Milestone PRESTO User manual

PRESTO
Automatic Processor/Stainer
for Frozen Sections
Operator Manual - MM115

PRESTO MM115-003 – Operator Manual
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Thank you for choosing one of our systems and welcome to the ever more crowded club of Milestone laboratory
instrumentation users.
We feel confident that you will be fully satisfied with the addition of this new instrument to your laboratory.
We recommend carefully reading this operator manual and to always keep it within reach for convenient and
quick referencing.
For any clarification or request for assistance, please contact our representative in your country:
Or contact:
Milestone s.r.l.
Via Fatebenefratelli, 1/5
24010 Sorisole (BG) Italy
Tel. +39.035.412 8264
Fax [phone]
web site www.milestonemedsrl.com
e-mail [e-mail]
Carefully read this manual before using the instrument.
MM115-003 – PRESTO – Operator Manual
2018-05

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SUMMARY
SUMMARY ........................................................................................................................................................ 4
1. INTRODUCTION........................................................................................................................................ 6
1.1. Symbols used .................................................................................................................................... 6
1.2. Intended uses .................................................................................................................................... 7
1.3. Technical specifications..................................................................................................................... 7
1.3.1. Touch control terminal ............................................................................................................... 7
1.4. Transport and storage conditions ...................................................................................................... 8
1.5. Warnings............................................................................................................................................ 9
1.6. Label ................................................................................................................................................ 10
1.7. Compatible reagents........................................................................................................................ 10
1.8. Disposal ........................................................................................................................................... 11
2. INSTALLATION ........................................................................................................................................ 12
2.1. Space requirements......................................................................................................................... 12
2.2. Unpacking and checking components............................................................................................. 13
2.3. Fume extraction system................................................................................................................... 16
2.4. Water fitting...................................................................................................................................... 17
2.4.1. Water drain .............................................................................................................................. 18
2.5. Final placement ............................................................................................................................... 18
2.6. General description.......................................................................................................................... 19
2.6.1. Connect the Bar code reader................................................................................................... 20
2.6.2. Remove or put the vessel support tray.................................................................................... 20
2.6.3. Remove or put the reagent cover disc..................................................................................... 21
2.6.4. Remove or reposition the caps on the reagent vessels .......................................................... 23
2.6.5. Reagent positions inside PRESTO.......................................................................................... 24
2.7. Electrical installation ........................................................................................................................ 25
2.7.1. Power supply ........................................................................................................................... 25
2.7.2. Rear panel ............................................................................................................................... 26
2.8. Remote alarm connection................................................................................................................ 26
2.9. Reagents.......................................................................................................................................... 26
2.10. Log in and Log out ........................................................................................................................... 27
2.10.1. Creating a new user................................................................................................................. 28
2.11. Set date and time............................................................................................................................. 30
2.12. Change the language ...................................................................................................................... 30
2.13. FineFIX tanks................................................................................................................................... 31
2.13.1. Labels ...................................................................................................................................... 31
2.13.2. How to prepare the FineFIX working solution in tank .............................................................. 32
2.14. Charge the reagent FineFIX in the PRESTO .................................................................................. 33
2.14.1. Charge the consumables runs................................................................................................. 33
2.14.2. Software activation sequence.................................................................................................. 33
2.14.3. Fill the FineFIX into the PRESTO ............................................................................................ 34
2.14.4. FineFIX heating settings .......................................................................................................... 36
2.15. Fill reagent vessels in the PRESTO ................................................................................................ 38
2.15.1. Labels ...................................................................................................................................... 38
2.15.2. Fill staining and cleaning reagents in the PRESTO................................................................. 38
2.16. Most used programs ........................................................................................................................ 41
2.17. Owner's settings .............................................................................................................................. 42
3. OPERATE WITH PRESTO ...................................................................................................................... 45
3.1. Loading slides in the rack ................................................................................................................ 45
3.2. Running a program .......................................................................................................................... 45
3.2.1. Run the most used program .................................................................................................... 46
3.2.2. Run a standard program.......................................................................................................... 48
3.3. Editing a program ............................................................................................................................ 51
3.3.1. Modify FineFIX loading temperature........................................................................................ 52
4. REAGENT MANAGEMENT ..................................................................................................................... 53
4.1. FineFIX use...................................................................................................................................... 53
4.1.1. FineFIX use as consumable .................................................................................................... 53
4.1.2. FineFIX use as reagent ........................................................................................................... 54
4.2. Vessel reagent reuse life ................................................................................................................. 55
4.3. Set staining and cleaning reagents ................................................................................................. 56

