NIHON KOHDEN Life Scope PT (BSM-1700 Series) Transport Monitor and Data Non-Continuity

Category: NIHON KOHDEN Life Scope TR (BSM-6000 series), Life Scope PT (BSM-1733, BSM-1753, BSM-1763, BSM-1773), Life Scope Telemetry, Life Scope J (BSM-9101) bedside monitor, Nihon Kohden SpO2 algorithm type, semi-quantitative Waveform, Host Monitor, MULTI connectors, discontinuous seamless monitoring, IntelliVue X2, patient monitoring

Life Scope PT transport monitors are derived from the bulky input units of Life Scope TR (BSM-6000 series) bedside monitors

 

These 5.5-inch transport monitors are adapted from the three types of multi-parameter Input Units designed initially for configured Life Scope TR (Life Scope BSM-6000 series) bedside monitors.

 

Both transport monitors and Input Units are also currently key constituents of Life Scope G9 (CSM-1901) bedside monitor, Life Scope G5 (CSM-1500 series) bedside monitors, and Life Scope G7 (CSM-1700 series) bedside monitors. 

 

The transport monitors design is an attempt to imitate the Philips IntelliVue MMS X2, by the addition of touch-screen, storage memory and rechargeable battery to the existing Input Units, doing away the need to attach it to a portable monitor during patient transfer.

 

Configured Input Units made into Transport Monitors imitating Philips IntelliVue MMS X2

There are three types of Input Units that can be used on Life Scope TR (BSM-6000) bedside monitors, and only input units using Nellcor and Masimo algorithms are available in the US market.

 

Below image shows the three types of Input Unit,

1. AY-663P Input Unit uses NIHON KOHDEN SpO2 algorithm

2. AY-653P Input Unit uses Nellcor OxiMax SpO2 algorithm

3. AY-633P Input Unit the Masimo SET SpO2 algorithm

 

Similarly configured input units with different SpO2 algorithms; what are these yellow connection sockets?

Other than placing the input unit directly onto the monitor main unit, it is possible to place the input unit closer to the patient by using an extension known as Data Acquisition Unit (DAU). Note a DAU unit is a serial device and connects to the main unit using only serial communication, it does not have an IP address for networking flexibility. There are two types of DAU units, the JA-694 DAU unit has four additional yellow MULTI sockets for use by the input unit while the JA-690 DAU unit comes without any yellow MULTI sockets (see below picture). How these yellow MULTI sockets work will be explained in due course.

 

 

When a transport monitor is needed, the input unit is replaced by a Life Scope PT transport monitor; the transport monitor works as an input unit when attached to a main unit known as the Host Monitor, and becomes an independent transport monitor upon its release from the Host Monitor.

 

There are four models of Life Scope PT (BSM-1700 series) transport monitors:

1. Life Scope BSM-1773 transport monitor (Nihon Kohden older version SpO2 algorithms)

2. Life Scope BSM-1763 transport monitor (Nihon Kohden current version SpO2 algorithms)

3. Life Scope BSM-1753 transport monitor (OEM SpO2 board supplied by Nellcor)

4. Life Scope BSM-1733 transport monitor (OEM SpO2 board supplied by Masimo)

 

A Life Scope PT transport monitor placed on a JA-694P DAU unit (left)

 

The difference among the four transport monitor models is the SpO2 algorithms.

 

The four types of Life Scope PT transport monitors

The two models (BSM-1773 and BSM-1763) on left side of above table make use of Nihon Kohden SpO2 algorithms but they have different version of SpO2 algorithm. The version for US market is using the previous-generation algorithm, and why would the US market need an older version of current SpO2 algorithm is really a puzzle.

 

While NIHON KOHDEN is recognized for developing the non-invasive SpO2 measurement principle in the 1970s, the company is no longer in the forefront of non-invasive SpO2 technology. The two models on the right side of above table (BSM-1733, BSM-1753) are using SpO2 OEM boards supplied by Masimo and Nellcor respectively.

