Aquarius haemofiltration machines - follow instructions carefully

(Edwards Lifesciences Ltd, supplied by Baxter Healthcare) reports that the wheels break if not used properly, which could cause the machine to fall over to cause injury and interrupt therapy. (MDA/2010/039)

Device

All Aquarius haemofiltration machines.

Manufactured by Edwards Lifesciences Ltd and supplied by Baxter Healthcare.

Aquarius haemofiltration machines manufactured by Edwards Lifesciences Ltd and supplied by Baxter Healthcare

An image of an Aquarius haemofiltration machine.

Aquarius haemofiltration machines used to be manufactured and badged by Edwards Lifesciences. However, Baxter Healthcare took over responsibility for the supply and servicing of Aquarius Haemofiltration Devices in September 2009, following their acquisition of the Edwards Haemofiltration business.

Problem

Reports have been received of the wheels breaking due to wear or improper use. There is a risk of the machine toppling or falling over, which can cause injury and therapy interruption.

Damage to the wheels (which are referred to in the attached technical bulletin as ‘rollers’) may not have been detected during routine servicing, so it is essential to check them regularly. If the wheels are damaged, the machine should be taken out of service and repaired.

Appendix to MDA/2010/039 - Edwards Lifesciences: Technical bulletin (74Kb)

Action

Users should ensure that machines are transported in accordance with the instructions in the operating manual.

Maintenance staff should ensure that:

  • they are aware of the recent technical bulletin (see appendix), which describes specific wheel inspections
  • all wheels are inspected for wear and/or damage and appropriate action is taken, as required.

Users should refer to the instructions in the operating manual in order to minimise damage to the machine’s wheels, which is most likely to be caused by movement of the machine over steps, stairs or other uneven surfaces. The instructions state:
‘To move or transport the Aquarius it is necessary to release the locking tabs on the wheels. The Aquarius can then be rotated and freely moved about. To move the Aquarius over steps or stairs the locking tabs must be released. The system should be tilted, lifted, and carried by at least three people. The Aquarius must not be pushed over uneven floors’.

Distribution

This MDA has been distributed to:

  • NHS trusts in England (Chief Executives)
  • Care Quality Commission (CQC) (Headquarters)
  • HSC trusts in Northern Ireland (Chief Executives)
  • NHS boards in Scotland (Chief Executives)
  • NHS boards and trusts in Wales (Chief Executives)

Onward distribution

Please bring this notice to the attention of all who need to know or be aware of it. This may include distribution by:

Trusts to:
CAS and SABS (NI) liaison officers for onward distribution to all relevant staff including:

  • anaesthetists
  • biomedical engineering staff
  • health and safety managers
  • intensive care nursing staff (adult)
  • intensive care nursing staff (paediatric)
  • intensive care physicians
  • intensive care units (adult and paediatric)
  • intensive care, directors of
  • medical directors
  • nursing executive directors
  • renal technicians
  • risk managers
  • theatre managers

Care Quality Commission (CQC) (England only) to:
The MHRA considers this information to be important to:

  • hospitals in the independent sector

Manufacturer contact

Manufacturer

Edwards Lifesciences

Andleeb Arshad

Sherwood House

78-84 London Road

Newbury

Berkshire

RG14 1LA

Tel: 0870 606 2040

Fax: 0870 606 2050

Email: [email protected]

Supplier

Baxter Healthcare

Surecall

Wallingford Road

Compton

Newbury

Berkshire

RG20 7QW

Tel: 01635 206 345

Email: [email protected]

Feedback

If you have any comments or feedback on this Medical Device Alert, please email us at: [email protected]

Appendix

Appendix to MDA/2010/039 - Edwards Lifesciences: Technical bulletin (74Kb)

England

If you are in England, please send enquiries about this notice to the MHRA, quoting reference number MDA/2010/039 or 2010/003/011/291/021.

Technical aspects

Roopa Prabhakar or Catriona Blake

Medicines and Healthcare products Regulatory Agency

Market Towers

1 Nine Elms Lane

London

SW8 5NQ

Tel: 020 7084 3293/3219

Fax: 020 7084 3209

Email: [email protected] or [email protected]

Clinical aspects

Jonathan Plumb

Medicines and Healthcare products Regulatory Agency

Market Towers

1 Nine Elms Lane

London

SW8 5NQ

Tel: 020 7084 3128

Fax: 020 7084 3111

Email: [email protected]

How to report adverse incidents

Please report via our website: Reporting adverse incidents involving medical devices.

Further information about CAS can be found on the Central Alerting System website .

Northern Ireland

Alerts in Northern Ireland will continue to be distributed via the NI SABS system.

Enquiries and adverse incident reports in Northern Ireland should be addressed to:

Northern Ireland Adverse Incident Centre

Health Estates Investment Group

Room 17

Annex 6

Castle Buildings

Stormont Estate

Dundonald

BT4 3SQ

Tel: 02890 523 704

Fax: 02890 523 900

Email: [email protected]

Northern Ireland Adverse Incident Centre (NIAIC)

How to report adverse incidents in Northern Ireland

Please report directly to NIAIC, further information can be found on the NIAIC website .

Further information about SABS can be found on the SABS website .

Scotland

Enquiries and adverse incident reports in Scotland should be addressed to:

Incident Reporting and Investigation Centre

Health Facilities Scotland

NHS National Services Scotland

Gyle Square

1 South Gyle Crescent

Edinburgh

EH12 9EB

Tel: 0131 275 7575

Fax: 0131 314 0722

Email: [email protected]

Health Facilities Scotland - Incident Reporting and Investigation Centre .

Wales

Enquiries in Wales should be addressed to:

Dr Sara Hayes

Senior Medical Officer

Medical Device Alerts

Welsh Assembly Government

Cathays Park

Cardiff

CF10 3NQ

Tel: 029 2082 3922

Email: [email protected]

Download documents

Medical Device Alert: All Aquarius haemofiltration machines manufactured by Edwards Lifesciences Ltd and supplied by Baxter Healthcare (MDA/2010/039) (271Kb)

Updates to this page

Published 17 December 2014