Well, a diaphragm failure is going to cause you to take on water . . . in that case, I WOULD go to my alternate reg. I was talking about a sudden and complete lack of delivery of gas to the mouthpiece. Can anybody think of a failure that will do that, and not deliver water instead?
Okay, Thal, I posted while you were writing. There's one.
Here is what I have personally seen with dive buddies or customers bringing regs in for repair:
1) The lever becoming obstructed by ice formation in the second stage while ice diving preventing the lever from lifting the seat off the orifice and resulting in a failure to deliver nay gas. (This was doubly fun as it was in a FFM - underscoring the need for an octo and a back up face mask if you are diving a FFM.) This did not used to be a issue with metal cased second stages but with plastic cases and plastic air barrels it is much more common.
2) The tabs on a lever spreading and allowing the poppet to jump past the lever, making it impossible for the lever to lift the poppet and seat off the orifice, again creating a failure to deliver gas.
3) Loss of the retaining nut on an unbalanced dual adjustment design second stage, causing loss of the lever and a failure to deliver gas.
4) gravel in the second stage blocking movement of the lever and causing a failure to deliver gas.
So...it can happen, not often, but perhaps enough to make it worth your while switching to an octo if the buddy's reg is not immediately available.
Something to consider though is that in this type of failure, you usually discover it just after you have exhaled and gotten nothing back, so you don't want to exhale whatever you have left in your lungs clearing the octo, so train to make the switch and clearing via the purge.
Flooded regs can happen just as quickly due to a cracked case, torn diaphragm or folded over/failed exhaust valve and again bailing out to the backup second stage will resolve the problem.