device
utilizes a conversion factor of 1.026 g/ml. The Procedure Complete Screen and
Haemo Update Screen will provide the operator with detailed product volume
information.
To manually determine the collection product volume, the operator should:
" Weigh the final product on a calibrated scale.
" Subtract the weight of the empty collection container(s) from the product
weight.
" Divide by 1.026 g/ml.
Calculating The platelet yield in a final platelet product can be calculated by multiplying the
platelet yield platelet concentration of the final product by the total final product volume. The
platelet yield is calculated in 10e11 platelets.
Note: When the platelet concentration is provided using the units of 10e3/µl
or 10e6/ml, the factor 100,000 should be used to arrive at the correct number of
digits.
For example, if the platelet concentration in the product is 1300 x 10e3/µl
and the product volume was 300 ml, the platelet yield can be calculated to be
1300 x 300/100,000 or 3.9 x 10e11 platelets.
Calculating The platelet collection efficiency can be calculated by dividing the platelet yield
platelet by the total number of platelets processed. The preferred method of calculating
collection the platelet collection efficiency is based on the average of pre-collection and
post-collection platelet counts.
efficiency
The mean platelet collection efficiency of the MCS+ device can be entered by an
authorized Haemonetics representative, once a sufficient number of platelet
collection procedures have been completed.
To calculate the platelet collection efficiency:
" Determine the average platelet count of the donor.
Note: If both a platelet pre-count and a post-count are available, the average of
the pre- and post-counts can be used. When a post-collection platelet count is
not available, and only a pre-collection platelet count is available, this value can
be used.
" Determine the net volume of donor blood processed by subtracting the
volume of AC used from the total volume processed during the procedure.
" Calculate the number of platelets which have passed through the bowl
during the procedure:
Example: If the donor platelet count was 250 10e3/µl and the total donor blood
processed was 3500 ml, the total number of platelets processed was
250 x 3500/100,000 equaling 8.75 10e11 platelets processed through the bowl.
Platelet Yield
Platelet Efficiency = x 100%
Platelets Processed
To comply with the IEC 60601-1 collateral standards for medical electrical equip-
ment, general requirements for safety, do not connect more than one multiple
portable socket outlet or extension cord to the system. In addition, do not power
the MCS+ device using a power cord other than the one originally supplied by
Haemonetics for your instrument. Always ensure the power cord is connected to
an appropriately grounded power source.
In addition, the Haemonetics device and accessories must not be placed directly
adjacent to, or top of other equipment, unless specifically approved by Haemon-
etics.
Electromagnetic The Haemonetics system is intended for use in the electromagnetic environment
immunity specified in the following tables and the operator must ensure that each system
is used in such an environment.
IEC 60601-1-2, Table 201: Guidance and manufacturer’s declaration - electromagnetic immunity
IEC 60601-1-2, Table 202: Guidance and manufacturer’s declaration - electromagnetic immunity
*Electrical fast ± 2 kV for power ± 2 kV for power Mains power quality should be that of a typi-
transient burst supply lines supply lines cal commercial or hospital environment.
IEC 61000-4-4
± 2 kV common ± 2 kV common
mode mode
Voltage dips, < 5% UT (> 95% < 5% UT (> 95% Mains power quality should be that of a typi-
short interrup- dip in UT) for 0.5 dip in UT) for 0.5 cal commercial or hospital environment.
tions, voltage cycles cycles If the operator of the Haemonetics system
variations on requires continued operation during power
power supply 40% UT (60% 40% UT (60% mains interruptions, it is recommended that
input lines dip in UT) dip in UT) the Haemonetics system be powered from an
IEC 61000-4-11 for 5 cycles for 5 cycles uninterruptible power supply or battery.
IEC 60601-1-2, Table 204: Guidance and manufacturer’s declaration - electromagnetic immunity
Non-live supporting equipment
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.
a) Fieldstrengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur
radio AM and FM broadcast and TV broadcast cannot be predicted theoretically with accuracy. To asses the electromagnetic environ-
ment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location
in which the Haemonetics system is used exceeds the applicable RF compliance level above, the Haemonetics system should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting
or relocating the Haemonetics system.
b) Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be esti-
mated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter
in watts (W) according to the transmitter manufacturer.
NOTE 1: At 80 MHz, the separation for the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.