Fetal Toco Transducer Repairs - 5 Year Warranty!!!
During the month of February 2008, L & D dept. head got very upset with all of us. In that meeting, she presented the tracking record and performance issues with the fetal transducers - Toco & Ultrasound (Fetal Heart) that shocked everyone. She pointed out that she had been complaining about it for last 4 years and finally started keeping the track record for almost last 2 years. Most of us had not paid serious attention to such complaints as were informed by repair service company that the pahysical damages are due to rough handling. It is true that there has always been some physical breakage due to mishandling but the tracking data presented in the meeting clearly indicated the poor quality repairs, repeated failures and overall poor performance. Though the repair cost per transducer was very low, by way of repeated service the amount paid per unit turned out to be more than a new transducer from the original manufacturer that too in less than a year.
Our director ordered to replace the repaired transducers with new from the original manufacturer. The purchasing department came with the price quote that was close to a quarter million dollars to replace all of them. The warranty offered was about a year and the management got concerned over the high cost of the replacement as well as incurring cost every year. We were asked to find out an alternative vendor for the quality repairs.
Back to square one, we started using a different company for our repairs of Toco transducers. The issue became very hot when some patient had complications during the labor and relative threatened to take action based on the poor quality of monitoring devices. Person with in depth knowledge of medical devices and experience, can get to the root cause of the problem. We started testing each repaired item before putting into usage. It was time consuming and stressful as we are short staffed due to economic situation and number of PMs performed per month demands us to stay late every day. We were not happy with the quality of repairs. The solution - we changed to another vendor and a month passed, same problem of poor quality of repairs. Again changed vendor, same problem continued and by the end of the year we had already used 6 different companies other than the one that we were using for years.
During the December 2008, the management decided to buy at least 20% of new transducers from the original manufacturer. It was based on the testing records and our recommendations. Meanwhile we found a company that charged more but assured guaranteed performance and 2 year warranty but price quote was shot down by the purchasing department obviously being on higher side.
Beginning of the year 2009, the issue was discussed in the meeting for department budgets and L & D head brought a print out of the blog that talked about the same problem we were facing and the company recommended by the blogger was the one that was shot down by our purchasing department! Our director checked out the blog and gave us approval to try out the services from the company out of Georgia. We are satisfied with the quality and moreover L & D is extremely happy with the performance for last 9 months. We are not blamed any more! Nor we blame Nurses for poor handling!
The new vendor makes sense to us as they pointed out some of the inherent problems with particular models and the simple remedy that reduces cost as well as down time. Last Monday, we were informed by this vendor that all our rebuilt fetal ultrasound transducers M1355A have warranty not only for 2 years as a whole unit but also for 5 years on crystal bonding which is a very common problem (rattling). We did drop the rebuilt transducer from second floor about 26 ft. height and the crystal did not come off. Only thing that got slightly affected was the belt buckle but the transducer worked just fine! In regular usage the drop would be at the most from 6 -7 ft. if the monitors are mounted high on wall or bedside trolley.
We hope the following blog link would also help you and would be happy to share our experience. The key factor is precise tracking and unbiased analysis. The approval of the vendor should be strictly based on the quality of the work rather than taking their word for granted.
We mostly have old HP fetal monitors. HP is bought over by Philips and latest fetal monitors from Philips are Avalon series with triplets monitoring capability. The Avalon fetal monitors can be configured with the wireless transducers M2725A, M2726A or with cable transducers model M2734A, M2735A and M2736A. Avalon series fetal monitors are excellent but the cost of transducers is in the range of $1400 and hence it is not economical from service point of view. We have been using following fetal transducer models.
