Symptoms
Two items were recently submitted. Both are stuck at the Approval stage. The user has approved via email and that didn't work. He's also been unable to use the form to approve the items.
Diagnoses
Sync appeared to be clogged up and wasn't processing actions.
Resolution
A restart of the K2 server changed the SyncState and allowed the backlog of actions to be processed (though many of the tasks had already been actioned or passed.