Smith Medical - H-1200 Fast Fluid Warmer

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Level 1® H-1200

Fast Flow Fluid Warmer

H-31, Version B, Air Detector/Clamp

H-1200 115 V
H-1200 230 V

OPERATOR’S MANUAL
P/N 4533708GB Rev. 002
ii | Operator’s Manual
C o p y r i g h t

Copyright
Level 1 H-1200 Fast Flow Fluid Warmer
®

Part Number: 4533708GB Rev. 002 (2006-07)

This revision supercedes all previous revisions.

Under copyright laws, this manual may not be reproduced in any form, in
whole, or in part, without prior written permission of Smiths Medical ASD,
Inc. (Smiths Medical).

The Level 1, and Smiths design mark are trademarks of the Smiths Medical
family of companies. The symbol ® indicates the trademark is registered in
the U. S. Patent and Trademark office and certain other countries.

Every effort has been made to ensure that the information in this manual is
accurate and details provided are correct at the time of printing. The
company, however, reserves the right to improve the equipment shown.

Other company and product names mentioned herein are trademarks of their
respective companies. Mention of third-party products is for informational
purposes only and constitutes neither an endorsement nor a recommendation.
Smiths Medical assumes no responsibility with regard to the performance or
use of these products.

For further information, please call your local Smiths Medical representative
or Smiths Medical direct at 1-800-258-5361
or +1-781-878-8011.

©2006 Smiths Medical family of companies.


All rights reserved.

The products described are covered by one or more of the following U.S.
Patent Nos. 4,759,749; 4,878,537; 4,900,308; 5,063,994; 5,097,898;
5,417,274 and 5,512,043.

Manufactured in the U.S.A.

| Operator’s Manual iii


Con te n ts

Contents
1 About this Manual 1

2 Description 3

3 Indications for Use 4

4 Important Safety Information 5


Contraindications 5
Warnings 5
Cautions 8
5 Out of the Box—Assembly 9
Step 1 Verify Components 10
Step 2 Assemble I.V. Pole to Warming Unit 11
Step 3 Install the Pressure Chambers 12
Step 4 Attach the I.V. Bag Hanger 13
Step 5 Disinfect the Recirculating Solution Reservoir 13
Step 6 Preliminary Preparation 14
Step 7 Connect the Pneumatic Tubing 14
Step 8 Install the Level 1® H-31, Version B, Air Detector/
Clamp 16
Step 9 Perform Electrical Safety Tests 17
6 Principle of Operation 19
Fluid Warming 19
Pressurized Fluid Delivery 19
Air Detector/Clamping 19
7 Controls and Displays 21
Fluid Warmer Power and Alarm Test Panel 22
Fluid Warmer Display Panel 23
Air Detector/Clamp Control Panel and Alarms 24
Pressure Chamber Control Panel 25
Interlocks 26
8 Operation 29
Modes Of Operation 30
OFF Mode 30
ON/ Automatic Operation Mode for Fluid Warmer 30
Alarm Test Mode 31
Over Temperature Test Mode 31
Temperature Display 31
Check Disposables Mode 32
Add Recirculating Solution Mode 32
Over Temperature Alarm Mode 33
Power ON Test for the Air Detector/Clamp 33
Automatic Operation Air Detector/Clamp 34
Check Tubing Mode 34
Air Detected/Clamped Mode 35
Pressurized Display 35
Pressurized Mode 35
Unpressurized Mode 36

iv | Operator’s Manual
C o nt en t s

9 Operating Instructions 37
Warnings 37
9.1 Set Up for Use 38
A—Install Disposable Administration Set 38
B—Prime the Disposable Administration Set 39
C—Prime the Patient Line 41
D—Test the Audible and Visual Alarms 41
E—Test the Air Detector/Clamp 42
9.2 Use of the Fluid Warmer 44
Step 1—Load the Pressure Chambers 44
Step 2—Pressurize the Pressure Chambers 44
Step 3—Make Patient Connection 45
Step 4—Replace the Gas Vent/Filter Assembly 45
Step 5—Change the Fluid Bag 45
9.3 Replace the Gas Vent/Filter Assembly 46
9.4 Activated Alarms 47
9.5 After Use 49
10 Troubleshooting 50
General Troubleshooting Guide 50
Slow Flow Rate Troubleshooting Guide 51
11 Testing 52
Add Recirculating Solution Alarm 52
Check Disposables Alarm 52
Over Temperature Test 53
Fluid Warmer Alarm Signal Test 53
Performance Testing 54
Cold Start Test 54
Calibration Test 54
Alternative Calibration Test 54
Calibration Test with DSTA-40 54
Proper Calibration of Recirculating Solution Temperature 55
Periodic Electrical Testing 56
Earth Leakage 56
Ground Continuity 56
12 Maintenance 57
Maintenance Performed Prior to Every Use 57
Clean the Exterior 57
General Inspection 57
Maintenance Performed Every 30 Days 57
Lubricate O-Ring Seals 57
Change Recirculating Solution with Distilled Water 58
Maintenance Performed Every 12 Months 58
Disinfect the Recirculating Solution Reservoir 58
Change Recirculating Solution with 0.3% Hydrogen
Peroxide/Distilled Water Solution 59
Change O-Rings 59
Clean Fan Filter 59
Inspect Air Detector/Clamp 59
Testing Fluid Warmer Operation 59
Maintenance and Calibration Log 60
Scheduled Maintenance and Calibration Checklist 60

| Operator’s Manual v
Con te n ts

13 Limited Warranty 61

14 Service 62
Warranty Service 62
Non-Warranty Work 62
Additional Documentation 62
Disposal Information 63
Service Contacts 63
15 Specifications 64
System Specifications 64
Physical 64
Environmental 64
Thermal 64
Electrical 64
Electromagnetic Environment Recommendations 65
Disposable Administration Set Specifications 65
D-50 / DI-50 65
D-60 / DI-60HL 65
D-70 / DI-70 66
D-100 / DI-100 66
D-300 / DI-300 66
16 Symbols 67

Index 70

vi | Operator’s Manual
S EC T I O N 1 • A b o ut t his Ma n u a l

SE CTION 1

About this Manual


These instructions contain important information for safe use of the
product. Read the entire operator's manual, including Warnings and
Cautions, before using the Level 1® H-1200 Fast Flow Fluid Warmer.
Failure to properly follow warnings, cautions, and instructions could
result in death or serious injury to the patient.
This Operator’s Manual describes the set-up, use, and maintenance of:
• Level 1® H-1200 Fast Flow Fluid Warmer
• Level 1® H-1000 Fast Flow Fluid Warmer with the
Level 1® H-31, Version B, Air Detector/Clamp

Descriptions about the use and functionality of the Level 1® H-1200


Fast Flow Fluid Warmer in this manual are also applicable to the
Level 1® H-1000 Fast Flow Fluid Warmer when equipped with the
H-2 Pressure Chambers and Level 1® H-31, Version B, Air
Detector/Clamp.
The manual is intended for use by individuals trained in the
healthcare and biomedical professions.

WARNING!

Read the entire operator’s manual before using the


Level 1® H-1200 Fast Flow Fluid Warmer. Failure to properly follow
warnings, cautions, and instructions could result in death or serious
injury to the patient.

This manual is organized into the following sections:

2 and 3 Description and Indications for Use


These sections provide the purpose and indications for use of the
Level 1® H-1200 Fast Flow Fluid Warmer.

4 Important Safety Information


Lists the Contraindications, Warnings, and Cautions associated with the
use of the Level 1® H-1200 Fast Flow Fluid Warmer.

5 Out of the Box—Assembly


Guides the user through the installation of the Level 1® H-1200 Fast Flow
Fluid Warmer and the Level 1® H-31, Version B, Air Detector/Clamp.

| Operator’s Manual 1
SECTIO N 1 • About this Manu a l

6 Principle of Operation
Provides a functional description of the Level 1® H-1200 Fast Flow Fluid
Warmer.

7 Controls and Displays


Provides a description of the function and purpose of the controls,
displays, and indicators for the Level 1® H-1200 Fast Flow Fluid Warmer.

8 Operation
Describes Operation, Indicator, and Alarm modes of the Level 1® H-1200
Fast Flow Fluid Warmer.

9 Operating Instructions
Describes the Set Up, Use, and Alarm modes of the Level 1® H-1200
Fast Flow Fluid Warmer.

10 Troubleshooting
Contains information on troubleshooting the Level 1® H-1200
Fast Flow Fluid Warmer. This section also details troubleshooting
slow fluid flow rates.

11 Testing
Describes Operational, Performance, and Electrical Tests that are used to
verify the proper operation of the Level 1® H-1200 Fast Flow Fluid
Warmer.

12 Maintenance
Regular maintenance procedures for every use, 30-day, and 12-month
intervals are covered in this section.

13 Limited Warranty
Describes the Limited Warranty and its provisions.

14 Service
Explains Warranty Service and Non-Warranty Work as well as listing
Service Contacts.

15 Specifications
Provides physical, environmental, and electrical specifications of the device.

16 Symbols
Lists the symbols and their definitions used with the Fluid Warmer.

2 | Operator’s Manual
S EC T I O N 2 • D e s crip t i o n

SE CTION 2

Description
The Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer) is an I.V. fluid
warmer with pressure chambers, air detection, and automatic clamping
capability. I.V. fluid and/or blood products are warmed through the use of a
sealed heat exchanger through which a recirculating solution flows. Pressure
Chambers apply pressurization and deliver the fluids at a fast flow rate. The
Air Detector/Clamp monitors for the presence of air in the disposable Gas
Vent/Filter Assembly.

This non-invasive method employs single-use, disposable administration sets


that include a Gas Vent/Filter Assembly and Heat Exchanger. When air is
detected in the Gas Vent/Filter Assembly, the Air Detector/Clamp closes off
the patient line and alerts operators to the presence of air with audible and
visual alarms. An ultrasonic signal continually passes through the fluid filled
Gas Vent/Filter Assembly (GV/FA). As a bolus of air displaces the fluid in the
GV/FA, the ultrasonic signal is broken and the clamp closes, stopping the air
before it enters the patient line. Audible and visual alarms are activated,
notifying the user that the fluid flow has stopped. Clearing the bolus of air
and restoring the fluid flow are quickly accomplished without disconnecting
from the patient.

Disposable Administration Sets

The installation, set up, and replacement of Level 1® Fast Flow I.V. Disposable
Administration Sets (Disposable Sets) follows a four-step sequence that
corresponds to numbered blocks on the device. Disposable Sets available for
use on the Level 1® H-1200 Fast Flow Fluid Warmer are listed below.

• D-50 / DI-50
• D-60 / DI-60HL
• D-70 / DI-70
• D-100 / DI-100
• D-300 / DI-300

D-series Disposable Sets are for use in the U.S.A. DI-series Disposable Sets
are for use in markets outside of the U.S.A.

| Operator’s Manual 3
SECTIO N 3 • Indic ations f or U s e

SECTIO N 3

Indications for Use


The Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer) provides a
rapid flow of warmed fluids, such as crystalloid or blood product, including
red blood cells, as volume replacement for patients suffering from blood loss
due to trauma or surgery.

The Fluid Warmer provides fast flow of warmed fluid to re-warm patients
during surgery by trained medical personnel.

4 | Operator’s Manual
S EC T I O N 4 • I m p o rt a nt S a f e t y I nf o rm a t i o n

SE CTION 4

Important Safety Information


This section covers information for prescribers and guidelines for safe use of
the Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer).

CONTRAINDICATIONS

• Not for use in warming platelets, cryo-precipitates, or


granulocyte suspensions.

WARNINGS

Death or serious injury may occur to the patient or user if


these warnings are not followed:

• Read and follow all instructions, labeling, and accompanying


documents supplied with this medical device. Failure to
follow instructions, including all warnings and cautions,
could lead to misuse of the device or device malfunction.

• Remove all air from fluid lines before connecting to patient.


Failure to do so can result in infusion of air into the patient.

• Replace Gas Vent/Filter Assembly every three hours, or when


the filter becomes clogged, or when air is slowly vented.
Failure to do so will result in a reduction of flow rate. This
may result in inadequate patient treatment.

• The replacement Gas Vent/Filter Assembly must be fully


primed before continuing infusion. Failure to do so may
allow air to be infused into the patient.

