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What This Guide Helps With
Troubleshoot concentrate detection problems caused by empty supplies, incorrect concentrate, pickup connections, tubing, configuration, flow, or service-level sensing issues.
Step-by-Step Troubleshooting
1. Protect the Patient and Prevent Incorrect Dialysate Preparation
Do not initiate or continue dialysis if required acid or bicarbonate concentrate is not being correctly detected or delivered.
Transfer treatment to another verified machine when needed and keep the affected machine out of patient use.
Expected outcome: The patient is protected from incorrect dialysate preparation.
2. Confirm Which Concentrate Is Affected
Determine whether the issue involves acid concentrate, bicarbonate, or both. Record any displayed message exactly and note whether the problem began after a container, cartridge, bag, or connection was changed.
Expected outcome: The affected concentrate pathway is clearly identified.
3. Verify Concentrate Availability
Confirm the required concentrate supply is present, not empty, properly prepared when applicable, correctly labeled, and intended for the current setup.
Check expiration or facility-use restrictions where appropriate without substituting an unauthorized product.
Expected outcome: The correct usable concentrate is available. If replacing an empty or incorrect supply restores detection and normal preparation, troubleshooting may stop after verification.
4. Inspect Pickup Connections and Hoses
Check accessible concentrate connectors, pickup tubes, hoses, caps, and fittings for loose installation, improper placement, cracks, kinks, blockage, or air entry.
Reseat connections and replace damaged approved external accessories as appropriate.
Expected outcome: Concentrate connections are secure and unobstructed. If correcting the connection restores detection, troubleshooting may stop after required checks.
5. Verify Correct Port and Concentrate Configuration
Confirm each concentrate source is connected to the intended port and the accessible machine configuration matches the concentrate setup.
Do not alter restricted service configuration or calibration values.
Expected outcome: Physical connections and accessible setup correspond correctly.
6. Inspect for Crystallization or Residue
Examine accessible concentrate pickup components and connectors for dried bicarbonate, crystallization, residue, or other contamination that may prevent proper flow or detection.
Clean or replace external components only using approved procedures.
Expected outcome: The external concentrate path is clean and functional.
7. Substitute a Known-Good Concentrate Source or External Pickup Component
When appropriate, use a known-good compatible concentrate source or approved pickup component to determine whether the issue follows the consumable or accessory.
Expected outcome: If detection returns with the known-good item, replace the defective consumable or external component and complete verification.
8. Observe Preparation and Conductivity Response
Run the normal non-patient preparation process and confirm the machine recognizes the concentrate supply and progresses toward stable dialysate preparation.
Do not bypass concentrate-related warnings.
Expected outcome: Concentrate is detected and the machine completes preparation normally.
9. Escalate Persistent Detection Failure
If correct concentrate, secure connections, clean pickup components, proper configuration, and known-good substitutions do not resolve the issue, remove the machine from service.
Expected outcome: Internal concentrate sensing, pump, valve, flow, hydraulic, calibration, or control issues are referred for qualified service.
If the Problem Persists
Common external causes have been ruled out. Remaining causes may involve concentrate sensing, internal delivery components, hydraulic pathways, valves, pumps, calibration, or control electronics.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate B. Braun documentation and approved test equipment.
- Repaired, calibrated, or configured only by qualified personnel.
Complete required concentrate-recognition, conductivity, dialysate, alarm, and functional testing before returning the machine to service.
Stopping after consumable and connection causes are ruled out is proper troubleshooting.
Clinical Use Tip
Confirm the actual concentrate source and connection before changing any machine setting in response to a concentrate-detection problem.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported the Dialog+ would not detect the bicarbonate concentrate during machine preparation."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found dried bicarbonate residue obstructing the external pickup connection."
Resolution
What action was taken.
Example:
"The approved external connection was cleaned, concentrate detection returned, preparation completed normally, and the machine passed functional verification before return to service."
Helpful Details to Include (If Known)
- Acid or bicarbonate affected
- Exact displayed message
- Concentrate type
- Supply level
- Pickup connection condition
- Hose condition
- Correct port verified
- Residue or crystallization present
- Known-good substitution result
- Conductivity response
- Final device status
Final Thought
Protect the patient, verify concentrate supply and connections before assuming internal delivery failure, confirm normal preparation after correction, escalate unresolved conditions, and document the final result accurately.
That is successful troubleshooting.