® Verigene RV+ Technical Bulletin January 2011 Verigene® Respiratory Virus Plus Nucleic Acid Test (RV+) on the Verigene® System Technical Bulletin For in vitro Diagnostic Use Page 1 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 SUBJECT ® This communication is in regard to operation of the Verigene Respiratory Virus Plus Nucleic Acid Test (RV+). This information is supplemental and clarifies the directions provided in the ® package inserts for the RV+ and the User’s Manuals for the Verigene Processor SP and ® Verigene Reader. TABLE OF CONTENTS INSTRUMENTS AND REAGENTS REQUIRED FOR RV+ ............................................................ 3 RECEIVING AND STORING THE TEST KIT COMPONENTS ....................................................... 3 MATERIALS NEEDED BUT NOT PROVIDED ............................................................................... 4 SAMPLE COLLECTION, HANDLING, AND STORAGE ................................................................. 4 PREPARING THE WORK AREA FOR TESTING ........................................................................... 4 PREPARING THE RV+ REAGENTS FOR LOADING .................................................................... 5 Preparing the Extraction Tray for Loading ............................................................................ 5 Preparing the Tip Holder Assembly for Loading .................................................................. 5 Preparing and Assembling the Amplification Tray for Loading .......................................... 6 Removing the Test Cartridge Cover ...................................................................................... 6 Settling the Test Cartridge Reagents .................................................................................... 7 STEP-BY-STEP LOADING OF THE CONSUMABLES INTO THE PROCESSOR SP .................. 8 Starting a Verigene® Session and Entering the Cartridge Barcode ................................ 11 ANALYZING RESULTS ................................................................................................................. 12 INTERPRETATION OF RESULTS................................................................................................ 13 RV+ INTERNAL CONTROLS ........................................................................................................ 14 PRINTING RESULTS .................................................................................................................... 15 COLLECTION OF RESIDUAL RNA (OPTIONAL) ........................................................................ 15 DISPOSAL OF CONSUMABLES AFTER TEST COMPLETION .................................................. 15 DAILY MAINTENANCE – END OF DAY ....................................................................................... 16 TIPS AND TROUBLESHOOTING ................................................................................................. 16 RV+ QUICK REFERENCE GUIDE ............................................................................................... 19 QUESTIONS OR CONCERNS ..................................................................................................... 20 Page 2 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 INSTRUMENTS AND REAGENTS REQUIRED FOR RV+ ® Verigene Instruments ® • Verigene Reader (Cat. No. 10-0000-01) ® • Verigene Processor SP with Amplification (Cat. No. 10-0000-07) Test Kit Components ® • Verigene RV+ Nucleic Acid Test Kit (Cat No. 20-005-020) ® • Verigene RV+ Test Cartridges ® • Verigene RV+ Extraction Trays ® • Verigene RV+ Amplification Reagent Kit (Cat No. 20-012-020) ® • Verigene RV+ Amplification Trays RECEIVING AND STORING THE TEST KIT COMPONENTS ® Reagents and consumables for the Verigene RV+ are shipped in two separate boxes: ® Verigene RV+ Nucleic Acid Test Kit (Cat No. 20-005-020) Reagents Storage Conditions Quantity per Box Comments Test Cartridge 2 – 8°C 20 Refrigerate Upon Arrival Extraction Tray 2 – 8°C 20 Refrigerate Upon Arrival Tip Holder Assembly 2 – 30°C 20 Shipped with Extraction Trays Do not freeze Extraction Trays or Test Cartridges. ® Verigene RV+ Amplification Reagent Kit (Cat No. 20-012-020) Reagents Storage Conditions Quantity per Box Comments Amplification Tray – 20°C or colder 20 Freeze Upon Arrival Amplification Tube Room temperature 20 Shipped in Plastic Bag with Amplification Trays The Amplification Tray must remain frozen until the assay is performed. Do not store in a frost-free freezer. If the user suspects that the Amplification Tray did not remain frozen during shipping (i.e. no dry ice remaining in the shipping package), immediately contact Nanosphere. Do not use the Amplification Trays in question. Page 3 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 MATERIALS NEEDED BUT NOT PROVIDED Equipment • -70°C Freezer • -20°C Freezer • 2 – 8°C Refrigerator • Micro-pipette for 200 microliter volume • Vortex mixer • Mini-centrifuge Consumables • Sterile RNase/DNase-free micro-pipette tips with aerosol resistant filter • Nylon or Rayon tipped nasopharyngeal swabs (Copan Innovation) • Sani-Cloth Plus Germicidal Disposable Cloths (Professional Disposables Int’l No. Q85084) or comparable lint free decontaminating wipe • Polyurethane foam swabs (McMaster-Carr, #7074T52, or comparable) Reagents • Universal Transport Medium (Catalog number 330C, Copan Innovation) OR Micro Test M5 Viral Transport Medium (Catalog number R12515; Remel, Inc.) SAMPLE COLLECTION, HANDLING, AND STORAGE Collecting and Transporting the Sample • Training in sample collection and handling is highly recommended because of the importance of specimen quality. • Use Nylon or Rayon tipped nasopharyngeal swabs for sample collection. • Place swab into Universal Transport Medium (3 mL). Break swab shaft and cap the tube. • Transport human respiratory samples refrigerated at 2 – 8ºC. When transporting human respiratory samples, ensure that all applicable regulations for the transport of etiologic agents are met. Storing the Sample • Wipe down the outside of each sample tube with a lint-free decontaminating wipe when the samples are received to avoid cross contamination. • Store the nasopharyngeal swab samples refrigerated at 2 – 8 ºC for up to 72 hours before processing. • For longer term storage, store the samples frozen at – 70 ºC or below. Preparing the Sample for Testing • [Frozen samples only] Thaw samples at room temperature and thoroughly vortex each sample for a minimum of 5 seconds. • [Frozen samples only] Briefly centrifuge (e.g. 5 – 10 seconds) the sample in a minicentrifuge after mixing to ensure all of the sample fluid is at the bottom of the tube. • Open and load one sample tube at a time to avoid cross contamination from tube to tube. Improper collection, storage, or preparation of samples may negatively impact test results and/or lead to cross contamination. PREPARING THE WORK AREA FOR TESTING • Sanitize vortex mixers, centrifuges, pipettes, countertops, and any other equipment used for sample processing with a lint-free decontaminating cloth before and after sample preparation. Page 4 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 PREPARING THE RV+ REAGENTS FOR LOADING This section provides step by step instructions for performing the Verigene Respiratory Virus Plus Nucleic Acid Test (RV+) on the Verigene System. Note: A quick overview is provided at the end of this document. Preparing the Extraction Tray for Loading The Extraction Tray is a single use plastic tray filled with reagents required for the nucleic acid extraction portion of the assay. The tray is stored at 2 – 8 ºC. The reagents include magnetic beads, which settle during storage. Briefly shake the tray to resuspend the magnetic beads prior to loading. Check for resuspension by visually inspecting the well containing the beads. Following resuspension, tap the tray on the counter to ensure that the reagents settle to the bottom of each well. Sample Well Residual RNA Well Preparing the Tip Holder Assembly for Loading The Tip Holder Assembly is a plastic holder that contains two Pipette Tips and a rubber Tip Seal. Each Pipette Tip contains an O-ring on top. Tip Holder Assemblies are shipped in the same container as Extraction Trays and are stored refrigerated or at room temperature (2 – 30 ºC). O-Ring Pipette Tip Tip Seal Before using the Tip Holder Assembly, check the top of each Pipette Tip for the O-ring and check for the rubber Tip Seal between the tips. If either is missing, replace with a new Tip Holder Assembly. Page 5 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 Preparing and Assembling the Amplification Tray for Loading The Amplification Tray is a single-use plastic tray filled with reagents required for the amplification o portion of the assay. The tray is stored at – 20 C or colder. (A) The reagents within the Amplification Tray must be adequately thawed to ensure homogeneity during the assay. Thaw the Amplification Tray at room temperature for 10 – 30 minutes before initiating a run. Visually inspect the tray for an orange reagent which moves when agitated in liquid form. Note: Only thaw Amplification Trays that will be used immediately to avoid enzyme degradation. Do not re-freeze Amplification Trays. (B) Once thawed, mix the reagents in the amplification tray by using a vortex mixer. Set the vortex mixer to a setting between 5 and 6 and turn it on. Gently hold the amplification tray against the vortex mixer for 10 seconds. Tap the tray on a solid surface to ensure that the reagents return to the bottom of each well. (C) The Amplification Tube is also required for the amplification process. It is stored at room temperature. Remove the cap on the Amplification Tube prior to inserting the tube into the Amplification Tray. Note: Always