Bad Home Monitor Machines ??????

[M&M]

Hi Y'all,

Well, guess who called me at home tonight ? QAS !!!! Wondering why I haven't ordered any more supplies for my home monitor kit. Yes, the company that sold me the home monitor machine. Well, after 4 different machines 'NOT' matching any of my lab results - I gave up with the home machine. But you know the interesting part - the lady at QAS admitted that alot of home machines are not accurate and not matching the lab tests. Not even close !!! You can't take it personally she said: Its business !! Yup, that's what she said. She'll unfortunately probably lose her job for saying that to me and because I'm posting it here. I feel bad for her. But, I think you all should check your home machines to make sure they are relatively close to your 'lab' results. I took my machine and tested myself right after the blood was drawn from the lab. Although, I agree they don't have to match perfectly but .5 or more discrepancy is not reliable. My coumadin clinic did not feel comfortable changeing my med doseage from the home monitor results. Due, to the results not matching or coming close to matching the lab results. Therefore, I am going to forego any home monitor kit. I don't care to have my chest ripped open because of blood clots on my valve.

Whatever, I felt compelled to report this. After a year of inconsistancy's with 4 different machines not within a .5 range of the lab results - I have decided to forgo any home testing. I've heard it from several coumadin clinics that home testing is not close to being accurate. I told QAS on the phone that they should be looking for a better supplier - its good business !!! We don't need bad machines. This is our "LIFE" and I don't care to risk it on some company that is out to make money and not produce a reliable product. I think QAS should be monitoring they equipment they are selling. Just my opinion based on informative information from the (QAS) horses' mouth... She agreed with me.. There you go.. take it or leave it, its your life..

Good Luck and Best of Care.
M&M

 

[Bina]

I understand that you are frustrated and I don't have any experience with QAS, but I do have a Coaguchek XS and I am thrilled with it. When I compared a test with the lab the difference was .2 which is what my handbook had said that I could expect. That is totally acceptable because even different labs can come up with a small difference.
If I make sure to stay in the middle of my range, then really nothing should go wrong.
Don't give up on home testing.

 

[Freddie]

WOW & OMG
This is what my doctor has been saying to me and therefore has not given me the 'go-ahead' to get a monitor.

 

[Bina]

Freddie, you would be getting the Coaguchek, same as me.
My machine is German made, I trust my life with it.....obviously. And I've heard that the INRatio is it's equal.

 

[zipper2]

Sorry to hear you had problems with QAS...not familiar

with this machine i do use coagucheck xs almost a year

in Jan. Compared to lab twice....come out same.

My family Dr. luvs the freedom and my heart surgeon will

be using them in the hospital there,when i went for my

angiogram and tee they allowed me the freedom of use and

administering my own coumadin..........loved it.

especially with finding so many problems with Dr's today

being able to conduct the proper use of coumadin,then i had

to result to long lines at the lab and 16 years scar tissue from

from vein draws........i suggest a different brand such as Bina

or i have if your interested.

zipper2 (DEB)

 

[Bina]

M and M, don't give up.
How do you know what the labs do to your blood draw sample.
Maybe the sample has been sitting around or slightly mishandled. Things happen.
That's why I find that it's safest to try and aim for the middle of your range or a bit higher and learn to trust it.
Store your machine and strips properly, and there shouldn't be a problem.

 

[dcat96]

I am new to the home testing 4 weeks, Inratio machine. I am still testing every5-6 days (7 weeks post op) I am not reporting result through Raytell yet (will start Dec 1). I have home tested each time I go to the lab and my results have been consistantly.3 difference one way or another. The anticoagulation clinic is trackingmine vs. lab each time. As long as the difference is close to being consistant I think your ok.

 

[Eva]

M and M,

I sympathize with you, it is frustrating. I also like to share the following.

When I last saw my cardio, he checked my INR using the Coagucheck machine. My INR was 7.5...I asked him to draw blood and send it to the lab just for my peace of mind. He told me the difference won't be more than .2; he was right. The lab results were 7.7!!
I am planning to buy the machine as it only requires a few drops, while doctor's office withdraws 2 tubes of blood

 

[ALCapshaw2]

Hmmm....

4 different machines tested Different that the Lab
and you think the Machines are ALL WRONG.

Have you considered that the CONSISTENT ERROR
just may be with your LAB ?

Did you cross check that Lab with ANOTHER Lab?

Just curious.

 

[Roger Frank]

I have the HemoSence which matches my doctors CoaguChek which matches my local hospitals lab sample. However I've found out the hard way, (and expensive) sampling correctly is critical in obtaining an accurate reading.

My 2 cents,

 

[catwoman]

M&M:
I'm sorry you've had bad experiences with home-testing. I have never compared my INR results to lab draws, but I have done so with my PCP's CoaguChek. His clinic relies on POC machines, rather than lab draws.

Which brings me to this question:
Why is it that many doctors rely exclusively on lab draws and say that only lab draws are 100% correct?
Yet many reputable, Anticoagulation Forum-certified anticoagulation clinics have POC machines (CoaguChek, INRatio, Protime 3)...

I've had only 1 lab draw (that I know of) since I went to home testing. That was when I had my TEE in August 2007. Not sure why they would have needed to do an INR for a TEE, but they did.

Wonder how much personal experience with INR testing machines the QAS employee has had? When I got my INRatio, the RN that QAS got to call me was very helpful and, in fact, had been home-testing herself for quite some time. Don't remember the reason she was on warfarin, but she had used all of the products that QAS sells. So we were able to discuss the differences in the machines.

