NONIN 9590 Finger Pulse Oximeter Onyx Vantage Instruction Manual

NONIN 9590 Finger Pulse Oximeter Onyx Vantage

Indications for Use

The Nonin® Onyx Vantage 9590 Finger Pulse Oximeter is a small, lightweight, portable device indicated for use in measuring and displaying functional oxygen saturation of arterial hemoglobin (%SpO2) and pulse rate of patients who are well or poorly perfused. It is intended for spot-checking of adult and pediatric patients on digits (fingers, thumb, toes) that are between 0.3 – 1.0 inch (0.8 – 2.5 cm) thick. The device’s intended use environments include hospitals, clinics, long-term care facilities, skilled nursing facilities, emergency medical services, and home healthcare services.
CAUTION: Regulatory authorities outside the U.S. recognize the use of this device in motion conditions.

Warnings

• Do not use the device in an MR environment, in an explosive atmosphere, or on neonatal patients.
• This device is not defibrillation proof per IEC 60601-1.
• Inspect the sensor application site at least every 4 hours to ensure correct sensor alignment and skin integrity. Patient sensitivity to the sensor may vary due to medical status or skin condition.
• Avoid excessive pressure on the sensor application site as this may cause damage to the skin beneath the sensor.
• This device is intended only as an adjunct in patient assessment. It must be used in conjunction with other methods of assessing clinical signs and symptoms.
• The device must be able to measure the pulse properly to obtain an accurate SpO2 measurement. Verify that nothing is hindering the pulse measurement before relying on the SpO2 measurement.
• Operation of this device below the minimum amplitude of 0.3% modulation may cause inaccurate results.
• The general operation of the device may be affected by the use of an electrosurgical unit (ESU).
• This device should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the device should be observed to verify normal operation.
• Keep the oximeter away from young children. Small items such as the battery door, battery, and lanyard are choking hazards.
• Certain activities may pose a risk of injury, including strangulation if the lanyard should become wrapped around your neck.
• Before changing batteries, make sure the device is off and is not applied to a digit.
• Portable RF communications equipment such as cell phones or radios (including peripherals such as antenna cables and external antennas) should be used no closer than 30 cm (12 inches) to any part of the ME system, including cables specified by the manufacturer. Otherwise, degradation of the performance of this equipment could result.

Cautions

• This device has no audible alarms and is intended only for spot-checking.
• This device is designed to determine the percentage of arterial oxygen saturation of functional hemoglobin. Factors that may degrade pulse oximeter performance or affect the accuracy of the measurement include the following:
  • do not apply the pulse oximeter on the same arm as a blood pressure cuff, arterial catheter or infusion line(s) (IVs)
  • excessive light, such as sunlight or direct home lighting
  • excessive motion
  • moisture in the device
  • improperly applied device
  • the finger is outside the recommended size range
  • poor pulse quality
  • venous pulsations
  • anemia or low hemoglobin concentrations
  • cardio green and other intravascular dyes
  • carboxyhemoglobin
  • methemoglobin
  • dysfunctional hemoglobin
  • artificial nails or fingernail polish
  • residue (e.g., dried blood, dirt, grease, oil) in the light path.
• The device may not work when circulation is reduced. Warm or rub the finger, or re-position the device.
• This device’s display will go blank after 30 seconds of no readings or poor readings.
• In some circumstances, the device may interpret motion as good pulse quality. Minimize patient motion as much as possible.
• Clean the device before applying it to a patient.
• Do not sterilize, autoclave, or immerse this device in liquid. Do not pour or spray any liquids onto the device.
• Do not use caustic or abrasive cleaning agents, or any cleaning agent containing ammonium chloride.
• This device is a precision electronic instrument and must be repaired by Nonin Technical Service. Field repair of the device is not possible. Do not attempt to open the case or repair the electronics.
• Opening the case may damage the device and void the warranty.
• A flexible circuit connects the two halves. Do not twist or pull the flexible circuit or overextend the device’s spring. Do not hang the lanyard from the device’s flexible circuit.
• A functional tester cannot be used to assess the accuracy of a pulse oximeter monitor.
• This equipment complies with IEC 60601-1-2 for electromagnetic compatibility for medical electrical equipment and/or systems. This standard is designed to provide reasonable protection against harmful interference in a typical medical installation.
• However, because of the proliferation of radio-frequency transmitting equipment and other sources of electrical noise in healthcare and other environments, high levels of such interference due to proximity or strength of a source might disrupt the performance of this device. Medical electrical equipment needs special precautions regarding EMC, and all equipment must be installed and put into service according to the EMC information specified in this manual.
• Batteries may leak or explode if used or disposed of improperly. Remove batteries if the device will be stored for more than 30 days. Do not use different types of batteries at the same time. Do not mix fully charged and partially charged batteries at the same time. These actions may cause the batteries to leak.
• Follow local, state, and national governing ordinances and recycling instructions regarding disposal or recycling of the device and device components, including batteries.
• In compliance with the European Directive on Waste Electrical and Electronic Equipment (WEEE) 2002/96/EC, do not dispose of this product as unsorted municipal waste. This device contains WEEE materials; please contact your distributor regarding take-back or recycling of the device. If you are unsure how to reach your distributor, please call Nonin for your distributor’s contact information.
• When using the device in the home, avoid exposing the device to lint and dust.