use clean gloves during Amplification Tube insertion. (D) Push the Amplification Tube into the Amplification Tray. Amplification Tube Push Tube into Tray Push with thumb to ensure it is all the way down Amplification Tray (E) After thawing, visual inspection, vortex mixing, and Amplification Tube insertion, tap the tray gently on a solid surface to ensure that the reagents return to the bottom of each well. Once the Amplification Tray has been removed from the freezer, begin test run in the next 10 to 30 minutes or discard. Wear clean gloves to insert the Amplification Tube. Save the Amplification Tube cap to re-cap the Amplification Tube after completion of the assay. Removing the Test Cartridge Cover ® The Verigene Test Cartridge contains the reagents required for the identification portion of the assay, and it also contains a barcode for identification purposes. The cartridge is shipped and stored with a cover to prevent reagent evaporation. It is stored at 2 – 8 ºC. The user must remove the Test Cartridge’s cover prior to loading. Hold the cartridge on the handle side with the left hand (see illustration below), and remove the cartridge cover with the right hand by bending the cover away from the snaps. While applying pressure with the palm of the hand, pull up on the handle to bend the cover for removal. Page 6 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 Make sure that the valve plate (refer to image below) is not moved during cover removal. The best way to avoid moving the valve plate is to grip the handle of the Test Cartridge with your left hand as shown in the image on the right. Do not remove the Test Cartridge cover until immediately prior to inserting the Test Cartridge into the Processor SP. Pull here to remove cartridge cover Palm of hand on cover and fingers pulling on cartridge cover handle Valve plate: Take care to not move the valve plate when removing the cartridge cover. Settling the Test Cartridge Reagents The user must “settle” the reagents in the cartridge before loading into the Verigene Processor SP. The optimal method for “settling” the reagents is to hold the Test Cartridge’s reagent container on the side opposite the handle and tap the reagent container’s barcode with your index finger. When tapping the cartridge, allow the force of the tapping to move the cartridge and your right hand. The tapping is more effective when the cartridge is held in the air so that it moves slightly. Page 7 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 STEP-BY-STEP LOADING OF THE CONSUMABLES INTO THE PROCESSOR SP The following series of images can be used as a visual guide to loading each of the kit components into the Verigene Processor SP. (A) Image A shows an empty Verigene Processor SP. Open the Drawer Assembly by pressing the black open/close button located on the front of the Verigene Processor SP. Open the Drawer Clamp by pressing in the silver latch and lifting the Clamp prior to loading the consumables. Press to open the Drawer Assembly Press to lif t Drawer Clamp A (B) Image B shows a properly loaded Extraction Tray. Prior to loading, shake the tray by hand to re-disperse the magnetic beads before loading, and then tap the tray on the counter to ensure the reagents return to the bottom of each well. The Sample Well is located in the lower right hand corner of the open Drawer Assembly when loaded properly. Press down on the corners of the tray to ensure it is level. Extraction Tray Sample Well B Page 8 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 (C) Image C shows a properly loaded Tip Holder Assembly. For orientation, there are two holes on the deck of the Drawer Assembly that fit each Pipette Tip. Tip Holder Assembly C (D) Image D shows a properly loaded Amplification Tray and Amplification Tube. Prior to loading, vortex the tray to mix reagents, then tap the tray on the counter to ensure the reagents return to the bottom of each well before loading. Remember to insert the Amplification Tube into the Amplification Tray before loading into the Processor SP. The arrow in the image points to the location of the Amplification Tube which must be inserted into the Tray. Note the location of the Amplification Tube and the corresponding amplification well on the deck of the Drawer Assembly. The Amplification Tube can be used to help guide the placement of the Amplification Tray in the proper orientation. When loaded properly, the tray sits flat. Amplif ication Tray D Page 9 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 (E) Image E shows a closed Drawer Clamp over properly loaded trays and Tip Holder Assembly. The Drawer Clamp will latch onto the Drawer Assembly when closed properly, and the user will be unable to lift the Drawer Clamp without pressing in the silver latch. If the Drawer Clamp is not latched properly, the Processor SP will display a message on the information screen when