 

[lance]

I'm sorry to learn this

I'm sorry to learn this

M&M
I'm shocked by your frustrating experience with point of care testing I remember Ross mentioning that the vein draw and the home monitors use different reagents and sometimes result in different readings. There is an acceptable difference between the two.
also, I remember Al Lodwick posting about a machine(not a POC monitor) in the hospita lab that was not correctly calibrated resulting in approximately 800 incorrect tests with 4 deaths.
There must be something happening you're not aware of and it's hard to understand what it is. Have you comparison checked your results against someone not anti-coagulated?
Comparison vein draws from my XS are accurate to within .2 of lab. On several occasions my spouse and I had comparison tests exactly the same as the lab. I tell the lab technician she does a good job because to me I'm checking the accuracy of the lab not the other way around. POC monitors should be comparison tested with the lab once in 6 months. I suspect the QAS rep hasn't worked there very long.
If POC monitors are as inaccurate as the QAS rep implied I'm surprised any of us using home monitors haven't stroked or worse.
I think so highly of my XS that I have funds set aside to purchase my next XS when when/if required.
Your experience is a puzzlement. Hopefully an answer will be found.
Best wishes
Sandra

 

[EVELYN]

Hello M&M

First of all, I would like to say that we think home testing is the ONLY WAY to go. I'm sorry you have been having so much trouble with your machine, and can tell you that we have been there and done that.

We have had 4 inr machines over 6 years....two Protime, one Coaguchek, and one INRatio. We had nothing but trouble with our Protimes....terribly incorrect readings so much so that the corporation that produces Protimes (their name escapes me at the time, but they're located in Jersey) sent us a "Professional" unit to use and double check against one of our inaccurate machines.

Our Coaguchek machine was wonderful and unquestionably a huge step above the Protime, but alas, the strips stopped being produced for a very long time and the ones we had were recalled. During that time, our cardio's office switched their clinic machines (Coaguchek) to INRatio by Hemosense.

To make a long story short, the INRatio has been the very best machine we have ever had. It's easy, accurate, compact and easy to travel with. We check it against a lab draw on occasion, and test me (not on warfarin) about every 3-6 month. It has always, and I repeat, ALWAYS been in range.

I'm sorry you have had so much trouble with your machine (you didn't mention which brand you had) but hope you will reconsider testing at home with, possibly, a new machine. Don't give up the ease and convenience of home testing.

Evelyn

 

[catwoman]

Lance:

Here is a link to the thread about the wrong lab test results:

http://www.valvereplacement.com/forums/showthread.php?t=415&highlight=incorrect+death

 

[ALCapshaw2]

To make a Universal Condemnation of 'finger stick' Testing
would seem to overstep the evidence presented.

I agree there is a correlation problem in your case (M&M), but further testing and evaluation would need to be done to make a proper determination of where the discrepancy lies. (MY *guess* is that the Lab Results may be Questionable).

My own Coumadin Clinic uses professional grade Finger Stick Testers which stores the data and can read bar codes and write to a computer database.

It is known that for the reagents used in the test strips, that variation increases with Higher INR readings. As a safety precaution, whenever they get an INR result over 4.5 they require a Lab Draw for confirmation. This Clinic oversees 1500 anticoagulated patients with well over 100 tests per day supervised by 4 Certified Registered Nurse Practicioneers who have been well trained.

Another endorsement for Home Testing is the fact that after study, MEDICARE approved Home INR Testing for Medicare Patients on long term Anti-Coagulation Therapy.

I agree that some (usually small) variation between Lab and Finger Stick measurements exists, but I do NOT agree with your (M%M) condemnation of Finger Stick as being totally inaccurate.

'AL Capshaw'

 

[Marty]

There is a voluminous literature documenting the accuracy of finger-stick monitors vis-a-vis central lab monitors. Check into hemosense.com and you can download and study the reprints. Coaguchek also has a similar section but I am more familiar with INRatio which I have been using the last few years. Your experience is most unusual. I would worry a little about your central lab.

 

[catwoman]

Please watch Part 3

Please watch Part 3

of Discovery Health Channel's CME program on anticoagulation.

The panelists -- experts in the anticoagulation therapy field -- discuss variances among INRs and lab results.

 

[Petros]

I understand that you are frustrated and I don't have any experience with QAS, but I do have a Coaguchek XS and I am thrilled with it. When I compared a test with the lab the difference was .2 which is what my handbook had said that I could expect. That is totally acceptable because even different labs can come up with a small difference.
If I make sure to stay in the middle of my range, then really nothing should go wrong.
Don't give up on home testing.

I totally agree with Bina. I have the same XS monitor for over a year with excellent results. I also try to stay in the middle of my range-that is 3.0. My surgeon said that an INR at 3.0 would be perfect (advised range: 2.5-3.5). Home testing is easy, convenient but most of all it is a perfect way to be tested and kept safequarded at any time.
Just a short question: for the first time and after 17months of my aortic valve replacement I have just remembered that I did not take my dose at six o'clock. Now the European time is 11.15 so I am 5 hours behind. I have just taken my warfarin dose. Is is possible that such a delay of 5 hours can cause any harm? Should I take my next day's dose again tomorrow at six?

 

[Bina]

Hello Petros,
Don't worry about the 5 hours delay. It will all balance out after a couple of days.

 

[Petros]

Hello Petros,
Don't worry about the 5 hours delay. It will all balance out after a couple of days.

Hello Bina.
Your quick reply is really appreciated.