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What This Guide Helps With
Troubleshoot blood-pump failure or unstable speed caused by tubing installation, obstruction, controls, disposable setup, alarms, or external mechanical interference.
Step-by-Step Troubleshooting
1. Protect the Patient
Do not continue dialysis with a blood pump that stops unexpectedly or runs inconsistently. If the issue occurs during treatment, clinical staff should manage the extracorporeal circuit and patient according to facility procedure before Clinical Engineering evaluation.
Do not repeatedly restart an unreliable blood pump on a patient.
Expected outcome: Patient therapy is safely maintained or transferred and the affected machine is available for off-patient troubleshooting.
2. Confirm the Pump Complaint
Determine whether the pump:
- Does not start
- Starts and immediately stops
- Runs intermittently
- Appears unusually slow or fast
- Changes speed unexpectedly
- Produces abnormal sound or vibration
- Stops because another alarm condition is active
Expected outcome: The pump problem is differentiated from a machine safety interlock or unrelated alarm.
3. Check for Active Alarms or Interlocks
Review the normal user display for other conditions that intentionally prevent blood-pump operation, such as an unresolved setup or safety alarm.
Do not bypass an alarm simply to force the pump to run.
Expected outcome: Any legitimate external reason for inhibited pump operation is identified and corrected first.
4. Inspect Blood Tubing Installation
With no patient connected, inspect the pump tubing segment for:
- Correct routing
- Full seating
- Twisting
- Kinks
- Excessive stretching
- Flattening
- Visible damage
- Incorrect disposable installation
Expected outcome: Pump tubing is correctly installed and free of mechanical obstruction. If correcting tubing placement restores normal pump operation, troubleshooting can stop after verification.
5. Inspect the Accessible Pump Area
Check for dried residue, foreign material, damaged tubing fragments, or another external obstruction around the accessible pump mechanism.
Do not disassemble the pump or force rollers or drive components manually.
Expected outcome: The accessible pump path is clean and unobstructed.
6. Install a Known-Good Approved Disposable
If the tubing segment is suspect, replace the disposable set with a new approved set and repeat the normal setup process.
Expected outcome: Normal pump operation with the replacement disposable indicates the original tubing or setup caused the issue.
7. Verify User Controls and Programmed Conditions
Confirm user-accessible pump-related settings are appropriate and controls respond normally. Determine whether a touchscreen or control-input problem is preventing commands from being accepted.
Do not modify service-level motor parameters.
Expected outcome: Pump commands are accepted normally and no user-level configuration issue is present.
8. Observe Pump Operation Off Patient
Using the normal approved setup process, observe pump start, stop, and speed stability. Listen for unusual grinding, clicking, binding, or other abnormal mechanical sound.
Expected outcome: The pump operates smoothly and consistently without unintended speed changes or abnormal noise.
9. Perform Final Functional Verification
Allow the Tablo to complete its normal preparation and applicable pump checks with the approved disposable installed.
Expected outcome: Blood-pump operation is consistent and no recurring pump-related alarm is present. Troubleshooting can stop.
10. Escalate Persistent Pump Failure
If proper tubing, clean external pump surfaces, known-good disposables, and correct controls have been verified but the pump remains unreliable, remove the machine from service.
Expected outcome: Motor, drive, sensing, control, or other internal pump-related faults are evaluated by qualified service personnel.
If the Problem Persists
Common external tubing, disposable, obstruction, alarm, and control causes have been ruled out. A persistent problem may involve the pump drive, motor, speed sensing, control electronics, mechanical alignment, or another internal service-level condition.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate Outset Medical documentation and approved test equipment
- Repaired or calibrated only by qualified personnel
Blood-pump performance and applicable dialysis safety checks must be verified before return to service. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
An intermittently functioning blood pump should not be returned to clinical use simply because it operates normally during one brief retest.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported the Tablo blood pump would start and then stop during setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the pump tubing segment twisted and not fully seated in the pump pathway."
Resolution
What action was taken.
Example:
"Corrected the tubing installation, repeated setup, verified smooth and stable blood-pump operation, and returned the machine to service."
Helpful Details to Include (If Known)
- Pump would not start or ran inconsistently
- Active alarms
- Tubing installation condition
- Pump-area contamination or obstruction
- Abnormal sound or vibration
- Known-good disposable substitution
- User-control response
- Off-patient pump test result
- Results after correction
- Final device status
Final Thought
Blood-pump problems should be approached by first checking the disposable, tubing path, alarms, and accessible mechanical area. Do not force or internally adjust the pump. Verify repeatable operation after correction and escalate any persistent or intermittent failure before returning the machine to patient care.
That is successful troubleshooting.