• Do not use the Fluid Warmer in high-energy fields such as:


MRI, X-RAY, portable and mobile RF communications equipment,
and other such devices. The Fluid Warmer may act as a
projectile in a strong magnetic field, cause image artifacts, or
not function as intended.

| Operator’s Manual 5
SECTIO N 4 • Important Saf ety I nf o rm a t io n

WARNINGS [continued]

• Do not bend the heat exchanger. Bending may damage the


heat exchanger allowing communication between the
recirculating solution and I.V. fluid path, resulting in the I.V.
delivery of inappropriate fluids.

• Blood and blood products could contain pathogenic


organisms. Failure to follow institutional policy and
procedures for biomedical-hazardous materials could lead to
exposure to harmful pathogens.

• When injecting medications into the fluid path, do not inject


through the triple lumen tubing of the D/DI-60HL Disposable
Set. This may allow communication between the recirculating
solution and I.V. fluid path.

• Exposed conductor on MAINS power cord can cause an


electrocution hazard. Remove device from service if MAINS
power cord has exposed wires.

• Do not re-use partially full fluid bags. Fluid bags that have
been partially drained, un-spiked, and then reinstalled may
contain air, which if used can result in infusion of air into the
patient. Use only new fluid bags from which the air has been
removed.

• The tubing must be properly placed in the Clamp Slot of the


Air Detector/Clamp. Failure to ensure that the tubing is
correctly positioned in the Clamp Slot may result in failure to
stop air infusion.

• Activation of the Air Detector/Clamp alarm during infusion


indicates that fluid flow has stopped and that immediate
operator intervention is required to restore fluid flow.

• Activation of the Over Temperature warning signal indicates


that warming has stopped and immediate operator interven-
tion is required to clear the over temperature condition
or to take the device out of service.

• The Fluid Warmer is not for use with irrigating tubing, which
may not fit into the clamp slot of the Air Detector/Clamp
causing diminished flow or a failure to stop flow.

6 | Operator’s Manual
S EC T I O N 4 • I m p o rt a nt S a f e t y I nf o rm a t i o n

WARNINGS [continued]

• The Fluid Warmer is for use only with Smiths Medical


supplied or approved parts, accessories, and D or DI series
Disposable Sets. The device may not function as intended with
the use of unapproved parts, accessories, or Disposable Sets.

• Grounding reliability can only be achieved when MAINS


power cords are connected to a properly grounded
receptacle. Risk of electrical shock exists if the equipment is
not connected to a properly grounded receptacle.

• The functional test for the Air Detector/Clamp accessory


must be performed before each use. If the device does not
function correctly, air in the I.V. line may not be detected, and
the patient line may not be clamped. Remove the device
from service immediately.

• Use of a bedside leukocyte reduction filter may cause a


sudden precipitous drop in blood pressure resulting in
respiratory distress, facial flushing, abdominal pain and
nausea, and loss of consciousness. Immediately stop
transfusion, and follow institution’s protocol for treatment of
transfusion reactions.

• If any visual indicator does not illuminate or the audible


signal does not sound, do not use the Fluid Warmer.
Remove the device from service immediately.

• Do not operate the Fluid Warmer in the presence of a


flammable anesthetic mixture with air, oxygen, or nitrous oxide.
The risk of explosion exists if the Fluid Warmer is operated in
a potentially explosive environment.

• No user-serviceable parts. All service must be performed by


Smiths Medical or an authorized representative.

• Do not use Disposable Set if luer caps are not securely in


place, else I.V. flow path may not be sterile and may cause
death or serious injury.

| Operator’s Manual 7
SECTIO N 4 • Important Saf ety I nf o rm a t io n

CAUTIONS

Physical injury to the patient, user, and/or an adverse effect


on the device or its performance may occur if these cautions
are not followed:

• Do not use the Fluid Warmer if equipment or Disposable


Set malfunction is evident.

• To reduce the risk of cross contamination, do not reuse


Disposable Sets. Disposable Sets are for single use only.

• When loading fluid bags into Pressure Chambers, choose a


hanging hook that allows the bag port to hang freely in the
indented slot at the bottom of the chamber door. If bag ports
are positioned above this slot, diminished flow could occur.

• Federal law (U.S.A.) restricts this device to sale by or on the


order of a physician.

8 | Operator’s Manual
S EC T I O N 5 • O ut o f t he B o x — A s s e m b l y

SE CTION 5

Out of the Box—Assembly


This device must be assembled and tested by authorized Smiths Medical
personnel, an authorized distributor of Smiths Medical, or a qualified person
prior to placing the device into service.

The following steps describe how to assemble and do preliminary set up of the
Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer).

Refer to Step 8 if you need to install the Level 1® H-31, Version B, Air
Detector/Clamp to the Level 1® H-1000 Fast Flow Fluid Warmer.

Step 1 Verify components of the Fluid Warmer

Step 2 Assemble I.V. Pole to Warming Unit

Step 3 Install Pressure Chambers

Step 4 Attach the I.V. Bag Hanger

Step 5 Disinfect the Recirculating Solution Reservoir

Step 6 Preliminary Preparation

Step 7 Connect the Pneumatic Tubing

Step 8 Install the Level 1® H-31, Version B, Air Detector/Clamp

Step 9 Perform Electrical Safety Tests

Read through the instructions completely prior to setting up the device.

Note: After unpacking the system, recycle packaging material according to


hospital policy for recyclable materials.

| Operator’s Manual 9
SECTIO N 5 • Out of the Box— A s s e m b ly

Step 1

Verify Components of the Level 1® H-1200 Fast Flow Fluid Warmer

Note: The Level 1® H-31, Version B, Air Detector/Clamp is shipped as a separate accessory only for
installation on an existing Level 1® H-1000 Fast Flow Fluid Warmer.
Check the contents of all packaging to verify that the following components are present. If any parts are
missing or damaged, do not use the Fluid Warmer. Do not substitute parts not supplied by Smiths
Medical. Contact Smiths Medical for replacement parts. Below is a listing of the component parts for the
Level 1® H-1200 Fast Flow Fluid Warmer.

Components Checklist
Qty Component
in order of appearance in illustration TI
O
N
LU N
SO TIO
.V. LU
YI N
AN SO TIO
N OT F ITH .V. U
OR USE W YI OL
AN .V. S
N OT F ITH YI
OR USE W AN
N OT F ITH
OR USE W

2 Pressure Chambers / Contents:


(2) “U” brackets
N
O
TI
LU N
SO TIO
.V. LU
YI N
AN SO TIO
N OT F ITH .V. U
OR USE W YI OL
AN .V. S
N OT F ITH YI
OR USE W AN
N OT F ITH
OR USE W

(4) Thumbscrews

1 I.V. Bag Hanger

1 Fluid Warming Unit


2

1 H-31, Version B, Air


Detector/Clamp
1 Accessory Pack
R

(2) Pan-head screws 00

(2) Power Cord Clips


L
VE 10
LE EM
ST
SY

(2) Flat-head screws


1

1 Operator's Manual MA
X

H-31B

H-31B

1 I.V. Pole with Flanking Brackets MIN

1 Accessory Pack / Contents:


(2) Plastic “J” Clamps
(1) Y Connector
(1) Black Tubing
(1) Hex Wrench

1 O-Ring Kit / Contents:


(1) Silicone
(2) O-Rings
(1) Hex Wrench
(1) Instructions for Use

3 Bolts
3 Washers

1 I.V. Pole Base

10 | Operator’s Manual
S EC T I O N 5 • O ut o f t he B o x — A s s e m b l y

Step 2

Assemble I.V. Pole to the Warming Unit

There are three steps involved in assembling the I.V. Pole to the
Warming Unit. The steps are: 1. Assemble the I.V. Pole to the Base,
2. Close the Drain Valve, and 3. Attach the Warming Unit to the
Flanking Brackets. Each step is detailed in a short procedure.

2.1 Assemble the I.V. Pole to the Base

1 Locate the I.V. Pole Base (a).

2 Locate the dark-gray extruded I.V. Pole (b) with Flanking


b Brackets.

3 Place the I.V. Pole Base upright on its wheels, (c) and lock the
wheels to prevent movement during set up.
d
4 Locate three bolts (d) and washers for the pole base.
e
5 Align the three holes (e) in the I.V. Pole with the three screw
holes on the pole base.
f
6 Slide the I.V. Pole down over the pole base, (f) keeping holes
aligned.
g
a
7 Guide three bolts and washers through the holes (g) at the base
of the pole and tighten.

2.2 Close the Drain Valve

Turn valve, located on the bottom of the device, perpendicular to


stem (h) of the Warming Unit as shown.

| Operator’s Manual 11
SECTIO N 5 • Out of the Box— A s s e m b ly

2.3 Attach the Warming Unit to the Flanking Brackets

1 Align the eight hex screws on the back of the Warming Unit
with the eight keyhole notches on the flanking bracket.

2 Slide screw heads down into keyhole notches. 2

3 Tighten all eight hex screws with the supplied hex R

wrench and secure in place.


L 00
VE 10
LE EM
ST
SY

H-31B

Step 3

Install the Pressure Chambers

1 Locate the two Pressure Chambers.

2 Locate the U-brackets and thumbscrews supplied with the


Pressure Chambers.

3 Attach the U-brackets with thumbscrews to the back of the


Pressure Chambers, as shown. Keep thumbscrews and brackets loose.

4 Slide one Pressure Chamber with attached U-bracket over the top
of each flanking pole.

5 Align the U-bracket slightly below the top of the flanking pole. 2

Tighten the thumbscrews securely.


2

12 | Operator’s Manual
S EC T I O N 5 • O ut o f t he B o x — A s s e m b l y

Step 4

Attach the I.V. Bag Hanger

1 Slide the I.V. Bag Hanger on top of the I.V. Pole.

2 Align with tabs.

3 Press down and snap into place.

Step 5

Disinfect the Recirculating Solution Reservoir

2
1 Remove the fill-port plug (a) on the reservoir.
c
2 Prepare a 0.3% hydrogen peroxide/distilled water solution for
the reservoir. Mix 140 ml of 3% hydrogen peroxide solution and
R
1,260 ml of distilled water.

3 Fill the reservoir with 1.4 liters of 0.3% hydrogen peroxide/


L 00
distilled water solution.
VE 10
LE TEM
S
SY

4 Replace the fill-port plug.


b
5 Insert a Disposable Set into the Fluid Warmer.
1

a MA
X 6 Insert the power cord into a properly grounded receptacle.

7 Turn the Fluid Warmer ON. Let the solution circulate for a 30-
minute disinfection period.

8 Turn the Fluid Warmer OFF.

9 Empty the reservoir.

10 Remove the Disposable Set and discard according to established


hospital procedures.

| Operator’s Manual 13
SECTIO N 5 • Out of the Box— A s s e m b ly

Step 6

Preliminary Preparation
2
c
1 Remove the fill-port plug (a) on the front of the warming unit and
fill the reservoir to the maximum level with 1.4 liters of one of the
following solutions:
R

• 0.3% Hydrogen Peroxide/Distilled Water Solution


Mix 140 ml of 3% hydrogen peroxide and 1,260 ml of distilled
water. VE
L
LE TEM
S
10
00

SY

Note: If this option is selected, the maintenance requirement


to change the recirculating solution is once every 12 months.
Always use a 0.3% hydrogen peroxide/distilled water solution b
when refilling the reservoir.
1

a MA
X

• Distilled Water
Note: If this option is selected, the maintenance requirement
to change the recirculating solution is once every 30 days.

2 Replace the fill port plug.

3 Lubricate O-Rings in #1 Block (b) and #2 Block (c). Place a small


amount of silicone lubricant, provided in the supplied O-Ring Kit,
on a cotton swab and apply all around the inside of each O-Ring.

Step 7 a

Connect the Pneumatic Tubing

1 Locate the Accessory Pack with the black pneumatic tubing (a), b
two “J” clamps (b), and one “Y” Connector (c).

14 | Operator’s Manual
S EC T I O N 5 • O ut o f t he B o x — A s s e m b l y

2 Locate the orange protective plug in the red ring


connector (d) located on the back of the device.
Remove the plug by depressing the red plastic
ring as you pull the plug out of the connector.

f 3 Take the pneumatic tubing and press one end of


the tubing firmly into the ring connector (d)
until it can go no further.
e
g 4 Take the “Y” connector and press the other end
of the pneumatic tubing into the bottom of the
“Y” connector, as shown (e), until it can go no
further.