the user attempts to close the Drawer Assembly. Try re-latching the Drawer Clamp if this occurs. Lower the Drawer Clamp E (F) Image F shows the user loading an RV+ Test Cartridge into the Verigene Processor SP. Prior to loading the Test Cartridge, the Test Cartridge barcode must be scanned into the Verigene Reader and the Test Cartridge cover must be removed as described above. Once the barcode is scanned and the cover is removed, the user inserts the Test Cartridge into the Verigene Processor SP until it reaches a stopping point. If the Test Cartridge is not inserted properly, the Processor SP will display a message on the information screen when the user attempts to close the Drawer Assembly. Test Cartridge F Page 10 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 (G) After loading all of the consumables, load 200 microliters of sample into the Sample Well of the Extraction Tray using a micropipette (refer to image below for Sample Well location). Sample Well Make sure the sample is pipetted into the bottom of the sample well before closing the Drawer Assembly. (H) Once the sample is added, close the Drawer Assembly by pressing the open/close button on the front of the Processor to begin automated testing. The Processor will automatically verify that each consumable is properly loaded and begin sample processing. The user can monitor the assay status on the Verigene Processor SP information screen or on the Verigene Reader by selecting the appropriate Processor. ® Starting a Verigene Session and Entering the Cartridge Barcode (A) Login to the Verigene Reader as a ‘user’. (B) From the Menu Bar, SESSION tab, select Start New Session. The Session Setup window will appear. (C) Touch Session ID button and enter information by using the data entry keyboard. This can be any unique identifier in a format defined by the laboratory. The operator ID is automatically entered as the currently logged in operator. (D) Touch the Processing option on the Navigation Bar at the bottom of the screen. (E) Enter the Test Cartridge’s number by scanning the barcode using the barcode wand attached to the Reader or keying in the cartridge number with the Reader’s keyboard. Enter the sample number/ID by scanning or using the Reader’s keyboard. Press Yes to confirm the sample ID (see image below). Page 11 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 (F) In the subsequent dialogue box, de-select viruses or subtypes from the list to de-activate results reporting for those targets. Press Yes to confirm (see image below). Note: once a test run is started, results for de-selected targets cannot be retrieved. The cartridge is now ready for loading as described in the section below. Note: These steps can be repeated for additional cartridges; up to 60 cartridges can be entered into a single session. ANALYZING RESULTS (A) Once the Processor SP and Reader indicate that the procedure is completed, remove the Test Cartridge. The Verigene Processor SP will display “Procedure Done” on the front of the instrument. The Reader will have an arrow in the Test Cartridge icon when the Processor is finished. (B) After removing the Test Cartridge from the Processor, orient the substrate on its side and immediately remove the reagent container from the substrate holder. Keep the substrate holder on its side until it is inserted into the Verigene Reader. Keeping the substrate on its side allows any residual rinse reagent to flow away from the array part of the slide while evaporating. (C) Leave the substrate on its side on a clean, dust-free surface until the Reader is available for analysis. Scan the barcode, remove the tape from the substrate, and insert the substrate into the Reader for analysis. Substrate Holder Keep the substrate on its side during reagent pack removal, and leave it on its side for 30-60 seconds after removal. Page 12 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 INTERPRETATION OF RESULTS The Verigene System software automatically determines the specimen results for Influenza A; Influenza B; RSV A; RSV B; and Influenza A subtypes H1, H3, and 2009 H1N1. The test is designed to provide a “Detected,” “Not Detected,” or “N/A” decision for each of the 7 targets evaluated in each test sample. For example, the presence of Influenza A in a sample is described as “Influenza A Detected” and the absence of RSV A in the same sample is described as “RSV A Not Detected”. When Influenza A is Not Detected, the Influenza A subtype targets are not analyzed and a “N/A” result is displayed for H1, H3, and 2009 H1N1. An example of a detailed report can be found below. A normalized ratio of 0.85-1.00 indicates a positive call and “Detected” is displayed alongside the virus. Page 13 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 Failure of the system, cartridge or sample to produce a test result for one or more of the targets can produce a “No Call” result. The