ISMP (Institute for Safe Medication Practices) reported two more cases of catheter misconnections last month but noted progress in initiatives to get industry to adopt standards that would render certain catheter fittings incompatible with tubing sets intended for other purposes.
One case involved administration of cholestyramine into an IV catheter and the other administration of barium into a central venous line. The article lists many other published examples of catheter misconnections and a link to a page with all their previous articles dealing with catheter misconnections.
ISMP. Preventing catheter/tubing misconnections: Much needed help is on the way.
ISMP Medication Safety Alert (Acute Care Edition) 2010; 15(14): 1-2 July 15, 2010
ISMP. Collection of all their catheter misconnection articles.