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I've reviewed the logs quickly, and the full context is this:

[MobileSDK-5.2.72.3277] 393481631 PJLog:          sip_resolve.c    PJSIPImpl  Starting async DNS A query: target=sip.cloudonix.io, transport=TLS, port=443 
[MobileSDK-5.2.72.3277] 393481632 PJLog:             resolver.c    PJSIPImpl  Nameserver [2001:4860:4860::8844]:53 state changed Probing --> Bad 
[MobileSDK-5.2.72.3277] 393481632 PJLog:          sip_resolve.c    PJSIPImpl  Failed to resolve 'sip.cloudonix.io'. Err=320046 (No working DNS nameserver (PJLIB_UTIL_EDNSNOWORKINGNS)) 
[MobileSDK-5.2.72.3277] 393481632 PJLog:         tsx0x1161fb8a8    PJSIPImpl  Failed to send Request msg INVITE/cseq=594 (tdta0x11cbf80a8)! err=320046 (No working DNS nameserver (PJLIB_UTIL_EDNSNOWORKINGNS)) 
[MobileSDK-5.2.72.3277] 393481632 PJLog:         tsx0x1161fb8a8    PJSIPImpl  State changed from Null to Terminated, event=TRANSPORT_ERROR 
[MobileSDK-5.2.72.3277] 393481632 PJLog:         dlg0x11c89e8a8    PJSIPImpl  Transaction tsx0x1161fb8a8 state changed to Terminated 
[MobileSDK-5.2.72.3277] 393481632 cxsdk.PJSIPImpl: Entering on_call_tsx_state call 1 
[MobileSDK-5.2.72.3277] 393481632 cxsdk.PJSIPImpl: Entering on_call_state on_call_state PJSIP_EVENT_TSX_STATE 
[MobileSDK-5.2.72.3277] 393481632 cxsdk.PJSIPImpl: Call info->last_status =  503 tx state: DISCONNECTED DISCONNCTD 

A. This is not using USE_LOCAL_NAME_SERVESR - the configuration that has USE_LOCAL_NAME_SERVER is the watch, and in this case, its the iOS caregiver app - it is using the default Google name servers.
B. Several transactions were successful before the problematic transaction (at 2025-02-13 14:05:00).
C. From the last reachability report (at 2025-02-13 14:04:40), the device is on WiFi that has only a reachable IPv4 address.
D. For some reason, the SDK decided to make a DNS query to the IPv6 DNS server address 2001:4860:4860::8844 - which then failed as expected.

It is not clear why that happened - as can be seen at 2025-02-13 14:04:40.6940, the SDK is expected to make a DNS query to all 4 default name servers (2 on IPv4 and 2 on IPv6), which doesn't seem to be the case at (at 2025-02-13 14:05:00).

I will investigate more tomorrow.