 

Some sales and marketing teams are very excited about the bigger screen of Life Scope PT in the market but overlooked their lack of knowledge why the configured multi-parameter Input Units of Life Scope TR (BSM-6000 series) bedside monitors are so different and big from the competitions that a 5.7 inch screen can just be mounted on one of the side!

 

Why are the Input Units of Life Scope TR so big and different from the competitions?

They should wonder why is the shown input unit so big and different from the competitors? The reason is because they are configured with much more internal hardware than any competitor in the market. Try holding it with one hand and see how heavy it is compared to other competitors in the market.

 

The shown input unit is heavily loaded with patient-monitoring hardware inside

 

There are much more hardware inside than what you can gather from the smaller number of sockets on the outside. The details are avoided in product communication to the market, intentionally done to hide the fact the input units are not modular in design. 

 

Many internal hardware are not made clear in product communication to the market

 

Life Scope TR bedside monitors had been upgraded to Life Scope G5 series bedside monitors using panel PCs as displays

  

The updated model of Life Scope TR series are the Life Scope G5 series bedside monitors; the main units of Life Scope G5 bedside monitors are Life Scope TR main units updated with integrated panel PCs replacing previous LCD displays.

 

  

There is an alternative model to Life Scope G5 bedside monitors, known as Life Scope G7 bedside monitors. The latter model makes use of a Panel PC as main unit and rely on the data acquisition unit to interface with input units or Life Scope PT transport monitor.

As shown below, the main unit is the panel PC with touchscreen sizes of 15.6-inch and 19-inch. Notice the Input Units (originally designed for Life Scope TR) cannot be placed on the main unit, and a data acquisition unit is mandatory for use. Life Scope G7 monitor configuration makes it redundant to have Life Scope G5 bedside monitor using a data acquisition unit. The external socket box for Life Scope G7 bedside monitor is the same one (AA-174P) as Life Scope G5, with MULTI sockets arranged horizontally and must be linked to a new type Data Acquisition Unit (JA-170PA).

 

 

The distinctive feature of the AY-663P/AY-653P/AY-633P Input Units for Life Scope G5 or Life Scope G7 bedside monitors is the utilization of three flexible MULTI (short for multi-parameter) sockets. The flexible MULTI sockets are colored yellow; they are meant for frugal sharing by a group of internal hardware, and can also switch to be a pass-through path for digital communications from serial kit sets. 

 

The yellow flexible MULTI sockets can be utilized for IBP, Temperature, Cardiac Output, FiO2 and Thermistor-method Respiration, plus a variety of digital serial kit sets supported by system software. There is no free lunch, so what cost must be incurred in order to achieve the flexibility of these yellow MULTI sockets?

 

What does this mean?

The first cost comes from the measurement cables; ordinary measurement cables cannot be used on such flexible sockets, and additional expenses are needed to pay for custom measurement cables that must be embedded with digital parameter codes in their yellow plugs. This is a necessary basic step because a flexible MULTI socket must by definition accept more than one type of measurement cable; the parameter code in the plug is the method adopted to differentiate the cables, and inform the monitor what internal hardware/ software are needed for support when a measurement cable is being plugged in.

 

The manufacturer made the mistake of thinking a flexible MULTI socket exhibits characteristics similar to what a modular monitor offers, only to learn painfully from market rejections flexible sockets are indeed only poor man's sockets. It was unnecessary lessons, and expected if you understand the working principles.

 

The consequence of using flexible MULTI sockets for general use actually translates to insufficient physical sockets for users, and the deprived users are not hesitating to demand them back! There is no customer value in socket flexibility when its use results in not having enough physical sockets for the users, and the manufacturer had failed to make socket flexibility relevant.

 

This specific MULTI-PARAMETER UNIT (MPU) design from the 1990s is responsible for the manufacturer's woe

 

Veiled in secrecy, NIHON KOHDEN does not explain to the market how they could make sockets that are flexible enough for a total five types of internal hardware, as well as being diverted for use as serial ports for self-contained kit sets. Almost the entire sales and marketing people employed in Japan Head Office have no engineering background, how could any one discuss anything of substance with the distributors or customers (except for prices and deliveries).

