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Evaluation of Mechanical and Electrical Faults in Dialysis Machines

Article in Journal of Physical Therapy and Health Promotion · December 2013

DOI: 10.18005/PTHP0101001

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Journal of Physical Therapy and Health Promotion Dec 2013, Vol. 1 Iss. 1, PP. 1-7

Evaluation of Mechanical and Electrical Faults in

Dialysis Machines
Alnazier O. Hamza1, 2, Mohammed O. Osman2, 3, Mohamed O. Khider1
1
Department of Biomedical Engineering, University of Medical Sciences and Technology, Khartoum, Sudan
2
Department of Biomedical Engineering, Sudan University of Science and Technology, Khartoum, Sudan
3
National Blood Transfusion Centre (NBTC), Federal Ministry of Health, Khartoum, Sudan
alnazier_67@hotmail.com; mohammedomer121@gmail.com; birreema25@hotmail.com

Abstract- This research is aimed to study the mechanical and electrical faults in dialysis machines, depending on four types of dialysis
machines (Fresenius - B. Braun - Gambro – NIPRO).
The objectives of this research are to determine the causes of these faults, their best solutions and how to prevent them in future.
To verify these faults visual inspection and maintenance reports were taken into account in 80 dialysis machines in 11 dialysis
centres in Khartoum state, Sudan. It was found out that these faults were due to five causes. These causes were machine pumps,
power supply, conductivity, transducers, sensors and pressure failures.
The mean of all faults is 21.80 and standard deviation is 3.96. The maximum mean of causes was found in power supply failure
and minimum mean was found in pressure causes. The maximum standard deviation of causes was found in power failures and
minimum was found in transducers and sensors failures, so the impact of the values was found homogeneous in transducers and
sensors failures.
Keywords- Mechanical Faults; Electrical Faults; Urinary system; Homeostasis; Dialysis Machine; Conductivity; Electrolyte
Concentrations

I. INTRODUCTION

More than 500 individuals, per million populations, per year, reach end stage renal failure in the Sudan [1]. Dialysis care is
particularly complex and multiple factors may influence patient survival [2]. The cost of such treatment for end stage kidney
disease is high and needs attention for reducing it. Individual patient survival may depend on an intricate interrelationship
between various demographic and clinical variables, medications, medical interventions and the dialysis treatment prescription
[2]. The urinary system plays a vital part in maintaining homeostasis of water and electrolyte concentrations within the body.
The kidneys produce urine that contains metabolic waste products, including the nitrogenous compounds urea and uric acid,
excess ions and some drugs [3]. The kidneys also maintain stability of the extra-cellular fluid volume by adjusting excretion of
water and electrolytes to balance changes in intake. Chronic renal failure occurs when the kidneys are operating at less than 50%
of normal capacity [4]. End-stage renal disease occurs when the kidneys are working at less than 10%-15% of normal capacity
[4, 5]. At this stage, either transplantation or repetitive kidney dialysis becomes necessary for survival [6].

II. DIALYSIS MACHINE

A dialysis machine works to filter a patient's blood. This process includes the removal of impurities and excess water.
Using an artificial vein in the forearm, blood is drawn from the patient into the dialysis machine through tubing. Then, the
purified blood is taken back through tubing to the patient's vein. Routine dialysis can be done at a hospital, clinic, or at home.
Patients typically perform this dialysis two to three times per week [7].
Various alarms built into the system can indicate impending or ongoing system malfunction. Alarms should never be taken
carelessly and disarming of alarms should never be practiced. The range and sensitivity of the alarms should be internally set
as default and the operator should only be able to operate within the set range without being able to alter these settings,
especially while the machine is in progress. Alarms should be not only visible (2 m) but also easily audible (70 dB). All blood
alarms [air detector, arterial, venous, blood leak, trans-membrane pressure, and blood pump torque] should automatically shut
off the blood pump, clamp the venous return line, and stop Ultra filtration, thus isolating the patient from the dialysis machine.
This does not correct the operational characteristics that set off the alarm in the first place, however. Properly trained nurses
who take active (and proactive) action to correct the malfunction are always the ultimate backup to ensure patient safety [8].
These procedures must be taken in account to ensure the patient safety in case of the machine malfunctions.

III. METHODOLOGY

A. Study Approach
This research was conducted to evaluate the mechanical and electrical faults in dialysis machines using daily hospitals

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reports in dialysis centres in Khartoum state, Sudan.

B. Study Design
Dialysis centres in Khartoum state in four models of dialysis machines are Fresenius, B. Braun, Gambro and NIPRO.
The electrical and mechanical faults include:
 Conductivity problems.
 Pressure problems.
 Sensors and transducers problems.
 Power supply problems.
 Pumps problems.

C. Methods of Data Collection

Visual Inspection of the machine was used to obtain initial information about the dialysis machines and their electrical and
mechanical faults of these machines.
Visual inspection will assist to gather information about:
 Water treatment system.
 General information about the dialysis centre.
 The electrical and mechanical faults of dialysis machines.

