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What This Guide Helps With
A calibration or quality-control check does not complete or meet expectations because of setup, positioning, test equipment, environment, readiness, or system conditions.
Step-by-Step Troubleshooting
1. Protect Patients and Suspend Affected Clinical Use
If a required QC or calibration check has failed, do not use the affected function clinically unless departmental policy specifically permits continued use.
Expected outcome: The failed verification does not create an unrecognized patient-treatment risk.
2. Identify the Exact Failed Test
Record the name of the calibration or QC procedure, the point at which it failed, the displayed message, and whether failure occurred during setup, acquisition, analysis, or completion.
Expected outcome: The exact failed process is identified rather than treating all QC failures as equivalent.
3. Verify Test Setup
Confirm that the correct test device, phantom, accessory, fixture, positioning arrangement, and workflow are being used according to approved procedures.
Expected outcome: The test setup matches the approved method.
4. Inspect Test Equipment
Check accessible test equipment for damage, contamination, depleted batteries where applicable, loose cables, incorrect connection, or expired calibration status.
Do not use test equipment with questionable accuracy.
Expected outcome: The independent test equipment is suitable for use.
5. Verify System Readiness and Positioning
Confirm that the Versa HD and relevant imaging, positioning, or treatment subsystems have completed startup and are in the required state for the test.
Verify gantry, table, detector, and accessory positions as applicable.
Expected outcome: The system is correctly configured externally for the intended test.
6. Check Environmental Conditions
Check for unusual temperature, power, HVAC, construction, vibration, or other room conditions that could affect a sensitive QC measurement.
Expected outcome: No obvious environmental condition is compromising the test.
7. Repeat the Approved Test Once
After correcting any setup issue, repeat the approved QC or calibration check according to the established procedure.
Do not repeatedly rerun a failing calibration in an attempt to force a pass.
Expected outcome: The test completes normally and meets the department's approved acceptance criteria.
8. Compare With Previous Results
If available, compare the current result with prior documented QC or calibration results to determine whether the change is abrupt, gradual, or isolated.
Expected outcome: The result provides useful evidence about whether the problem is a setup anomaly or a persistent system change.
9. Verify Any Corrected Function
If the failure is traced to an external setup or test-equipment issue, repeat the applicable verification using the corrected setup before clinical use.
Expected outcome: The system successfully passes the required verification. Troubleshooting can stop after documentation and return-to-service requirements are completed.
10. Escalate a Repeated Failure
If the approved test continues to fail after external setup, test equipment, positioning, readiness, and environmental causes have been ruled out, stop troubleshooting.
Expected outcome: The affected system or function remains out of clinical service pending qualified evaluation.
If the Problem Persists
Common external causes have been ruled out. The remaining condition may involve calibration data, detector performance, treatment delivery, mechanical alignment, internal communication, system configuration, or another service-level condition.
The Versa HD should be:
- Removed from service when required QC acceptance cannot be demonstrated.
- Labeled Out of Service.
- Evaluated using appropriate Elekta documentation and approved calibrated test equipment.
- Sent for qualified service or repair.
- Calibrated or configured only by authorized qualified personnel.
All required QC and return-to-service testing must be passed before clinical operation resumes.
Knowing when to stop external troubleshooting and escalate is proper troubleshooting.
Clinical Use Tip
A failed required QC test is itself a meaningful safety finding; do not clear the device for treatment merely because normal operation appears possible.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Radiation Oncology reported that a scheduled Versa HD imaging QC test repeatedly failed."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the QC phantom was incorrectly positioned for the approved test procedure."
Resolution
What action was taken.
Example:
"Clinical Engineering corrected the phantom setup, repeated the approved QC test successfully, and documented the passing result before return to service."
Helpful Details to Include (If Known)
- Exact QC or calibration test
- Exact failure message
- Test setup used
- Phantom or fixture condition
- Test-equipment calibration status
- Gantry, table, or detector position
- Environmental conditions
- Previous QC result
- Repeat-test result
- Final clinical status
Final Thought
Treat failed QC as evidence that requires explanation. Verify setup, calibrated test equipment, positioning, system readiness, and environment before assuming internal failure, and escalate any unexplained repeated failure.
That is successful troubleshooting.