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What This Guide Helps With
Troubleshoots delayed, absent, or inconsistent results caused by specimen tracking, analyzer status, workflow, communication, configuration, or external infrastructure problems.
Step-by-Step Troubleshooting
1. Protect Patient Care and Result Integrity
Treat missing, delayed, or inconsistent blood culture information as a potential patient-safety issue. Notify appropriate laboratory staff so they can follow approved result-verification and downtime procedures.
Do not recreate, modify, or release patient results solely to resolve a technical discrepancy.
Expected outcome: Clinical follow-up and specimen/result handling are controlled while the technical cause is investigated.
2. Confirm the Exact Reported Discrepancy
Identify the affected specimen and determine whether the problem is a delayed instrument result, a result missing from the analyzer, a result present locally but missing from the LIS, or inconsistent information between systems.
Record timestamps and displayed status where available.
Expected outcome: The exact location and timing of the discrepancy are established.
3. Verify the Specimen Was Correctly Loaded and Identified
Confirm with laboratory staff that the correct specimen was loaded, recognized, and associated with the expected patient or accession.
Check for specimen-identification or barcode issues without changing patient data.
Expected outcome: The specimen is correctly identified and associated with the expected workflow. If an identification workflow error is found, laboratory staff correct it under approved policy.
4. Check Analyzer Status
Verify the BACTEC FX is powered, fully initialized, and not reporting alarms or subsystem faults that could delay processing.
Check whether the affected specimen position remains active and whether other specimens are progressing normally.
Expected outcome: The analyzer is operational and the scope of the delay is known. If the analyzer is not ready, troubleshoot the underlying system fault before investigating results further.
5. Determine Whether the Issue Is Specimen-Specific
Compare the affected specimen's status with other specimens loaded around the same time. Determine whether the delay or inconsistency affects one item, one position, or the entire analyzer.
Expected outcome: The issue is isolated to one specimen/position or shown to be system-wide.
6. Verify Position and Detection Status
Confirm the affected bottle remains properly seated and detected. Inspect the accessible position for obstruction or a detection issue that could interrupt normal monitoring.
Expected outcome: The specimen is securely positioned and recognized. If reseating an appropriate noncritical test item demonstrates a position problem, remove that position from service and escalate as necessary.
7. Check Workstation and Application Status
Confirm the connected workstation is responsive and displaying current analyzer information. Look for frozen screens, application errors, stale data, or loss of connection.
Do not modify stored patient data or protected application configuration.
Expected outcome: The workstation is receiving current analyzer information. If restoring a permitted workstation connection resolves the delay, continue to end-to-end verification.
8. Check LIS and Network Communication
Determine whether the result exists on the analyzer or workstation but has not reached the LIS. Verify external network connections and coordinate with LIS or IT support if necessary.
Compare with other recent result transmissions to determine whether the problem is isolated or system-wide.
Expected outcome: The location of the result within the communication chain is identified. If restoring an external connection completes transmission, verify accurate receipt.
9. Check for Configuration or Workflow Changes
Ask whether there were recent software updates, interface changes, network work, workflow changes, or configuration modifications before the issue began.
Do not change settings experimentally.
Expected outcome: Any recent external change is identified and routed to the appropriate support group for verification or correction.
10. Perform End-to-End Verification
After correction, use an approved laboratory test or known-good workflow to verify that a specimen can be recognized, monitored as expected, displayed at the workstation, and communicated to the intended destination when applicable.
Confirm that timestamps, identity, and result association remain accurate.
Expected outcome: The complete result path functions normally and consistently. If results remain delayed, missing, or inconsistent, remove the affected function from service and escalate.
If the Problem Persists
Specimen identification, physical loading, analyzer readiness, workstation operation, external network connections, and LIS communication have been evaluated. The remaining issue may involve an internal detection subsystem, application database, interface engine, server, configuration, network infrastructure, or other service-level problem.
The affected analyzer or result pathway should be:
- Removed from routine use when result integrity cannot be assured.
- Labeled Out of Service as appropriate.
- Sent for repair or service-level evaluation.
- Evaluated using current BD documentation and approved test equipment.
- Reviewed with LIS, IT, interface, or BD support when the issue extends beyond the analyzer.
- Repaired or configured only by qualified personnel.
Before return to service, verify the complete specimen-to-result communication pathway and complete any laboratory-required quality checks.
Stopping when result integrity cannot be proven is proper troubleshooting.
Clinical Use Tip
When a result is missing or inconsistent, verify where it exists in the analyzer-to-LIS chain before anyone manually re-enters patient data.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Laboratory reported that blood culture results were visible on the BACTEC FX workstation but were delayed or missing in the LIS."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the analyzer workstation had lost its external network connection while local analyzer operation remained normal."
Resolution
What action was taken.
Example:
"The network connection was restored, pending communication was verified through the approved workflow, and laboratory staff confirmed accurate result receipt in the LIS."
Helpful Details to Include (If Known)
- Specimen or accession affected
- Time specimen was loaded
- Time discrepancy was first noted
- Whether the result existed on the analyzer
- Whether the result existed on the workstation
- LIS receipt status
- Position or module involved
- Analyzer readiness and alarms
- Other specimens affected
- Workstation status
- Network status
- Recent IT or configuration changes
- End-to-end verification result
- Final system status
Final Thought
A delayed or missing result is not resolved until its path from specimen recognition through final destination is verified. Protect result integrity, isolate the break logically, escalate infrastructure or internal faults appropriately, and document exactly what was found and confirmed.
That is successful troubleshooting.