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There was an allegation of questionable ise indirect na-k-cl for gen.2 results for 1 patient sample on a cobas 6000 c (501) module.This medwatch will cover potassium.Refer to medwatch with a1 patient identifier (b)(6) for information on the chloride results and medwatch with a1 patient identifier (b)(6) for information on the sodium results.The initial na result was 104 mmol/l, the initial k result was 3.5 mmol/l, and the initial cl result was 73.2 mmol/l.The customer questioned the results which prompted them to repeat the sample.The sample was repeated on another c 501 analyzer and the na result was 129 mmol/l, the k result was 4.32 mmol/l, and the cl result was 94.3 mmol/l.The repeat results were deemed correct.No questionable results were reported outside of the laboratory.
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It was found that the customer's centrifugation time may be shorter than recommended, and the spin speed may be faster than recommended.The alarm trace did not contain a conspicuous event.The field service engineer (fse) found that the vacuum on the rinse nozzle was not working and found a crack in the ise acrylic block.The fse rerouted the vacuum tubing, replaced the acrylic block, ise electrodes, valve bank, and rinse water check valve, cleaned the sample probe, sipper nozzle, internal standard and reference dispense nozzles, and the detergent probe, decontaminated the sipper flow path, verified gear and water pump pressure, adjusted rinse levels, and performed ise checks, precision testing, calibration, and qc successfully.The service maintenance actions performed by the fse resolved the issue.No further issues were reported after the service visit.
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