Roche CoaguChek XS System User manual

REF 0 4625374160
6 Test Strips REF 0 4499603001
and 1 Code Chip
PERSONAL USE
0 4899954001(04)
V1/R1 (black) – 2007-12
CoaguChek
®
XS
PT Test
# 152 / 2008 - RPD B 075 - Frau Frank
US
Purpose
The CoaguChek XS PT test strips are part of
the CoaguChek XS System. The CoaguChek
XS System measures blood-clotting time
for people who are taking anticoagulation
medications such as Coumadin
®
or warfarin.
The CoaguChek XS System uses blood from
a fingerstick. The system is intended for
properly selected and suitably trained users
or their caregivers on the prescription or other
order of the treating doctor. Users should be
stabilized on anticoagulation medications
such as Coumadin or warfarin prior to self-
testing with the CoaguChek XS System.
Caution: These test strips are for use
outside the body only. Do not eat the test
strips.
Before You Start Testing
If you are new to the CoaguChek XS System,
watch the CoaguChek XS System Patient
Training DVD and read the CoaguChek XS
System Getting Started Guide before testing.
Storing the Test Strips
Store the test strips in their container, with
the cap closed. You can store the test strips
at room temperature or in the refrigerator
(2 to 30°C or 36 to 86°F). When stored
properly, the test strips can be used until
the expiration date printed on the test strip
strip container.
Throw the test strips away if they are past
their “Use By” date.
Handling the Test Strips
When you are ready to test, remove 1 test
strip from the container. Close the container
tightly.
You must use the test strip within 10 minutes
of removing it from the container. Otherwise,
you may get an error message and you will
have to repeat the test.
Step 1: Getting Ready to Test
Gather supplies:
● CoaguChek XS Meter
● Container of CoaguChek XS PT Test Strips
● Test Strip Code Chip
● ACCU-CHEK
®
Softclix Lancet Device and
Lancet
Place the meter on a flat surface (like a table
or countertop) or hold it roughly horizontal so
that it will not vibrate or move during testing.
Vibrations or other movement can result in an
error message.
If you are using test strips from a new,
unopened box, you will need to change the
test strip code chip. The 3-number code on
the test strip container must match the 3-
number code on the code chip. To install the
code chip, follow the instructions in the Code
Chip section of the CoaguChek XS System
User Manual for Self-Testing.
Step 2: Getting a Good Drop of Blood
Increasing the blood flow in your finger will
help you get a good drop of blood. Before you
lance your finger, try the following techniques
until you see that your fingertip has good color:
● Warm your hand by holding it under your
arm, using a hand warmer, and/or washing
your hand with warm water.
● Hold your arm down to the side so that
your hand is below your waist.
● Massage your finger from its base.
● If needed, immediately after lancing,
gently squeeze your finger from its base to
encourage blood flow.
Step 3: Performing the Test
1. Wash your hands with warm, soapy water.
Dry completely.
2. Take a test strip out of the container. Close
the container tightly.
3. Insert a test strip as far as you can into the
meter. The meter turns on.
4. Confirm that the number displayed
matches the number on the test strip
container, then press M. If the numbers
are different, make sure you are using the
code chip that came with the test strips
you are using. If they still do not match, call
the Roche Diagnostics Technical Service
Center at 1-800-428-4674, 24 hours a day,
7 days a week, 365 days a year.
7. Use the lancet device to perform a
fingerstick. Set the penetration depth
to 5. See the CoaguChek XS System
User Manual for Self-Testing for more
information. After sticking your finger, you
have 15 seconds to apply blood to the test
strip. If it takes longer to form a good drop
of blood, lance a different finger for the test.
It’s important to hold the blood drop to
the test strip until you hear a beep.
9. You’ll see the hourglass when the blood
test begins. Then, pull your finger away
from the test strip.
Limitations of Procedure
Information for You and Your Physician:
• The CoaguChek XS System for patient self-
testing should not be used for patients
being treated with any direct thrombin
inhibitors, including Hirudin, Lepirudin,
Bivalirudin and Argatroban.
• The CoaguChek XS PT Test for patient self-
testing uses only fresh capillary blood from
a fingerstick.
• The blood drop must be a minimum of 10 μL
in volume. Low sample volume will cause an
error message.
• Never add more blood to test strip after test
has begun or perform another test using the
same fingerstick.
• When a patient is on intravenous infusion
therapy, do not collect fingerstick sample
from arm receiving the infusion line.
• Hematocrit ranges between 25-55% do not
significantly affect results.