Here are the historical facts, and it was just a quest to find the solution for a small module with a front panel that did not have enough panel space to mount all the numerous connector sockets needed.

The special need that was searching for a solution

The problem was not unique to NIHON KOHDEN, with the most common solution in the market being to integrate more than one signal onto a socket and using an external splitter to get back the original individual signals. The thought-provoking solution from NIHON KOHDEN was, however, to frugally share a small number of common sockets.

 

That was in the 1990s, and NIHON KHODEN development team managed to identify five types of analog hardware (Temperature, IBP, Cardiac Output, Thermistor-method Respiration, FiO2) that could form a hardware group frugally sharing just two sockets that are flexible for group use. The two flexible sockets are known as MULTI (short for multi-parameter) sockets and are specially colored yellow for easy identification.

 

The hardware group and flexible sockets together made up the MULTI-PARAMETER UNIT (MPU), and was a peculiar design to minimize the number of physical sockets needed on a front panel that had a limited space area; thus, the MPU has the special characteristic of possessing more hardware than physical sockets. It is a design to optimize a few physical sockets for frugal sharing, and is therefore operating under constraint of limited sockets.

 

The MPU must be viewed from the right perspective, that it is illogical to use when there is no lack of panel space, because we should typically be optimizing use of expensive hardware instead of cheap sockets.

It was a design to optimize a fraction of total needed physical sockets for sharing, and is operating under constraint of limited sockets

To access each type of hardware, an external measurement cable with a digital parameter code stored in its plug needs to be inserted into one of the two MULTI sockets. These custom measurement cables that come with yellow coded plugs are collectively cited as Smart Cables by the manufacturer and each embedded digital parameter code pinpoints the exact type of internal hardware and software needed by a particular measurement cable. Thus, the mission of the Smart Cables is to make use of digital codes to share the yellow flexible MULTI sockets.

 

The digital hexadecimal parameter code is programmed into a non-volatile EEPROM chip (Electrically Erasable Programmable Read-only Memory) mounted on a small flexible PC board and wired to the plug of a Smart Cable at the factory; users cannot change the code after production using settings on the monitors. The Smart Cables are priced highly by the manufacturer, and only the common IBP cable can be sourced from China suppliers at a reasonable price.

 

A non-volatile code is embedded in the plug of a Smart Cable

 

Each yellow MULTI socket can only link to one channel of the internal hardware, except for Temperature which can accommodate up to two.

 

As an exception, a MULTI socket can link up to two channels of internal Temperature hardware

The hardware mentioned here are  linked to the flexible MULTI socket internally, and not from the outside

The hardware are Temperature, IBP, Cardiac Output, Thermistor-method Respiration and FiO2; these hardware are already placed internally in the MPU before leaving the factory.

An external measurement cable with a valid digital code embedded in its plug selects the intended internal hardware (only if available)

Below image shows the MULTI-PARAMETER UNIT (MPU), complete with two yellow MULTI sockets for group sharing. An external Smart Cable with a valid parameter code selects the needed hardware using one of the two MULTI sockets.

 

Based on the fact both MULTI sockets must be capable of doing IBP monitoring, and the logic that IBP hardware should not be more than the number of MULTI sockets, the IBP hardware are therefore not placed in the common pool for sharing; instead each MULTI socket comes with its own dedicated IBP hardware.

 

 

A MULTI socket can only access its own dedicated IBP hardware, and makes use of it when an IBP measurement cable is plugged into it. For non-IBP monitoring, both MULTI sockets can access the common hardware pool comprising Temperature, Cardiac Output, Thermistor-method Respiration and FiO2 hardware in the MPU.

 

Given the large amount of hardware that are idling in the MPU block, more physical sockets are needed to make good use of these valuable hardware; yet, only physical sockets in the form of MULTI sockets can access the MPU. The arrangement to add more physical sockets is thus achieved using external expansion boxes filled with two or more MULTI sockets (each with its own dedicated IBP amplifier hardware). It is important at this point to be clear the purpose is to add more physical sockets linking to the existing MPU, and not to add more monitoring parameters.