5 Press the pneumatic tubing from the Pressure


Chamber into place (f) on the top of the “Y”
connector until it can go no further. Repeat this
h procedure with the pneumatic tubing from the
other Pressure Chamber.

6 Remove the protective backing sheet on one “J”


clamp, exposing the adhesive side.
d
7 Carefully position the “J” clamp and press the
adhesive side against the gray I.V. Pole in the
approximate locations (g)(h) shown.

Press down firmly to secure in place.

Repeat this procedure for the other “J” clamp.

8 Press the pneumatic tubing into place on the “J”


clamps.

| Operator’s Manual 15
SECTIO N 5 • Out of the Box— A s s e m b ly

Step 8

Install the Level 1® H-31, Version B, Air Detector/Clamp


d
1 Remove 4 screws (a) from the rear of the Fluid Warmer,
lower left side, from locations shown in figure. a

2 Plug in the power cord (b) of the Level 1® H-31, Version B,


Air Detector/Clamp into the auxiliary MAINS outlet located a
on the bottom of the Fluid Warmer.

Note: If you turn the Fluid Warmer off and the Air
Detector/Clamp does not turn off, contact Smiths Medical or
an authorized representative.

3 Loosen the two screws holding the mounting bracket to the a


e
rear of the Air Detector/Clamp (do not remove).

4 Align the slot on the Air Detector/Clamp with #3 Block on


the Fluid Warmer (c). Fit in place over the block. a

5 Align the mounting bracket on the rear of the Air


Detector/Clamp with two screw holes, shown (d). Insert two
flat-head screws and tighten, securing the Air
Detector/Clamp to the Fluid Warmer. Tighten the two
screws on the mounting bracket on the Air Detector/Clamp. b

6 Locate two power cord clips (e) included with the Air
Detector/Clamp and snap onto power cord. Align clips with
the two screw holes as shown, insert screws, and tighten.

H-31B

16 | Operator’s Manual
S EC T I O N 5 • O ut o f t he B o x — A s s e m b l y

Step 9

Perform Electrical Safety Tests

Perform all applicable electrical safety tests as required per


institutional procedure. These include but are not limited to:

• Leakage current • Hypot • Ground bond test

WARNING!

Grounding reliability can only be achieved when MAINS power


cords are connected to a properly grounded receptacle. Risk of
electrical shock exists if the equipment is not connected to a
properly grounded receptacle resulting in death or serious
injury to the patient or user.

The Electrical Safety Check must be performed by qualified personnel


authorized by the institution to perform such testing. The Safety Check
must be performed and documented at least once per year, or according
to institutional policy.

| Operator’s Manual 17
SECTIO N 6 • Princ iple of Opera t io n

H-1200

Pressure
Pressure Gauge
Chambers

N
TIO
OLU
NO
I.V. S
TF N
OR U
SE WITH ANY TIO
OLU
NO
I.V. S ION
TF
OR U
NO SE WITH ANY LUT
TF . SO
OR USE WITH ANY I.V

I.V. Blood Product


/Fluid Bag
Heat
Exchanger

Drip
Chamber

Fluid Gas Vent


Return

MAX

Patient

Float Patient Line


Switch MIN

Reservoir

Solution Particle
Air Heaters Filter
Compressor

Solution
Pump

Air
Clamp OFF
Detection

18 | Operator’s Manual
S EC T I O N 6 • Princip le o f O p e ra t i o n

SE CTION 6

Principle of Operation
The schematic illustration on the facing page depicts the Level 1® H-1200 Fast
Flow Fluid Warmer’s (Fluid Warmer) operations. The primary operations are
described below.

Fluid Warming

The Fluid Warmer utilizes a solution reservoir housed in a controller


unit. Recirculating solution is warmed and pumped through a heat
exchanger (a part of the Disposable Set). The solution is returned to
the reservoir for continuous recirculation and remains isolated from the
patient and from the I.V. fluid path. The on-board recirculating solution
is heated to a pre-set manufacturer’s temperature set-point. The system
continuously monitors and controls the recirculating solution
temperature. The Fluid Warmer is designed to shut down and provide
audible and visual alarms in the event of an over-temperature condition.

Pressurized Fluid Delivery

The Fluid Warmer provides pressurized fluid delivery through the use of
an on-board compressor and two Pressure Chambers. The Pressure
Chambers pressurize the fluid bags for fast fluid delivery.

Air Detection/Clamping

The Air Detector/Clamp detects the presence of air in the Gas


Vent/Filter Assembly (GV/FA)—a part of the Level 1® D/DI series
Disposable Administration Sets (Disposable Sets)—and clamps the
patient line. An ultrasonic signal continually passes through the fluid-
filled GV/FA. As a bolus of air displaces the fluid in the GV/FA, the
ultrasonic signal is broken and the clamp closes, stopping the air before
it enters the patient line. Audible and visual alarms are activated,
notifying the user that air has been detected and fluid flow has been
clamped off. Clearing the bolus of air and restoring the fluid flow are
quickly accomplished without disconnecting from the patient.

| Operator’s Manual 19
SECTIO N 7 • Controls and Disp la y s

H-31B

20 | Operator’s Manual
S EC T I O N 7 • C o nt ro ls a nd D is p l a y s

SE CTION 7

Controls and Displays


Five locations on the Level 1® H-1200 Fast Flow Fluid Warmer (Fluid
Warmer) govern how the device is controlled and where function
indicators are displayed. They are called-out in the figure on the facing
page and are defined in the list below.

1 Fluid Warmer Display Panel

2 Power and Alarm Test Panel

3 Reservoir Level Display

4 Air Detector/Clamp Control Panel

5 Pressure Chamber Control Panel

The Fluid Warmer has five Interlocks, which detect for correct
installation of a Disposable Set, that are also defined this section.

| Operator’s Manual 21
SECTIO N 7 • Controls and Disp la y s

Fluid Warmer Power and Alarm Test Panel

The Power and Alarm Test Panel is located on the front of the Fluid
Warmer directly above the reservoir fill-cap. This panel contains four
pressure-sensitive buttons that are activated when pressed. Refer to the
Power Alarm Test Panel (figure on right) whose numbered call outs
correspond to a description of the button and the function it performs.

Button/Function

1 Power ON Button
The green button on the top-left of the Power and Alarm Test
Panel powers on the device. Power is applied to the on-board
compressor for the pressure chambers and the Air
Detector/Clamp. The green Automatic Operation LED on the
Fluid Warmer Display Panel illuminates when the Power ON
button is activated, with a Disposable Set in place.

2 Power OFF Button


The Power OFF is the orange button to the right of the Power
ON button on the Power and Alarm Test Panel. This button
turns power off to the unit. The green Automatic Operation
LED on the Display Panel will turn off when this button is
pressed.

3 Over Temperature Test Button


The Over Temperature Test is used to confirm the proper
operation of the Over Temperature circuitry. Testing the circuitry
requires that the Fluid Warmer is at operating temperature
(41°C). Once this is established, press and hold the button.
Then, release the button. The Over Temperature alarm
continues to function. Clear the alarm mode by turning the
device off, then back on. See Section 11, Testing, for instruction
on performing an Over Temperature Test.

4 Fluid Warmer Alarm Signal Test Button


The Fluid Warmer Alarm Signal Test is used to confirm proper
operation of the visual and audible alarm indicators. Press and
hold this button to test circuitry. Then, release the button. The
Over Temperature alarm continues to function. Clear the alarm
mode by turning the device off, then back on.

5 Reservoir Capacity
Capacity for recirculating solution reservoir is 1.4 liters. Use
recirculating solution. Do not exceed maximum capacity.

22 | Operator’s Manual
S EC T I O N 7 • C o nt ro ls a nd D is p l a y s

Fluid Warmer Display Panel

The Fluid Warmer Display Panel provides continuous information


about the operation of the Fluid Warmer. A liquid crystal display (LCD)
indicates recirculating solution temperature. Just below the LCD, four
light-emitting diodes (LEDs) indicate operation modes for the device.
For identification purposes, the diodes are shown illuminated.

1 Recirculating Solution Temperature


The temperature of the recirculating solution is displayed in the
LCD panel. The temperature is displayed in degrees celsius.

Note: This is NOT the temperature of fluid delivered to the


patient—the display reflects the temperature of the recirculating
solution.

2 Automatic Operation LED


The green LED indicator illuminates when the power is ON and
the Disposable Set has been properly installed. When lit, this
indicates the Fluid Warmer is operating.

3 Check Disposables LED


The yellow LED indicator illuminates and an audible attention
signal beeps when the Disposable Set is not properly installed.
See the Interlocks description in this section for directions on
clearing the Check Disposables alarm.

4 Add Recirculating Solution LED


The yellow LED indicator illuminates and an audible attention
signal beeps when reservoir is low. Additional recirculating
solution must be added to the reservoir. Maximum capacity for
the reservoir is 1.4 liters of recirculating solution.

5 Over Temperature LED


The red LED indicator illuminates and an audible warning signal
1 beeps when the recirculating solution is over the acceptable
temperature for safe use.
a
Reservoir Level Display

The Reservoir Level Display has a clear window for viewing the amount
of recirculating solution present in the reservoir. Check the reservoir to
ensure the solution level is near the maximum level indicator (a). If the
recirculating solution level is too low, the Add Recirculating Solution
LED on the Display Panel illuminates and an audible attention signal
beeps.

| Operator’s Manual 23
SECTIO N 7 • Controls and Disp la y s

Air Detector/Clamp Control Panel and Alarms

The Air Detector/Clamp Control Panel has three LED indicators that
display the operational state of the Air Detector/Clamp. Refer to figure
on right.

1 Automatic Operation LED H-31B


The green Automatic Operation LED illuminates when the
following conditions are present: The Fluid Warmer power is
ON, a Disposable Set is properly installed in the Fluid Warmer
and primed, the patient line from the Gas Vent/Filter Assembly
is correctly placed in the #3 Clamp Slot, and the Clamp Slot
door is closed.

2 Check Tubing LED


The yellow Check Tubing LED illuminates and an audible
attention signal beeps when the patient line tubing from the Gas
Vent/Filter Assembly is not correctly placed in the #3 Clamp
slot, and when the Clamp Slot door is not closed correctly.

3 Clamped LED
The red Clamped LED illuminates and an audible warning signal
beeps when air is detected in the Gas Vent/Filter Assembly. The
patient line is automatically clamped.

24 | Operator’s Manual
S EC T I O N 7 • C o nt ro ls a nd D is p l a y s

Pressure Chamber Control Panel

The Pressure Chamber Control Panel uses a control lever to switch


from pressurized to unpressurized mode. A gauge displays pressure
levels in the Pressure Chamber.

1 Pressurize / Unpressurize Lever


This lever is used to control the pressure mode in the
Pressure Chamber.

a To Pressurize the Pressure Chamber


With Pressure Chamber door closed and latched, slide lever
to the left, all the way to the plus (+) pressurized position.
a This applies 300 mmHg pressure in the Pressure
Chamber when the Fluid Warmer is turned ON.

b To Unpressurize the Pressure Chamber


To remove pressure from the Pressure Chamber, slide the
lever to the right, all the way over to the minus (–)
b
unpressurized position. Pressure is released on the fluid bag
in the Pressure Chamber.

2 Pressure Gauge
This gauge indicates the pressure present in the Pressure
Chamber. When the Pressurize lever is in the plus (+)
pressurized position and the Fluid Warmer is ON, this gauge
displays the operating pressure in the Pressure Chamber. The
operating pressure should be 300 mmHg.

| Operator’s Manual 25
SECTIO N 7 • Controls and Disp la y s

Interlocks

The Fluid Warmer has five Interlocks that detect for proper installation
of a Disposable Set’s components. Refer to the figure on the facing page
to identify the positions of interlocks.

Note: Block 1 is not an Interlock. It cannot detect if a Disposable Set


is not correctly installed. It is identified here because it is an essential
step for proper installation of the Disposable Set components.

Three Interlocks are located on the Fluid Warmer and check for proper
installation of:
2 Heat Exchanger, top end
4 Gas Vent/Filter Assembly
5 Heat Exchanger (guide)

Two Interlocks are located in the Air Detector/Clamp 3 and check for
the proper installation of:
Patient I.V. Line in the Clamp Slot
Door for the Clamp Slot

Interlocks 2, 4, and 5 prevent the Fluid Warmer’s pump from


circulating reservoir solution if the Disposable Set’s Heat Exchanger and
Gas Vent/Filter Assembly are not installed properly.

