Professional Documents
Culture Documents
ANALYZER
OPERATION MANUAL
Instrument manufactured by
Sigma Amelung,
Lemgo, Germany
October 2001 EN
KC4 ∆™
Table of Contents
0
1 INTRODUCTION.................................................................................................... 1-1
1.1 INTENDED USE ................................................................................................. 1-1
1.2 PRINCIPLES OF OPERATION.............................................................................. 1-1
1.3 PHYSICAL SPECIFICATIONS .............................................................................. 1-2
1.4 PERFORMANCE SPECIFICATIONS ..................................................................... 1-3
1.5 PHYSICAL DESCRIPTION ................................................................................... 1-6
1.6 FRONT VIEW (FIGURE 1) ................................................................................... 1-7
1.7 KEYPAD (FIGURE 2)........................................................................................... 1-8
1.8 BACK VIEW (FIGURE 3) ..................................................................................... 1-9
1.9 MULTIPETTE (FIGURE 4 A & B) ....................................................................... 1-10
1.10 BALL DISPENSER (FIGURE 5) .......................................................................... 1-11
1.11 THERMAL PRINTER (FIGURE 6) ....................................................................... 1-11
1.12 PRINTER OPTIONS ........................................................................................... 1-12
2 INSTALLATION ..................................................................................................... 2-1
2.1 UNPACKING ....................................................................................................... 2-1
2.2 KC4 ∆™ COAGULATION ANALYZER START-UP KIT ............................................ 2-1
2.3 LOCATION REQUIREMENTS .............................................................................. 2-2
2.4 ELECTRICAL REQUIREMENTS .......................................................................... 2-2
2.5 PRELIMINARY CHECK OF THE INSTRUMENT OPERATION ................................ 2-3
3 GENERAL OPERATION ......................................................................................... 3-1
3.1 INSTRUMENT PREPARATION ............................................................................. 3-1
3.2 TEMPERATURE INDICATOR SCREEN ................................................................ 3-1
3.3 MAIN MENU FUNCTIONS ................................................................................... 3-2
3.4 PASSWORD MODIFICATION .............................................................................. 3-2
3.5 PROGRAM MODIFICATION ................................................................................ 3-3
3.6 REAGENT HANDLING ........................................................................................ 3-4
3.7 CUVETTE PREPARATION ................................................................................... 3-4
3.8 SAMPLE PREPARATION ..................................................................................... 3-5
3.9 PIPETTING ......................................................................................................... 3-6
3.10 TO DISPENSE SAMPLE ...................................................................................... 3-7
3.11 TO DISPENSE FIRST REAGENT ......................................................................... 3-8
3.12 TO DISPENSE START REAGENT ........................................................................ 3-9
3.13 SELECTING A TEST TO BEGIN A RUN ............................................................. 3-10
3.14 PATIENT IDENTIFICATION ............................................................................... 3-11
3.15 TESTING .......................................................................................................... 3-11
3.16 MANUAL START PROCEDURE ......................................................................... 3-12
3.17 AUTOMATIC START PROCEDURE .................................................................... 3-12
3.18 PRINTING RESULTS ......................................................................................... 3-13
4 MODE PROGRAMMING ......................................................................................... 4-1
4.1 ROUTINE PROGRAMMING ................................................................................. 4-1
4.2 EMERGENCY PROGRAMMING ........................................................................... 4-2
4.3 INDIVIDUAL PROGRAMMING ............................................................................. 4-3
Contents
Incubation Wells: 8
Reagent Wells: 5
Dimensions
Height: 12.0 cm
Width: 35.4 cm
Depth: 45.0 cm
Weight 6.3 kg
Power Supply
Voltage 110–220V/50–60 HZ
Power Consumption 1.5A at 100V; 0.4A at 220V
Temperature Control
Reagent Warming Wells: 37.0°C ± 0.5°C
Reaction Incubation Wells: 37.0°C ± 0.5°C
Measurement Wells: 37.0°C ± 0.5°C
Measurement Time
Minimum: 4.5 seconds
Maximum: 999.9 seconds
Activated Partial
Prothrombin Time Thromboplastin Time
Number of Samples 121 110
Correlation Coefficient (r) 0.998 0.896
Slope 1.051 1.235
Intercept –0.241 0.873
The following linear regression data was obtained during evaluation to show
equivalence with a commercially available photo-optical coagulation analyzer.
