Preventing Tubing and Luer Misconnections
- Preventing Tubing and Luer Misconnections
- Information for Manufacturers of Small-Bore Connectors and Medical Devices with Connectors
- Recommendations for Health Care Facilities
- Tips for Health Care Providers
- How Luer and Other Small-Bore Connectors are used in Clinical Settings
- How Tubing and Luer Misconnections Occur
- Examples of Tubing and Luer Misconnections
- Factors that Contribute to Tubing and Luer Misconnections
- Report a Problem to the FDA
- Additional Resources
Patients in health care settings receive food, medication and other therapies through a variety of tubes and catheters. These delivery systems are often connected to one another by small-bore connectors (e.g. Luer connectors).
Because these connectors are compatible between different delivery systems, patient injuries and deaths have occurred when medicines, liquid feeding formulas, or air were accidentally delivered through the wrong tubing. These errors are sometimes called tubing misconnections, wrong route errors, catheter misconnections or Luer misconnections.
The FDA continues to work with industry and the standards community to promote the development of connectors that reduce the risk of misconnections.
Example of a Luer Lock
Photo Courtesy of Beaumont Hospitals