If Check Disposable Alarm is Activated on the Fluid Warmer

a Check Heat Exchanger for proper installation in Block 1, and


Interlocks 2 and 5.

b Press Heat Exchanger down firmly in Block 1 to secure in O-Ring.

c Press Interlock 2 tab down firmly to engage the Interlock switch.

d Press Heat Exchanger firmly into Interlock 5.

e Check Gas Vent/Filter Assembly installation in Interlock 4.

If Check Tubing Alarm is Activated on the Air Detector/Clamp

a Open the door and check the Patient Line for proper installation in
the Clamp Slot at interlock 3.

b Close the door and check that the tab on the top edge of the door is
fully inserted into the Air Detector/Clamp at interlock 3 before
pushing the door down to close it.

26 | Operator’s Manual
S EC T I O N 7 • C o nt ro ls a nd D is p l a y s

H-31B

| Operator’s Manual 27
SECTIO N 8 • Operation

Operation Level 1® H-1200 Fast Flow Fluid Warmer

Function Interface # Description Indicator/ Alarm Signal

Visible Audible Beep

1 OFF None None


Fluid Warmer
Power 2 ON LEDs display None
and Alarm 3 Alarm Test LEDs display 1/second
Test Panel
4 Over Temperature Alarm Test LEDs display 1/second

Fluid
Warming

5 Temperature Display LCD Readout None


6 Automatic Operation Green LED None
Fluid Warmer 7 Check Disposables Yellow LED 1/5 seconds
Display Panel
8 Add Recirculating Solution Yellow LED 1/5 seconds
9 Over Temperature Red LED 1/second

H-31B

Air Detection Air Detection/


/Clamping Clamp 10 Automatic Operation Green LED None
Alarm and for Air Detection
Control Panel
11 Check Tubing/Patient Line Yellow LED 1/5 seconds
12 Air Detected/Clamped Red LED 1/second

Pressure 13 Pressure Gauge Numbered Dial None


Pressurized Chamber
Control
14 Pressurized + Symbol None
Fluid Delivery
Panel 15 Unpressurized – Symbol None

28 | Operator’s Manual
S EC T I O N 8 • O p e ra t i o n

SE CTION 8

Operation
The Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer) performs three
primary functions; Fluid Warming, Air Detection/Clamping, and Pressurized
Fluid Delivery. Functions are monitored and controlled by four
interfaces/control panels located on the Fluid Warmer.
The four interfaces are:

• Fluid Warmer Power and Alarm Test Panel


• Fluid Warmer Display Panel
• Air Detector/Clamp Alarm and Control Panel
• Pressure Chamber Control Panel

In the table on the facing page, operation of the device is represented in terms
of the four interfaces that control specific device functions. The numbers call-
out individual Modes of Operation activated or indicated on the interface.

Functions
• Fluid Warming
• Air Detection/Clamping
• Pressurized Fluid Delivery
Operational modes
• OFF Mode
• ON/Automatic Operation for Fluid Warmer
• Alarm Test Mode
• Over Temperature Test Mode
• Check Disposables Mode
• Add Recirculating Solution Mode
• Over Temperature Alarm Mode
• Power ON Test for Air Detector/Clamp
• Automatic Operation Air Detector/Clamp
• Check Tubing Mode
• Air Detected/Clamped Mode
• Pressurized Mode
• Unpressurized Mode

The modes of operation are individually defined in the following section. This
includes a description of each mode, activation and/or monitoring of the
mode, mode characteristics, and clearing of the mode state.

| Operator’s Manual 29
SECTIO N 8 • Operation

Modes of Operation

WARNING!

If any visual indicator does not illuminate or the audible signal


does not sound, do not use the Fluid Warmer. Remove the
device from service immediately. Death or serious injury may
occur to the patient or user if this warning is not followed.

OFF Mode
Power is off only for a part of the equipment. The MAINS are still
connected. Press the OFF button (a) on the Power and Control Panel to a
turn the device off.

ON/Automatic Operation Mode for Fluid Warmer

The Fluid Warmer enters Automatic Operating mode when a


Disposable Set is properly installed and the device is turned ON. This is
done by pressing the ON button (b). b

Mode characteristics
• The green Automatic Operating LED on the Display Panel
illuminates (c).
• Fluid warming begins. c
• Pressure infusion is provided by activating the Pressure Chambers.
• Air Detector/Clamp enters the Power ON Test, then enters default
Automatic Operation mode.

30 | Operator’s Manual
S EC T I O N 8 • O p e ra t i o n

Alarm Test Mode

The Alarm Test mode is used to test the visual and audible indicators of
d the Level 1® H-1200 Fast Flow Fluid Warmer. This mode is entered by
pressing and holding the Alarm Test button (d) on the Fluid Warmer’s
Control Panel.

Mode characteristics
• All visual indicators on the Fluid Warmer’s Display Panel (e)
illuminate.
• The Fluid Warmer’s audible alarm beeps.
• When the Alarm Test button is released, the Over Temperature
e
LED and an audible alarm remains active.
• To clear the Over Temperature alarm, turn the Fluid Warmer OFF
and then back ON.

Over Temperature Test Mode

The Over Temperature Test mode is used to test the operation of the
Fluid Warmer’s Over Temperature Circuitry. This mode is entered by
pressing and holding the Over Temperature Test button (f) on the Fluid
f Warmer Control Panel with the Fluid Warmer at operating temperature
(41°C).

Mode characteristics
• The red Over Temperature LED (g) on the Display Panel
g illuminates.
• An audible warning signal beeps.

To Clear this mode


• Turn Fluid Warmer OFF.
• Turn Fluid Warmer back ON.

Temperature Display

The Temperature Display functions when the Fluid Warmer is powered


ON. Temperature is displayed in degrees Celsius.

| Operator’s Manual 31
SECTIO N 8 • Operation

Check Disposables Mode

The Check Disposables mode of the Fluid Warmer indicates a missing


or improperly installed Disposable Set.

Mode characteristics
• The Check Disposables yellow LED (a) on the Fluid Warmer’s a
Display Panel is illuminated.
• An audible attention signal beeps.
• Reservoir solution circulation is stopped; fluid warming stops.
• Pressure Chambers continue to operate.

To Clear this mode


Install a disposable or check the disposable installation as follows:
• Check the position of the disposable in the #1 Block.
• Make sure the heat exchanger is seated in the heat exchanger guide.
• Press down firmly on the #2 Block.
• Check the position of the Gas Vent/Filter Assembly in the #4
Interlock.

Add Recirculating Solution Mode

The Add Recirculating Solution mode of the Fluid Warmer indicates


that the solution level in the recirculating solution reservoir is below its
minimum level.

Mode characteristics
• The yellow Add Recirculating Solution LED (b), on the Fluid
Warmer’s Display Panel, is illuminated b
• An audible warning signal beeps.
• Solution circulation stops, fluid warming stops.
• Pressure Chambers continue to operate.
• Fluid flow to the patient continues.

To Clear this mode


Add recirculating solution to the Fluid Warmer’s reservoir.

32 | Operator’s Manual
S EC T I O N 8 • O p e ra t i o n

Over Temperature Alarm Mode

The Over Temperature Alarm mode is entered when the temperature of


the recirculating solution reservoir is at or above 43.9°C

WARNING!

Activation of the Over Temperature warning signal indicates that


warming has stopped and immediate operator intervention is
required. Failure to clear the over temperature condition or to take
the device out of service may result in patient death or serious
injury.

Mode characteristics
• The Over-Temperature LED warning light illuminates (c).
• An audible warning signal beeps.
c • Solution circulation is stopped; fluid warming stops.
• Pressure Chambers continue to operate.
• Fluid flow to the patient continues.

To Clear Over Temperature Alarm mode


Do the following:
• Turn OFF the Fluid Warmer to clear the alarm.
• Turn the power back ON.

Power ON Test for Air Detector/Clamp


H-31B

The Power ON Test for the Air Detector/Clamp is activated when the
the Fluid Warmer is turned ON. This test activates the Air
Detector/Clamp’s visual and audible indicators.

Mode characteristics
• Audible alarm indicator beeps.
• All LED indicators on the Air Detector/ Clamp Control Panel
illuminate:
1 Automatic Operation LED indicator - Green
2 Check Tubing LED indicator - Yellow
3 Clamped LED indicator - Red

At the end of the Power ON Test the Air Detector/Clamp enters


Automatic Operation mode. This is the default mode for the Air
Detector/Clamp.

| Operator’s Manual 33
SECTIO N 8 • Operation

Automatic Operation Air Detector/Clamp


H-31B
In Automatic Operating mode, the Air Detector/Clamp monitors for
the presence of air in the Disposable Set’s Gas Vent/Filter Assembly
(GV/FA). If air is detected the patient line is clamped off and an
audible alarm beeps. The Air Detector/Clamp goes into Automatic
Operation mode when the Fluid Warmer is turned ON and Disposable
Set is properly installed and primed—no air is present in the GV/FA.

Mode characteristics
• The green Automatic Operation LED (1) is illuminated.
• Monitoring for air in the Gas Vent/Filter Assembly is active.
• Fluid is ready to be delivered to the patient when in Automatic
Operating mode.

Check Tubing Mode

The Air Detector/Clamp’s Check Tubing mode is entered when the


patient line from the the Gas Vent/Filter Assembly is not properly
installed in the Air Detector/Clamp Slot and when the Clamp Slot door
is not closed correctly.

Mode characteristics
• The yellow Check Tubing LED (b) on the Air Detector/Clamp
Control Panel is illuminated.
• An audible low-priority warning signal beeps.
To Clear this mode b
• Place the patient line from the Gas Vent/Filter Assembly in the
#3 Clamp Slot of the Air Detector/Clamp and close the Clamp Slot
door.

34 | Operator’s Manual
S EC T I O N 8 • O p e ra t i o n

Air Detected/Clamped Mode

In this mode the Air Detector/Clamp is activated when the ultrasonic


sensor detects the presence of air in the Gas Vent/Filter Assembly.
Auditory and visual warnings are activated and the clamp is closed,
preventing passage of fluid through the patient line.

Mode characteristics
• The patient line is clamped until alarm condition is removed.
• The red Clamped warning indicator LED (c) illuminates.
• The Air Detector/Clamp warning signal beeps.

c
To Clear this mode
Perform the steps in Section 9, Operating Instructions, under the
heading: Clear the “Air Detected” Alarm mode.

Pressure Display

The Pressure Display gauge (a) functions when the device is ON. The
graduated indicator represents the level of pressure applied to the fluid
bags. Pressure should be in the range of 280-300 mmHg pressure.
a

Pressurized Mode

The H-2 Pressure Chambers deliver fluids at an increased flow rate


with the application of 300 mmHg pressure upon the fluid bags. Flow
rate varies according to fluid type and viscosity, temperature, Disposable
Set used, and the amount of clamping applied to the roller clamps.

Pressurized infusion is enabled when:


• A fluid bag is installed in the Pressure Chamber.
• The Fluid Warmer is turned ON.
+)
• The Pressure Chamber switch is placed in the plus (+
pressurized position (b).
b
Mode characteristics
• The Fluid Warmer must be ON for the Pressure Chamber to work.
• Operating pressure should be between 280-300 mmHg.
• Pressure is not adjustable on the Pressure Chamber.
• Pressure is applied to the fluid bag in the Pressure Chamber.
• Pressure is indicated on the pressure gauge.

| Operator’s Manual 35
SECTIO N 8 • Operation

To Exit this mode


• Place the Pressure Chamber switch in the minus (–) unpressurized
position (c).

Unpressurized Mode

Disable pressurization by moving the switch on the Pressure Chamber


to the minus (–) unpressurized position (c).

Mode characteristics c
• Pressure is released from the Pressure Chamber.
• A fluid bag can be removed or loaded into the Pressure Chamber.

36 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

SE CTION 9

Operating Instructions
The Operating Instructions are grouped into five segments. Read through
each section BEFORE performing a procedure.

WARNINGS

• For use only with Smiths Medical supplied or approved parts,


accessories and Level 1® D/DI series Disposable Administration Sets
(Disposable Sets). The device will not function as intended with the
use of unapproved parts, accessories, or Disposable Sets resulting in
death or serious injury to the patient.

• When injecting medications into the fluid path, do not inject through
the triple-lumen tubing of the Level 1® D/DI-60HL Disposable Set.
This
may allow communication between the recirculating solution path
and I.V. fluid path, which could result in death or serious injury to
the patient.