The following linear regression data was obtained in three physician’s office laboratories
(POL) during evaluation to show equivalence with manufacturer derived results on the
KC4 ∆™ Coagulation Analyzer.
Activated Partial
POL #1 Prothrombin Time Thromboplastin Time
Number of Samples 47 44
Correlation Coefficient (r) 0.991 0.960
Slope 0.981 1.066
Intercept 0.492 0.379
Activated Partial
POL #2 Prothrombin Time Thromboplastin Time
Number of Samples 45 46
Correlation Coefficient (r) 0.989 0.965
Slope 1.019 1.029
Intercept –0.248 1.021
PT total imprecision was evaluated in three physician’s office laboratories (POL) at three
levels according to NCCLS EP10-T protocol. Within-Run imprecision was evaluated in
three physician’s office laboratories at two levels.
APTT total imprecision was evaluated in three physician’s office laboratories (POL) at
three levels according to NCCLS EP10-T protocol. Within-Run imprecision was
evaluated in three physician’s office laboratories at two levels.
Precision: Fibrinogen
Imprecision was evaluated at three levels according to the NCCLS EP5-T2 protocol.
Low Mid High
Mean (mg/dl) 104.09 154.10 323.53
Total Imprecision (CV%) 3.53 6.21 4.36
Within-Run Imprecision (CV%) 2.05 2.86 2.12
Precision: Factor IX
Imprecision was evaluated at three levels according to the NCCLS EP5-T2 protocol.
Low Mid High
Mean (%) 24 49 98
Total Imprecision (CV%) 5.88 6.89 4.06
Within-Run Imprecision (CV%) 3.96 4.04 2.54
3
4
5
1
6
2
7
1 2 3 4 4 4 4 5
12
6
11
7 10 9
3.
4.
2. 1.
Combitip Multipette
4-A 4-B
Contents
17. Start timers by pressing the <START> key , followed by the individual well
timers . When all timers are showing 0.0, press and hold the <START>
key , while at the same time, depress the trigger switch on the Multipette 4
times. All wells should begin timing.
18. After at least 10 seconds, remove the cuvette rack from the rotating test
positions. Observe that the timers stop and are indicating the elapsed time in
seconds and tenths of seconds.
19. The first result will print automatically (if the optional printer has been
installed), or will appear on the screen. Press <↵> to print the second result,
and clear the memory.
With the completion of the Preliminary Checks of Instrument Operation, installation is
complete and the instrument is ready for operation. If the instrument fails to perform
any of the tests with the specifications listed, call Sigma Diagnostics Technical Service
for assistance.
Contents
3.15 TESTING...............................................................................................3-11
Sprachwahl.
Deutsch 1
Englisch *2
Franzoesisch 3
Italienisch 4
Niederlaendisch 5
Spanisch 6
Weiter mit Taste ENTER
S I G M A - A M E L U N G
KC 4 DELTA
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Press ↵ to continue
Password modify 1
Routine Program modify 2
Emergency Program modify 3
Individual Program modify 4
Delete all programs 5
Language modify 6
Press ↵ to continue
Parameter Check with Enter
Select 1, Password modify. Enter a new password, Press <↵>. The default password
for a new analyzer is 1 2 3 4.
Enter Password:
Press ↵ to continue.
Reagents for the appropriate test are prepared according to the manufacturer’s
instructions. Refer to the manufacturer’s reagent application for specific instructions
on preparation and handling of reagents. Any reagent requiring pre-heating should be
placed into a 15-mm tube and inserted into the reagent incubation well. The fluid level
in the tube should not be above the top edge of the incubation well. A minimum of
15 minutes will be required to warm reagent to 37°C ± 0.5°C. (Note: Reagents direct
from the refrigerator may take slightly longer to warm up.) All reagents should be
used before the expiration date listed by the manufacturer for each reagent. Do not
place any opened reagent bottles on the instrument.
