Submit a Ticket

Contact Person *

Company name *

Your E-Mail *

Date

Subject

Short summary of the problem.
Example: System error

Potential impact on diagnostic result? *

No

Possibly

Yes

Affacted Products *

ColorJet Nano

Etzel I

Alberich I

Reagent

Please select the affected products!

Serial Number of the ColorJet Nano *

Please type in all of the affected Serial Number of the ColorJet Nano.

Firmware version of the ColorJet Nano

Firmware Version of the ColorJet Nano. It is shown in the menu: "Device Setting" -> "Firmware"

GUI version of the ColorJet Nano

GUI Version of the ColorJet Nano. It is shown in the menu: "Device Setting" -> "Firmware"

JaClean Calibration value *

Please type in all Calibration values for JaClean. Example: 14 ml

R5 Calibration value *

Please type in all Calibration values for R5. Example: 14 ml

R4 Calibration value *

Please type in all Calibration values for R4. Example: 14 ml

R3 Calibration value *

Please type in all Calibration values for R3. Example: 14 ml

R2 Calibration value *

Please type in all Calibration values for R2. Example: 14 ml

R1 Calibration value *

Please type in all Calibration values for R1. Example: 14 ml

Staining method of the affected colorJet Nano

Gram

MGG

Wright-Giemsa

Please select which methods the ColorJet Nano is set to.

Staining application

Which application was the issue identified in?

How was the smear performed? *

Manual

Automated

How was the smearing done?

Which System? *

Etzel I

Others

How was the smearing done?

Used System *

Brand / Model / Dimensions

Slides used

Model & Brand & Dimension

Sample material

Exempel: Blood / Bone marrow / etc.

Age of sample material

Hours or days

Drying time after smearing

Minutes

Used Reagent on the ColorJet Nano *

Please enter LOT number and opening date.

Example:
JaClean LOT: ______ opening date: ______
R5 LOT: ______ opening date: ______
R4 LOT: ______ opening date: ______
R3 LOT: ______ opening date: ______
R2 LOT: ______ opening date: ______
R1 LOT: ______ opening date: ______

Staining result from position S1 to S6

Uniform staining

Non-uniform staining

please select and upload picture of the stained slide.

By Other *

Please explain in detail.

Microscopic Evaluation of Staining Result

Please upload microscope images at 100x magnification. Label the images according to the slide position (S1–S6). Maximum file size: 20MB.

Serial Number of the Etzel I *

Please type in all of the affected Serial Number of the Etzel I.

Slides used

Brand / Model / Dimensions

Sample material

Exempel: Blood / Bone marrow / etc.

Age of sample material

Hours or days

Drying time after smearing

Minutes

Serial Number of the Alberich

Please type in all of the affected Serial Number of the Etzel I.

Used Reagent for manual staining *

Describe your field here.

Staining result *

Uniform staining

Non-uniform staining

please select and upload picture of the stained slide.

Frequency of the issue *

Once

Occasionally

Every staining/ smearing cycle

Unknown

Description *

Please describe:
• What happened?
• What did you/ your customer expect?
• How often does the issue occur?
• When did it start?

Attachment

please upload images that are labeled accordingly. (Max File size: 20MB)

*

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