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What This Guide Helps With
Addresses disposable processing-set, centrifuge-bowl, and tubing installation problems caused by incorrect seating, routing, damaged components, or incompatible disposables.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Continuity of Care
Do not troubleshoot a cell salvage system while the patient depends on unreliable blood recovery or reinfusion capability. Notify the clinical team and establish an alternate blood-management plan before removing the system from active use.
If recovered blood is already present, maintain appropriate handling and disposition according to facility policy and clinical direction.
Expected outcome: Patient care continues safely without dependence on the malfunctioning Cell Saver Elite+. If alternate support is established, continue troubleshooting.
2. Confirm the Exact Loading Problem
Ask staff to describe where installation fails: initial set placement, bowl seating, tubing routing, pump-segment loading, cover closure, or recognition after installation.
Inspect the system without forcing any disposable component into position.
Expected outcome: The loading failure is reproduced or clearly localized. If correct installation resolves the complaint and the system recognizes the disposable normally, troubleshooting can stop after functional verification.
3. Verify the Correct Processing Set Is Being Used
Confirm the disposable set is appropriate for the Cell Saver Elite+ and is within its usable packaging condition. Inspect for damaged packaging, bent components, deformation, contamination, or evidence that the set was previously opened or improperly stored.
Do not modify a disposable to make it fit.
Expected outcome: A correct, undamaged processing set is available. If replacing an obviously damaged or incorrect set restores normal loading, the issue is resolved.
4. Inspect the Bowl and Mechanical Seating Areas
With the system safely stopped, inspect accessible bowl-retaining surfaces and mounting areas for debris, dried fluid, foreign material, or obstruction.
Verify the bowl is oriented and seated without tilting or excessive resistance. Do not force the bowl into the centrifuge mechanism.
Expected outcome: The bowl seats fully and evenly without obstruction. If normal seating restores operation, troubleshooting can stop after completing the normal startup checks.
5. Inspect External Tubing Routing
Trace the disposable tubing through all externally accessible routing points. Look for crossed tubing, twists, kinks, tubing trapped beneath another component, or tubing positioned where it prevents proper cover closure.
Correct routing using approved manufacturer documentation when needed.
Expected outcome: Tubing follows the intended path without kinks, trapping, or interference. If the system then accepts the set normally, the issue is resolved.
6. Check Pump-Segment Placement
Inspect the disposable tubing segment that interfaces with the pump mechanism. Verify it is not twisted, stretched, pinched, or partially seated.
Do not operate the pump against improperly loaded tubing.
Expected outcome: The pump tubing is securely and evenly positioned. If correcting placement restores normal set loading and pump operation, troubleshooting can stop.
7. Inspect Accessible Latches, Guides, and Retainers
Inspect external guides, retaining features, doors, and latching surfaces involved in disposable installation. Look for cracks, bent parts, looseness, contamination, or obvious mechanical damage.
Do not attempt internal mechanical adjustment or disassembly.
Expected outcome: All accessible retaining components move normally and show no damage. An obviously damaged retaining mechanism requires removal from service and repair evaluation.
8. Perform a Known-Good Disposable Comparison
If permitted and practical, install a new known-good compatible processing set. Compare how it seats and routes with the set involved in the complaint.
Do not reuse a potentially compromised disposable for patient care.
Expected outcome: The known-good set loads normally. If so, the original disposable was the likely external cause and troubleshooting can stop after documenting the finding.
9. Verify Normal System Recognition and Operation
After installation, confirm the system accepts the disposable arrangement, closes normally, and completes applicable startup or operational checks without abnormal noise, binding, or repeated loading indications.
Do not proceed to clinical use if installation remains questionable.
Expected outcome: The Cell Saver Elite+ recognizes the installed components and operates normally through an appropriate nonpatient functional verification.
10. Remove From Service if Loading Remains Unreliable
If multiple correctly installed compatible sets will not load, seat, or remain secured, remove the system from service.
Label it Out of Service and send it for bench evaluation using approved manufacturer documentation and appropriate test equipment.
Expected outcome: An unresolved or mechanically unreliable unit is prevented from returning to clinical use.
If the Problem Persists
Common disposable selection, seating, routing, obstruction, and external mechanical causes have been ruled out. The remaining cause may involve a mechanical retention assembly, sensing system, alignment condition, or another service-level fault.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate manufacturer documentation and approved test equipment
- Repaired or configured only by qualified personnel
After corrective action, perform appropriate operational and safety testing before returning the system to service. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Never force a processing set or bowl into position; incorrect seating can compromise blood processing and damage the equipment or disposable.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"OR staff reported that the processing bowl would not seat correctly and the Cell Saver Elite+ could not be prepared for use."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the disposable tubing crossed beneath the bowl area and preventing full seating."
Resolution
What action was taken.
Example:
"Tubing was rerouted correctly, the bowl seated normally, and the system completed functional verification without further loading problems."
Helpful Details to Include (If Known)
- Exact disposable set used
- Where the loading process failed
- Bowl seating condition
- Tubing routing observed
- Visible damage or contamination
- Known-good disposable substitution
- Cover and retaining mechanism condition
- System indication before and after correction
- Final functional test result
- Final device status
- Exact disposable set used
- Where the loading process failed
- Bowl seating condition
- Tubing routing observed
- Visible damage or contamination
- Known-good disposable substitution
- Cover and retaining mechanism condition
- System indication before and after correction
- Final functional test result
- Final device status
Final Thought
Safe troubleshooting begins by protecting the patient, then verifying the disposable, routing, seating, and accessible mechanical interfaces before assuming an internal failure. Escalate unreliable equipment appropriately and document exactly what was found and verified.
That is successful troubleshooting.