Sunday, December 14, 2008

Philips Avalon Fetal Toco Ultrasound M2725A / M2726A, M2735A / M2736A


We have used almost all the service companies from USA for the repair work on following items.

Pulse Oximetry Probes - Reusable probes (HP, Philips, Masimo, Nellcor, BCI, Marquette, Datex, Ohmeda etc.)

Fetal Ultrasound and Toco Transducers Mostly made by Corometrics, GE, HP and Philips.

We have variety of equipment and most of the time lot of money is spent on above-mentioned accessories than the main equipment. We try to reduce the down time by keeping sets of accessories as spare in stock. The major trouble is when we receive back the repaired or rebuilt items, we find that the parts used are non OEM, the unit does not function to OEM specs and inconsistency (intermittent) in performance or readings. We did a very thorough tracking and documented the quality problem each vendor wise for past 3 years. To our surprise, we found that 88% of repaired or rebuilt items were failing within 3 months and when sent back to the same vendor, we were never told that they were under warranty. Unless you mention and fight (of course by producing tracking document with dates and sr. no.), they do not honour warranty. If we sent original transducers (with OEM parts, logos on it), most of them come back with cheap quality after market plastic casings and fixtures. For instance, HP/Philips fetal Toco or ultrasound transducer (M1355A & M1356A) some times comes back with a CLIP in place of Wire Form (Belt Buckle Snap). This clip does not last more than 3-4 months as it is fixed with Self Threading aluminum screw that cannot sustain the tension due to heavy clip. Such a transducer with the clip is much heavy compared to the original and does not give Toco readings as per the testing procedure in the service manual. Our technicians have found that the cable quality is very poor, shield keeps internally breaking in short usage, the strain reliefs are heavily glued to the casings, top and bottom casings are also glued as these after market parts do not match dimensionally. The strain guages used in Toco transducers are 99% cases are non OEM and do not perform to original specs. We sent some of these items to local testing labs and got the same results.

In fact, we called Philips and obtained the quote for the strain guage P/N 0960-0810. It costs US $ 274.46 plus the taxes and shipping, so the cost for just the strain guage is little over US $300. Then the question comes to our mind that how come these repair service companies can afford to do the entire repair of the Toco transducer (M1355A) just for US $130? Is not it interesting?

Well, we have complete analysis, tracking documentation, testing results, performance tracking record, photographs, OEM testing procedures from manuals etc. and we can share with biomedical community if any one is interested. The fact is that we jump on LOWEST price quote and in long run more money is spent on repairs, rather repeated repairs than replacing with new one. Our record tells us that it would have been best to replace the transducers with new from OEM at first instance rather than sending for LOWEST cost repairs. And that is what we had started doing since mid of the year 2006 until 10 months back when we found a company in Atlanta (USA) for the repairs of Nonin Xpod 3013. This service company did a superb job on those nonin Xpod external pulse oximetry module that most of the other service companies expressed inability to repair. In a process, we learnt that the company also does many other accessories such as pulse oximetry probes sensors, fetal transducers, phaco hand-pieces, harmonic scalpels, electronic circuit boards etc.

We sent many different accessories, mainly fetal transducers to this company and our tracking shows that they do excellent work. The strain guages they use are from OEM and when asked, they clarified that they have good understanding with OEM and hence there is some saving on bulk part purchase which is passed on to client by way of little reduction in service repair charges as compared to the OEM repair or replacement/exchange cost. Obviously they are not competitive to the companies who use substitute parts but they are 100% reliable. Moreover the repair work performed by them lasts longer and they also offer choice of 2 year warranty. Some of the points about their quality are as follows and worth checking out.

Repair Service label with Sr. No. is of transparent plastic, the sr. no. does not get washed away or fade with water, soap, cleaning alcohol or other solutions used in hospital environment as well as in biomed shop. The label has company name and hence no dispute when you send the repaired unit back. I would say, "perfect labeling for perfect tracking". One has to use razor to take this label off! When discussed with the company officials, they were very delighted to answer that their goal is to track and find out if quality lacks in any aspect from their end. Secondly, they analyze the failure leading to a solution to weakness in the original design or end user problem.