• Testing has confirmed that PT/INR test
results are not affected by:
• Bilirubin up to 30 mg/dL
• Lipemic samples containing up to 500 mg/dL
of triglycerides.
• Hemolysis up to 1000 mg/dL
• Clopidogrel (Plavix
®
) up to 20 mg/dL
• Fondaparinux (Arixtra
®
) up to 5 mg/L
• The results are unaffected by heparin
concentrations up to 0.8 U/mL.
5. An hourglass appears as the meter warms
up, which takes about 30 seconds.
6. When the meter is warmed up, a flashing
test strip and blood drop symbol appear
and the meter begins a countdown. You
have 120 seconds to apply blood to the
test strip.
8. Apply 1 drop of blood to the side of the
test strip.
Remember to apply only one drop of blood—
don’t add more. Do not touch or remove the
test strip when a test is in progress.
The result appears in about 1 minute.
10. Record the result on the CoaguChek XS
System Prothrombin Time Self-Testing Log
Book. Call your doctor with the test result.
11. Properly dispose of the used lancet and
test strip.
12. Turn the meter off.
If you need to redo a test, use a new lancet, a
new test strip, and a different finger.
PDF-X3-Druckdaten - Helmut Benz KG
pi_04899954001_04_US_594x160.ind1 1 26.02.2008 11:22:24

Error Messages
If you see Error 7, this means the meter was
unable to detect a clot. Repeat the test. Be sure
to carefully follow the steps in the CoaguChek
XS System User Manual for Self-Testing. For
example, make sure the fingertip is thoroughly
dry, use the meter on a surface free of vibrations,
and apply the blood drop within 15 seconds of
sticking the fingertip. If you still get Error 7, call
your doctor immediately to arrange for testing
using another method. If the meter displays any
other error message, refer to
the Error Messages section
of the CoaguChek XS System
User Manual for Self-Testing.
Built-In Controls
The CoaguChek XS System has built-in quality
control functions in the meter and test strips.
The meter automatically runs its own quality
control test as part of every blood test, so you
never have to run quality control tests with
liquid quality controls. For more information
about the built-in quality control functions,
see the CoaguChek XS System User Manual
for Self-Testing.
Performance Characteristics
Measuring Range: The CoaguChek XS PT
System has a PT measuring range of 0.8–8.0
INR and 9.6–96.0 seconds.
Accuracy: A study was conducted comparing
test results obtained by trained users with
those obtained by healthcare professionals,
when both were using the CoaguChek XS
System. The correlation was very good, as
indicated by the following statistics: N=463,
Slope=1.000, Intercept=0.0 and Correlation
Coefficient=0.977. This study shows that
trained users are able to obtain results
that are as accurate as those obtained by
healthcare professionals trained in the use of
the CoaguChek XS System.
• The CoaguChek XS PT Test is insensitive to
low molecular weight heparins (LMWH) up
to 2 IU anti-factor Xa activity/mL.
• The presence of anti-phospholipid antibodies
(APAs) such as Lupus antibodies (LA) can
potentially lead to prolonged clotting times,
i.e., elevated INR values. If you have or suspect
that you have APAs, contact your doctor.
• Differences in reagents, instruments, and
pre-analytical variables can affect prothrombin
time results. These factors should be
considered when comparing results from
different test methods. Results obtained with
the CoaguChek XS System for patient self-
testing may not consistently correlate with
clinical laboratory results, particularly for
certain types of laboratory reagents. Your
doctor can provide additional information
regarding results comparison.
• In rare cases, patients with long clotting
times (>8 INR) may receive an “ERROR 7”
message on the meter display. If this error
message appears again after repeating the
test, call your doctor immediately to arrange
for testing using another method.
Additional Information
The CoaguChek XS System User Manual for
Self-Testing contains more information. If you
need technical help, call the Roche Diagnostics
Technical Service Center at 1-800-428-4674,
24 hours a day, 7 days a week, 365 days a year.
0 4899954001(04)
R1 (black)
The test results obtained by trained users
were also compared to results obtained using
a laboratory-based reference method. Results
are shown in the plot below.
Study User Demographics: A clinical
study was conducted by Roche Diagnostics,
consisting of four visits to the clinical
site. Informed consent and randomization
occurred at Visit 1. Testing began at Visit 2.
Ninety-one patients completed at least one
visit after Visit 1. The following table outlines
the demographic information for the trained
users who completed at least one visit after
Visit 1.