 

This is a process of adding more physical sockets, not more monitoring parameters

The additional MULTI sockets are integrated using analog interface, and must be limited to a maximum of four sockets to avoid signal deterioration caused by voltage drop and noise.

 

A MULTI socket can additionally switch to be a pass-through path for digital communication from any serial kit set

 

This is done via the parameter code, bypassing the internal analog hardware and go directly for digital processing.

 

Using the parameter code, a MULTI socket can switch to be a transit point for any digital serial signal

The purpose of the MPU was to solve the problem of limited panel space area, and by using MULTI sockets as serial ports does help in furthering the reduction of one more physical socket on the front panel. The initial design was to save on one physical socket and meant only for use by the mainstream CO2 serial kit sets.

 

 

Shown above is the original label for the two MULTI sockets. It shows each socket can be utilized for monitoring of IBP, Temperature, Cardiac Output, FiO2 and (Thermistor-method) Respiration, as well as a pass-through path for mainstream CO2 serial kit sets.

 

The small module mentioned earlier was named Saturn multi-parameter module and the outcome of the MPU solution is as shown below. The Saturn module is housed in a 8-slot module rack, with two expansion boxes next to it; in this arrangement, there were a total of six MULTI sockets (with six channels of IBP hardware) available for use. It is possible to use the Saturn module alone, but the two MULTI sockets would not be enough.

 

The MPU block without the module rack housing is meaningless

 

Unfortunately, the digital measurement LAN network for data communication between module rack housing and monitor main unit was unstable requiring huge processing power, and had to be finally given up for good. This means the first two digital modular monitors (shown below) developed by the manufacturer were failures, and were not ready for releases. They were withdrawn before FDA registration in the biggest US market.

 

Note the failed LAN network is not referring to the real-time clinical LAN network for data exchanges between bedside monitors and central nurse stations.

 

 

After the decision to stop development work on the digital measurement LAN network, a younger team of risk-averse engineers took over key positions and decided to keep the MPU and using the expansion sockets to simulate scalability. This is desperate and unprofessional behavior, because they did it to avoid working on a new measurement LAN; at the same time, they also knew they could get away with it in Japan given the low bargaining power of users in the domestic market.

 

The MPU was only a compromise to accommodate limited panel space area and should never be mistaken as an innovation; without the module rack, the MPU is meaningless and most importantly, there is no demand for socket flexibility outside of Japan.

 

Professionally, many are puzzled by the behaviors of the MPU but refrained from asking or faced with a wall of silence. The situation was so acute that at one point we had regular telephone calls and letters from undergraduates around the world (excluding Japan) hoping to understand the principle behind the MULTI sockets; we of course could not help them in any way then. When we have ample panel space area, there is no need for such a compromise and the use of an MPU (with its Smart Cables and MULTI sockets) actually becomes a burden and is a waste of money. Its continued use regardless of need is the very reason for its eventual failure.

 

Besides, there are other cheaper and practical ways to solve the problem of insufficient panel space on the input panel, such as commonly integrating more than one signal onto a socket and using an external splitter to resolve back the original signals.

 

Example of resolving an integrated signal back to original P1 and P2

 

So far, time sharing of connector sockets is only done by NIHON KOHDEN, and avoided by all other manufacturers of patient monitors.

 

Variations to the basic theme

There are variations to the basic theme, such as

a. doing without use of external expansion box,

b. increasing the number of multi-parameter sockets in the MPU,

c. reducing the hardware configured in the MPU.

 

We also found a standalone yellow MULTI socket that does not have any IPB amplifier attached, such a socket can be found on the CardioLife TEC-5600 series defibrillators. The naked yellow MULTI socket on said TEC-5600 series defibrillators is just a serial port dressed as a flexible socket and the system software only supports TG-900P mainstream CO2 serial kit set (P903).  

 

 

A Life Scope PT (BSM-1700) transport monitor has no link to the Central Monitor after leaving the host monitor

 

Note a Life Scope PT transport monitor (BSM-1700) can only link to a central monitor using telemetry or wired Ethernet when not acting as an input unit. Thus, when a BSM-1700 transport monitor leaves a Host Monitor, its only way to keep in contact with the Central Monitor is using a telemetry transmitter. Without a telemetry transmitter attached to its side, there is no other way to communicate with the Central Monitor.