• Replace Gas Vent/Filter Assembly (GV/FA) every three hours, or when


the filter becomes clogged, or when air is slowly vented. Failure to do
so will result in a reduction of flow rate. This may result in inadequate
patient treatment resulting in death or serious injury to the patient.

• Replacement Gas Vent/Filter Assembly must be fully primed before


continuing infusion. Failure to do so may allow air to be infused into
the patient resulting in death or serious injury to the patient.

• Grounding reliability can only be achieved when MAINS power cords


are connected to a properly grounded receptacle. Risk of electrical
shock exists if the equipment is not connected to a properly grounded
receptacle resulting in death or serious injury to the patient or user.

• Do not bend the heat exchanger. Bending may damage the heat
exchanger allowing communication between the recirculating solution
path and I.V. fluid path, resulting in the I.V. delivery of inappropriate
fluids which could result in death or serious injury to the patient.

• The Gas Vent/Filter Assembly (GV/FA) must be oriented properly in


the Detector Head. Failure to do so could result in air not venting
from the GV/FA which may cause the Air Detector/Clamp to mal-
function resulting in death or serious injury to the patient.

• The tubing must be properly placed in the Clamp Slot of the Air
Detector/Clamp. Failure to ensure that the tubing is correctly
positioned in the Clamp Slot may result in failure to stop air infusion
which may result in patient death or serious injury.

| Operator’s Manual 37
SECTIO N 9 • Operating Instruct io ns

9.1 Set Up for Use

WARNINGS

• Read and follow all instructions, labeling, and accompanying documents supplied
with this medical device. Failure to follow instructions, including all warnings and
cautions, could lead to misuse of the device or device malfunction.

• Disposable Sets are supplied with a sterile fluid path which may be compromised
if the caps are not in place. Do not use administration sets if luer and spike caps
are not securely in place, else flow path may not be sterile and may cause death
or serious injury to the patient.

• Disposable Sets are for single use only. To reduce the risk of cross contamination,
do not reuse Disposable Sets.

A—Install the Disposable Administration Set

The installation sequence for the Disposable Administration Set corresponds to the
numbered Blocks marked 1-2-3-4 on the Fluid Warmer.

Remove the Disposable Set from its packaging and review the Instructions for Use
provided. Do not remove spike caps or luer caps at this time.

1 Push the bottom end of the Heat Exchanger (a) [the end near the Gas Vent/Filter
Assembly] into #1 Block (b). Press the Heat Exchanger down firmly to properly seat
in the block.
Note: D/DI-60HL Disposable Sets require the Heat Exchanger to be placed with the
Patient Line extending to the left.

2 Slide #2 Block up (c). Snap Heat Exchanger into guide (d). Press firmly into place
to ensure it is properly seated. Slide #2 Block down (e), push down firmly to secure.

a e L 00
VE 10
LE TEM

a
S
SY

b
X
MA

38 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

3 Move the pinch clamp on the Patient Line to a point midway


between the Gas Vent/Filter and the luer connector. Close the pinch
clamp.
Note: Level 1® D/DI-60HL Disposable Sets do not have a pinch
clamp on the Patient Line. In this case, move the pinch clamp below
the Gas Vent/Filter Assembly (GV/FA) to a midway point between
the GV/FA and the luer connector. Then, close the pinch clamp.

4 Install the Gas Vent/Filter Assembly. Refer to the series of figures


on the left.

a Open the #3 Clamp Slot door by pushing down on tab, (a)


b and lifting up the front of the door (b).
b Pull the door down (c) and away from the Clamp Slot.
a c Insert the Patient Line in the Clamp Slot (d) and push
it back into the slot.
d Hold the Patient Line in the Clamp Slot and push the door
up (e) to engage the top hinge. Then push the front of the
door down to close it.
e Pull the Patient Line to the right (f) to align it in the Clamp
c Slot without kinking.
f Align the Gas Vent/Filter Assembly to the #4 Block, (g) and
press it into place.
H-3

d
e f g

B—Prime the Disposable Administration Set

1 Close the Disposable Set clamps above the Heat Exchanger.


• For D/DI-50, D/DI-60HL, D/DI-70 Disposable Sets,
– close pinch clamps below the bag spikes, and
– close roller clamp below the drip chamber (a).
• For D/DI-100, D/DI-300 Disposable Sets
– close ratchet clamps below the drip chambers.

2 Remove all air from the fluid bag:

a
a Invert solution bag.
b Use aseptic technique. Pierce membrane of bag port
with spike of Disposable Set. Then withdraw spike.
c Squeeze bag to exhaust ALL air.
d Place spike in bag port. Do not allow air to re-enter bag.

| Operator’s Manual 39
SECTIO N 9 • Operating Instruct io ns

3 Remove spike cap and insert spike into the port of an air-free
fluid bag. Repeat this step for each fluid line to be used.

4 Slide lever on H-2 Pressure Chamber to the minus (–)


unpressurized position.

5 Hang spiked fluid bag/s in Pressure Chamber:


a Release hinged latch, open door and hang fluid bag inside
on tab appropriate for bag size.
b Close the door and secure latch.
c Injection and Spike ports on the fluid bag should extend
from opening at the bottom of the Pressure Chambers
without being obstructed.
Note: When installing Level 1® D/DI-300 series Disposable Sets,
hang the third fluid bag from the I.V. pole.

CAUTIONS
• When loading fluid bags into H-2 Pressure Chambers,
choose a hanging hook that allows the bag port to hang
freely in the indented slot at the bottom of the chamber
door. If bag ports are positioned above this slot, diminished
flow could occur.
• Do not overextend I.V. pole; If I.V. pole is overextended the
Fluid Warmer may become unstable.

6 Open clamp above Drip Chamber on Level 1® D/DI-50, D/DI-60HL,


and D/DI-70 Disposable Administration Sets for each I.V. fluid bag
being used to prime the drip chamber.

7 Prime Drip Chamber by squeezing drip chamber until one-third


to one-half full of fluid.

Note: • D/DI-50, D/DI-60HL, D/DI-70 series use a single drip


chamber.
• D/DI-100 and D/DI-300 series use a separate drip chamber
for each spiked bag. The clamp is below the drip chamber.

8 Open remaining clamps above the Heat Exchanger. Fluid flows into
the Gas Vent/Filter Assembly (GV/FA).

9 Vigorously tap the Gas Vent/Filter Assembly to dislodge air bubbles


from filter screen.

10 Press the green Power ON button, located on the Power and Alarm
Test Panel, to turn ON the Fluid Warmer.

40 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

• The Air Detector/Clamp runs a Power ON Test.


• All Air Detector/Clamp indicator LEDs illuminate.
• The audible warning beeps.
• Upon completion of the Power On Test the Air Detector/Clamp
enters Operation mode with the Automatic Operation LED
illuminated.
• If the Disposable Set is incorrectly installed, the Fluid Warmer’s
Check Disposables attention indicator illuminates and the
audible attention signal beeps. Check the installation of the
Disposable Set following the directions provided in Section 6
Controls and Displays, on Interlocks.

C—Prime the Patient Line

1 Remove the male luer cap from the distal end of the Patient Line.

Note: On Level 1® D/DI-60HL Disposable Administration Sets


(D/DI-60 HL Disposable Sets), verify that no recirculating solution
comes out of the distal end of the Patient Line.

WARNING
If fluid exits in the Patient Line or the D/DI-60HL Disposable Set,
replace the Disposable Set.

2 Open the pinch clamp below the Gas Vent/Filter Assembly.

3 Allow fluid to flow until no air is observed in the Patient Line and
the line is primed with fluid. Then, close the pinch clamp, roller
clamp, or ratchet clamp on the Patient Line.
Note: On D/DI-60HL Disposable Sets close roller clamp below Drip
Chamber.

D—Test the Audible and Visual Alarms


Test the visual and audible alarm signals by performing the
following steps.

1 Press and hold the Alarm Test button on the Fluid Warmer’s
Power and Alarm Test Panel.
• All Fluid Warmer visual alarm LEDs illuminate
and the audible alarm signal beeps.

2 Release the Alarm Test button; the Over Temperature alarm


continues.

| Operator’s Manual 41
SECTIO N 9 • Operating Instruct io ns

3 Clear the Over Temperature alarm condition.


• Turn the Fluid Warmer OFF, then ON.
• The Air Detector/Clamp runs a Power On Test.
• The Air Detector/Clamp goes into Automatic
operation.

E—Test the Air Detector/Clamp

1 Slide the lever on the Pressure Chambers to the plus (+)


pressurized position to pressurize fluid delivery.

2 Move the top of the Gas Vent/Filter Assembly away from the Air H-3
1B

Detector sensor as shown.

3 The following occurs:


• The patient line clamp closes.
• The red Clamped indicator LED illuminates.
• The audible warning signal beeps.
• Fluid Warmer disposable alarm activates.

4 Open the pinch clamp, roller clamp, or ratchet clamp on the


Patient Line to verify that fluid does not flow.

5 Return to normal operation by pressing the top of the Gas


Vent/Filter Assembly back into the #4 Block. H-3
1B

6 The Air Detector/Clamp resumes Automatic Operation mode.


• The green Automatic Operation LED on the
Air Detector/Clamp Control Panel illuminates.

7 The Fluid Warmer is now ready for patient connection. Unclamp


Patient Line to begin infusion.
Note: On D/DI-60HL Disposable Sets open roller clamp below
drip chamber.

Conclusion

This concludes Section 9.1, Set Up for Use. Operators can proceed to
the next Section 9.2, Use of the Fluid Warmer.

42 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

WARNINGS

• Remove all air from fluid bags before connecting to patient.


Failure to do so can result in infusion of air into the patient
resulting in death or serious injury to the patient.

• Do not reuse partially full fluid bags. Fluid bags that have
been partially drained, un-spiked, and then reinstalled may
contain air, which if used can result in infusion of air into the
patient resulting in death or serious injury to the patient. Use
only new fluid bags from which the air has been removed.

• Do not leave the tubing in a closed Pinch Clamp for longer


than three hours, as this may cause tubing deformation that
could result in diminished flow resulting in patient death or
serious injury.

• Replace Gas Vent/Filter Assembly every three hours, or when


the filter becomes clogged, or when air is slowly vented.
Failure to do so will result in a reduction of flow rate. This
may result in inadequate patient treatment resulting in death
or serious injury to the patient.

• The Replacement Gas Vent/Filter Assembly must be fully


primed before continuing infusion. Failure to do so may
allow air to be infused into the patient which could result in
patient death or serious injury.

CAUTION

• When loading fluid bags into Pressure Chambers, choose a


hanging hook that allows the bag port to hang freely in the
indented slot at the bottom of the chamber door. If bag ports
are positioned above this slot, diminished flow could occur.

| Operator’s Manual 43
SECTIO N 9 • Operating Instruct io ns

9.2 Use of the Fluid Warmer

Use of the Fluid Warmer requires that the steps in Section 9.1, Set Up
for Use have been completed.

Overview
Use of the Fluid Warmer involves the following steps:
1—Load the Pressure Chambers
2—Pressurize the Pressure Chambers
3—Make patient connection, begin infusion
4—Replace Gas Vent/Filter Assembly
5—Change fluid bag

Step 1—Load the Pressure Chambers

a Turn the hinged latch on the right side of the Pressure Chamber
outward. Open the door.

b Hang a solution bag on the appropriate hanging hook inside the


door. The Pressure Chamber can hold bags of varying sizes.

• On the inside of the Pressure Chamber door are hooks for


bags smaller than 1000ml.
• On the top of the Pressure Chamber door are hooks
appropriate for 1000ml bags.
• Bags from different fluid manufacturers vary somewhat in
their dimensions.
• Choose a hanging hook that allows the bag drain port to
hang freely in the indented slot at the bottom of the
Pressure Chamber door.

c Close the door and secure side latch.

Step 2—Pressurize the Pressure Chambers

a Turn ON the Pressure Chamber by moving the lever


located at the top of the Pressure Chambers over to the plus (+)
pressurized position.

b Check gauge to ensure pressure of 280-300 mmHg is achieved.


• Pressure in the chambers is not adjustable.

Note: Power must be ON for the Pressure Chambers to operate.

44 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

WARNING!

Blood and blood products could contain pathogenic organisms.


