Abridge Common Errors

Overview

Comprehensive troubleshooting guide for Abridge clinical documentation integration. Covers authentication failures, EHR connectivity, audio streaming, note generation, and FHIR push errors.

Error Reference

Authentication & Authorization Errors

Code	Error	Root Cause	Fix
`401`	`INVALID_CREDENTIALS`	Expired or wrong partner secret	Rotate credentials in Abridge Partner Portal
`401`	`TOKEN_EXPIRED`	SMART on FHIR token expired	Refresh token before 60-min expiry
`403`	`ORG_NOT_PROVISIONED`	org_id not activated	Contact Abridge sales engineer
`403`	`SPECIALTY_NOT_LICENSED`	Specialty not in contract	Check licensed specialties in Partner Portal
`403`	`PROVIDER_NOT_ENROLLED`	Provider not onboarded	Complete provider enrollment in Abridge admin

Session & Encounter Errors

Code	Error	Root Cause	Fix
`409`	`SESSION_ALREADY_ACTIVE`	Duplicate session for same encounter	Reuse existing session_id
`422`	`INVALID_SPECIALTY`	Unsupported specialty code	Use codes from `/specialties` endpoint
`422`	`PATIENT_NOT_FOUND`	Patient ID not in EHR context	Verify FHIR Patient resource exists
`408`	`SESSION_TIMEOUT`	Session idle > 30 minutes	Create new session; old ones auto-expire
`500`	`SESSION_CORRUPTED`	Server-side state error	Create new session; report to Abridge support

Audio & Transcription Errors

// Common audio streaming diagnostics
async function diagnoseAudioIssues(wsUrl: string): Promise<string[]> {
  const issues: string[] = [];

  // Check WebSocket connectivity
  try {
    const ws = new WebSocket(wsUrl);
    await new Promise((resolve, reject) => {
      ws.onopen = resolve;
      ws.onerror = reject;
      setTimeout(() => reject(new Error('Connection timeout')), 5000);
    });
    ws.close();
  } catch {
    issues.push('WebSocket connection failed — check firewall allows wss:// on port 443');
  }

  // Check audio format requirements
  // Abridge requires: 16kHz, mono, 16-bit PCM little-endian
  const requiredFormat = { sampleRate: 16000, channels: 1, encoding: 'pcm_s16le' };
  issues.push(`Verify audio format: ${JSON.stringify(requiredFormat)}`);

  return issues;
}

Symptom	Root Cause	Fix
Empty transcript	Microphone not capturing	Check audio input device; verify 16kHz sample rate
Garbled transcript	Wrong encoding	Must be 16-bit PCM LE mono at 16kHz
Speaker mislabeled	Single-channel audio	Use stereo mic or speaker diarization hints
WebSocket drops	Network instability	Implement reconnect with buffered chunks
High latency	Large audio chunks	Send 100ms chunks, not full sentences

Note Generation Errors

// Note generation failure handler
async function handleNoteFailure(sessionId: string, error: any): Promise<void> {
  const status = error.response?.status;
  const code = error.response?.data?.error_code;

  switch (code) {
    case 'INSUFFICIENT_CONTENT':
      console.error('Transcript too short — need at least 30 seconds of clinical conversation');
      break;
    case 'UNSUPPORTED_LANGUAGE':
      console.error('Language not in Abridge supported set (28+ languages)');
      break;
    case 'TEMPLATE_NOT_FOUND':
      console.error('Note template not available — use: soap, hp, progress, procedure');
      break;
    case 'GENERATION_TIMEOUT':
      console.error('Note generation exceeded 120s — complex encounter, retry once');
      break;
    default:
      console.error(`Unknown note error: ${status} ${code}`);
  }
}

FHIR Integration Errors

Error	Root Cause	Fix
FHIR `422 Unprocessable`	Invalid DocumentReference	Validate against FHIR R4 schema
FHIR `401 Unauthorized`	Epic token expired	Re-authenticate via SMART on FHIR
FHIR `404 Not Found`	Wrong FHIR base URL	Verify Epic FHIR endpoint in EHR config
FHIR `409 Conflict`	Duplicate document ID	Generate unique DocumentReference IDs
Epic SmartPhrase error	Template mismatch	Verify SmartPhrase names match Epic config

HIPAA Compliance Errors

// PHI leak detection in error logs
function auditErrorLog(error: any): void {
  const serialized = JSON.stringify(error);

  // Check for accidental PHI in error output
  const phiPatterns = [
    /\b\d{3}-\d{2}-\d{4}\b/,        // SSN
    /\b\d{10}\b/,                     // MRN (10-digit)
    /\b[A-Z][a-z]+\s[A-Z][a-z]+\b/,  // Patient names (heuristic)
    /\b\d{1,2}\/\d{1,2}\/\d{4}\b/,   // DOB
  ];

  for (const pattern of phiPatterns) {
    if (pattern.test(serialized)) {
      console.error('WARNING: Possible PHI detected in error log — redact before logging');
      return;
    }
  }
}

Diagnostic Script

#!/bin/bash
# abridge-diagnostic.sh — Run before opening a support ticket

echo "=== Abridge Integration Diagnostics ==="

# 1. Check credentials
echo "Checking credentials..."
curl -s -o /dev/null -w "%{http_code}" \
  -H "Authorization: Bearer $ABRIDGE_CLIENT_SECRET" \
  -H "X-Org-Id: $ABRIDGE_ORG_ID" \
  "${ABRIDGE_BASE_URL}/health"

# 2. Check FHIR server
echo "Checking FHIR connectivity..."
curl -s -o /dev/null -w "%{http_code}" \
  "${EPIC_FHIR_BASE_URL}/metadata"

# 3. Check WebSocket
echo "Checking WebSocket..."
curl -s -o /dev/null -w "%{http_code}" \
  --header "Upgrade: websocket" \
  "${ABRIDGE_BASE_URL/http/ws}/ws/health"

echo "=== Diagnostics Complete ==="

Output

Identified root cause from error code lookup
Applied targeted fix for the specific error
HIPAA-safe error logging verified

Resources

Next Steps

For collecting debug evidence for support tickets, see abridge-debug-bundle.

abridge-common-errors