 

 

It is, however, impossible to attach the optional ZS-900PK transmitter to the transport monitor when the latter is placed on a DAU unit (acting as an Input Unit to a Host Monitor). This is illustrated in below picture.

 

A telemetry transmitter cannot be attached to a Life Scope PT transport monitor when it is placed on a DAU unit

It is clear when a BSM-1700 transport monitor leaves a Host Monitor, it is not attached with a telemetry transmitter, and loses contact with the Central Monitor. This is a terrible design flaw that you should know before committing.

 

The communication link is re-established when the Transport Monitor is again attached to a Host Monitor as Input Unit; once this is done, the patient data stored in the Life Scope PT during the transport period will be updated to the Central Monitor. This is not what the users want, since the patient should be monitored on the Central Monitor during transportation.

 

The telemetry transmitter option can only be used on BSM-1700 monitor operating as a stand-alone monitor. The monitor obviously will be over-priced for such use and an unlikely installation outside of Japan.

 

 

The above image shows a Life Scope BSM-1700 transport monitor equipped with a ZS-900PK telemetry transmitter. The brochure talked about continuous monitoring using telemetry but such communication does not exist when Life Scope PT acts as a transport monitor. 

Why is this description so out of context?

The reason Philips IntelliVue MMS X2 has continuous link with Central Monitor after leaving the Host Monitor

The Philips IntelliVue MMS X2 is similarly a transformation of MMS (multi-measurement server module) into a compact monitor with display and battery, primary purpose to link an MMS module to a patient and follow the patient's movement.

 

IntelliVue MMS X2 was launched long before BSM-1700

 

When the IntelliVue MMS X2 is connected to a host monitor, it has two options to connect to the Central Monitor.

1. via the Host Monitor (wired Ethernet or WiFi)

2. via its own wireless telemetry transceiver

 

The option 2 should be selected; it means patient identity is by the telemetry transceiver, and the Host Monitor is automatically paired to it for monitoring at the Central Station.

During patient transfer, the IntelliVue MMS X2 disconnects from Host Monitor and the latter is no longer paired to it. The MMS X2 now operates as an independent transport monitor, and communication link with Central Station is not broken since the telemetry transceiver is always inside the IntelliVue MMS X2.

When the patient arrives at a new location, a new Host Monitor is now paired to the transport monitor's telemetry transceiver for monitoring at the Central Station. Such patient transfer is truly seamless at the system level.

 

The telemetry transceiver in the IntelliVue MMS X2 is the token for tracking the patient

In fact, the Philips IntelliVue MMS X2 was released much earlier than the Life Scope BSM-1700 transport monitor, so there was no reason the project leader of BSM-1700 could be unaware of this important requirement. It was ignored due to the outdated protocols of the clinical monitoring network (officially named as LS-NET); this outdated protocols currently do not support patients moving together with a monitor from one location to another. It should also be mentioned that there is a big difference in telemetry technology.

The Outdated Clinical Network Protocols

Using the SC-170R AC Cradle, a stand-alone BSM-1700 monitor (not acting as input unit to a host monitor) can connect to a Central Nurse Station using wired Ethernet.

Shown below is how a BSM-1700 monitor, resting on an SC-170R AC Cradle, is connected to the LS-NET. The SC-170R AC Cradle also provides the power for a BSM-1700 monitor placed on it, as well as charging its internal battery for transport use.

 

The SC-170R AC Cradle does not make practical sense

When a BSM-1700 monitor is placed on a SC-170R AC Cradle, its function is only an ordinary stand-alone monitor but the price of a purpose-built BSM-1700 is twice that of an ordinary monitor with equivalent monitoring capability. To justify the higher price, Life Scope BSM-1700 monitor must qualify as a "PICK and GO" monitor.

 

The problem is the outdated network protocols of LS-Net, which define behaviors for communications on the network connecting bedside monitors and central monitors; this protocols is still at the first-generation version and needs a major revision.