3.9 Pipetting
The overall performance of the KC4 ∆™ Coagulation Analyzer is dependent on the
accuracy and precision of pipetting both sample and reagent(s).
Testing can be performed with either standard microliter pipette(s) or with the
Multipette fitted with a starting cable. When the Multipette is used to dispense the final
start reagent, the timer is automatically started simultaneously with reagent dispense.
When a standard microliter pipette is used for addition of the final start reagent, the
timer is started manually using the Specific Channel Key.
Regardless of what kind of pipette is used, the care taken with pipetting is directly
proportional to the overall accuracy and precision of testing.
To avoid contamination of reagents, if the same pipette is being used for both sample
and reagent, a new tip must be used when transitioning between sample and reagent.
To avoid cross-contamination between samples, a new tip should be used for each
sample, whether running plasma or whole blood samples.
Pipetting Technique for Non-Repeating Pipettes
To fill the pipette tip: Depress the button to the first stop. With the button depressed,
insert the tip into the sample or reagent to a depth of approximately 2–3 mm. If
pipetting plasma directly from a centrifuged tube of blood, the tip should be kept well
away from the blood/plasma interface. This will assure that no red cells or platelets will
be aspirated into the tip. If pipetting a particulate reagent, the reagent should be well
mixed prior to aspiration.
Release the button slowly in such a manner that the sample or reagent flows smoothly
into the pipette tip. Slow aspiration will assure that the volume aspirated into the tip is
accurate. If the button is allowed to snap back, an incorrect volume may be aspirated.
In addition, sample or reagent can be aspirated into the barrel of the pipette. This can
result in contamination of subsequent samples or reagents. Unless the pipette is
dismantled and cleaned, inadvertent aspiration into the pipette barrel will result in
eventual obstruction and incorrect operation of the pipette.
Once the tip is filled, no dripping should be observed. If dripping is observed, either the
tip is not seated correctly on the pipette or the pipette requires maintenance. In such a
circumstance, replace the tip. If this does not correct the problem, the pipette should
not be used until maintenance can be performed.
Pipetting Technique for Multipettes
Only pipette tips recommended for use with the pipette should be used. Any pipette tip
whose insertion opening is out-of-round should be discarded. Any pipette tips that are
bent or otherwise damaged should be discarded. The tip opening must not be occluded.
Slide the filling lever down until it stops, then raise the locking clamp upward.
Insert the combitip until it clicks into position. Be sure the combitip plunger is fully
inserted into the barrel before attaching it to the Multipette. Be sure the filling lever is
completely down and then lower the locking clamp to secure the combitip in place.
Position 1 2 3 4
Inc. Time 0 0 0 0
Meas. Time 0 0 0 0
Start Inc.
Ready
1 2 3 4
The upper left shows the current patient ID and the upper right shows the temperature
of the measuring block in °C.
<MENU> Accesses up Main Menu functions.
<RUN> accesses the Program Menu.
Select 1 Routine Program. Select number of samples per rack, press < ↵ >.
Enter the Patient ID, press < ↵>. The analyzer will display the first test programmed
into the Routine Program (see Section 4). For example, if INR, APTT and FIB are in
the Routine Program, then the first test to be performed will be INR. INR will
appear in the upper right corner of the Operating Screen (replacing the
temperature). To scroll to the next test in the program (ie. APTT), press < ↵>. Enter
the number of samples per rack, press < ↵>. The next test in the program (APTT),
will appear in the upper right corner of the Operating Screen. To end the program,
press <RUN>.
Select 2 Emergency Program. Enter Patient ID, press < ↵>. The first test
programmed in the Emergency Program will appear in the upper right corner of the
Operating Screen. Only one sample at a time can be run in the Emergency
Program. At the end of the first test, the result will be displayed. Record the result,
Press < ↵> to scroll to the next test in the program. To end the program, press
<RUN>.