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4.4. Edit reagents list .............................................................................................................................. 57
5. SAFETY PROCEDURE ........................................................................................................................... 59
5.1. Water error....................................................................................................................................... 59
5.2. Arm position error ............................................................................................................................ 61
5.3. FineFIX loading error ....................................................................................................................... 62
6. MAINTENANCE ....................................................................................................................................... 64
6.1. Introduction ...................................................................................................................................... 64
6.2. Before/after every process............................................................................................................... 64
6.3. Daily ................................................................................................................................................. 65
6.4. Weekly ............................................................................................................................................. 65
6.5. Yearly............................................................................................................................................... 65
7. DECONTAMINATION AND CLEANING .................................................................................................. 66
7.1. Safety precautions ........................................................................................................................... 66
7.2. Procedure for PRESTO decontamination and cleaning .................................................................. 66
7.2.1. Detergents ............................................................................................................................... 66
7.2.2. Procedure ................................................................................................................................ 67
8. PROCESS DOCUMENTATION ............................................................................................................... 70
8.1. Export saved process data .............................................................................................................. 70
8.1.1. How to remove a saved process ............................................................................................. 71
8.2. Install and operate with the LogViewer............................................................................................ 72
8.3. Open process .................................................................................................................................. 72
8.4. Print process .................................................................................................................................... 73
8.5. Send process to customer support (Milestone) ............................................................................... 73
8.6. Export Events log............................................................................................................................. 74
9. PRESTO OPTIONAL................................................................................................................................ 76
9.1. External exhaust fume filter kit (CODE 61550/F) ............................................................................ 76
9.2. FineFIX tanks................................................................................................................................... 76
A. Appendix – Tricks and advice.............................................................................................................. 77
A.1. Fatty tissues..................................................................................................................................... 77
A.2. Suggestions for staining protocol modification ................................................................................ 77
To have better cleaned slide .................................................................................................................... 77
To modify staining .................................................................................................................................... 77
B. Appendix – Alarm management .......................................................................................................... 78
B.1. Alarm management ......................................................................................................................... 78

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1. INTRODUCTION
1.1. Symbols used
The instructions marked by this symbol are important and require to be read carefully.
Instructions marked by this ATTENTION symbol indicate one should proceed with
caution. Failure to comply with the instructions might cause damage to the user or the
instrument.
Instructions marked by this symbol indicate one should proceed with caution due to the
electrocution hazard. Ensure the instructions are followed carefully in order to avoid
this type of incident.
Biological hazard: pay attention when performing a procedure marked with this symbol:
biological contamination hazard.
Pay attention: parts identified with this symbol are areas at risk of crushing hand and
or fingers.
Surfaces identified by this symbol feature a high temperature hazard.
CE Logo: this instrument complies with European Community directives.
IVD medical device according to directive 98/79/EC.
Symbol of the European WEEE directive (2002/96/EC):
electric/electronic material, do not disperse to the environment.
Fragile
Manufacturer.

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1.2. Intended uses
Milestone PRESTO and its parts have been designed for laboratory use and are therefore able to withstand
the harshest lab conditions. They have been developed for continuous use in procedures for fixation,
processing and staining of samples for extemporaneous diagnoses in a quick, reliable and standardised
manner.
The instrument has been conceived only for laboratory use (indoor use only).
Milestone PRESTO must exclusively be used with the reagents listed in the chapter 1.7, “Compatible
reagents”.
Any other use of the instrument should be deemed as misuse and forfeits the
manufacturer's warranty.
1.3. Technical specifications
Power supply:
PRESTO Code 100000 230V~ 50/60Hz 500W
PRESTO Code 100001 115V~ 60Hz 500W
Productivity: 90 slides per hour
Rack capacity: 6 slides
Number of stations: 10
Reagent vessel volume: 200ml
Operating Temperature: 18°C – 30°C (64.4°F – 86°F)
Humidity (relative): up to 80%, non condensing
Maximum altitude: 2000m
Airflow interval: 35-45m
3
/h (cubic metres per hour), 20.6-26.5cfm
Weight: 60Kg (132lbs)
Indoor use only.
1.3.1. Touch control terminal
The following picture shows the Touch Control TERMINAL of the PRESTO unit. It is possible to operate the
unit simply by touching the icons on the screen.

