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What This Guide Helps With
Troubleshoots unexpectedly wet loads or poor processing results associated with loading, drainage, channel connections, consumables, utilities, or incomplete cycles.
Step-by-Step Troubleshooting
1. Protect Patient Safety and Quarantine Questionable Items
Do not release a device if processing results are questionable. A visibly soiled device, an incompletely processed device, or a load associated with an abnormal cycle must be reprocessed according to approved policy.
Expected outcome: Questionable instruments remain out of clinical use while processing performance is investigated.
2. Confirm the Reported Result
Determine whether the concern is retained water, visible soil, residue, inconsistent results, specific channels not being processed, or a general perception that the load is wetter than expected. Confirm whether the cycle completed normally.
Expected outcome: The complaint is defined accurately. If the issue is unrelated to an actual process failure, document the observation and verify normal equipment performance.
3. Confirm Pre-Cleaning Requirements Were Completed
Verify the endoscope or device received the required bedside and manual pre-cleaning steps before automated processing. Clinical Engineering should not attribute poor results to the reprocessor until upstream workflow is considered.
Expected outcome: Required pre-cleaning was completed. If poor results are caused by missed upstream cleaning steps, correct the workflow and verify subsequent processing.
4. Inspect Load Arrangement
Check that the device, tubing, adapters, and accessories were arranged correctly and that loops, folds, or positioning do not trap fluid or restrict circulation.
Expected outcome: Load orientation supports normal fluid flow and drainage. If repositioning corrects the result, verify another approved cycle and stop.
5. Verify Channel and Accessory Connections
Confirm all required connections are complete, secure, and appropriate for the endoscope or accessory. Check for disconnected, kinked, or visibly damaged tubing.
Expected outcome: All required channels and accessories are connected correctly. If correction restores acceptable results, verify cycle performance and stop.
6. Verify Consumables
Confirm the approved chemistry or detergent is present, properly installed, and suitable for use. Do not substitute materials or alter process concentrations outside approved procedures.
Expected outcome: Required consumables are available and correctly configured. If replacing or reseating a consumable corrects the issue, complete functional verification.
7. Check Fill and Drain Performance
Observe whether the chamber fills and drains normally and whether water remains unexpectedly after cycle completion. Inspect accessible drains and external hoses for restriction.
Expected outcome: Fluid movement and final drainage are normal. If correcting an external drain restriction resolves retained moisture, verify a full cycle and stop.
8. Review Cycle Completion and Alarms
Confirm that the affected load actually completed the intended cycle without abort, alarm, or interruption. A load from an incomplete cycle should not be evaluated as a normal processing result.
Expected outcome: Only fully completed cycles are used to judge equipment performance.
9. Perform Final Functional Verification
Run an approved test load or known-good setup and verify proper circulation, drainage, cycle completion, and acceptable post-process condition according to facility and manufacturer requirements.
Expected outcome: Processing results are repeatable and acceptable. Troubleshooting can stop.
10. Escalate Persistent Poor Processing Results
If pre-cleaning, loading, connections, consumables, and drainage are correct but poor results continue, remove the reprocessor from use.
Expected outcome: The SYSTEM 1E is evaluated for an internal circulation, delivery, sensing, or process-control problem.
If the Problem Persists
External workflow, loading, connection, consumable, and drainage causes have been ruled out. Remaining causes may involve internal circulation, valves, pumps, process chemistry delivery, temperature control, sensing, or another service-level condition.
Remove the SYSTEM 1E from service, label it Out of Service, and arrange qualified repair or bench evaluation using appropriate manufacturer documentation and approved test equipment.
Return-to-service testing should confirm complete cycles, proper fluid handling, process delivery, and acceptable processing results using approved test methods.
Recognizing when poor results require equipment escalation rather than repeated processing is proper troubleshooting.
Clinical Use Tip
Visible cleanliness alone does not prove successful processing; verify the complete approved reprocessing workflow before releasing an endoscope for patient use.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Sterile Processing reported endoscopes were retaining excessive water after completed SYSTEM 1E cycles."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found an external drain hose partially restricted by its routing behind the unit."
Resolution
What action was taken.
Example:
"Corrected the drain hose routing, completed a functional cycle with normal drainage, and verified acceptable post-cycle condition before return to service."
Helpful Details to Include (If Known)
- Whether the concern was moisture, visible soil, or residue
- Whether the cycle completed normally
- Pre-cleaning status
- Load position
- Channel connection status
- Consumable condition
- Fill and drain behavior
- External hose condition
- Any alarms
- Results with a known-good setup
- Final device status
Final Thought
Separate reprocessing workflow problems from equipment problems, verify loading and external fluid paths first, confirm acceptable results with a controlled test, and escalate whenever process effectiveness remains uncertain.
That is successful troubleshooting.