Select 3 Individual Program. A grid of available tests programmed into the
Individual Program will be displayed (see section 4). Select a test by pressing the
test Function Key. For example, INR, APTT and FIB are displayed on the grid. To
begin INR testing, press the INR key. Press < ↵>. Enter number of samples per rack,
press < ↵>; enter Patient ID, press < ↵>. INR will be displayed in the upper right
corner, and the Patient ID will be displayed in the upper left corner of the Operating
Screen.
ROUTINE PROGRAM
Patient ID:
Start Patient ID Modify 1
Manual Patient ID 2
Press ↵ to Continue
3.15 Testing
1. With the transfer of the first rack to the rotating wells, Press Incubation timer:
Operating Screen
Patient ID: 333 INR
Position 1 2 3 4
Inc. Time 0 0 0 0
READY
Contents
Password Screen
Enter Password, press Enter Password:
ENTER <↵>.
Press ↵ to continue.
Modify Screen
Password Modify 1
Routine Program Modify 2
Routine Program
Tests
Select from the keypad all tests In Routine Program
desired for this group. When INR APTT FIB
complete, press ENTER <↵>.
New entry press ENTER to store
Press ESC to cancel
Programming Screen
Password Modify 1
Tests programmed will cycle, Routine Program Modify 2
allowing parameter changes to be Emergency Program Modify 3
made.
Individual Program Modify 4
See Section 5 regarding Delete all programs 5
programming tests.
Press ENTER to continue
Password Screen
Enter Password, press ENTER <↵> Enter Password:
to continue.
Press ↵ to continue.
Modify Screen
Password Modify 1
Routine Program Modify 2
Emergency Screen
Tests
Choose tests from the keypad for In Emergency program
this group. When complete, press INR APTT FIB
ENTER <↵>.
New entry press ENTER to store
Press ESC to cancel
Programming Screen
S I G M A - A M E L U N G
Tests will cycle allowing for KC 4 DELTA
Parameter changes to be made. DATE: 12 Sep 2001 1
See Section 5 for programming TIME: 10 : 08 2
changes. PROGRAM SELECTION 3
PRINT PARAMETERS 4
Password Screen
Enter Password:
Enter Password, press ENTER<↵>.
Press ↵ to continue.
Modify Screen
Password Modify 1
Routine Program Modify 2
Individual Screen
Tests
Choose tests from the keypad for this In Individual Programming
group. When complete, press INR APTT FIB
ENTER <↵>.
New entry press ENTER to store
Press ESC to cancel
Programming Screen
Password Modify 1
When complete, press ENTER <↵>. Routine Program Modify 2
Tests will cycle for parameter Emergency Program Modify 3
changes.
Individual Program Modify 4
See Section 5 for programming Delete all programs 5
information.
Press ENTER to continue
Contents
5.10 FACTORS..............................................................................................5-16
S I G M A - A M E L U N G
KC 4 DELTA
DATE: 12 Sep 2001 1
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Prior to testing, a Test Program or profile needs to be established. The three programs
available are discussed in Section 4. The Individual Program will be used here.
The KC4 ∆™ will automatically calculate the INR using the programmed values entered
for the mean of the Reference Range and the ISI value for the thromboplastin in use.
* Prior to entering values, a reference range should be determined for the lot number of
thromboplastin that will be used. Because PT reference ranges can vary between
laboratories and between different reagent formulations, determination of the reference
range on the population being served is recommended. For accurate INR reporting, the
determination of the geometric mean is recommended. When the geometric mean has
been determined, values may be programmed into the KC4 ∆™.
Default Value :
ISI-Value : New entry press ↵ to store
Press ESC to continue
Modify? No 2
Program INR
Yes 1
Default value:
Press ↵ to continue
Program INR
ISI-Value:
Program INR:
Incubation Time (sec) : 60
Default Value : 12,2
INR – Program ISI-Value : 1.78
Double Test?
Yes 1 No 2
Modify? Yes 1 No 2
Press ↵ to continue
NEXT TEST
S I G M A - A M E L U N G
KC 4 DELTA
DATE: 12 Sep 2001 1
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Prior to testing, a Test Program or profile needs to be established. The three programs
available are discussed in Section 4. The Individual Program will be used here.