HP/Philips Toco Transducer M1355A
HP/Philips Ultrasound Transducer M1356A
Philips Avalon Wireless Toco Transducer M2725A
Philips Avalon Wireless Ultrasound Transducer M2726A
Philips Avalon Wireless ECG Transducer M2727A
Philips Avalon Toco Transducer M2734A
Philips Avalon SMART Toco Transducer M2735A
Philips Avalon Ultrasound Transducer M2736A
GE/Corometrics Toco Transducer 2260
GE/Corometrics Toco Transducer 2260AAX
GE/Corometrics Trimline Toco Transducer 2260EAX
GE/Corometrics Nautilus Toco Transducer 2264 LAX/HAX/AAX
GE/Corometrics Ultrasound Transducer 5700 HAX
GE/Corometrics US Transducer 5700 LAX
Spacelabs Toco Transducer 700-0022-00
Spacelabs Ultrasound Transducer 700-0021-00
No matter how so ever the rugged design is, the transducers do fail and has wear and tear based on usage as well as the handling. We find that the HP transducers M1355A and M1356A are most reliable compared to Corometrics Trimline Toco 2260 EAX and Nautilus 2264 HAX/LAX. The GE/Corometrics Nautilus Ultrasound 5700, the original transducers after short term usage give intermittent problem. Once the cable is replaced with high flexibility and overall quality, they work well. The failures in HP/Philips transducers are very low provided they are original from HP or Philips and not the compatibles.
All the Biomeds being technically qualified and experienced, should take closer look at the repaired transducers, compare with the original and open (disassemble) it if problems are noticed in order to make thorough check. Some of the repair service companies deliberately break some internal walls of the original transducer top cases as their replacement bottom cases (NON OEM) do not fit due to dimensional mismatch. The replacement casings are manufactured using cheap raw materials and processes to reduce the cost. Some times we get carried away due to the bright color and the look that is deceiving. The compatibles transducers, if you open it up after 5-6 months of usage, you will get real head ache. Many of these transducers do not have the metal inserts for top-bottom fitting, the screws and internal metal parts are rusted being made out of cheap material other than standard Stainless Steel. The old gages are re-used by gluing some strain gage foils that do not conform to the OEM specifications. You would be lucky if you can dismantle the repaired or compatible Corometrics 2260 box style transducer without damaging. The Aluminum stand-offs come off as they are threaded directly into the plastic (No metal insert used in bottom casings) and can not be re-assembled without heavy gluing. The gage plate gets so much rusted and if you send it to lab, you would find a bacterial colony! Is not it scary?
It is our moral responsibility to make sure that the patients are given deserving treatment and we should do our part. or Purchasing Managers can be convinced if the performance testing, routine check and tracking is well documented. Cheapest is not always best. The quality and pricing has to be compared with what OEM offers and not with the cheapest stuff available in the town. It is a mistake to negotiate with the quality cautious vendor demanding to match or even go further down compared to the lowest quote obtained. Comparison has to be apple to apple and fact of the life is that Mercedes car can not bought at or the reduced price than lowest one available in the town.
End user i.e. the clinical staff nurses are most important and their feedback is always precious to cut the recurring cost to minimal level and obtain high up time of the equipment. During the emergency situations, patient's comfort and life is the priority and hence the equipment or the accessory like transducer gets least attention. If quality stuff is used, damages due to such incidences are not that significant as compared to the poor quality product. It is very unfair (on part of sales people from some service companies) to keep blaming the end users (nursing staff), neglect their repeated appeal about the poor performance and procure the services from a cheapest vendor just taking their word for granted. It is in our interest to train the end users for proper and safe handling. Working hand in hand with the L & D staff not only improves overall quality but is always a pleasure. Finally, we are the way we think and if we choose to accept sales pitch (from marketing people of cheap quality service companies) that the end users are solely responsible then the facts could never be unveiled. In today's economic situation, it is better to focus on quality that yields significant savings on long term basis.
In this digital era, common man is getting more educated day by day and it would not be a surprise if lot many patients start questioning poor quality monitoring equipment service. It is always better to be pro-active
Averon Bionics recently announced the capability to repair Philips Avalon wireless fetal transducers Toco M2725A, Ultrasound M2726A and Avalon wired fetal transducer TOCO M2734A, Smart Toco+ M2735A and US M2736A. Please check out following web link for the announcement.