Demographic Number Percent
Total number of users 91 100%
Caregivers 4 4.4%
Males 51 56%
Females 40 44%
Age range 32 – 89 100%
Mean Age 64 years N/A
Age 65 – 69 years 16 17.6%
Age 70 – 74 years 13 14.3%
Age 75 years and up 16 17.6%
Education Level-
Eighth grade or less 91 100%
through advanced
college degree
Median Education Level Some
college N/A
On warfarin 3 – 12 months 19 20.9%
On warfarin 1 – 2 years 22 24.2%
On warfarin 3 – 5 years 23 25.3%
On warfarin > 5 years 27 29.7%
Atrial fibrillation 38 41.8%
Valve replacement 25 27.5%
Stroke/stroke prevention 7 7.7%
DVT 5 5.5%
Other heart conditions 6 6.6%
Other clotting disorders 10 11%
There were 107 patients enrolled. A total of 88
patients completed all four visits to the site.
The reasons for drop-outs were as follows:
Reason for Drop-Out # of Subjects
Felt it was too stressful 2
Didn’t have time 3
Didn’t want to use meter on
his own 1
Didn’t think he could learn to
use meter 1
Was having knee surgery 1
Study terminated prior to Visit 4 1
Unknown 7
Disqualified due to target INR
range outside of study protocol 3
Precision: A study was conducted and the
precision of duplicates for capillary blood
results was calculated for both trained users
and healthcare professionals. The following
results were obtained:
User Professional
Results Results
N214 249
Mean 2.57 2.52
SD 0.13 0.13
CV 5.13 5.36
This study shows that trained users are able
to obtain results that are as precise as those
obtained by healthcare professionals trained
in the use of the CoaguChek XS System.
Limited Warranty
Roche Diagnostics warrants that your
CoaguChek XS PT test strips will be free from
defects in materials and workmanship until
the product expiration date printed on the
label if the test strips are stored and used in
the manner described in this package insert
and in your CoaguChek XS System User
Manual for Self-Testing.
If, prior to the expiration date of the test strips,
there is a defect in materials or workmanship,
Roche Diagnostics will replace the test strips
free of charge. Your sole and exclusive remedy
with respect to the strips shall be replacement.
Any warranty claim should be directed to the
Roche Diagnostics Technical Service Center
at 1-800-428-4674.
THE ABOVE WARRANTY IS EXCLUSIVE OF
ALL OTHER WARRANTIES, AND ROCHE
DIAGNOSTICS MAKES NO OTHER WARRANTIES,
Aspects of the CoaguChek XS System (meter and test strips) and
its use are convered by one or more of the following U.S. Patents:
6,662,439; 7,073,246; 6,881,378; 6,207,000; 7,084,251; 7,049,131;
5,625,036; 6,645,368. Additional U.S. Patents pending.
COAGUCH EK, ACCU-CH EK and SOFTCLIX are trademarks of Roche.
All other product names and trademarks are the property of their
respective owners.
Manufactured by:
"Roche Diagnostics GmbH D-68298 Mannheim
www.roche.com
www.poc.roche.com
Distributed in the U.S.A. by:
Roche Diagnostics
9115 Hague Road
Indianapolis, IN 46256
©2007 Roche Diagnostics.
All rights reserved.
Made in Germany
Very Low or Very High Test Results
The CoaguChek XS PT test strips provide test
results if the INR value is between 0.8 and
8.0. If the meter displays < (less than) 0.8 or
> (greater than) 8.0, repeat the test. If, when
you repeat the test, you get the same display
(either < 0.8 or > 8.0), call your doctor.
# 152 / 2008 - RPD B 075 - Frau Frank
OR
EXPRESS OR IMPLIED, INCLUDING WITHOUT
LIMITATION THE IMPLIED WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE. IN NO EVENT SHALL
ROCHE DIAGNOSTICS BE LIABLE TO THE
PURCHASER OR ANY OTHER PERSON FOR
ANY INCIDENTAL, CONSEQUENTIAL, INDIRECT,
SPECIAL OR PUNITIVE DAMAGES ARISING
FROM OR IN ANY WAY CONNECTED WITH
THE PURCHASE OR USE OF THE TEST STRIPS.
NO WARRANTY OF MERCHANTABILITY OR
FITNESS FOR A PARTICULAR PURPOSE, IF
ANY IS IMPLIED FOR THE SALE OF THE TEST
STRIPS, SHALL EXTEND FOR A LONGER
DURATION THAN THE EXPIRATION DATE OF
THE TEST STRIPS.
PDF-X3-Druckdaten - Helmut Benz KG
pi_04899954001_04_US_594x160.ind2 2 26.02.2008 11:22:25