Failure to follow Institutional policy and procedures for
biomedical-hazardous materials could lead to exposure to
harmful pathogens which could result in user death or serious
injury.

Step 3—Make Patient Connection

Make patient connection and begin infusion.

Step 4—Replace the Gas Vent/Filter Assembly

Replace the Gas Vent /Filter Assembly every 3 hours, when the
filter becomes clogged, or if air is venting slowly. Refer to Section
9.3, Replace the Gas Vent/Filter Assembly.

Step 5—Change the Fluid Bag

a Move the lever on the Pressure Chamber over to the


minus (–) unpressurized position. This will release the pressure in
the Pressure Chamber and deflate the bladder.

Close ratchet clamp under empty bag.

b Open door and remove the fluid bag from the Pressure Chamber.

c Remove the spike from the used fluid bag.

d Remove any air from the new fluid bag and spike the fluid bag.

e Hang the new fluid bag in the Pressure Chamber. Close and latch
the door.

f Move the lever on the Pressure Chamber over to the


plus (+) pressurized position to pressurize the chamber.

g Open ratchet clamp.

| Operator’s Manual 45
SECTIO N 9 • Operating Instruct io ns

9.3 Replace the Gas Vent/Filter Assembly

Use one of the following Gas Vent/Filters Assemblies:

• F-30 Filter with Gas Vent for D/DI-300 Disposable Sets


• F-10 Filter with Gas Vent for all other Fast Flow Disposable Sets

1 Close all clamps above and below the Gas Vent/Filter Assembly on
D-series Disposable Set and on new Gas Vent/Filter Assembly.

2 Turn the Fluid Warmer OFF.

3 Remove used Gas Vent/Filter Assembly while still connected to the


Disposable Set:
a Remove Gas Vent/Filter Assembly from the #4 Block.
b Open the #3 Clamp Slot door and remove the Patient Line from
the Clamp Slot.

4 Install the new Gas Vent/Filter Assembly:


a Open the Clamp Slot door.
b Insert outlet tube in the Clamp Slot.
c Close the Clamp Slot door.
d Align the outlet tube in the Clamp Slot without kinking.
e Press the Gas Vent/Filter Assembly into the #4 Block.

5 Using aseptic technique:


a Disconnect upper luer fitting from the used Gas Vent/Filter
Assembly.
b Remove upper luer end cap from new Gas Vent/Filter Assembly.
c Connect the Disposable Set to new Gas Vent/Filter Assembly inlet.

6 With Gas Vent/Filter Assembly clamped, open the clamp above Gas
Vent/Filter Assembly. The Gas Vent/Filter Assembly will self prime.

7 Turn power ON.

8 Remove the end cap on the outlet tube. Slowly release the outlet
tube clamp and allow outlet tube to fill completely.

9 Holding the used Gas Vent/Filter Assembly horizontally, disconnect


lower patient line luer lock. Connect used filter luer-lock fittings
together and discard.

10 Connect outlet tube luer lock to patient line.

11 Open clamps below the Gas Vent/Filter Assembly and resume


infusion.

46 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

9.4 Activated Alarms

Refer to Section 8, Operation for information on identifying Alarm states,


conditions that activate them, and methods for clearing Alarm states.

A. “Air Detected” Alarm mode

Detection of air in the Gas Vent/Filter Assembly results in the


following:

• The patient line is clamped off


• The red Clamped LED warning signal illuminates
• The audible warning signal beeps

WARNING!

Activation of the Air Detector/Clamp Alarm during infusion


indicates that fluid flow has stopped and that immediate
operator intervention is required to restore fluid flow. Failure to
reinstate flow (after purging any air or foam) may result in
patient death or serious injury.

B. Clear the “Air Detected” Alarm mode:

1 Close the following clamp/s:

• The clamp under the I.V. bag/s


• The clamp below or after the Gas Vent/Filter Assembly
• The Roller Clamp on the D/DI series Disposable Set

2 Remove pressure from the Pressure Chambers by moving the


lever to the minus (––) unpressurized position.

3 Inspect the entire circuit for the presence of air, locate the source of
the air, and correct this condition.

Note: Air or foam may have been vented through the Gas
Vent/Filter Assembly.

| Operator’s Manual 47
SECTIO N 9 • Operating Instruct io ns

4 Remove any remaining air from the circuit:


a Insert spike into an air-free bag/s of I.V. solution.
b Place the I.V. bag/s in the Pressure Chamber/s.
c Move the lever to the plus (+) pressurized position to
pressurize the Chamber/s.
d Prime the drip chamber/s and open the Disposable Set clamps
above the Gas Vent/Filter Assembly.
e Fluid flows freely through the tubing. Air in the I.V. line is
vented out through the Gas Vent/Filter Assembly. When air is
no longer present in the Gas Vent/Filter Assembly, the
Clamp opens and resumes automatic operation mode.

Note: If air is not freely vented, replace the Gas Vent/Filter


Assembly.

Refer to Section 9.3, Replace the Gas Vent/Filter Assembly.

5 If no warning signals are active, the Fluid Warmer with Air


Detection and Pressure Chambers is ready for use.

6 Open the remaining Disposable Set clamps, slowly open the


roller clamp, and reestablish fluid flow to the patient.

For more information on the following alarm conditions, refer to Section 8,


Operation:

• Over Temperature Alarm


• Check Disposables Alarm
• Check Tubing Alarm
• Add Recirculating Solution Alarm

48 | Operator’s Manual
S EC T I O N 9 • O p e ra t ing I ns t ruct i o n s

9.5 After Use

1 Discontinue infusion.

2 Turn the Fluid Warmer OFF.

3 Release chamber pressure before opening the Pressure Chamber


door:
a Move the lever to the minus (–) unpressurized position.
This will release the pressure in the chamber and
deflate the bladder.
b Open door and remove the fluid bag.

4 Remove the Disposable Set from the Fluid Warmer and the
Air Detector/Clamp Assembly.

5 Properly discard the Disposable Set in containers marked for


biohazardous materials. Dispose by incineration, or follow
hospital policies and procedures applicable for the disposal of bio-
hazardous material.

6 Visually check the condition of the device. Remove from service


any unit that shows physical damage.

7 Clean the device with warm soapy water.

| Operator’s Manual 49
SECTIO N 10 • Troubleshooting

SECTIO N 10

Troubleshooting
Only authorized personnel should perform any routine maintenance and
repairs to the Level 1® H-1200 Fast Flow Fluid Warmer.

The following two tables feature general troubleshooting information along


with slow flow rate troubleshooting.

General Troubleshooting Guide

Problem Check the following:

No Power Check to see if unit is plugged in and power is turned ON.


Be sure the unit is plugged into a working MAINS receptacle.

Disposables Check to see that the Heat Exchanger and Gas Vent/Filter
Alarm beeps Assembly are properly installed.

Add Recirculating Fill reservoir to the maximum reservoir level with recirculating
Solution Alarm solution.

Over - Press OFF button to clear alarm. Then, press ON button to


Temperature power on. If the Fluid Warmer continues to alarm, discontinue
Alarm beeps use of the medical device and remove from service. Contact
Smiths Medical or an authorized representative
for service.

Hot Cabinet Check the air inlet on the bottom of the unit. Remove any
blockage or dust to insure adequate air flow.

Heat Exchanger Lubricate O-Rings in #1 and #2 block heat exchanger sockets


hard to install with silicone lubricant. Silicone lubricant part # 80-04-002.

Loud Compressor Verify pneumatic tubing is fully seated into fittings.

LED doesn’t 1. Verify unit is plugged into MAINS.


light up during 2. If still no LED illumination, discontinue use of the medical
set up (on Fluid device and remove from service.
Warmer or Air
Detector/Clamp)

Tubing doesn’t fit Verify tubing is Level 1® D/DI series tubing.


in Air Detector/
Clamp

50 | Operator’s Manual
S EC T I O N 1 0 • Tro ub le s ho o t i n g

Slow Flow Rate Troubleshooting

Problem Check the following:

Pressure Chambers Verify the Fluid Warmer is ON.


not activated Verify the Pressure Chamber levers are fully in the plus (+),
pressurized position.
Verify pneumatic tubing is fully seated into fittings on the
Pressure Chambers and Fluid Warmer.

Blood develops Stored blood develops particulate. If blood is older


particulate than 5-7 days, consider using Level 1® PF-1 pre-filters.

Clogged filter Change Gas Vent/Filter Assembly if filter becomes


clogged.

Fluid bag not fully Make sure the membrane of the fluid bag port is fully
spiked or bag port pierced by the bag spike and that the neck of the bag port
twisted is not twisted.

Non-Level 1® bag 40 to 80 micron filters used between the bag port and
port filters the spikes of the Disposable Set may restrict flow. Consider
using Level 1® PF-1 pre-filters (340 micron).

Clamps partly Verify all clamps are fully open.


engaged

Clamps left in the Leaving clamps fully clamped for long periods will cause
clamped position the tubing to become deformed. Do not leave clamps
for long periods closed for extended periods of time.

Kinked tubing Verify that no tubing kinks are present.

Air trapped on filter Remove Gas Vent/Filter Assembly and tap against the
screen of Gas Vent/ cabinet of the Fluid Warmer to dislodge air bubbles,
Filter Assembly allowing them to vent. If this fails to correct problem, replace
with new Gas Vent/ Filter Assembly.

Non-high flow Use only extension lines with an inner diameter of


extension lines 0.103" (3.3mm) or larger, such as Level 1® X-36 or Y-30
extension sets.

Stopcock Use only Level 1® SC-3 (9 french inner diameter).

Small gauge needle Use large bore needles or catheters to maximize flow
or catheter rates.

| Operator’s Manual 51
SECTIO N 11 • Testing

SECTIO N 11

Testing
This unit should be tested by hospital biomedical personnel prior to placing it
in service. All testing and maintenance should be performed by qualified
personnel. If qualified personnel are not available, contact Smiths Medical. If
the Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer) and installed
accessories do not pass the tests, discontinue use of the medical device and
remove from service. Contact Smiths Medical or an authorized representative
for service. Testing requires a Level 1® Disposable Administration Set
(Disposable Set) to be installed in the Fluid Warmer.

Add Recirculating Solution Alarm

The Fluid Warmer is equipped with a float switch that senses the level
of the recirculating solution in the reservoir. When the solution level is
too low, an LED on the Display Panel illuminates and an audible alarm
beeps. In the Add Recirculating Solution Alarm mode, the circulating
pump is not running. With a Disposable Set in place and the unit
turned on, test the Add Recirculating Solution Alarm by draining the
solution until the level has dropped below the minimum reservoir level.
The Add Recirculating Solution Alarm should activate. To drain
recirculating solution from the Fluid Warmer, turn the drain valve, on
the bottom of the unit 90 degrees clockwise and allow some of the
recirculating solution to drain into a container.

Check Disposables Alarm

Five Interlocks detect the proper installation of an Disposable Set in the


Fluid Warmer. If a Disposable Set is not properly installed and the
power is ON, an indicator will illuminate and an audible alarm beeps.
With the Fluid Warmer ON, the Interlocks should be tested one at a
time by performing the following steps.

1 Top Heat Exchanger Socket – Slide the #2 Block up slowly. The


Check Disposables indicator will illuminate and the audible alarm
beeps.

2 Heat Exchanger Interlock – Gently pull on the middle of the heat


exchanger. The Check Disposables indicator will illuminate and the
audible alarm beeps.

52 | Operator’s Manual
S EC T I O N 1 1 • Te s t i n g

3 Gas Vent/Filter Assembly Interlock – Pull the top of the Gas


Vent/Filter Assembly from the #4 Block. The Check Disposables
indicator will illuminate and the audible alarm beeps.

4 #3 Check Tubing Interlock on the Air Detector/Clamp – Remove


the tubing from the Clamp Slot and close the door. The Check Tubing
alarm signal on the Air Detector/Clamp is activated and the audible
alarm beeps.

5 #3 Check Door Closed Interlock on the Air Detector/Clamp – With


tubing installed in the Clamp Slot, open the door. The Check Tubing
alarm signal on the Air Detector/Clamp is activated and the audible
alarm beeps.

Over Temperature Test


a
Do the following
1 Insure that the Fluid Warmer is at operating temperature (41°C).
2 Press and hold the Over Temperature Test button (a).
3 The Over Temperature LEDs illuminate, and an audible alarm
beeps.
4 Release the Over Temperature Test button.
5 Over Temperature LED and audible alarm signal remains active.

