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Electrophoresis Information Form
Key Contact
Name:
Contact Number:
Contract details
Contract type:
(please circle
appropriate) if other
please detail in box
below
Term:
Start Time:
MSC (Y/N):
MSC Start Date:
Katherine
Wright
01302 366666
Ext 3883
Position:
Clinical Scientist
Email Address:
[email protected]
Reagent Rental / Capital Purchase / Annual Renewal / Reagent
Purchase only / Other
Details:
10 years
YES
1/11/11
End Time:
MSC Provider:
MSC End Date:
ABBOTT
1/11/21
Please provide the annual throughput, equipment manufacturer / model and reagent
provider for the following:
Serum Protein Electrophoresis:
Tests per year:
Equipment Manufacturer:
Model:
Serum Immunofixation / Immunotyping Electrophoresis
Tests per year:
Urine Protein Electrophoresis (Bence Jones Protein Screen)
Tests per year:
Urine Immunofixation Electrophoresis
Tests per year:
Alkaline Phosphatase Isoenzymes
Tests per year:
Equipment Manufacturer:
Model:
IgG Isoelectric focusing (Multiple Sclerosis screen)
Tests per year:
Equipment Manufacturer:
Model:
Carbohydrate deficient transferrin quantitation
Tests per year:
Equipment Manufacturer:
Model:
Alpha-1- antitrypsin phenotyping
Tests per year:
Equipment Manufacturer:
Model:
Y
6017
Sebia
CapillaryS
Y
493
Y
1772
Y
216
Y
39
Hydrasys
N
N
N
Haemoglobinopathy Screening Information Form
Key Contact
Name:
Contact Number:
Contract details
Contract type:
(please circle
appropriate) if
other please detail
in box below
Term:
Start Time:
MSC (Y/N):
MSC Start Date:
Sarah
Bambrough
01302 366666
ext 6187
Position:
Chief BMS
Email Address:
[email protected]
Reagent Rental / Capital Purchase / Annual Renewal / Reagent
Purchase only / Other
Details:
10 years
YES
1/11/11
End Time:
MSC Provider:
MSC End Date:
ABBOTT
1/11/21
Please provide the annual throughput, techniques used, equipment manufacturer / model
and reagent provider for the following:
Mainline screening analyser – HbA1c quantitation only. All HBE work is referred to
external Lab.
TOSOH
Manufacturer:
G8
Model:
HPLC
Technique:
2
Number of analysers:
Mainline confirmatory analyzer / technique – Not Required
Manufacturer:
Model:
Technique:
Number of analysers:
Test
Tests per year
Haemoglobinopathy screens (Quantitation of haemoglobin A & F)
Haemoglobin variant Identification
HbA1c quantitation
83777
In addition does your trust screen every antenatal patient or only those that have been
identified as at risk using a family origin questionnaire (FOQ)?
All Antenatal patients are screened using the FOQ form in conjunction with an FBC to
assess whether further investigations are required.
Coagulation Screening Information Form
Key Contact
Name:
Contact Number:
Contract details
Contract type:
(please circle
appropriate) if
other please detail
in box below
Term:
Start Time:
MSC (Y/N):
MSC Start Date:
Sarah
Bambrough
01302 366666
ext 6187
Position:
Chief BMS
Email Address:
[email protected]
Reagent Rental / Capital Purchase / Annual Renewal / Reagent
Purchase only / Other
Details:
10 YEARS
YES
1/11/11
End Time:
MSC Provider:
MSC End Date:
ABBOTT
1/11/21
Please provide the annual throughput, techniques used, equipment manufacturer / model
and reagent provider for the following:
Mainline coagulation analyser
IL
Manufacturer:
TOP500
Model:
4
Number of analysers:
Prothrombin Time
(Y)
75374
Tests per year:
IL
Reagent manufacturer:
INR
(Y)
74317
Tests per year:
IL
Reagent manufacturer:
Activated Partial
(Y)
Thromboplastin Time
49089
Tests per year:
IL
Reagent manufacturer:
Fibrinogen (excluding
(Y)
derived fibrinogen)
462
Tests per year:
IL
Reagent manufacturer:
Thrombin Time
(Y)
Protein C
Tests per year:
Reagent manufacturer:
Protein C resistance
Tests per year:
Reagent manufacturer:
Prothrombin gene
mutation
Tests per year:
Reagent manufacturer:
Protein S
(N)
(N)
(N)
(N)
Tests per year:
Reagent manufacturer:
Factor Assays
(N)
Tests per year:
Reagent manufacturer:
D-Dimers
5
IL
(Y)
Tests per year:
Reagent manufacturer:
vWF assay
(N)
Tests per year:
Reagent manufacturer:
Lupus screens
5162
IL
(Y)
Tests per year:
Reagent manufacturer:
Platelet aggregation
(N)
Tests per year:
Reagent manufacturer:
934
IL
studies
Tests per year:
Equipment manufacturer:
Model:
Reagent manufacturer:
Please outline any additional equipment used, for example point of care or backup anaylsers.
Additional equipment 1
Manufacturer:
Model:
Number of analysers:
Test:
Reagent manufacturer:
Tests per year:
Additional equipment 2
Manufacturer:
Model:
Number of analysers:
Test:
Reagent manufacturer:
Tests per year:
Additional equipment 3
Manufacturer:
Model:
Number of analysers:
Test:
Reagent manufacturer:
Tests per year:
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