This article explains the behavior with the ‘-downStateFlush’ parameter as it relates to the instance of a NetScaler monitor marking a service down. It also explains what the client connected to that service could expect.
If downStateFlush is set to ON, any established connections are freed by a zombie cleanup process. This process generates a reset with a window size of 9301 sent from the VIP to the client immediately terminating that connection.
If downStateFlush is set to OFF, connections will not reset, but instead might become unresponsive or get a response depending on what state the back-end server is exactly in. That is, it might be DOWN from the monitoring criteria perspective, but still alive and capable of sending a response.