Clear the Alarm mode


1 Turn the Fluid Warmer OFF.
2 Turn the Fluid Warmer back ON.

Fluid Warmer Alarm Signal Test

The Alarm Test button is used to confirm proper operation of the visual
b and audible alarm indicators.

Do the following
1 Press and hold the Alarm Test button (b).
2 The LED illuminates, and an audible alarm beeps.
3 Release the Alarm Test button.
4 Over Temperature LED remains lit, and the audible alarm
continues to beep.

Clear the Alarm mode


1 Turn the Fluid Warmer OFF.
2 Turn the Fluid Warmer back ON.

| Operator’s Manual 53
SECTIO N 11 • Testing

Performance Testing

Cold Start Test


Store the Fluid Warmer unit in a room where the room temperature is
approximately 21°C (70°F).

1 Put a Disposable Set in place.


2 Record the start time.
3 Turn the Power button ON.
• The green system operational indicator illuminates.
• The Air Detector/Clamp goes through the Power ON Test.
• Rapidly rising numbers will appear on the recirculating solution
temperature display.
• Within 60 seconds (±) the display should read at least 30°C.
• In 3 to 10 minutes the display should read 41°C.
The Temperature Set Point is 41.7°C (+/– 0.3°C).
Note: If the Fluid Warmer does not pass the Cold Start Test, it should
be removed from use and returned to Smiths Medical or an authorized
representative for service.

Calibration Test
One approved way to confirm proper calibration of the recirculating
solution temperature is to use the Level 1® Thermal Calibration Well
(TCW) (Part Number 80-03-002). A replacement filter (F-10 or F-30)
must be in place to utilize the TCW.
Note: Use of the TCW requires a digital thermometer NIST traceable
and accurate within 0.1°C. Required probe size: 0.099" OD (Outside
Diameter) maximum (0.25 cm) 0.50" — 1.50" long (1.27—3.81cm).

Alternative Calibration Test H-3


1B

Another approved way to confirm proper calibration of the recirculating


solution temperature is to use the Level 1® DSTA-40 TEMPCHECK
(Part Number 80-01-004).

Calibration Test with DSTA-40


The DSTA-40 TEMPCHECK (DSTA-40) is an electronic thermometer
used to verify the recirculating solution operating temperature of the
Fluid Warmer. The DSTA-40 uses thermistor technology to sense the
temperature of the recirculating solution temperature for the Fluid
Warmer. The recirculating solution temperature is displayed by a liquid
crystal display (LCD). The DSTA-40 is powered from the auxiliary
outlet of the Fluid Warmer. No batteries are required.

Note: The Level 1® DSTA-40 TEMPCHECK is available for purchase


from Smiths Medical.

54 | Operator’s Manual
S EC T I O N 1 1 • Te s t i n g

Proper Calibration of Recirculating Solution Temperature


Confirm proper calibration of recirculating solution temperature by
performing the following steps:

1 Plug the DSTA-40 into the auxiliary outlet located on the


bottom of the Fluid Warmer.

2 Install the DSTA-40 in the heat exchanger position (#1 Block


and #2 Block).

3 Install a test filter in the #4 Block.

4 Turn the Fluid Warmer ON. Allow to warm up until the


DSTA-40 temperature display stabilizes.

5 Compare the DSTA-40 temperature display with the


temperature display on the Fluid Warmer’s Display Panel.

Note: The Fluid Warmer’s temperature display must read within


0.3°C of the Level 1® DSTA-40 TEMPCHECK display on a properly
calibrated unit.

If the DSTA-40 reads 41.7°C and the Fluid Warmer’s tempera-


ture display is within the range of 41.4°C-42.0°C, the calibration
is OK.

| Operator’s Manual 55
SECTIO N 11 • Testing

Periodic Electrical Testing

Earth Leakage

The Fluid Warmer must be tested in accordance with EN 60601-1.


The earth leakage current test should be performed with the immersion
heater circuit in the full ON condition; for this reason the leakage
current test should be performed on units which have room
temperature recirculating solution in the reservoir. Units not meeting
this standard should be returned to Smiths Medical or an authorized
representative for service.

Ground Continuity

The Fluid Warmer must be tested in accordance with EN 60601-1.

WARNING!

Grounding reliability can be achieved only when MAINS power


cords are connected to a properly grounded receptacle. Risk of
electrical shock exists if the equipment is not connected to a
properly grounded receptacle resulting in death or serious
injury to the patient or user.

56 | Operator’s Manual
S EC T I O N 1 2 • M a int e n a n c e

SE CTION 1 2

Maintenance
Only authorized personnel should perform any routine maintenance and
repairs to the Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer).
Maintenance is scheduled prior to each use, every 30 days, and annually. The
tasks are detailed below.

Note: If distilled water is used as the recirculating solution, change the


solution every 30 days. If a 0.3% hydrogen peroxide/distilled water
solution is used as the recirculating solution, change the solution
every 12 months, and during the 12 month period, always refill the
reservoir with a 0.3% hydrogen peroxide/distilled water solution.

Maintenance Performed Prior to Every Use

Clean and inspect the Fluid Warmer with Air Detector/Clamp and
Pressure Chambers after each use.

Clean the Exterior

• Clean the entire Fluid Warmer after every use. Use only mild
detergents, water, and a soft cloth.
• To disinfect external surfaces, use 10% bleach/distilled water solution.

General Inspection

• Check the condition of the Fluid Warmer with a visual inspection.


Remove from service any unit that shows physical damage.
• If the Disposable Set does not install easily, lubricate the O-Rings
as directed in the following section.

Maintenance Performed Every 30 Days

Lubricate O-Ring Seals

It is not necessary to disassemble the blocks to lubricate the O-Rings.

1 Place a small amount of silicone grease on a cotton swab.

2 Apply the silicone grease along the O-Rings in the bottom


#1 Block, and top #2 Block Heat Exchanger sockets.

| Operator’s Manual 57
SECTIO N 12 • Maintenanc e

Change Recirculating Solution with Distilled Water

1 Place a container under the drain valve of the Fluid Warmer.

2 Drain the recirculating solution by turning the drain valve


clockwise 90 degrees.

3 When all solution has drained from the reservoir, close


the drain valve.

4 Refill the reservoir with distilled water. The reservoir


holds 1.4 liters.

Maintenance Performed Every 12 Months

Disinfect the Reservoir

1 Place a container under the drain valve of the Fluid Warmer.

2 Drain the recirculating solution by turning the drain valve


clockwise 90 degrees.

3 When all solution has drained from the reservoir,


close the drain valve.

4 Remove the fill-port plug on the reservoir.

5 Prepare a 0.3% hydrogen peroxide/distilled water solution. Mix


140 ml of 3% hydrogen peroxide solution and 1,260 ml of
distilled water.

6 Fill the reservoir with 1.4 liters of 0.3% hydrogen


peroxide/distilled water solution.

7 Replace the fill-port plug.

8 Insert a Disposable Set into the Fluid Warmer.

9 Turn the Fluid Warmer ON. Let the solution circulate


for a 30-minute disinfection period.

10 Turn the Fluid Warmer OFF.

11 Empty the reservoir.

12 Remove the Disposable Set and discard according to established


hospital procedures

58 | Operator’s Manual
S EC T I O N 1 2 • M a int e n a n c e

Change Recirculating Solution with a 0.3% Hydrogen


Peroxide/Distilled Water Solution
1 Place a container under the drain valve of the Fluid Warmer.
2 Drain the recirculating solution by turning the drain valve
clockwise 90 degrees.
3 When all the solution has drained from the reservoir, close the
drain valve.
4 Prepare a 0.3% hydrogen peroxide/distilled water solution. Mix
140 ml of 3% hydrogen peroxide solution and 1,260 ml of
distilled water.
5 Fill the reservoir with 0.3% hydrogen peroxide/distilled water
solution. The reservoir holds 1.4 liters.
Change O-Rings
Change the O-Rings in the #1 Block and #2 Block.
1 Remove each O-Ring from its socket by pulling it out with a pair
of needle-nose pliers or by prying it out with a small screwdriver.
2 Lubricate the new O-Rings from the O-Ring Kit.
3 Press each O-Ring into its socket.
Clean Fan Filter
The Fan Filter (a) is located on the bottom of the Fluid Warmer. The fan
guard snaps in place.
X
1 Remove four screws and unsnap the fan guard from the bottom
of the unit.
a
2 Clean the filter with warm soapy water.
3 Replace the fan guard and filter.
Inspect Air Detector/Clamp
1 Check Clamp Cover Door for proper closure.
2 Check the Clamp Cover Door, Clamp Slot and Detector
Head for structural integrity.
Testing Fluid Warmer Operation
Perform all the tests described in the testing section of this manual.
See Section 11, Testing.
• Add Recirculating Solution Alarm
• Check Disposables Alarm
• Over Temperature Alarm
• Performance Testing

| Operator’s Manual 59
SECTIO N 12 • Maintenanc e

Maintenance and Calibration Log

All maintenance and testing should be done by qualified personnel.


Regularly scheduled maintenance ensures proper functioning of the
equipment. Refer to the table below for required tasks and frequency of
routine maintenance.

Scheduled Maintenance and Calibration Checklist

Task Every Use Every 30 Days Every 12 Months

Clean Exterior 9
General 9
Inspection

Change Distilled 9
Water

Lubricate O-Rings 9
Disinfect 9
Recirculating
Solution Reservoir

Change 0.3% 9
Hydrogen
Peroxide Solution

Replace O-Rings 9
Clean Fan Filter 9
Test Over 9
Temperature Alarm

Test Add 9
Recirculating
Solution Alarm

Test Disposable 9
Alarm

Test Fluid Warmer 9


Alarm Signal

Verify Temperature 9
Calibration

Electrical Safety 9
Tests

60 | Operator’s Manual
S EC T I O N 1 3 • L im it e d Wa rr a n t y

SE CTION 1 3

Limited Warranty
The Level 1® H-1200 Fast Flow Fluid Warmer (Fluid Warmer) and the
The Level 1® H-31, Version B, Air Detector/Clamp (Air
Detector/Clamp) are warranted by Smiths Medical ASD, Inc., (Smiths
Medical) to be free from defects in material or workmanship for a
period of 1 year (12 months) from the date of shipment to the customer.

If the customer finds any Fluid Warmer or Air Detector/Clamp to have


such defects during this period, it should be returned to the address
provided in the Service section of this manual. At the option of Smiths
Medical, the product will either be repaired or replaced by a new Fluid
Warmer or Air Detector/Clamp, and returned to the customer.
Provided Smiths Medical confirms that there were defects in the Fluid
Warmer or Air Detector/Clamp, Smiths Medical will also refund the
customer’s reasonable cost of returning the Fluid Warmer or Air
Detector/Clamp for repair.

This warranty will not apply in respect of any Fluid Warmer or Air
Detector/Clamp product which does not have its original serial number
plates intact. Nor will this warranty apply to any damage or defect
caused by misuse of the product, by careless or deliberate mistreatment
of the product, or by any impact to the product.

In no event will Smiths Medical or its distributors be liable for


consequential or economic loss incurred by the customer. The liability
of Smiths Medical and its distributors for any defect in the Fluid
Warmer or Air Detector/Clamp product will be limited to the invoice
value of the product.

This warranty does not affect any warranty or guarantee to which the
customer is irrevocably entitled by virtue of any applicable law. With
that proviso, this warranty replaces all other express or implied
warranties, representations, or indemnities to which the customer may
otherwise be entitled by virtue of any law, trade practice, or otherwise.

| Operator’s Manual 61
SECTIO N 14 • Servic e

SECTIO N 14

Service
All service must be performed by Smiths Medical or an authorized service
representative. Service by any other person or organization voids the warranty
and transfers liability for malfunctions of the device to the servicing
organization.

Warranty Service

Units received for repair which have not been obviously abused or
impact damaged and are still under warranty will be promptly repaired
and returned at no charge. See the limited warranty section of this
manual. A no-charge purchase order is requested for tracking.

Non-Warranty Work

Units received which have suffered obvious abuse or impact damage


and units no longer under warranty will be promptly inspected and a
verbal estimate of repair cost will be supplied. A purchase order will be
required from the hospital consistent with the verbal estimate. A
written estimate will be provided upon request.