Symbols

Installing Batteries
Two 1.5-volt AAA-size batteries power the 9590 for about 6,000 spot checks or 36 hours of operation. Nonin recommends using alkaline batteries (included with each new device). When batteries are low, the numeric displays flash once per second. Remove batteries if the device will be stored for more than 30 days. Replace low batteries as soon as possible, using the instructions below.
WARNING: Before changing batteries, make sure the device is off and is not applied to a digit.
NOTE: Rechargeable batteries may be used; however, they require more frequent replacement.

1. Hold the 9590 as shown in Figure A. To release the device’s battery tray, press upward and then pull outward slightly with the thumb.
2. Remove the old batteries from the battery tray. Dispose of the batteries properly.
3. Insert two new 1.5-volt AAA-size batteries. Follow the polarity markings (+ and -) as illustrated in Figure B. Proper positioning of the batteries is essential for operation.
4. Carefully guide the battery tray back onto the device. Press downward and then push inward slightly to re-secure the battery tray (figure C). Do not force it into place; it fits only when properly positioned.
5. Insert your finger into the device to verify the operation. See the Activating the Onyx Vantage 9590 and Verifying Operation section for more information.

Activating the Onyx Vantage 9590 and Verifying Operation

The device contains numeric Light-Emitting Diodes (LEDs) that display oxygen saturation and pulse rate. A tricolour LED display (pulse quality indicator, shown at left) provides a visual indication of the pulse signal quality while blinking at the corresponding pulse rate. This display changes colours to alert you to changes in pulse quality that may affect the readings:

• Green indicates a good pulse signal.
• Yellow indicates a marginal pulse signal.
• Red indicates an inadequate pulse signal.

Activate the 9590 by inserting the patient’s finger into the device. The device detects the inserted finger and automatically illuminates the display. Correct positioning of the device on the finger is critical for accurate measurements.
NOTE: While on the finger, do not press the device against any surface and do not squeeze or hold it together. The internal spring provides the correct pressure; additional pressure may cause inaccurate readings.