D. Data Analysis
After collecting the required data, a number of evaluation and statistical tests have been completed. To accomplish these
tests Microsoft excel and Statistical Package for the Social Sciences (SPSS) computer softwares are used for data presentation
and analysis process.

IV. RESULTS AND DISCUSSIONS

The number of machines which have mechanical and electrical faults in dialysis centres was found to be 80 machines. A
comprehensive analysis was made to find mechanical and electrical of these faults which are shown in Table 1 and illustrated
in Fig. 1. The SPSS analysis is shown in Table 2.
TABLE 1 MECHANICAL AND ELECTRICAL FAULTS IN 80 DIALYSIS MACHINES IN KHARTOUM STATE

Fault No. of machines having the fault %

from the 80 machines
Conductivity 18 from 80 22.5
Pressure 19 from 80 23.75
Pumps 27 from 80 33.75
Power 25 from 80 31.25
Transducers and Sensors 20 from 80 25

Fig. 1 Mechanical and electrical faults in 80 dialysis machines in Khartoum state

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TABLE 2 THE SPSS ANALYSIS

Mean 21.800
Standard deviation 3.69

The main faults in dialysis machines can be classified into two main parts:
 Mechanical faults.
 Electrical faults.
Mechanical faults can be divided into three common types:
 Conductivity faults.
 Pressure faults.
 Pumps faults.
The electrical faults on the other hand can be divided into two common types:
 Power faults.
 Transducers and sensors faults.

A. Conductivity Faults
The number of machines which have faults in conductivity was found to be 18 machines. A comprehensive analysis was
made to find the causes of this fault which are illustrated in Table 3 and presented in Fig. 2. The SPSS analysis is shown in
Table 4.
Some causes of conductivity faults are:
 Machine pumps malfunction which is due to long period of operation i.e. the preparation of the dialysis solution takes
about four hours per session.
 Bad solution and this can be caused by the improper acid concentration.
 Temperature and conductivity transducers suffer from faults that occur when temperature and conductivity transducers
are not calibrated.
TABLE 3 CAUSES OF CONDUCTIVITY FAULTS

Cause Number of machines %

Bad solution 6 33.3
Temperature faults 2 11.1
Pumps malfunction 8 44.5
Non calibrated 2 11.1
transducer
Total 18 100

No of machines

Conductivity faults

Fig. 2 Causes of conductivity faults distribution in 18 dialysis machines

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TABLE 4 THE SPSS ANALYSIS

Mean 4.5
Standard deviation 3.0

From the results shown, we can see that the dominant causes of conductivity faults are bad solution and pumps failure
faults.

B. Pressure Faults
The number of machines which have faults in pressure was found to be 19 machines. A comprehensive analysis was made
to find the causes of these faults in pressure which are shown in Table 5 and Fig. 3. The SPSS analysis is shown in Table 6.
Common causes are:
 Filters and valves; sometimes the filters are stuck by wastes and valves failure can be due to high electric current.
 Leakage; this is due to overheat which causes pressure fault.
 Pumps when the pressure of pumps is not calibrated pressure fault can occur.
 Pressure transducers if are not calibrated or the calibration is not proper, pressure fault occurs.
TABLE 5 CAUSES OF PRESSURE FAULTS

Cause Number of machines %

Non calibrated pressure transducers 2 10.5
Filters and valves wastes 7 36.8
Non calibrated pumps 4 21.1
Transducer failure 1 5.3
Fluids leakage 5 26.3
Total 19 100

No of machines

Pressure faults

Fig. 3 Causes of pressure faults distribution in 19 dialysis machines

TABLE 6 THE SPSS ANALYSIS

Mean 3.8
Standard deviation 2.38
From the above results, the most common causes of pressure faults are filters and valves failures.

C. Pumps Faults
The number of machines which have pumps faults was 27 machines. A comprehensive analysis was made to find the
causes of these faults in pumps which are shown in Table 7 and illustrated in Fig. 4. The SPSS analysis is shown in Table 8.
Pumps faults causes can be classified into:
 Brush defect due to longer brush operation.
 Gear erosion; this can happen because of longer brush operation.
 Pumps stuck as a result of bad solution or no proper disinfection of machine after dialysis sessions.

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 Over heat which leads to tubes detaching and leakage into pumps and so pump defect occurs.
 Belt defect in blood pumps caused by long operation period or calibration procedures are not made.
TABLE 7 CAUSES OF PUMPS FAULTS

Cause Number of machines %

Brush defect 6 22.2
Gear defect 4 14.8
Stuck in Pumps 8 29.7
Over heat 2 7.4
Blood pump belt defect 7 25.9
Total 27 100

No of machines

Pumps faults

Fig. 4 Causes of Pumps faults distribution in 27 dialysis machines

TABLE 8 THE SPSS ANALYSIS

Mean 5.40
Standard deviation 2.40

D. Power Faults
The number of machines which have faults in power was found to be 25 machines. A comprehensive analysis was made to
find the causes of these faults in power which are shown in Table 9 and Fig. 5. The SPSS analysis is shown in Table 10.
Causes of power faults can be:
 High current which is common fault in power and it is due to instability of the electric current from the main electricity
supply.
 High temperature; that is when the word temperature is above 29℃ a power fault may occur.
 Fluid spills in the machine which could make a short circuit and a power fault occur.
 Software defects due to:
o Mobile telephone electromagnetic waves.

o The installed software is not matched with the machine.

