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What This Guide Helps With
Troubleshoot startup, boot, or automated setup failures caused by power, connections, consumables, configuration, or environmental conditions before escalating for service.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Dialysis Continuity
Do not troubleshoot an unreliable Tablo while a patient depends on it for treatment. If the failure occurs before treatment, keep the machine unavailable until it completes setup successfully. If it occurs during treatment, follow the facility's clinical procedure for safely maintaining or transferring therapy using another verified dialysis system.
Inspect for smoke, unusual odor, fluid intrusion, abnormal heat, damaged power components, or other obvious hazards.
Expected outcome: The patient is supported by a safe alternative when necessary, and troubleshooting proceeds only on equipment that is not actively supporting the patient. Stop immediately and remove the machine from service if a safety hazard is present.
2. Confirm the Exact Startup or Setup Failure
Attempt a normal startup only when safe. Determine whether the system:
- Shows no signs of power
- Begins booting but stops
- Restarts repeatedly
- Reaches the user interface but will not begin automated setup
- Starts setup but stops at a repeatable point
- Displays a specific message or alarm
Record the exact displayed wording rather than paraphrasing it.
Expected outcome: The failure is reproducible and clearly defined. If the system now starts and completes setup normally, verify basic operation and stop troubleshooting.
3. Verify AC Power
Confirm the power cord is fully seated and visually intact. Check the receptacle for damage or looseness and verify the outlet using an approved method consistent with facility practice.
Avoid extension cords, questionable adapters, or unapproved power strips.
Expected outcome: Reliable facility AC power is available and the Tablo powers normally. If restoring proper AC power resolves the condition and setup completes successfully, troubleshooting can stop after final verification.
4. Inspect External Connections and Machine Condition
Inspect accessible external cables, connectors, doors, covers, fluid connections, and attached accessories for incomplete seating, physical damage, contamination, or obstruction.
Confirm nothing is pinched, disconnected, improperly installed, or preventing normal setup.
Expected outcome: All externally accessible components required for startup are secure and undamaged. Correcting an obvious external connection problem should allow setup to proceed.
5. Verify Required Consumables and Setup Components
Confirm the correct dialysis disposables and other required setup components are present, properly installed, and compatible with the machine. Look for packaging material, incomplete installation, kinks, misrouting, or improperly seated components.
Do not bypass a setup check simply to make the machine proceed.
Expected outcome: Required consumables and components are installed correctly and recognized. If setup completes after correcting installation, troubleshooting can stop after functional verification.
6. Check Water Supply and Drain Availability
Because automated setup depends on the machine's fluid preparation systems, verify that the approved water connection and drainage arrangement are available, connected, unobstructed, and appropriate for normal operation.
Look for closed valves, kinked hoses, disconnected fittings, visible leaks, or drainage backup.
Expected outcome: Water supply and drainage conditions support normal setup. If correcting an external water or drain issue allows automated setup to complete, the issue is resolved.
7. Verify Controls, Configuration, and Environment
Confirm the system is being started through the normal operator interface without stuck controls or unintended input. Check for obvious environmental problems such as blocked ventilation, excessive heat, condensation, or recent relocation that may have disturbed connections.
Do not enter restricted service modes or make undocumented configuration changes.
Expected outcome: The machine operates in an appropriate environment with normal controls and configuration. If startup and setup now complete normally, proceed to final verification.
8. Perform a Controlled Restart When Appropriate
If no active patient is connected and no safety condition exists, perform a normal shutdown and restart using the approved user-accessible controls.
Do not repeatedly power-cycle a machine that continually fails at the same point.
Expected outcome: The Tablo boots and completes automated setup without recurring interruption. A successful restart followed by normal setup indicates the immediate problem is resolved.
9. Perform Final Functional Verification
After corrective action, allow the machine to complete its normal automated setup and required pre-treatment checks. Confirm that no unresolved alarms remain and that the machine reaches the expected ready state.
Do not return a dialysis machine to service solely because the display turns on.
Expected outcome: The Tablo completes startup and automated setup normally with no recurring fault. Troubleshooting can stop and the machine may be returned to service according to facility procedure.
10. Escalate a Repeatable Startup or Setup Failure
If the machine still fails to start, repeatedly restarts, or cannot complete automated setup after external causes have been ruled out, discontinue further external troubleshooting.
Expected outcome: The device is removed from service and routed for qualified evaluation rather than subjected to unnecessary disassembly or speculative repair.
If the Problem Persists
Common external power, connection, consumable, water, drain, control, and environmental causes have been ruled out. A persistent failure may involve an internal power, sensing, fluid-management, software, configuration, or other 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 configured only by qualified personnel
After corrective service, complete all required functional and safety verification before returning the Tablo to clinical use. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Never begin or continue dialysis on a Tablo that cannot consistently complete its normal automated setup and pre-treatment checks.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported the Tablo powered on but repeatedly stopped during automated setup and could not be prepared for treatment."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the facility water inlet connection was not fully seated, preventing normal setup from completing."
Resolution
What action was taken.
Example:
"Reseated and inspected the water connection, repeated automated setup successfully, verified normal operation with no recurring alarms, and returned the unit to service."
Helpful Details to Include (If Known)
- Exact startup or setup message
- Whether the display powered on
- AC power condition
- Outlet verification result
- Point where setup stopped
- Water and drain connection condition
- Consumables installed
- Any visible leaks or damage
- Whether restart was attempted
- Results before and after correction
- Final device status
Final Thought
Safe troubleshooting starts by protecting the patient, defining exactly where startup fails, and ruling out simple external causes before assuming internal failure. Verify the complete setup sequence after correction, escalate repeatable failures appropriately, and document the complaint, cause, and resolution clearly.
That is successful troubleshooting.