3. Press <↵>.
15. Enter the third value of the PT calibration curve. Program PT:
The third point, the lowest point of the curve is a
Incubation Time (sec) : 60
dilution of the reference plasma.
Example: 12.5% is used: Calibration Curve PT : ?
Point 1 (%) : 100
16. Enter the clotting time in seconds of the third
point of the PT calibration curve. (sec) : 12
Point 2 (%) : 30
17. Enter the Maximum % PT value.
Values exceeding maximum value (sec) : 27
18. Select No (2), when modification is complete. The cycle will return to the MAIN
MENU when all modifications are complete.
Program PT:
NEXT TEST
Incubation Time (sec) : ?
Calibration Curve PT : ?
Program PT:
Point 1 (%) : ?
Incubation Time (sec) : 60
(sec) : ?
Calibration Curve PT : ?
Point 2 (%) : ?
Point 1 (%) : 100
(sec) : ?
(sec) : 12
Point 3 (%) : ?
Point 2 (%) : 30
(sec) : ?
(sec) : 27
PT MAX % : ?
Point 3 (%) : 12.5
Difference Check PT : No
(sec) : 62
Modify? Yes 1 No 2
PT MAX % : 130
Max. Difference (%) : 10
Modify? Yes 1 No 2
PT – Program
Double Test?
Yes 1 No 2
PT – Program
Double Test?
Yes 1 No 2
Difference Check: No
Press ↵ to continue
Program RATIO
Double Test?
Yes 1 No 2
New entry press ↵ to store
Press ESC to continue
Max. Difference (%): ?
Press ↵ to continue
Press ESC to continue
Program RATIO
Default Value:
RATIO – Program
Max. Difference (%): 5%
Double Test?
Yes 1 No 2
RATIO: No
Modify? Yes 1 No 2
Max. Difference (%):
NEXT TEST
Press ↵ to continue
S I G M A - A M E L U N G
KC 4 DELTA
DATE: 12 Sep 2001 1
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Prior to testing, a Test Program or profile needs to be established. The three programs
available are discussed in Section 4. The Individual Program will be used here.
Modify? Yes 1 No 2
PTT – program
Double Test?
Program – PTT
Yes 1 No 2
Incubation time (sec): 240
Max. Difference(%): ?
Press ↵ to continue
Max. Difference (sec): 10
Modify? Yes 1 No 2
Max. Difference(%): ?
PTT – program
Double Test?
Yes 1 No 2
Difference Check: No
Press ↵ to continue
S I G M A - A M E L U N G
KC 4 DELTA
DATE: 12 Sep 2001 1
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Prior to testing, the test must be programmed into a testing format as discussed in
Section 4. The Individual Program will be used here.
Press ↵ to continue
13. Enter the clotting time in seconds for the first point of the Fibrinogen reference
curve.
14. Enter the second value for the Fibrinogen reference curve. The second point is a
dilution of the reference plasma.
15. Enter the clotting time in seconds for the second point of the Fibrinogen reference
curve.
16. Enter the third value for the Fibrinogen reference curve. The third point is a
dilution of the reference plasma.
17. Enter the clotting time in seconds for the third point of the Fibrinogen reference
curve.
18. Enter the fourth value of the Fibrinogen reference curve. The fourth point is a
dilution of the reference plasma.
19. Enter the clotting time in seconds for the fourth point of the Fibrinogen reference
curve.
20. Enter the fifth value of the Fibrinogen reference curve. The fifth point is a dilution
of the reference plasma.
21. Enter the clotting time in seconds for the fifth point of the Fibrinogen reference
curve.
22. Enter the dilution for the patient or control samples to be analyzed. Fibrinogens
use a 5 point reference curve.
23. Select No (2) when modifications are complete. The cycle will return to the Main
Menu when all modifications are complete.
Note: Suggested dilutions and volumes used are found in the KC4 ∆™ Fibrinogen
Application.