1. Insert the patient’s finger, nail side up, into the 9590 until the fingertip touches the built-in stop guide.
2. Make sure the finger is lying flat (not on its side) and is centred within the device. For best results, keep the device at the patient’s heart or chest level.
3. If the device does not turn on, remove the finger and wait a few seconds before reinserting it. When a finger is inserted, the device performs a brief startup sequence. Verify that all LEDs illuminate during the startup sequence. If any LED is not lit, do not use the 9590; contact Nonin Technical Service for repair or replacement.
4. After the startup sequence, the device begins sensing the pulse (indicated by the blinking pulse quality indicator). Allow the device to stabilize and observe about 4 seconds of continuous green-coloured pulse quality before relying on the displayed values. Continually verify operation. It is common for the displayed values to fluctuate slightly over several seconds. If the pulse quality indicator blinks yellow or red, try another finger.
5. A minus sign (-) appears in the left-most digit of the %SpO2 display when the device senses the finger has been removed.
6. The last measured SpO2 and pulse rate values display for 10 seconds while the device automatically turns off.
7. The device will automatically shut off (to conserve battery life) approximately 10 seconds after the finger is removed or after 2 minutes of inadequate pulse signals.
8. If the 9590 does not turn on or if it shuts off unexpectedly:
   • Verify batteries are correctly inserted. Note: If batteries are installed backwards, the unit will not function.
   • The batteries are depleted. Replace batteries.
   • Continually verify operation. If the problem persists, remove the batteries and contact Nonin Technical Service.
   • The OxitestPlus7 by Datrend Systems, Inc. can be used to verify the operation of the pulse oximeter.

Using the Lanyard
WARNING: Certain activities may pose a risk of injury, including strangulation if the lanyard should become wrapped around your neck.
CAUTION : A flexible circuit connects the two halves. Do not twist or pull the flexible circuit or overextend the device’s spring. Do not hang the lanyard from the device’s flexible circuit. A lanyard is provided for convenience. The device will function with or without the lanyard. If lanyard use is desired, thread the lanyard as shown below.

Onyx Vantage 9590 Care, Maintenance, and Cleaning

The advanced digital circuitry within the device requires no calibration or periodic maintenance other than battery replacement. The device’s expected service life is 5 years. Field repair of the 9590 circuitry is not possible. Do not attempt to open the case or repair the electronics. Opening the case will damage the device and void the warranty. Do not open the 9590 more than 90°, and do not twist or pull on the device when cleaning.

Cleaning the Onyx Vantage 9590
CAUTIONS

• Clean the device before applying it to a patient.
• Do not sterilize, autoclave, or immerse this device in liquid. Do not pour or spray any liquids onto the device.
• Do not use caustic or abrasive cleaning agents, or any cleaning agent containing ammonium chloride or isopropyl alcohol.
• To clean, wipe the surfaces with a soft cloth dampened with a mild detergent or a 10% bleach solution or equivalent. (household bleach [5.25% sodium hypochlorite]).
• Do not use undiluted bleach or any cleaning solution other than those recommended here, as permanent damage could result.
• Dry with a soft cloth, or allow to air dry. Ensure that all surfaces are completely dry.

Equipment Response Time
If the signal from the sensor is inadequate, the last measured SpO2 and pulse rate values freeze for 10 seconds and are then replaced with dashes.

Example: SpO2 Exponential Averaging
SpO2 decreases 0.75% per second; pulse rate = 75 BPM
The response of the 4-beat average is 1.5 seconds.

Testing Summary
SpO2 accuracy and low perfusion testing were conducted by Nonin Medical, Inc. as described below.

SpO2 Accuracy Testing

At an independent research laboratory, SpO2 accuracy testing is conducted during induced hypoxia studies on healthy, male and female, non-smoking, light-to-dark-skinned subjects that are aged 18 years and older. The measured arterial hemoglobin saturation value (SpO2) of the device is compared to the arterial hemoglobin oxygen (SaO2) value, determined from blood samples with a laboratory co-oximeter. The accuracy of the device is in comparison to the co- oximeter samples measured over the SpO2 range of 70–100%. Accuracy data is calculated using the root-mean-squared (Arms value) for all subjects, per ISO 80601-2-61 and ISO 9919, Standard Specification for Pulse Oximeters for Accuracy.