Corometrics Trimline Toco transducer model 2260 EAX - Our technicians found that the original unit from factory itself (in most cases) does not have steady (stable) base line and overall performance is poor. The Atlanta based service company eliminates that problem and all our repaired Trimline transducers are functioning perfectly all right. This is the first company who instructed us to have Trimline transducer connected to the Corometrics monitors for at least 5 minutes in power on condition (warm up) before putting on to patient. The old style transducers (Model 2260) does not require power on warm up. Many a times the end user does not do the warm up of Trimline transducers and then they are not able to 'Zero' the base line, it is taken out of service, sent to repairs and comes back with repair invoice though there is no repair needed! The Atlanta based company did not charge us for the Trimline transducers sent to them and found working fine after 'Warm Up'. Also the Nautilus Toco transducers perform more reliably if warm up is given for about 5 minutes before 'Zeroing' the base line. Most of the Corometrics monitors have Base Line count as 10. It is worth while to note that the old style Corometrics transducer model 2260 (Box Style) performs most reliably compared to the new Nautilus Toco transducer model 2264 GAX/HAX/JAX/KAX/MAX. The reading linearity, stability and repeatability is far superior with the old model. The Atlanta based company brought this to our notice and our technicians confirmed it by extensive testing. Now we have taken the policy decision to have rebuilt transducers, old style model 2260 to replace all Nautilus transducers. I would strongly recommend you to procure at least one rebuilt unit of model 2260 from the Atlanta based company and compare the performance with the Nautilus. The company even takes it back if returned within 2 weeks. Moreover brand new transducers of old model 2260 are not available from the OEM-Corometrics. Though we were convinced, initially we had difficulty with the end users as they liked the shape of the Nautilus. Finally performance won over the Looks! Thanks to our technicians who patiently tracked the performance and convinced everyone involved. Patients deserve the best, they pay the fees without a bargain and hence we felt it our moral obligation to measure the performance of service that we used to get at 'real bargain' price. In reality, we were paying more by repeated (non tracked) repairs in short periods, substandard performance, unease to end users, longer and repeated down time etc.

Generally the turn around time is 4-5 working days and they keep us informed when they are over loaded but always try to send at least 50% units within 2-3 days. This mostly happens during holiday season.

We also found that this company does repair latest Philips Avalon transducers model M2735A and M2736A. Some units can not be repaired as Philips does not provide them the proprietary software and related parts. Our experience is that 7 out of 10 transducers (Avalon series) get repaired and that too 100% with original parts as well as the performance. This means, for every consignment of 10 units that are faulty, we would have landed up spending US $13,000 if they were to be sent to Philips authorised dealer but we land up saving over $4800 against 7 repaired transducers. The turn around time for the Avalon transducer is little higher but it is worthwhile looking at the savings during this economic situation.

The company officials told us that they are developing the capability for the Philips Avalon cordless (wireless) fetal Toco M2725A & Ultrasound M2726A transducers used with Philips Avalon Fetal Monitors Model FM-20, FM-30, FM-50. We changed our transducers from wireless to cord type as they used to "walk out" or get dropped and damaged. Few working and non working transducers that were left with us, have been donated to them for developing the repair capability. Though we had not asked for any compensation, the company added co-operation discount in the repair invoicing and a thanking note for the support. We are glad to say that these folks are honest and very professional in their approach.

Other items like Phaco Hand-pieces, Harmonic scalpel, DEEG Module M1364A, circuit board etc., we do not have a very large volume but the few units we sent to this company for repairs turned out in excellent shape and significant cost savings. Again, the savings compared to OEM pricing and not the companies that use substitute parts. We used to make the mistake in past by jumping on lowest price but our tracking system made us wise. The credit goes to all the end users who brought it to our notice with consistent follow up. Hope that you would also experience the same if proper tracking is done.

The details of the repair service company are as follows.

Averon Bionics, Inc.
7094 Peachtree Ind. Blvd.
Suite 255, Norcross, GA 30071
Tel: +1 770 263 8090

We hope that the information helps all the Biomed Tech community, especially those who are under pressure from the end users. Also, it is great to save huge amounts by way of quality repair service during the current economic situation.

Using a professional service company for the repair work is not the only solution in keeping cost as well as the down time low but also the regular care on our part as a end user. These accessories should be cleaned on regular basis, proper care has to be taken while handing and storage are most important aspects. The cables should always be coiled circularly (6 to 8 inch diameter) and use a twist tie. This certainly increases the life span of the accessories.

Philips Avalon wireless transducer repair capability announcement, follow web link 1 below:

And also the blog -