Monday, one of our sales reps reported a wash indicator failure at a local facility currently using our cleaners and our Case Soil indicator. We knew it was an opportunity to solve a problem and possibly improve their process. The wash indicator is supposed to fail when something in the wash sequence isn’t right. It’s your first alert that something is wrong, so let’s look at the facts and follow the clues to figure out what the problem is and how to solve it.

Here’s what we know, at the conclusion of the wash process our Case Soil Indicator was not clear. It showed retained organic soil. Bear in mind the Case Soil Indicator is a stainless steel coupon with a soil sample formulated by our chemists to be representative of the soil found on surgical instruments, including blood, fats, proteins, and carbohydrates. There are other wash monitors out there which use plastic for their indicators, but we believe a stainless steel coupon better represents the surface of surgical instruments. So, it’s quite likely that if there is retained soil on our indicator there is also retained soil on the instruments in the load.

Additionally, the Case Soil Indicator works with automated washer disinfectors and ultrasonics. The stainless steel coupon is designed to work with our proprietary coupon carrier, which acts as a challenge device ensuring that the spray pattern of the washer is getting into every nook and cranny, much like the challenge of surgical devices on top of each other in the washer tray. In the ultrasonic the coupon carrier holds the sample vertically creating a challenge for ultrasonic cleaning. As a matter of fact, several coupons and holders can be used to check that all the ultrasonic transducers are working correctly. We recommend placing a Case Soil coupon and holder in each corner of the ultrasonic basin and one in the center, a failure of any of the coupons indicates possible transducer failure in that area of the basin and it’s time for maintenance.

The Case Soil Indicator is so much more than a simple GO/No GO indicator, our soil formulation gets cleaned off by degrees of efficacy. You may find a result where the initial red color of the sample has been cleaned away. Upon closer inspection, you may see that there is a white hazy residue left by other components of our formula, this would be a failure. Then again bioburden and other proteins may not be visible with the naked eye. That is why if you really want to be very thorough, we offer a protein indicator solution that lets you see what would be otherwise invisible residue. If the coupon looks totally clean to the naked eye, yet the protein indicator turns blue, you know that not all the bioburden has been washed away.

Armed with good questions and Case Soil Indicators, our sales rep returned with the support of our technician to help diagnose the facility’s wash failure. Are the pre-programed wash cycles correct, have any steps been omitted? We found that the settings on the washer were changed to reduce the rinse time and the wash cycle  settings changed to "0" so that no detergent was being drawn. One washer was correctly set. The one with the failure was changed. Was it gremlins in the night or someone on second shift with the password or the equipment repair tech who arrived before the weekend leaving this for us to discover and fix on Monday?

Visit with us next week as we gather more facts about how equipment and process failures can be solved with our Case Soil wash indicator. And remember Case Medical is here to help, whether you need an in-service, help with a recurring problem, or you need CE credits.

Contact us at [email protected], or visit us anytime at www.casemed.com to learn more about our products and services.