Low Perfusion Testing
This test uses a SpO2 Simulator to provide a simulated pulse rate, with adjustable amplitude settings of various SpO2 levels. The device must maintain accuracy by ISO 80601-2-61 and ISO 9919 for pulse rate and SpO2 at the lowest obtainable pulse amplitude (0.3% modulation).

Performance in Motion
Motion artifact simulation introduced by a pulse oximeter tester determines whether the oximeter meets the criteria of ISO 80601-2-61 and ISO 9919 for pulse rate during simulated movement, tremor, and spike motions. Contact regulatory@nonin.com for more information regarding motion testing.

Principles of Operation
Pulse oximetry is a non-invasive method that passes red and infrared light through perfused tissue and detects the fluctuating signals caused by arterial pulses. Well-oxygenated blood is bright red, while poorly oxygenated blood is dark red. The pulse oximeter determines functional oxygen saturation of arterial hemoglobin (SpO2) from this colour difference by measuring the ratio of absorbed red and infrared light as volume fluctuates with each pulse.

Specifications

• Oxygen Saturation Display Range: 0% to 100% SpO2
• Pulse Rate Display Range: 18 to 321 beats per minute (BPM)

Declared Accuracy

• The tables below show Arm values measured using the Onyx Vantage 9590 in a clinical study in non-motion conditions.
  NOTE: If your national regulatory authority recognizes accuracy in motion, please contact regulatory@nonin.com for accurate data

Accuracy Summary by Decade – Finger and Thumb

This graph shows plots of the error (SpO2 – SaO2) by SaO2 using the 9590 with a linear regression fit and upper 95% and lower 95% limits of agreement. Each sample data point is identified by a subject from a clinical study in non- motion conditions.

Accuracy Summary by Decade – Toe

This graph shows plots of the error (SpO2 – SaO2) by SaO2 using the 9590 with a linear regression fit and upper 95% and lower 95% limits of agreement. Each sample data point is identified by a subject from a clinical study using toes in non-motion conditions. SpO2 Low Perfusion Accuracy (Arms) 70 to 100% ±2 digits Pulse Rate Declared Accuracy Range (Arms): 20 to 250 BPM ±3 digits Low Perfusion Pulse Rate Declared Accuracy Range (Arms*): 40 to 240 BPM ±3 digits.

Measurement Wavelengths and Output Power:

• Red: 660 nanometers 0.8 mW maximum average
• Infrared: 910 nanometers  1.2 mW maximum average

Temperature

• Operating: 23 °F to 104 °F / -5 °C to 40 °C
• Storage/Transportation: -40 °F to 158 °F / -40 °C to 70 °C
• Time (from storage) for the monitor to be ready for its intended use: 3 minutes to warm from -40 °C to -5 °C
• 5 minutes to cool from 70 °C to 40 °C

Humidity

• Operating: 10% to 90% non-condensing
• Storage/Transportation: 10% to 95% non-condensing
• ± 1 Arm represents approximately 68% of measurements at zero bias.
• This information is especially useful for clinicians performing photodynamic therapy.

Altitude
Operating: Up to 13,123 feet / 4,000 meters
Hyperbaric Pressure: Up to 4 atmospheres

Battery Life

• Operating: Approximately 6,000 spot checks or 36 hours of continuous operation
• using new alkaline batteries.
• Storage: 12 months
• Classifications per ANSI/AAMI ES60601-1 / CAN/CSA-C22.2 No. 60601-1:
• Degree of Protection: Type BF-Applied Part
• Enclosure Degree of Ingress Protection: IP33
• Mode of Operation: Continuous
• This product complies with ISO 10993-1, Biological evaluation of medical devices – Part 1: Evaluation and testing.
• This device is not made with natural rubber latex.