The said LS-NET protocols only work when the monitors do not move with the patients; it was developed at a time when a monitor is always stationary at a fixed location, and only the patients were being transferred from one location to another. Patient identity was by a combination of both monitor and location, with assumption of a non-moving monitor; the protocols now needs a fundamental revamp to allow patients moving together with their monitors.

This means although a BSM-1700 monitor placed on a SC-170R AC Cradle is easily released mechanically by a lever, the BSM-1700 monitor cannot be used as a valuable "PICK and GO" monitor due to the outdated network protocols of LS-NET.

The manufacturer had confirmed there would be patient location confusion at the Central Nurse Station for such a setup shown in below image.

 

Life Scope PT placed on a SC-170R AC Cradle causes confusion when used with a Central Monitor!

 

In the above monitoring setup with a Central Monitor, the Central Monitor would still remember the last bed locations even if the patients (together with the Life Scope PT monitor) had been swapped between BED ONE and BED TWO. This is serious matter.

 

Instruction not to link the AC Cradle to a central monitor

Above image shows the relevant explanation to sales teams. There is no clear indication the company is capable of fixing it yet.

 

 

Thus, the SC-170R AC Cradle is only meaningful for telemetry use in Japan where there is government subsidy for monitors making use of telemetry, one of entry barrier for foreign competitors. There is no similar subsidy system for telemetry monitor outside of Japan.

 

 

The manufacturer quietly conceded the yellow flexible MULTI sockets are indeed poor man's sockets

In 2001, a popular Life Scope BSM-2301K (also known as Life Scope i) was launched and many customers bought it for standalone applications not restricted by system compatibility. It was popular because the Life Scope BSM-2300K series range of monitors were the first in the industry to adopt the new-generation type 8.4-inch high-resolution touchscreen introduced by the electronics industry. The new touchscreen display was a huge jump in touchscreen technology and made for highly-intuitive operation, hence its popularity. The company tried to attribute its popularity to the use of Smart Cables and a flexible MULTI socket. Let's see if this is true.

 

The portable 8.4-inch Life Scope i (BSM-2301K)

 

How can one flexible socket do the jobs of three fixed purpose sockets?

  

To insist the use of Smart Cables, the Life Scope BSM-2301K monitor has a flexible yellow MULTI socket for three types of measurements, namely:

 

1. Invasive Blood Pressure

2. Thermistor-method Respiration

3. Mainstream CO2 serial kit sets.

 

Without any use of Smart Cables, all IBP, Thermistor-method Respiration and mainstream CO2 are freely available for carefree use via their respective dedicated sockets. The use of Smart Cables makes things unnecessarily complicated and requires deliberate operator attention and choice to choose one among three (IBP, Thermistor-method Respiration and mainstream CO2), but why introduced a need to choose?  This is obviously unwarranted stress and inconvenience, what is wrong with the conventional way of each doing their own job using three dedicated sockets? If MULTI socket is such a superior proposal, why is the Temperature socket a dedicated one?

 

This is compromised usage, like a poor man affording only one physical socket for three types of use

The patient monitoring hardware in the Life Scope BSM-2301 bedside monitor are divided into a conventional block and an MPU block. The conventional block uses dedicated sockets and ordinary measurement cables while the MPU block makes use of Smart Cables with different parameter code for different hardware.

CONVENTIONAL BLOCK

- 1-ch TEMP

- ECG

- SpO2

- NIBP

MPU BLOCK (one MULTI socket)

- 1-ch IBP

- Thermistor-method Respiration

- <MULTI socket as serial port> Mainstream CO2 Kit Sets

The reality is the absence of two physical sockets for users. However, one of the parameter for the yellow MULTI socket is thermistor-method respiration, which is for use in the operating room to overcome electrical noise interference; this parameter is therefore not for use in the ward. The real shortage felt by users is only one missing physical socket, and they are not hesitating to demand it back. Imagine the initial wonder of a flexible socket turned into an outrage for being shortchanged!

 

Users do not want to be shortchanged with a poor man's socket

The manufacturer was pressured to respond with an updated model, Life Scope BSM-2303K. The solution from new model BSM-2303K was to add a new yellow socket only for IBP.