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Two USB ports are fitted at the sides of the Touch Terminal.
When the USB ports are not used, it is required to leave the port protection on, as shown
in the picture above.
Features: Colour Display TFT-LCD 7”
Resolution 800X480,
Resistive Touch screen
Mass storage 4Gb
CPU 1GHz
Windows™ Embedded Compact 7
Programs: Pre-set program, with user customisable programs.
I/O-Interface 2 USB ports 2.0, 1 LAN Ethernet 10/100 Mbps RJ-45.
The manufacturer reserves the right to change and/or improve the specifications with no
prior notice and without incurring any obligation.
1.4. Transport and storage conditions
Temperature: –20°C up to +60°C (-4°F up to 140°F).
Humidity: up to 80% (up to 50% at 40°C-104°F) non condensing.
Before switching on PRESTO (when coming from a storage chamber), allow the instrument
to reach operating environment conditions (at least half an hour).

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1.5. Warnings
Any use of the instrument other than specified forfeits the warranty provided by the manufacturer.
The main power supply plug is to be considered as disconnect device. Disconnect all plugs from the power
outlet before assembling the system, before connecting parts (if any) and before cleaning it.
The equipment must be connected to well visible sockets and accessible by the operator.
The instrument is supplied with replaceable fuses, but their replacement must be effected by trained and
authorised SERVICE personnel. If the system is not working correctly yet, you are kindly requested to contact
the local authorised and qualified SERVICE representative or the manufacturer.
All parts of the instrument and parts must be exclusively be supplied by the manufacturer.
DO NOT OPEN THE UNIT'S CHASSIS. Failure to comply with the instructions in the
documentation might lead to a reduction in the device's safety. Should the
equipment not work correctly you are kindly requested to contact the supplier or
manufacturer.
Do not remove the instrument, parts, panels or cover. Only authorised and qualified
personnel may repair and access the instrument's internal components.
It is essential to always follow the normal laboratory safety standards and good
practices. In using the instrument it is required to always follow the rules of
common sense and best and most widespread laboratory practices.
The Competent Authority who owns the instrument has the primary responsibility
for incidents due to operations on the instrument without attending personnel in
charge of use or repairs.
Only use the reagents listed in chapter 1.7 “Compatible reagents”, to avoid damage
to the instrument. Failure to comply with the instructions might lead to a decrease in
the instrument's safety.

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1.6. Label
For an explanation of symbols see chapter 1.1.
1.7. Compatible reagents
Fixative
reagents Staining reagents
Cleaning
reagents
Milestone
FineFIX Hematoxylin Ethanol
Eosin Acetic Acid 2%
Xylene
Isoparaffin
(MileGREEN)
Isopropanol
DO NOT USE REAGENTS OTHER THAN THOSE LISTED ABOVE.
In case of doubts contact: [e-mail].
DO NOT USE HYDROCHLORIC ACID at any concentration.

