inforMED
MalfunctionFPK

LIFESHIELD PRIMARY SYMBIQ SET PIGGYBACK WITH BACK CHECK VALV

Received Jun 13, 2014 · Event occurred Jun 12, 2014

Report 3893491 · MDR key 3893491

Device

Generic name

Tubing, Fluid Delivery

Manufacturer

Hospira, Inc.

Model number

*

Catalog number

16120-28

Lot number

*

Product problems

  • Improper Flow or Infusion
  • Infusion or Flow Problem

Patient

*

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

THE MAIN IV D5.45NS/20 KCL WAS INFUSING THROUGH THE CENTRAL LINE ON A CABG (CORONARY ARTERY BYPASS GRAFT) PATIENT. RN HUNG A 1 GRAM CALCIUM CHLORIDE 60 CC RIDER AS A SECONDARY INFUSION TO THE MAIN IV. A FEW MINUTES LATER WHEN THE RN LOOKED UP HE REALIZED THAT THE CALCIUM RIDER HAD BOLUSED INTO THE PRIMARY INFUSION BAG. THE SECONDARY BAG HAD BYPASSED THE PUMP COMPLETELY. IT APPEARS THAT THE ANTI-REFLUX VALVE WITHIN THE PRIMARY TUBING HAD FAILED. THE RN HAD A 2ND RN CHECK AND THEY BOTH AGREED THAT THE IV PUMP AND TUBING HAD BEEN PROPERLY CONNECTED AND THE PUMP WAS SET-UP CORRECTLY. NO APPARENT HARM. PATIENT MONITORED.