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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting situations where the ACUSON Sequoia fails to transfer images to PACS or encounters DICOM communication errors. Common presentations include:
- Failed or delayed image transfers
- Error messages such as “DICOM connection failed” or “Server unreachable”
- System cannot reach network servers or PACS
The guide focuses on external and easily verifiable checks before considering internal issues.
Step-by-Step Troubleshooting
Verify Network Connectivity
- Ensure the ultrasound system is properly connected to the hospital network.
- Check Ethernet cable connections, Wi-Fi if applicable, and network port lights.
- Why: Network connectivity is a common cause of PACS transfer failures.
Ping the PACS Server
- Use system network tools to ping the PACS server IP.
- If the server is unreachable, note the network error.
- Why: Confirms whether communication is blocked at the network level.
Check DICOM Configuration
- Verify the AE Title, IP address, and port of the PACS server in the Sequoia DICOM settings.
- Ensure there are no typos or misconfigurations.
- Why: Incorrect DICOM settings prevent proper image transfer.
Confirm PACS Server Availability
- Check if the PACS server is online and accepting connections.
- Coordinate with the IT department if necessary.
- Why: Even with correct settings, the PACS server must be operational.
Test with Another Modality or Workstation
- If possible, send a test image from another system to the same PACS destination.
- Why: Helps isolate whether the issue is with the Sequoia or the PACS/network.
Review System Logs
- Check the Sequoia DICOM transfer logs for error codes.
- Note recurring messages or patterns.
- Why: Logs often indicate the source of failure (network timeout, server refusal, etc.).
Restart DICOM Service or System
- Restart the Sequoia DICOM service or perform a system reboot if external checks pass.
- Why: Clears temporary software or communication issues.
If the Problem Persists
External network and configuration issues have been ruled out. Device should be:
- Removed from service
- Labeled Out of Service
- Sent for vendor-assisted evaluation
Escalation ensures patient safety and prevents wasted troubleshooting on internal software/hardware.
Clinical Use Tip
- Do not attempt transfers while a patient is actively on the system.
- Ensure patient exams are sent from another functioning modality if imaging is urgent.
- Troubleshoot only when the system is idle to prevent delays in patient care.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Sequoia ultrasound system cannot send images to PACS; error ‘DICOM connection failed.’”
Cause
What was observed during troubleshooting.
Example:
“Network connectivity verified; PACS server reachable; Sequoia DICOM configuration checked—settings correct; logs show repeated timeouts.”
Resolution
What action was taken.
Example:
“Escalated device to vendor for internal software/communication evaluation; system labeled Out of Service; alternative imaging modality provided for patient exams.”
Helpful Details to Include
- Outlet tested and verified
- Network cables swapped/tested
- PACS server status at time of failure
- Error codes from DICOM logs
- Attempts from other devices to same PACS destination
Final Thought
Patient safety and continuity of care rely on accurate image transfers. A methodical, logic-based troubleshooting approach prevents unnecessary internal disassembly and ensures issues are escalated appropriately. Proper documentation reinforces accountability and aids future issue resolution.
That is successful troubleshooting.