 

The MPU of the Life Scope BSM-2301K was not designed to take on expansion, and any additional MULTI socket could load (disturb) the operation of existing MPU, causing it to malfunction. An additional MULTI socket not linked to the MPU is just an independent socket with its own dedicated IBP amplifier hardware. Such was the socket offered for Life Scope BSM-2303K, noting there was a need to recognize the IBP Smart Cable.

 

With a new socket for IBP, the existing yellow MULTI socket can move away from doing IBP monitoring, and just focus on being a serial port for mainstream CO2 or being an amplifier for respiration monitoring using a thermistor transducer.

 

It was ironical, a solution relying on an extra dedicated socket for IBP; there are now two IBP amplifier hardware in the monitor, which was not the original intention. It was clear the complaints were market rejections of sharing a flexible socket and the solution offered by Life Scope BSM-2303K was to return back the missing physical socket demanded by users.

 

Market rejection forced the manufacturer to return back the missing socket demanded by users

An even greater number of physical sockets had to be returned for later Life Scope BSM-3000 series bedside monitors

Undeterred, NIHON KOHDEN again launched the Life Scope VS bedside monitors in early 2011, with the Life Scope BSM-3500 series monitors (12.1-inch display) equipped with two yellow flexible MULTI sockets while the Life Scope BSM-3700 series monitors (15-inch display) have three yellow flexible MULTI sockets. The value captured by users for both models are again negative.

 

In below picture, users of the left monitor (BSM-3500 series with 2 channels of IBP) requires five physical connection sockets but only two yellow shared-use sockets are provided for a 2/5 availability ratio. The manufacturer cannot provide more than two MULTI sockets because the IBP hardware channels specified for this model is only two, and therefore fixed at two flexible MULTI sockets. 

 

Without any use of Smart Cables, all five parameters are freely available for carefree use via their respective dedicated sockets. The use of Smart Cables just makes things unnecessarily complicated and requires deliberate operator attention and a conscious efforts to choose two among the five. This is unwarranted attention, stress and inconvenience. What is wrong with using five dedicated sockets, which is a far superior norm since all parameters are available for connections at any time without hesitation. What user benefit is the manufacturer trying to provide?

These monitors are in dire shortage of physical connection sockets for use, the values captured by users are negative

Similarly, users of the right monitor (BSM-3700 series with 3 channels of IBP) requires six physical connection sockets for carefree use but the manufacturer insists three shared-use sockets are enough. The IBP hardware channels specified for this model is three, and therefore fixed at three flexible MULTI sockets. 

 

As expected, users soon found out the small number of MULTI sockets on Life Scope VS bedside monitors are not enough for use. The situation for Life Scope VS series bedside monitors is the same as Life Scope BSM-2301K bedside monitor, customers want their physical sockets back because they simply need it!

 

NIHON KOHDEN reluctantly had to offer two options for solution, the AA-372P Smart Expansion Unit returns two missing physical sockets while the AA-374P Smart Expansion Unit returns four missing physical sockets. The AA-374P expansion unit with four sockets is shown in below picture.

 

Life Scope VS series bedside monitors were not designed for expansion, although we were not surprised to find expansion units from Life Scope TR belatedly being offered as solution to the intense demand from users for more physical sockets. There are modifications done to the original items since the model names (AA-372P, AA-374P) are different; the makeshift solution makes the bedside monitor look awkward, resembling a product prototypes still undergoing tests.

 

The manufacturer found a way to return back the missing physical sockets

If you look at the below picture, it is going back to using dedicated sockets, but at a high cost. The rejection messages from the market are consistent and enough for the manufacturer to drop the flexible sockets for future products.

 

This picture tells us the manufacturer is returning back to users four missing physical sockets

The Life Scope VS monitors were originally not designed for socket expansion, there should be limitations and users may have to pay additional attention to correct socket selections as a result.

 

Turning To Magic Show

 

About 9 years after the launch of modular Life Scope S Bedside Station, a new Life Scope J (BSM-9101) purporting to be a modular bedside monitor was released for export.

 

 

Continue to PART TWO