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1.8. Disposal
This instrument is a medical in-vitro device and is usually installed in a laboratory where there are specimens
and other biological tissue. For your safety, it is therefore required to clean and disinfect the instrument prior
to coming into contact with it. It is also required to wear gloves when operating the system.
In the event this instrument should be returned to Milestone s.r.l., it is required to clean and disinfect the unit
before shipping it. Non disinfected devices will no longer be accepted and you will be contacted to incur the
relevant disinfection costs.
International health standards require shipments of biological hazard material to be effected in standard
containers (risk of sanctions).
Do not remove the instrument's structure panels during cleaning operations.
Disconnect the power supply before any operation.
Do not use water directly on the instrument or at high pressure to clean the unit.
For reasons of safety any operation without personal protection equipment is to be
avoided.
It is recommended to use polyphenolic disinfectants to clean and disinfect the instrument.
For further information please contact the manufacturer: [e-mail].
Complying with directive 2012/19/EC of the European Parliament and of the Council of 4 July 2012 on waste
electrical and electronic equipment (WEEE), the separate collection environmental managed of equipment is
mandatory.
It is necessary to return the used equipment to the distributor or to inquire about the presence of a local
empowered system for collection and disposal of WEEE.
The in-observance of Directive 2012/19/EC or of the local law which acknowledge it can have potential effects
on the environment and human health.
This symbol indicates separate collection
for electrical and electronic materials
If additional accident prevention and environmental protection requirements are in force in the country where
the instrument is installed, this instruction manual must be supplemented with appropriate instructions to
assure conformity with said requirements.
Disposal of reagents
Handle with the utmost care and store in a cool and dry area using a hermetic container.
Vapours might collect in empty containers, hence it is recommended to treat empty
containers as hazardous waste.
Waste materials must be disposed of in a certified incinerator or designated landfill, in
compliance with provincial and local government laws.
Certain reagents may have effects on health and cause environmental pollution.
For further information refer to the safety data sheets (MSDS) provided by the producer.

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2. INSTALLATION
Milestone PRESTO is an instrument that requires the utmost attention when unpacked and installed.
Arrange a bench at least 80cm (31.52in) wide and 100cm (39.4in) deep able to withstand the weight of
PRESTO which is 60Kg (132.28lb).
Then place PRESTO on the bench, ensuring the unit is level and the table is not flammable and vibration proof.
Ensure the instrument is positioned away from heat sources or directly under sunlight. Finally, ensure the tray
collecting excess reagents is in the proper position.
Ensure the unit is not placed against any side surface thus restricting intake/outlet cooling
air: leave at least a 20cm (7.88in) distance on each side.
2.1. Space requirements
PRESTO is shipped in a wood box with the following dimensions:
Width: 500mm (19.7”) Height: 950mm (37.43”) Depth: 1000mm (39.5”)
Unit dimensions:
Width: 400mm (15.76”) Height: 800mm (31.52”) Depth 920mm (36.25”)
Space dimensions required to place the unit:
Width: 800mm (31.52”) Height: 900mm (35.46”) Depth 1100mm (43.34”)
PRESTO is a heavy instrument. Check the bench for the maximum load.
At least two people are necessary to move and unpack the instrument.
The MINUMUM bench depth required is 710mm (28in) BUT the unit will extend beyond the
front of the bench.

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2.2. Unpacking and checking components
On opening the package ensure all parts are present by checking the list attached with the shipment. Attention
must be paid during PRESTO unpacking to avoid scratches or damage to the chassis.
The PRESTO system (230V version, Code 100000 and 115V version, Code 100001) includes the following
components:
•Qty.1 Main power supply cable (Code 50036 for version 230V and Code 50391 for version 115V)
•Qty.1 Fume extraction pipe (Code 61377) and Qty.2 Metal straps (Code 50051)
•Qty. 1 Water filter of 20µm (Code 100180L) with two connectors G 1/2’’ (Code 68278)
•Qty. 2 Water hose of 2m (Code 68309)
•Qty. 2 Electropolished steel racks for 6 slides (Code 100177)
•Qty. 10 Steel vessels for reagent (Code 100197)

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•Qty. 1 Disc covering reagent vessels (Code 100068)
•Qty. 2 2L Complete tanks (Code 65590)
•Qty. 1 2L Tank (Code 65798)
•Qty. 1 Kit Tank labels (Code 100016)

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•Qty. 1 Kit Reagents labels (Code 100157)
White labels for
reagents customization
•Qty.1 Magnetic pen to work with the touch screen terminal (Code 50597/M)
•Qty.1 Operator Manual in electronic format
•Qty.1 USB key (Code 62160)
•Qty.1 Bar code reader (Code 370059)
•Qty. 1 Polypropylene funnel for reagents filling (Code 65628)

