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What This Guide Helps With
Use this guide when a disinfection, rinse, or drain cycle stops, repeats, or cannot finish because of external fluid, drainage, setup, or service conditions.
Step-by-Step Troubleshooting
1. Keep the Machine Out of Patient Service
Do not use a dialysis machine clinically if a required disinfection, rinse, or drain process has not completed successfully.
Clearly identify the unit as unavailable until the cycle issue is resolved and required post-process verification is complete.
Expected outcome: No patient is placed on a machine with an incomplete cleaning or fluid-preparation process.
2. Confirm Which Cycle Fails
Determine whether the failure occurs during:
- Disinfection
- Rinse
- Drain
- Initial fill
- Transition between cycle stages
- Final completion
Record the exact message and the point at which the cycle stops.
Expected outcome: The failed cycle stage is identified and reproducible.
3. Verify Water Supply
Confirm the machine has normal approved water supply.
Inspect accessible supply connections for:
- Closed or interrupted source
- Kinked hose
- Loose connection
- Leakage
- Facility water-system issue
Check whether other dialysis machines are experiencing similar problems.
Expected outcome: Adequate external water supply is available.
4. Verify Drainage
Inspect the external drain path for:
- Kinks
- Pinching
- Obstruction
- Incorrect placement
- Backflow
- Loose or leaking connection
A restricted drain can prevent multiple cleaning cycles from completing.
Expected outcome: The drain path is open and properly routed.
5. Verify Required Solution and Connections
For cycles requiring an approved chemical or solution, verify the correct product and normal connection are present.
Inspect the external pickup connection and tubing for:
- Empty source
- Loose connection
- Kink
- Cracking
- Improper placement
Do not substitute unapproved chemicals or concentrations.
Expected outcome: Required external solution is available and correctly connected.
6. Check Machine Setup and Cycle Selection
Confirm the intended cycle was selected and that any normal prerequisites required by the machine's standard workflow have been satisfied.
Do not alter service-level cleaning parameters or bypass cycle stages.
Expected outcome: The cycle has been initiated under the correct normal operating conditions.
7. Inspect for Visible Fluid Leakage
Check the floor, rear connections, accessible hose connections, and exterior of the machine for leakage.
If unexplained fluid is originating from inside the unit, stop troubleshooting and remove it from service.
Expected outcome: No uncorrected leak is present.
8. Restart the Cycle After Correcting External Causes
If no hazard exists, restart the approved cycle after correcting water, drain, solution, or setup issues.
Do not repeatedly restart a cycle that stops at the same point without identifying a cause.
Expected outcome: The selected disinfection, rinse, or drain cycle completes normally.
9. Perform Required Post-Cycle Verification
Before return to patient service, complete all applicable manufacturer and facility verification associated with the completed process.
Ensure the machine is in the proper ready condition and that no residual cycle-related alarm remains.
Expected outcome: The cycle is complete, required verification passes, and the machine is suitable for return to service. Troubleshooting can stop.
If the Problem Persists
If water supply, drainage, solution connections, setup, and visible leakage have been checked and the cycle still cannot complete, common external causes have been ruled out.
Possible remaining categories include internal fluid routing, pumps, valves, sensors, heaters, control functions, or cycle-specific service faults. Do not bypass cleaning stages or alter internal service parameters without approved documentation.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate Nipro documentation and approved test equipment
- Repaired or configured only by qualified personnel
Required disinfection, rinse, drain, and post-process checks must pass before clinical use resumes. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Never place a dialysis machine back into service after an interrupted disinfection or rinse cycle until the required process has been successfully completed and verified.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported the SURDIAL X rinse cycle repeatedly stopped before completion."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the external drain hose kinked behind the machine and restricting flow."
Resolution
What action was taken.
Example:
"Clinical Engineering corrected the drain hose routing, repeated the rinse cycle, verified successful completion and required post-cycle checks, and returned the machine to service."
Helpful Details to Include (If Known)
- Exact cycle that failed
- Exact alarm or message
- Stage where the cycle stopped
- Water supply condition
- Drain routing and condition
- Required solution and connection status
- Visible leakage
- Whether other machines were affected
- Results after correction
- Final machine status
Final Thought
An incomplete disinfection, rinse, or drain process is a clinical safety issue, not merely an inconvenience. Verify external water, drain, and solution paths first, then escalate unresolved cycle faults and document successful completion before return to service.
That is successful troubleshooting.