Before returning your Level 1® H-1200 Fluid Warmer (Fluid Warmer)


or Level 1® H-31, Version B, Air Detector/Clamp for service, contact
Smiths Medical for Returned Goods Authorization. Be sure that ALL
recirculating solution is drained from the unit before packing the Fluid
Warmer for shipment.

Note: The Fluid Warmer must be cleaned and disinfected for


repair shipment or it will be immediately returned as received.

Additional Documentation

Upon request Smiths Medical will provide the following documentation:


• Circuit diagrams
• Components parts list(s)
• Description of function
• Service and calibration instructions

62 | Operator’s Manual
S EC T I O N 1 4 • S e r v i c e

Disposal Information

The Level 1® H-1200 Fast Flow Fluid Warmer contains lead that is used
in solder of electric assembly. When you are ready to dispose of the
device, observe federal, state, and local codes or requirements for
disposal of hazardous materials and for recycling of solid waste materials
that may impact the environment.

Service Contacts

Contact your Smiths Medical Technical Service Department or Smiths


Medical distributor at:

USA/ Canada

Smiths Medical ASD, Inc.


160 Weymouth Street
Rockland, MA 02370 USA

USA/Canada 1-800-258-5361
International +1-781-878-8011

European Representative

Smiths Medical International Ltd


Colonial Way, Watford,
Herts, WD24 4LG, UK

Tel +44 (0) 1923 246434


Fax +44 (0) 1923 240273

Australian Representative

Smiths Medical Australasia Pty. Ltd.


61 Brandl Street
Eight Mile Plains, QLD 4113, Australia

Tel +61 (0) 7 3340 1300


Fax +61 (0) 7 3340 1399

| Operator’s Manual 63
SECTIO N 15 • Spec if ic ations

SECTIO N 15

Specifications
System Specifications

Physical Measurement

Height, Overall 67 inches (1.7 m)


Width, Overall 20 inches (51 cm)
Depth, Overall 20 inches (51 cm)
Weight Assembled; Dry 63 pounds (28.5 kg)
Recirculating Solution Capacity 0.37 gallons (1.4 L)
Air Source Pressure 300 (294 ± 6) mm/Hg

Environmental Temperature Humidity [%]

Operation 10°C to 40°C 10 to 95


Transportation -18°C to 60°C 5 to 95
Storage 5°C to 40°C 5 to 95

Thermal
Temperature Set Point 41.7°C ± 0.3°C
Over Temperature Set Point 43.9°C ± 0.1°C

Electrical Type

Protection Against Electrical Shock Class I Equipment


Type BF Equipment

Mode of Operation Continuous

Type of Current Alternating

Ingress Protection Rating IPX1

MAINS Power Input (REF H-1200 115 V) 115 VAC, 60 Hz, 12 Amps
MAINS Power Input (REF H-1200 230 V) 230 VAC, 50 Hz, 6.3 Amps

Auxiliary MAINS Outlet (REF H-1200 115 V) 1.5 Amps


Auxiliary MAINS Outlet (REF H-1200 230 V) 0.75 Amps

64 | Operator’s Manual
S EC T I O N 1 5 • S p e cif ica t i o n s

Electromagnetic Environment Recommendations

Recommended separation distances between


portable and mobile RF communications equipment and the Level 1® H-1200 Fast Flow Fluid Warmer
The Fluid Warmer is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the Fluid Warmer can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the Fluid Warmer as recommended below, according
to the maximum output power of the communications equipment.
Rated maximum Separation distance according to frequency of transmitter m
output power
of transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2,5 GHz
W d=[3.5/V1]/P d=[3.5/E1]/P d=[7/E1]/P
.01 .116 .116 .233
.1 .368 .368 .737
1 1.16 1.16 2.33
10 3.69 3.69 7.38
100 11.66 11.66 23.33
For transmitters rated at a maximum output power not listed above, the recommended separation distance
d in metres (m) can be estimated using the equation applicable to the frequency of the transmitter, where P
is the maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.

Disposable Administration Set Specifications

D-50 / DI-50
Filter Size 170 Micron
Priming Volume 56 ml
System 1200 Normothermic (35 – 41°C)
Fluid Delivery Range
10°C Input: 40 ml/min. to 300 ml/min.
20°C Input: 40 ml/min. to 400 ml/min.
Maximum Flow Rate 500 ml/min.
(crystalloid, 300 mmHg, 14g catheter)

D-60 / DI-60HL
Filter Size 170 Micron
Priming Volume 74 ml
System 1200 Normothermic (35 – 41°C)
Fluid Delivery Range
10°C Input: 75 ml/hour to 530 ml/min.
20°C Input: 75 ml/hour to 530 ml/min.
Maximum Flow Rate 530 ml/min.
(crystalloid, 300 mmHg, 8.5 F catheter)

| Operator’s Manual 65
SECTIO N 15 • Spec if ic ations

Disposable Administration Set Specifications (continued)

D-70 / DI-70
Filter Size 170 Micron
Priming Volume 70 ml
System 1200 Normothermic (35 – 41°C)
Fluid Delivery Range
10°C Input: 50 ml/min. to 525 ml/min.
20°C Input: 30 ml/min. to 525 ml/min.
Maximum Flow Rate 590 ml/min.
(crystalloid, 300 mmHg, 14g catheter)

D-100 / DI-100
Filter Size 170 Micron
Priming Volume 65 ml
System 1200 Normothermic (35 – 41°C)
Fluid Delivery Range
10°C Input: 30 ml/min. to 650 ml/min.
20°C Input: 30 ml/min. to 950 ml/min.
Maximum Flow Rate 950 ml/min.
(crystalloid, 300 mmHg, 8.5 F catheter)

D-300 / DI-300
Filter Size 170 Micron
Priming Volume 90 ml
System 1200 Normothermic (35 – 41°C)
Fluid Delivery Range
10°C Input: 30 ml/min. to 650 ml/min.
20°C Input: 30 ml/min. to 1150 ml/min.
Maximum Flow Rate 1400 ml/min.
(crystalloid, 300 mmHg, 8.5 F catheter)

66 | Operator’s Manual
S EC T I O N 1 6 • S y mb o l s

SE CTION 1 6

Symbols
Symbol Meaning

Type BF Equipment

Protected Against Dripping Water

Catalog Number

Serial Number

PN Part Number

LOT Batch Code

Authorized Representative
in the European Community

Manufacturer

Date of Manufacture

Quantity

Protective Earth [Ground]

Alternating Current

Do Not Reuse

Attention, see instructions for use

| Operator’s Manual 67
SECTIO N 16 • Symbols

Symbol Meaning

Electrical Shock Hazard

Latex Free

Sterilised using ethylene oxide

Caution: Federal law (U.S.A.) restricts this device


to sale by or on the order of a physician.

CLASS 1 Device is a class type 1 equipment.

Protective earth terminal

Consult instructions for use

Do not use if package is damaged.


o
60 C
Temperature limitation
o
-18 C

Use by

Recyclable Product

Pressure Gauge

Pressurize

Unpressurize

Do not bend heat exchanger

68 | Operator’s Manual
S EC T I O N 1 6 • S y mb o l s

Symbol Meaning

Alarm Test

ON —Only for a part of the equipment.


MAINS are connected

OFF —Only for a part of the equipment.


The MAINS are still connected

Automatic Operation

Recirculating Solution Temperature

Over Temperature Test


(Recirculating Solution Over Temperature)

Add Recirculating Solution

Check Disposables, Check Tubing

Clamped

Maximum Reservoir Level

Minimum Reservoir Level

Device has been tested by National Technical


Systems, a nationally recognized technical lab, to
meet U.S. requirements for safety.

CE Mark and Notified Body number


0473
(0473 indicates AMTAC)

95%
% Humidity Limitation
5%

Collect separately for electrical and electronic


equipment.

| Operator’s Manual 69
In de x

A D M
Add Recirculating Solution indicator 23 Description 3 Maintenance 57
Add Recirculating Solution Mode 32 Air Detector/Clamp 3 Every 12 months 58
After Use 49 Disposable Administration Set 3 Every 30 days 57
Air Detected Alarm mode Fluid Warmer 3 Log/Schedule 60
Clear 47 Pressure Chambers 3 Prior to every use 57
Detected 47 Disinfect recirculating solution Modes of Operation 29
Air Detected/Clamped Mode 35 reservoir 58 Add Recirculating Solution Mode 32
Air Detection /Clamp During assembly 13 Air Detected/Clamped Mode 35
Description 3 Disposable Administration Set Alarm Test Mode 31
Principles of operation 19 Description 3 Automatic Operation Air
Air Detector/Clamp Control Panel 24 Install 38 Detector/Clamp 34
Alarm Test Mode 31 Prime 39 Check Disposables Mode 32
Alarms Disposal information 64 Check Tubing Mode 34
Add Recirculating Solution 32 Drain valve 11 OFF Mode 30
Air Detected 47 DSTA-040 calibration test 54 ON/Automatic Operation for Fluid
Air detected/Clamped 35 Warmer 30
Check Disposables 32 E Over Temperature Alarm Mode 33
Check Tubing 34 Electrical safety tests 17 Over Temperature Test Mode 31
Over Temperature 33 Electrical testing 56 Power ON Test for Air
Summary table 28 Electromagnetic Environment Detector/Clamp 33
Assembly instructions 9 Recommendations 65 Pressurized Mode 35
Disinfect recirculating solution Unpressurized Mode 36
reservoir 13 F
Fluid Warmer 9 Flanking brackets 12 O
H-31, B Air Detector/Clamp 16 Fluid Bag OFF Mode 30
Automatic Operation Air Detector/ Change 43 ON/Automatic Operation for Fluid
Clamp 34 Fluid Warmer Warmer 30
Automatic Operation indicator Description 3 Operating Instructions 37
Air Detector/Clamp 23 Principles of operation 19 Operation Display/Panel summary 28
Fluid Warmer 23 Fluid Warmer O-Rings
Description 3 Lubricate 57
B Use of 44 Over Temperature Alarm Mode 33
Button functions 22 Fluid Warmer Alarm Signal Test Over Temperature indicator 23
button 22 Over Temperature Test button 22
C Fluid Warmer Display Panel 23 Over Temperature Test Mode 31
Calibration of recirculating solution
temperature 55 G P
Change O-Rings 59 Ground continuity 56 Panels
Change recirculating solution Air Detection/Clamp Control 24
Distilled water 58 H Fluid Warmer Display 23
0.3% hydrogen peroxide/distilled H-31, B Air Detector/Clamp Power and Alarm Test 22
water solution 59 Assembly instructions 16 Pressure Chamber control 25
Check Disposables indicator 23 Performance testing 54
Check Disposables Mode 32 Pneumatic tubing 14
I
Check Tubing indicator 24 Power and Alarm Test Panel 22
Indications for use 4
Check Tubing Mode 34 Power OFF button 22
Interlocks for Disposable Set
Clamped indicator 24 Power ON button 22
installation 26
Clean fan filter 59 Power ON Test for Air Detector/Clamp 33
Clean the exterior 57 Pressure Chamber Control Panel 25
Components list 10
L Pressure Chambers
Log
Contraindications 5 Description 3
Maintenance and calibration 60
Controls and displays 21 Install 12
Lubricate O-Ring seals 57
Load for use 44
Pressurize for use 44
Principles of operation 19

70 | Operator’s Manual
I n d ex

Pressure gauge 25 S Check Disposables Alarm 52


Pressurize Pressure Chambers 44 Safety information 5 Electrical 56
Pressurize/Unpressurize lever 25 Service information 62 Fluid Warmer Alarm 53
Pressurized Mode 35 contacts 63 Ground continuity 56
Prime Set Up for use 38 Maintenance requirement 59
Disposable Administration Set 39 Specifications 64 Over Temperature test 53
Patient Line 41 Disposable Set 65 Performance 54
Principles of operation 19 system 64 Troubleshooting
Symbols 67 General 50
R Slow flow rate 51
Recirculating solution temperature T
calibration 54 TEMPCHECK calibration test 54 U
Recirculating Solution Temperature Temperature Unpressurized Mode 36
display 23 Display 23, 33
Replace Gas Vent/Filter Assembly 46 Test Air Detector/Clamp 42 W
Reservoir Capacity 22 Test Fluid Warmer Alarms 41 Warranty information 61
Reservoir level display 23 Testing 52
Add Recirculating Solution Alarm 52
Air Detector/Clamp 42

| Operator’s Manual 71
72 | Operator’s Manual

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