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The customer reported it is very hard to pull the top off.The anti-reflux valve is frequently extremely tight.Even opening a new tube, the reflux valve is very tight straight out of the package.They're able to get it out, but have to pull on it pretty hard with both hands before it releases.This is not great for replacing the valve when the tube is in someone's nose.Even new out of the package it is still quite difficult to remove the anti-reflux valve.This is a little different from what it has been like for the last couple years.Twisting, pulling, wiggling.It is all difficult and takes a fair amount of force.The reporter states they are not the only person who has resorted to cutting the blue lumen in order to put a new valve in.Very frequently, it is difficult enough to remove the valve that they have been nervous about hurting the patient or dislodging the tube.
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