Subtherapeutic ACT values after standard heparin dosing

We have had this issue since mid-December. It is not on every patient, but we are seeing it happen on more patients than not across our system. We are working with Abbott as well and we have heard the same information as Lisa. We started doing anti-Xa studies this week to help get more information as to whether it is the cartridges or the heparin. It seems like it is a problem with the ACT-K cartridges. Is anyone seeing this issue with the ACT-C cartridges? When we meet with Abbott on Tuesday, I didn't get a straight answer as to whether it was the Kaolin or Celite or both. 

I have had 2 events since late November where the ACT-c did not increase after multiple doses of Heparin.  What do you tell your Cath Lab/ OR staff to do as ACT by iSTAT is the only ACT available here?  What is the recommended time between Heparin dose and drawing the ACT sample? Thank you

Hi all!  Same issues over here.  I've opened 13 incidents with Abbott very recently for lots 436R252770181 (Cartridge ACT-K)  and 436R253191181 (Cartridge ACT-K).  We are using heparin lot G1050143 by Sagent and CT02512A by Sandoz.  Very sporadic issue for us as well.  I am leaning more towards an uptick in patients who have underlying issues, as it doesn't make sense to me that the ACT lots are performing sometimes, but not all the time, and all quality tests are passing without bias or trend.  All information submitted to Abbott last week, so hopefully that will add fuel to the overall investigation.

Has anyone gotten any updates from Abbott or found a brand of heparin that is working well?  Tiffany are you still getting good results with
 the Sandoz 5000 USP/mL?  I also have a case in with Abbott, our cath lab is at their wits end!  Is anyone using the Hemochron signature with same issues?  Alot of questions for a Friday!!!