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2.3. Fume extraction system
PRESTO is ventilated through the external exhaust outlet located at the rear of the instrument, with a pipe
connected to the fume extraction system (if any).
The external fume extraction system must be installed properly, according to the local
regulations in force on laboratory safety.
The customer is required to adapt the pipe connector. The plastic pipe supplied has the following features:
•Length: 3m
•Outer diameter: 69mm
•Inner diameter: 60mm
Insert the extraction pipe (Code 61377) in the suitable outlet (rear panel).
Use the metal strap to fasten the pipe to the fume exhaust duct. (Code 50051).
Now connect the other end of the pipe to the laboratory's fume extractor.
The external fume extraction system must allow an air flow of 40m
3
/h
(cubic metres per hour, 23.5cfm).
There is no air filter on the unit exhaust system.
It is possible to connect an external exhaust fumes filter kit (Code 61550/F), refer to
paragraph 9.1.

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2.4. Water fitting
PRESTO unit, in order to work correctly, needs to be connected at the hydraulic system. The connections for
the water loading (joint left IN) and unloading (joint right OUT), are present on the back side of the unit, they
are showed in the following picture.
Connect the water pipe to the cold (max temperature = 35°C) water inlet (IN) located at the rear of the unit
(minimum water pressure 2bar). Gradually open water "supply". Connect the drain pipe to the water outlet at
the rear of the unit.
It is mandatory to install the water filter between the tap and the
water inlet in the PRESTO
PRO. The filter prevents the formation of limestone and dirt in the water system of
PRESTO.
The filter fittings are G 1/2’’.
In order to simplify the replacement of the filter cartridges, it is important to have a tap
upstream of the filter, as pictured below.
Milestone recommends working in cooperation with the hospital’s clinical engineering
department when installing the water system of PRESTO.
Hydraulics Connection:
Input Water: tube connection 17mm (with connector G 1/2’’)
Output Water: tube connection 17mm (with connector G 1/2’’)
The loading and unloading water pipes and other connectors are not provided with the
unit.
The minimum difference height outlet permitted between the unloading of the unit and
your hydraulic system is up to 50cm (19.7in), otherwise the system cannot download the
water correctly.
Make sure that the output hose slope is about 10cm for every meter.
Minimum input pressure 2bar.
Milestone suggests to use a water softener.

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2.4.1. Water drain
The drain water is polluted with the reagents in which the rack is dipped before rinsing.
The amount of reagent that a fully loaded rack (6 slides) takes in is about 1 – 1.5ml. Therefore the drain water
of a standard process, with water flow duration 30 seconds, contains about 1.5ml FineFIX, haematoxylin and
2% acetic acid. The concentration of these substances in the drain water is about 0.075% of FineFIX and
Hematoxylin and 0.0015% of acetic acid.
The water discharged has to be connected following the local rules.
2.5. Final placement
The PRESTO unit may now be placed in its final use position. Ensure the unit is level.
Then connect:
The main power supply cable to the power plug located at the rear of the unit then the power supply cable plug
in the socket.
Now it is possible to switch PRESTO on.

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2.6. General description
1. Work area cover
2. Aspiration
3. Fresh FineFIX tank
4. Exhausted FineFIX tank
5. Reagent vessels
6. Touch control terminal
7. USB ports
8. Main switch
9. Tray for collecting excess reagents
1. Vessels cover disc
2. Reagent vessels
3. Water vessel
4. Arm with rack support
5. Slide rack
6. FineFIX vessel

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2.6.1. Connect the Bar code reader
Connect the USB of Barcode Reader to one of the USB ports on the PRESTO right side.
2.6.2. Remove or put the vessel support tray
The vessel support tray is needed for the correct positioning of the vessels.
To put or remove the support tray (e.g. in case of cleaning) it is required to move the PRESTO arm in the high
position, preferably in position 10UP in front of the operator (see section 2.6.5). Press the vessel reagent icon
to automatically move the arm to the 10UP position (see chapter 2.15).
Lift the tray and extract it from the arm.
Take out the support tray without the vessels on it.
To reposition the vessel support tray, insert the central hole in the arm, adjust the support so that the number
10 on the label is in front of you and the lateral holes fit with the fixed vessels (FineFIX and water vessels).