descriptions of possible “No Call” results can be found in the table below. In each case, the recommended recourse is to repeat the RV+ assay using the same sample. If the repeat test generates “Detected,” “Not Detected,” or “N/A” results for each of the 7 targets, the results are accepted. If the repeat test provides the same decision, the sample is inadequate for testing on the RV+. A fresh specimen should be collected and tested. No Call Reason No Call – INT CTL 1 Process Control 1 not detected No Call – INT CTL 2 Process Control 2 not detected No Call – INT CTL IC1 and IC2 not detected No Call – NO GRID Reader unable to image Test Substrate No Call – VARIATION No Call – NEG CTL No Call – BKGD High variability in the target-specific signals Target signal not sufficiently greater than negative control signal Target signal not sufficiently greater than background Potential Cause Inhibition during target amplification Processing and or target amplification issues Processing and/or target amplification issues -Protective silver tape not removed from back of Test Substrate -Test Substrate not properly seated in black plastic Substrate Holder Various Various Various RV+ INTERNAL CONTROLS Page 14 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 PRINTING RESULTS The user can print a summary report containing all of the results within a session using the following steps on the Verigene Reader: (A) Using the Navigation bar at the bottom of the touch screen, select results. (B) Under the menu tab located on the upper left of the touch screen, select “PRINT SESSION” COLLECTION OF RESIDUAL RNA (OPTIONAL) Residual RNA from test processing is collected from the Residual RNA Well in the Extraction Tray (refer to image below). 1) Set a P200 or P1000 micro pipette to 200 µL. 2) Insert the pipette tip to the bottom of the Residual RNA Well on the Extraction Tray (see diagram below) and draw up the residual nucleic acid from the well. 3) Transfer the RNA to a microcentrifuge tube or cryovial for transport and storage. 4) Store the RNA-containing vials at ≤ -70 °C. Note: RNA is inherently unstable. Collect RNA as soon as possible after test processing and place in cold storage (≤ -70 °C). Sample Well Residual RNA Well DISPOSAL OF CONSUMABLES AFTER TEST COMPLETION Re-cap the Amplification Tube before removal to prevent cross contamination. Treat all consumables as potentially infectious and dispose of them accordingly. Page 15 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 DAILY MAINTENANCE – END OF DAY The user should do a daily maintenance at the end of the day. (A) With a lint-free decontaminating wipe: a. Wipe the heat block inside the Processor SP module’s drawer opening. The heat block is the flat surface at the bottom of the opening. The wipe can be wrapped around a swab to facilitate wiping. b. Wipe the Amplification Tube Well and surrounding area on the drawer of the Verigene Processor SP. c. Wipe the Drawer Clamp and arms in the Processor SP. d. Wipe the outer surfaces of the Processor SP and Reader. TIPS AND TROUBLESHOOTING ISSUE ACTION CHANGING THE SAMPLE ID The user can change the sample ID prior to starting a run using the following steps: 1. Under the Menu tab, select Cancel Test Cartridge. 2. Scan the barcode of the Test Cartridge you want to cancel or enter the barcode manually. 3. Re-scan the barcode of the Test Cartridge and enter the appropriate Sample ID. TERMINATING A RUN The user can terminate a run with the following steps: 1. Under the menu tab, select Verigene Processors on the touch screen to display the status of each Processor. 2. Select the Processor of interest on the touch screen. 3. Wait for the countdown to begin on the Processor SP status screen, then select Terminate on the touch screen to end the run. Page 16 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 ISSUE ACTION REVIEWING RESULTS FROM A PREVIOUS The user can review results from a previous VERIGENE SESSION Verigene Session using the following steps: 1. Under the Sessions tab, select the Session that you would like to review. 2. Touch the results option on the navigation bar at the bottom of the touch screen. 3. Select the sample of interest using the touch screen to view the results. THE PROCESSOR DOES NOT START If the Processor fails to start automatically, it AUTOMATICALLY AFTER THE DRAWER will make a beeping sound to indicate a ASSEMBLY IS CLOSED consumable verification failure. The Processor will display the verified components in the “Ready to Start” screen. Under these circumstances, the user must follow these steps: 1. Open the Drawer Assembly to check the consumable that could not be verified. 2. Check to make sure the consumables are properly positioned. 3. Re-close the Drawer Assembly. 