EBME Forums Forums Maintenance Technical Assistance Medilog AR4 case issues

Hi Guys, this is my first post so be gentle.
Does anyone have a Medilog AR4 Digital Holter Recorder system in their hospital and has problems with case fractures.
Our system is 2 years old now and we are having to replace cases at an alarming rate such that the cost of cases now exceeds the cost of new units. The manufacturer states that we are the only hospital that this is happening to (heard that before ;))so it would be interesting to get some feedback from other facilities.

Could it all be due to rough handling Down Under?

Assurances from staff that they are handled gently as issue has now become a hot potato. Patients though an unknown quantity!
The number of failures and consistent area of failure do make it look like a design or material flaw. Initial units lasted a reasonable length of time(9 months) but the failures just seem to be escalating.

Doesn't look like the most rugged bit of kit in the world, I must say.

But, there again, what modern equipment does look up to the job?

Having said that, in my experience, a bit of Sherlocking often establishes some sort of pattern of (mis-)use. With luck (?) you may even track it down to a particular patient. Or (dare I say it? yes, why not?) staff member (any changes there recently?).

To be frank (and as you must know), a lot depends on how "on the ball" the staff are. I have come across cases (oh yes, a pun) in the past where staff had been trying to cover up for patients abusing the kit. Don't ask me why.

Care to share will us the nature of (details of) the damage you're seeing?

Are these cases regularly cleaned between patient use with alcohol wipes or similar?

Some grades of wipe are more aggressive than others and can "dry out" plastic moulded cases etc.

The worst examples I've seen of this type of deterioration is on Stethoscope flexible tubing

I reckon we need to hear about the exact nature of the damage before we can venture further comment, Old Mate.

The cases are wiped down with soapy damp cloth and the cables wiped down with alcowipes. We did an experiment with an old case soaking in alcohol over the weekend with no obvious deterioration in the material. The damage starts with small cracks around the battery compartment/corner screws and can develope into major fractures and bits falling off. We now remove them from service at the slightest crack. No other external damage is obvious.
I have asked the staff to carefully examine the cases on return from the patient to check when this deterioration starts.
The units are given to the patients in a fabric carry with shoulder strap for ease of carrying.

In the absence of any comments as yet from users on this side of the world, and weighing all the evidence so far placed before us, I am wondering if we are looking at cases (pun) of over-tightening of the case screws. But now, the mention of the battery compartment also leads me to ponder if we're not on to something there. Who fits and/or changes the batteries? Which battery size are we talking about (2 x AA)? Are standard sizes being used? Are patients playing about? Everything is possible!

As you have already indicated, one way of addressing the issue (now that the damage patterns have become known) is to carefully inspect the item before issuing and after being returned from patients. If (when) cases come back showing signs of recent damage, I think note should be made about what sort of regime the patient was following (pottering about, out rock-climbing, or whatever). Or, perhaps, a certain class of patient (heavy, for example).

Although the jury's still out, I am still of the view that we may be able to look forward to hearing that you have successfully recovered funds from "careless" (clumsy?) patients!

Lastly, have you tried reproducing such damage yourself? Try sitting on them!

The batteries are standard AA, X2 and the staff change them. I do think the the battery contact springs are very stiff which may contribute some stress to the case.
As a method of eliminating excessive screw tightening the cases are now changed by the agent(we changed them before this) who now has to come into our department to change the cases(4 a week at the moment). The units are used on inpatients and outpatients but with this number of failures it doesn't look patient related. We have a total of 10 units and they are constantly being used so it may be these units aren't up to the job, that's why I would like to hear if anyone else has had any problems.