TABLE 9 CAUSES OF POWER FAULTS

Cause Number of machines %

High current 15 60
Software defect 1 4
High temperature 5 20
Fluid spilling in the
4 16
machine
Total 25 100

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No of Machines

Power faults

Fig. 5 Causes of power faults distribution in 25 dialysis machines

TABLE 10 THE SPSS ANALYSIS

Mean 6.20
Standard deviation 6.075

From the above results, the most common cause of power faults is high current cause.

E. Transducers and Sensor Faults

The number of machines which have faults in transducers and sensors was found to be 20 machines. A comprehensive
analysis was made to find the causes of these faults in transducers and sensors which are shown in Table 11 and Fig. 6. The
SPSS analysis is shown in Table 12.
Causes could be:
 Software defects caused by:
o Mobile telephone electromagnetic waves.

o The installed software is not matched with the machine.

 Hardness due to the improper filtration of dialysis water.
 Calibration; when transducer is not calibrated or the calibration is not proper fault occurs.
 Long work time; if the machine is working for too long period sensor faults can occur.
TABLE 11 CAUSES OF TRANSDUCERS AND SENSORS FAULTS

Cause Number of machines %

Non calibrated transducer or sensor 3 15
Long time work 3 15
Software defects 7 35
Improper water filtration 7 35
Total 20 100

No of machines

Fig. 6 Causes of transducers and sensors faults in 20 dialysis machines

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TABLE 12 THE SPSS ANALYSIS

Mean 5.00
Standard deviation 2.3090

From the above results, the most common causes of transducers and sensor faults are software defects and hardness faults.

V. CONCLUSIONS

As a conclusion, from observing tables and plots, it can be said that the causes of the mechanical and electrical faults are
due to these five elements in pumps, power, transducers and sensors, pressure and conductivity.
The general mean of all faults is 21.80 and general standard deviation is 3.96. The maximum mean of causes was found in
power cause, on the other hand the minimum mean was found in pressure causes.
The maximum standard deviation of causes was found in power causes and minimum was found in transducers and sensors
causes, so the impact of the values found is homogeneous in transducers and sensors causes.
Generally the faults can be overcome by considering the following:
 The dialysis room's temperature must not exceed 27°C.
 The inside and outside of the machine must be cleaned and sterilized perfectly and periodically.
 Disposable parts of machine have to be changed after each 5000 hours of work.
 Dialysis machines have to be exposed to calibration processes to check their efficiency.
 Only original patient sets recommended to each machine have to be used i.e. universal patient sets must not be used.
 The operators must be aware of how to deal with the machine and the outcomes of using the machine in careless way.
The most important recommendation for decreasing the faults in dialysis machines is by conducting a preventive
maintenance program as shown on the manual for each type of machine, also workers on these machines have to be attentive to
the way of cleaning and sterilizing them.
Finally further studies on the subject have to be done in Sudan with a larger number of machines and dialysis centres for
more comprehensive study.

ACKNOWLEDGMENT

Praise to Allah, the almighty who supported us and gave us the needed strength to complete this work. Precious thanks to
all engineers in dialysis centres in Khartoum state, Sudan.

REFERENCES

[1] O. E. H. Hamid, S. M. Alhadi, F. A. Mohamed, S. M. Alfatih, “Dialysis control circuit”, Project thesis, Department of Medical
Engineering, University of Sciences and Technology, Omdurman, Sudan, June 2011.
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WA, January 2003, pp. 1-8.
[3] A. Waugh and A. Grant, Ross and Wilson: Anatomy and Physiology in Health and Illness, 9th ed., Churchill Livingstone, Edinburgh,
2001.
[4] National Kidney Foundation. “K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and
Stratification”. Am J Kidney 39:S1-S266, 2002.
[5] National Institute of Diabetes and Digestive and Kidney Diseases, National Kidney and Urologic Diseases Information Clearinghouse.
Your Kidneys and How They Work, 2002.
[6] A. Kusiak, B. Dixon and S. Shah, “Predicting survival time for kidney dialysis patients: a data mining approach”, Computers in Biology
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[7] http:\\kidney.niddk.nih.gov\kudisease\pubs\kustats\index.htm (accessed. January 2012).
[8] Madhukar MISRA, “The basics of hemodialysis equipment”, Hemodialysis International, vol. 9, pp. 30-36, 2005.

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