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What This Guide Helps With
Troubleshoot water-supply and integrated purification problems caused by inlet supply, hoses, drainage, connections, environmental conditions, or service-level water-system faults.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Therapy
Do not troubleshoot unreliable water purification while a patient depends on the Tablo for dialysis. If water quality or purification performance is uncertain, do not initiate treatment. If the issue develops during treatment, follow the facility's clinical procedure for safely maintaining or transferring therapy.
Treat visible leaks, unusual odors, overheating, or suspected contamination as removal-from-service conditions.
Expected outcome: No patient relies on a machine with uncertain water preparation, and unsafe conditions are isolated immediately.
2. Confirm the Reported Water Problem
Determine exactly what staff observed:
- No water entering the machine
- Setup stopping during water preparation
- Repeated purification-related alarm or message
- Inadequate or interrupted water supply
- Drain-related backup
- Visible external leak
- Failure that occurs only in one room or connection point
Record the exact displayed message if present.
Expected outcome: The complaint is clearly reproduced and narrowed to inlet supply, drainage, connection, or machine-side purification behavior.
3. Verify the Facility Water Source
Confirm the machine is connected to the intended approved water source. Inspect the accessible supply valve and connection for proper position, secure attachment, visible damage, or leakage.
Do not modify plumbing or connect the machine to an unapproved water source.
Expected outcome: An appropriate water source is available and connected correctly. If restoring the intended supply resolves the problem, troubleshooting can stop after verification.
4. Inspect the Water Inlet Hose and Connections
Trace the accessible water inlet path. Look for:
- Kinks
- Crushing
- Loose fittings
- Damaged connectors
- Incorrect routing
- Visible leakage
- Debris or obvious external obstruction
Do not disassemble internal water-treatment components.
Expected outcome: The inlet path is physically intact and unobstructed. Correcting a kink or loose external connection should restore normal water intake.
5. Check Drainage
Verify the drain hose is properly positioned and not kinked, submerged improperly, pinched, blocked, or backing up.
A drainage problem can interrupt setup or purification even when inlet water is available.
Expected outcome: Wastewater can drain normally without restriction or backup. If correcting drainage allows the machine to resume normal purification, the issue is resolved.
6. Compare the Location With a Known-Good Installation
When practical, determine whether another compatible Tablo operates normally from the same approved utility area, or whether the affected machine operates differently when connected at another approved location.
Do not move or reconnect equipment in a way that violates facility water-quality procedures.
Expected outcome: The comparison helps distinguish a facility water or drain issue from a machine-specific problem. A location-dependent failure should be referred to the appropriate facilities or water-management resource.
7. Check External Environmental Conditions
Inspect for recent plumbing work, loss of building water, unusual inlet conditions, freezing, heat exposure, recent relocation, or other environmental changes that may affect water delivery.
Coordinate with facilities personnel when the problem appears infrastructure-related.
Expected outcome: External infrastructure conditions are normal or an infrastructure cause is identified and corrected.
8. Repeat the Normal Setup or Water Preparation Sequence
With the machine off patient and external conditions corrected, perform the normal accessible setup sequence.
Do not override alarms or bypass purification-related checks.
Expected outcome: Water preparation completes normally and the machine proceeds through setup. If it does, troubleshooting can stop after final verification.
9. Verify Stable Operation
Confirm the machine remains free of water-related alarms or leaks and completes the normal pre-treatment preparation sequence.
Inspect the surrounding floor and accessible fittings after operation.
Expected outcome: Water inlet, purification, and drainage functions remain stable with no visible leak or recurring alarm.
10. Escalate Persistent Purification Failure
If supply and drainage conditions are satisfactory but the machine cannot complete its water-preparation process, stop troubleshooting externally.
Expected outcome: The unit is removed from service for qualified evaluation of the integrated purification system or related internal controls.
If the Problem Persists
Common external water supply, hose, fitting, drain, and infrastructure causes have been ruled out. A persistent problem may involve integrated purification components, internal valves, pumps, sensors, filters, controls, configuration, or another service-level water-system 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 water-quality/test equipment
- Repaired or configured only by qualified personnel
Appropriate water-quality and functional verification must be completed before clinical return. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Do not treat a patient when the Tablo cannot verify and maintain its required water-preparation process.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Staff reported the Tablo repeatedly stopped during water preparation and would not complete setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the external inlet hose sharply kinked behind the machine, restricting water flow."
Resolution
What action was taken.
Example:
"Corrected the hose routing, inspected the connections for leaks, repeated setup successfully, and verified normal water preparation before returning the unit to service."
Helpful Details to Include (If Known)
- Exact water-related alarm or message
- Room or utility connection used
- Water valve position
- Inlet hose condition
- Drain hose condition
- Visible leakage
- Whether other machines are affected
- Recent plumbing or facility work
- Results at another approved connection point
- Setup results after correction
- Final device status
Final Thought
Water-related dialysis problems require a patient-safety-first approach and careful separation of facility supply problems from machine-specific faults. Verify the entire external water and drain path before assuming internal purification failure, then escalate appropriately and document the findings clearly.
That is successful troubleshooting.