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What This Guide Helps With
Use this guide when clot, bubble, or inadequate-volume conditions repeatedly interrupt aspiration or produce unreliable sample handling.
Step-by-Step Troubleshooting
1. Protect the Specimen and Confirm the Pattern
Stop repeated attempts on a patient specimen if the analyzer is repeatedly reporting a clot, bubble, or volume condition.
Determine whether the problem:
- Follows one specimen
- Affects multiple specimens
- Occurs only with one tube type
- Occurs in one rack position
- Appears with QC or calibrators as well
- Began after a broader fluidic fault
Preserve limited or irreplaceable patient material.
Expected outcome: The failure pattern is defined and unnecessary sample consumption is prevented. If the condition is isolated to one unsuitable specimen, troubleshooting can stop once analyzer function is verified with suitable material.
2. Inspect the Sample Externally
Check the sample for:
- Visible clot
- Foam
- Bubbles
- Low volume
- Sample adhering to tube walls
- Incorrect tube
- Damaged container
- Improperly seated closure
Clinical Engineering should not make clinical decisions about specimen acceptability; involve laboratory personnel when sample integrity is in question.
Expected outcome: The specimen's physical condition is understood. If laboratory staff identify the sample itself as unsuitable, remove it from analyzer troubleshooting and verify the instrument separately.
3. Verify Available Sample Volume
Confirm there is sufficient accessible volume for the analyzer's normal aspiration process.
Consider whether:
- The sample has already been tested repeatedly
- The tube geometry places remaining material below accessible aspiration depth
- Excessive foam or bubbles reduce usable liquid
- The sample is distributed among multiple containers
Do not invent a minimum volume specification.
Expected outcome: Adequate accessible volume is available. If providing suitable volume resolves the error, the issue is resolved.
4. Verify Tube and Rack Positioning
Ensure the tube is fully seated, vertical, and unobstructed in the correct rack or carrier.
Check for:
- Leaning tube
- Warped rack
- Debris under the tube
- Label preventing full seating
- Incorrect carrier
Expected outcome: The sample is correctly positioned for aspiration. If correcting positioning eliminates the error, troubleshooting can stop.
5. Compare With Known-Good Nonpatient Material
Run appropriate laboratory-approved nonpatient material in a known-good container and rack.
Determine whether the error:
- Disappears
- Follows the original specimen
- Occurs with all materials
- Occurs only at one position
Expected outcome: The problem is separated into specimen-related versus analyzer-related behavior. Normal handling of known-good material supports an external specimen cause.
6. Inspect for Accessible Contamination
With the analyzer in a safe state, inspect accessible sample handling and probe areas for evidence of:
- Dried material
- Spill residue
- Foreign material
- Visible contamination
- Obstruction
Perform only approved external cleaning.
Expected outcome: Accessible surfaces are clean and unobstructed. If cleaning resolves the repeated condition, proceed to verification.
7. Check for Broader Aspiration or Fluidics Faults
Review whether clot/bubble/volume messages coincide with:
- Probe errors
- Aspiration faults
- Wash faults
- Waste faults
- Multiple assays or materials
- Unusual fluid-handling behavior
Expected outcome: The event is either isolated to sample quality or recognized as part of a wider analyzer fluidic problem.
8. Verify Normal Processing
Process suitable nonpatient material and, where required, QC after corrective action.
Confirm there are no repeated clot, bubble, or volume errors.
Expected outcome: Samples are aspirated and processed normally and required QC is acceptable. Troubleshooting can stop.
9. Escalate Analyzer-Wide Repeated Errors
If known-good material with adequate volume repeatedly produces the same condition, remove the analyzer from affected testing.
Do not attempt internal fluid path disassembly or obstruction removal unless qualified and specifically authorized.
Expected outcome: A likely analyzer-level aspiration or fluidic issue is safely escalated.
If the Problem Persists
If sample integrity, accessible volume, tube position, rack condition, visible contamination, and known-good substitutions have been checked, common external causes have been ruled out.
Possible remaining categories include internal aspiration sensing, probe or pipettor performance, internal obstruction, pressure control, tubing, valve, or other fluidic service-level problems.
The analyzer should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench/service evaluation
- Evaluated using Siemens Healthineers documentation and approved test equipment
- Repaired or adjusted only by qualified personnel
After service, verify consistent aspiration and complete required laboratory QC before returning the analyzer to patient testing.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Repeatedly aspirating a low-volume or compromised patient sample can exhaust the specimen; verify analyzer function with nonpatient material instead.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Laboratory staff reported repeated sample-volume errors on one Atellica IM 1600 specimen."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the sample tube was nearly depleted while known-good nonpatient material processed normally."
Resolution
What action was taken.
Example:
"The analyzer was verified with suitable test material, laboratory staff were advised the error followed the specimen, and the analyzer remained in service."
Helpful Details to Include (If Known)
- Exact clot, bubble, or volume message
- Whether one or multiple samples were affected
- Sample physical condition
- Approximate remaining usable volume
- Tube and rack condition
- Positioning observations
- Known-good material result
- Related aspiration or fluidic errors
- QC result after correction
- Final analyzer status
Final Thought
Repeated clot, bubble, and volume errors should be separated into specimen problems and analyzer problems before invasive action is considered. Protect limited patient material, verify with known-good test material, and escalate persistent analyzer-level faults.
That is successful troubleshooting.