Warranty
NONIN MEDICAL, INCORPORATED, (Nonin) warrants to the purchaser, for 4 years from the date of purchase, each Onyx Vantage 9590 exclusive of the batteries, spring, lanyard, and lanyard lock. Nonin shall repair or replace any Onyx Vantage 9590 found to be defective by this warranty, free of charge, for which Nonin has been notified by the purchaser by serial number that there is a defect, provided notification occurs within the applicable warranty period. This warranty shall be the sole and exclusive remedy by the purchaser hereunder for any Onyx Vantage 9590 delivered to the purchaser which is found to be defective in any manner whether such remedies be in contract, tort or by law.

This warranty excludes the cost of delivery to and from Nonin. All repaired units shall be received by the purchaser at Nonin’s place of business. Nonin reserves the right to charge a fee for a warranty repair request on any Onyx Vantage 9590 found to be within specifications. Onyx Vantage 9590 is a precision electronic instrument and must be repaired by trained Nonin personnel only. Any sign or evidence of opening the Onyx Vantage 9590, field service by non-Nonin personnel, tampering, or any kind of misuse of the Onyx Vantage 9590, shall void the warranty. All non-warranty work shall be done at Nonin’s standard rates and charges in effect at the time of delivery to Nonin.
nonin.com
Nonin Medical, Inc.
13700 1st Avenue North
Plymouth, Minnesota 55441 USA
800-356-8874 (USA and Canada)
+1 763-553-9968 (outside USA and Canada)
Fax +1 763-553-7807
E-mail: technicalservice@nonin.com

Nonin Medical B.V.
Prins Hendriklaan 26
1075 BD Amsterdam, Netherlands
+31 (0)13 – 79 99 040 (Europe)
Fax: +31 (0)13 – 79 99 042
E-mail: technicalserviceintl@nonin.com

WARNING
Portable RF communications equipment such as cell phones or radios (including peripherals such as antenna cables and external antennas) should be used no closer than 30 cm (12 inches) to any part of the ME system, including cables specified by the manufacturer. Otherwise, degradation of the performance of this equipment could result.

Manufacturer’s Declaration
Refer to the following tables for specific information regarding this device’s compliance with IEC 60601-1-2.

Essential Performance
The essential performance of the 9590 is defined as SpO2 accuracy and pulse rate accuracy or an indication of abnormal operation. Accuracies may be affected as a result of exposure to electromagnetic disturbances that are outside of the
environments listed in the Indications For Use. If issues are experienced, move the Nonin system away from the source of electromagnetic disturbances.

Table 1: Electromagnetic Emissions

This device is intended for use in the electromagnetic environment specified below.

The customer and/or user of this device should ensure that it is used in such an environment.

RF Emissions CISPR 11| Group 1
RF Emissions CISPR 11| Class B

Table 2: Electromagnetic Immunity

±15 kV air

Power Frequency (50/60 Hz) Magnetic Field IEC 61000-4-8| 30 A/m

Radiated RF IEC 61000-4-3

| 80 MHz – 2.7 GHz| 10 V/m
380 – 390 MHz| 27 V/m
430 – 470 MHz| 28 V/m
704 – 787 MHz| 9 V/m
800 – 960 MHz| 28 V/m
1.7 – 1.99 GHz| 28 V/m
2.4 – 2.57 GHz| 28 V/m
5.1 – 5.8 GHz| 9 V/m

Table 3: Not Applicable

Harmonic Emissions (IEC 61000-3-2), Voltage Flicker Emissions (IEC 61000-3-3), Electrical Fast Transients (IEC 61000-4- 4), Surge (IEC 61000-4-5), Voltage dips (IEC 61000-4-11), Conducted Immunity (IEC 61000-4-6)
NOTE: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects, and people. Harmonic Emissions (IEC 61000-3-2), Voltage Flicker Emissions (IEC 61000-3-3), Electrical Fast Transients (IEC 61000-4- 4), Surge (IEC 61000-4-5), Voltage dips (IEC 61000-4-11), Conducted Immunity (IEC 61000-4-6)
NOTE: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects, and people.

References

• Pulse and Regional Oximeters, Capnographs, Sensors | Nonin

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