4. The test should automatically begin. If the Processor fails to start the test automatically and the user is certain that all components are loaded correctly, the user can manually initiate the assay (see below for instructions). Page 17 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 ISSUE ACTION MANUALLY STARTING AN ASSAY IF THE If a manual start is necessary, the user can PROCESSOR DOES NOT START initiate the assay using the Verigene Reader AUTOMATICALLY with the following steps: 1. Under the menu tab, select Verigene Processors on the touch screen to display the status of each Processor. 2. Find the Processor that did not start when closed, and select start on the touch screen. 3. The user will be asked to select a cartridge identification number. Select the barcode of the inserted cartridge. THE READER IS UNABLE TO READ THE The Reader will return a “NO CALL – NO TEST SUBSTRATE (NO CALL – NO GRID) GRID” is if the user forgets to remove the silver tape from the back of the substrate or if the Substrate Holder is not appropriately placed into the Reader. The following steps can be taken to check the Test Substrate: 1. Remove the Test Substrate from the Reader. 2. Check to make sure the silver tape has been removed from the back of the substrate. If it is still attached, remove the silver tape. 3. Under the Menu tab, select Enter Barcode. 4. Re-scan cartridge barcode. 5. Re-insert the Substrate Holder into the Verigene Reader until it reaches a stopping point. Note: Ensure that the glass slide is positioned correctly within the Substrate Holder. Page 18 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 RV+ QUICK REFERENCE GUIDE TEST SETUP A. Remove the Amplification Tray from the freezer to thaw at room temperature (NOTE: Be sure to start a test run within 10 – 30 minutes of removal from the freezer) B. Remove Extraction Trays (with Tip Holders) and Test Cartridges from the refrigerator C. Open the Drawer Assembly and lift the Drawer Clamp D. EXTRACTION TRAY: a. Shake the Extraction Tray to resuspend magnetic beads b. Tap the Extraction Tray to settle reagents c. Insert the Extraction Tray into the Extraction Module E. Insert the Tip Holder Assembly (double check for O-Rings and Tip Seal) F. AMPLIFICATION TRAY: a. Check the Amplification Tray after 10 minutes to ensure it is thawed b. Vortex the Amplification Tray to mix the thawed reagents c. Tap the Amplification Tray to settle the reagents d. Remove the cap of the Amplification Tube e. Push the Amplification Tube into the Amplification Tray f. Insert the Amplification Tray/Tube into the Amplification Module G. Lower and Latch the Drawer Clamp over the Trays BEGIN RUN H. TEST CARTRIDGE: a. Use the Reader to set up a run: i. Login ii. Start new session or enter previous session using the Session Tab iii. Input session ID – up to 60 cartridges/session iv. Touch Processing Tab on navigation bar at bottom of touch screen v. Scan the Test Cartridge using the barcode scanner vi. Enter sample identification information vii. Confirm/adjust assay targets to be reported with results Sample Well b. Remove the cover from the top of the Test Cartridge c. Tap the Test Cartridge on the barcode to settle the reagents d. Insert the Test Cartridge into the Hybridization Module I. LOAD SAMPLE – pipette 200 microliters of sample into the bottom of the Sample Well J. Close the Drawer Assembly to begin test processing K. Confirm countdown has started on the Processor SP before leaving the area Page 19 of 20 For in vitro Diagnostic Use 10-0025-D ® Verigene RV+ Technical Bulletin January 2011 UPON COMPLETION OF RUN L. Open the Drawer Assembly M. Cap the Amplification Tube N. Remove the Test Cartridges: a. Remove the Test Cartridge from the Hybridization Module b. Keeping the cartridge on its side, remove and discard the Reagent Pack c. Leave the Test Substrate on its side on a clean, dust-free surface for 30 – 60 seconds O. Read the Test Cartridges: a. Remove the silver tape from the back of the Test Substrate b. Scan the barcode on the Test Substrate c. Insert the Test Substrate into the Reader for analysis d. Confirm that a result other than ‘No Call – NO GRID’ has been generated e. Dispose of used Test Substrate • COLLECT RESIDUAL RNA (OPTIONAL) i. Using a standard pipette tip, pipette the residual RNA from the Extraction Tray into the appropriate tube ii. Store the residual RNA tubes at -70 degrees C P. Dispose of all consumables Residual RNA Well Sample Well DAILY MAINTENANCE – END OF DAY (B) With a lint-free decontaminating wipe: a. Wipe the heat block inside the Processor SP’s Hybridization Module b. Wipe the Amplification Tube Well and surrounding area c. Wipe the Drawer Clamp and arms d. Wipe the outer surfaces of the Processor SP and Reader QUESTIONS OR CONCERNS If you have questions or concerns regarding this bulletin, please contact your Nanosphere Clinical Sales Representative or Nanosphere Product Support at 1-888-837-4436 or by email at productsupport@nanosphere.us. Page 20 of 20 For in vitro Diagnostic Use 10-0025-D