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What This Guide Helps With
Results are delayed, absent, or inconsistent because of sample quality, flags, processing status, QC, identification, communication, or analyzer performance conditions.
Step-by-Step Troubleshooting
1. Protect Patient Care and Confirm the Result Problem
Determine whether a result is delayed within the analyzer, missing from the LIS, or analytically inconsistent with expectations. Route urgent specimens to another verified analyzer if delays may affect patient care.
Expected outcome: The type of result problem is clearly identified and urgent testing continues through an approved alternative.
2. Confirm the Correct Patient and Sample
Verify the sample identifier, barcode, rack position, and associated order. Make sure the investigation is following the correct specimen and patient record.
Expected outcome: The result issue is linked to the correct specimen and patient without introducing identification risk.
3. Review Analyzer Sample Status
Check whether the specimen completed analysis, remains queued, was stopped, generated a flag, or requires review under laboratory workflow. Record relevant analyzer messages without overriding them.
Expected outcome: It is clear whether the result was generated, held, rejected, or never completed.
4. Inspect the Specimen
Check for clotting, insufficient volume, bubbles, poor mixing, abnormal tube condition, or other specimen issues that may produce incomplete or inconsistent analysis.
Expected outcome: The specimen is suitable for testing or is referred for recollection or laboratory review according to policy.
5. Verify QC Status
Confirm current QC is acceptable for the affected testing. Do not treat inconsistent patient results as a sample-only issue if QC is also abnormal.
Expected outcome: Analyzer performance is supported by acceptable QC, or testing remains restricted until the QC issue is resolved.
6. Compare Repeat or Related Results Appropriately
When laboratory policy allows, compare the result with an approved repeat, alternate analyzer, prior result, or other appropriate verification method. Do not repeatedly rerun a questionable sample without understanding why the first result was abnormal.
Expected outcome: The inconsistency is either confirmed as sample-specific or shown to be reproducible at the analyzer level.
7. Check for Aspiration or Processing Problems
Review whether the sample generated volume, clot, aspiration, reagent, or processing errors. Inspect accessible sample presentation and reagent conditions when relevant.
Expected outcome: No unresolved external sample or analyzer-processing condition explains the missing or inconsistent result.
8. Check Result Transmission
If the analyzer shows a completed result but the LIS does not, verify network connection, communication status, and the analyzer-to-LIS path using an approved test workflow.
Expected outcome: Results transmit and appear in the correct destination. If they do, the problem is resolved.
9. Perform Final Functional Verification
After correcting the identified cause, run appropriate QC or verification material and confirm normal analysis, result generation, and transmission.
Expected outcome: Results are generated consistently, QC is acceptable, and communication is complete. Troubleshooting can stop.
10. Escalate Unexplained or Reproducible Result Problems
If known-good material or QC produces delayed, missing, or inconsistent results after external causes are ruled out, stop external troubleshooting.
Expected outcome: The analyzer is removed from affected patient testing and service or laboratory technical escalation is initiated.
If the Problem Persists
Common specimen, identification, QC, aspiration, reagent, workflow, and communication causes have been ruled out. The remaining problem may involve analyzer measurement performance, internal processing, software, fluidics, sensing systems, data handling, middleware, or other service-level conditions.
Remove the analyzer from service for affected testing, label it Out of Service when appropriate, and arrange repair or service evaluation using Sysmex documentation and approved test equipment. Internal adjustments, software repair, or component replacement should be performed only by qualified personnel.
Before return to service, complete appropriate functional checks, acceptable QC, and end-to-end result verification. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
When a result appears clinically inconsistent, protect the patient by confirming sample identity and analyzer performance before assuming the result is valid.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Laboratory staff reported that completed XN-1000 results were intermittently missing from the LIS."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found an unstable external network connection causing intermittent communication between the analyzer and laboratory network."
Resolution
What action was taken.
Example:
"Corrected the external network connection and verified multiple test results transmitted to the correct LIS records without delay."
Helpful Details to Include (If Known)
- Whether the result was delayed, missing, or analytically inconsistent
- Patient/sample identification status
- Analyzer processing status
- Any flags or displayed messages
- Specimen condition
- QC status
- Repeat or alternate-analyzer comparison
- Aspiration or reagent errors
- LIS transmission status
- Results before and after correction
- Final analyzer status
Final Thought
Delayed or inconsistent results require investigation across the entire path from specimen quality through analyzer performance and result transmission. Verify each layer before assuming internal failure, and remove the analyzer from affected testing when reliability cannot be demonstrated.
That is successful troubleshooting.