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What This Guide Helps With
Troubleshoot incomplete disinfection or rinse cycles caused by supply, drain, connections, cycle conditions, external restrictions, consumables, or service-level problems.
Step-by-Step Troubleshooting
1. Protect Patients From Incompletely Disinfected Equipment
Do not use a Dialog+ for patient treatment if a required disinfection cycle did not complete or if the machine has not successfully completed the required rinse verification.
Remove the machine from clinical availability until disinfection and rinse status are confirmed.
Expected outcome: No patient is connected to equipment with uncertain disinfection or residual chemical status.
2. Confirm the Exact Cycle Problem
Determine whether the cycle will not start, stops partway through, takes unusually long, fails to drain, repeats a phase, or completes but does not achieve the expected rinse-clear condition.
Record any displayed message exactly and note the point where the cycle stops.
Expected outcome: The failure phase is clearly identified and reproducible.
3. Verify Required External Supplies
Confirm the appropriate approved disinfection supply or consumable is present and properly connected when applicable.
Check that containers are not empty and that external pickup components are correctly installed.
Expected outcome: The required external disinfection supplies are available and correctly connected. If correcting the supply allows the cycle to complete normally, troubleshooting may stop after successful rinse verification.
4. Inspect Water-Supply Connection
Confirm treated-water supply is available and that the inlet hose is connected, open, and not kinked or obstructed.
Determine whether facility water work or reduced supply is affecting other machines.
Expected outcome: Adequate water supply is confirmed.
5. Inspect Drain Path
Check the drain hose and accessible drain connection for kinks, elevation changes, blockage, improper placement, or restricted facility drainage.
Observe for backup or unusually slow drainage.
Expected outcome: The machine has an unrestricted drain path. If correcting the drain condition allows the cycle to complete, troubleshooting may stop after final rinse verification.
6. Inspect External Disinfection Connections
Check accessible hoses, connectors, caps, pickups, and ports involved in the cycle for residue, crystallization, loose connection, leakage, or incorrect placement.
Clean or replace approved external components as appropriate.
Expected outcome: External connections are secure, clean, and unobstructed.
7. Confirm Cycle Preconditions and Normal Controls
Verify that normal accessible operating conditions required to start the cycle are satisfied, such as proper machine state and correctly positioned external components.
Do not bypass an interlock or use an unauthorized service setting to force the cycle to run.
Expected outcome: The cycle starts normally when all standard conditions are met.
8. Repeat the Approved Disinfection Cycle
With the machine out of clinical service, repeat the appropriate approved cycle after correcting any external cause.
Observe progress through the complete sequence and note any repeated stopping point.
Expected outcome: The full cycle completes without unexplained interruption.
9. Verify Rinse Completion Before Clinical Use
Complete all required post-disinfection rinse verification using the applicable approved method and facility procedure.
Do not rely solely on the fact that the machine displays a completed cycle if residual disinfectant has not been appropriately ruled out.
Expected outcome: Rinse verification confirms the machine is ready for subsequent required functional checks. If all checks pass, troubleshooting may stop.
10. Escalate Persistent Disinfection or Rinse Failure
If supplies, water, drain path, connections, and normal cycle conditions are satisfactory but the cycle still will not start, complete, or rinse clear, remove the machine from service.
Expected outcome: Internal hydraulic, heating, pump, valve, sensor, control, or service-level problems are referred for qualified evaluation.
If the Problem Persists
Common external causes have been ruled out. Remaining possibilities may involve internal water pathways, valves, pumps, heaters, temperature sensing, chemical delivery, drainage control, sensors, or machine configuration.
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 or configured only by qualified personnel.
After repair, complete the full required disinfection process, rinse verification, functional testing, and safety checks before returning the machine to clinical use.
Knowing when to stop rather than bypassing an incomplete disinfection or rinse process is proper troubleshooting.
Clinical Use Tip
Never release a dialysis machine for patient use until both the required disinfection process and post-disinfection rinse verification are complete.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported the Dialog+ disinfection cycle repeatedly stopped before completing the rinse phase."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the drain hose kinked behind the machine and restricting drainage."
Resolution
What action was taken.
Example:
"The drain hose was rerouted, the complete disinfection cycle and rinse verification were successfully completed, and the machine passed functional checks before return to service."
Helpful Details to Include (If Known)
- Cycle type
- Exact displayed message
- Phase where the cycle stopped
- Disinfection supply condition
- Water-supply condition
- Drain-hose condition
- External connection condition
- Recent facility water or drain work
- Rinse-verification result
- Results after correction
- Final device status
Final Thought
Protect patients from uncertain disinfection status, verify supplies, water, drainage, and external connections before assuming internal failure, confirm the complete rinse process, escalate unresolved problems, and document all verification.
That is successful troubleshooting.