Point 3 (G/L) :
(sec) : New entry press ↵ to store
NEXT TEST
S I G M A - A M E L U N G
KC 4 DELTA
DATE: 12 Sep 2001 1
TIME: 10 : 08 2
PROGRAM SELECTION 3
PRINT PARAMETERS 4
Prior to testing, a Test Program or profile needs to be established. The three programs
available are discussed in Section 4. The Individual Program will be used here.
Max. Difference: ?
Press ↵ to continue
Max. Difference: ?
Press ↵ to continue
FAC – Program
NEXT TEST
Double Test?
Yes 1 No 2
Difference Check: No
Press ENTER ↵ to continue
Regularly performed quality control is the best monitor of test performance. To assure
that control and unknown sample results are evaluated under the same test conditions,
control material should be included with each run.
The reagent manufacturer's QC recommendations should be used as a guide for
establishing a QC protocol. Control results deviating from established ranges are
indicative of a system failure and should be investigated immediately. The more
common sources of error and the corrective action to take are presented in the
Troubleshooting section, Section 8.
Introduction
There is no routine mechanical maintenance associated with the KC4 ∆™. The KC4 ∆™
was factory calibrated for rotational speed, magnetic sensor strength and temperature.
General housekeeping is the only maintenance that need be performed with any
regularity. Occasional cleaning with a damp paper towel is recommended to remove
accumulated dust or other material. Spills should be cleaned up as they occur.
Reagents can be corrosive and any spillage into the reagent incubation well should be
cleaned up immediately. All sample spills should be considered to have created a
potentially biohazardous environment and should be cleaned up immediately using
appropriate safeguards to avoid personal contamination. If decontamination is
required, wipe area with a paper towel moistened with a mild disinfectant.
Any balls that inadvertently find their way into the bottom of any of the wells can be
removed using a magnet.
Contents
Contents
A.7 INTRINSIC FACTORS VIII, IX, XI AND XII FAST TRACK ......................... A-7
Note: Use the Multipette. See Section 5 for information regarding programming.
14. Press to prepare Incubation Timers and then press for each channel with
sample in cuvette.
15. Upon completion of incubation Timing for the last well being tested, place rack into
rotating test positions, and open Flap.
16. Press <START> and begin dispensing PT reagent into wells. With the Multipette,
the timer starts automatically as reagent is dispensed.
17. Record results.
Note: Use the Multipette. See Section 5 for information regarding specific
programming.
14. Press to prepare Incubation Timers and then press for each channel with
sample in cuvette.
15. At 185 seconds add 50 µl APTT reagent.
16. Upon completion of incubation Timing for the last well being tested, place rack into
rotating test positions, and open flap.
17. Press <START>. Begin dispensing 50 µl CaCl2 into cuvettes. Using the Multipette,
measurement timing begins automatically.
18. Record results.
Note: Use the Multipette. See Section 5 for information regarding programming.
14. Press to prepare Incubation Timers and then press for each channel with
sample in cuvette.
15. Upon completion of incubation timing for the last well being tested place rack into
rotating test positins, and open flap.
16. Press <START> and begin dispensing 100 µl Thrombin Reagent into each well.
Using the Multipette, the timer starts automatically as reagent is dispensed.
17. Record results.
Note: Use the Multipette. See Section 5 for information regarding programming.
15. Press to prepare Incubation Timers and then press for each channel with
sample in cuvette.
16. Upon completion of incubation timing for the last well being tested, place rack into
rotating test positions, and open flap.
17. Press <START> and begin dispensing 100 µl thromboplastin into each well.
Using the Multipette, the timer starts automatically as reagent is dispensed.
18. Record results.
Note: Use the Multipette. See Section 5 for information regarding programming.
16. Press to prepare Incubation Timers and then press for each channel with
sample in cuvette.
17. At 185 seconds add 50 µl APTT reagent.
18. Upon completion of incubation timing for the last well being tested, place rack into
rotating test positions, and open flap.
19. Press <START>. Begin dispensing 50 µl CaCl2 into cuvettes. Using the Multipette,
measurement timing begins automatically.
20. Record results.