Needleless Luer access devices have been used since the 1990s to prevent needlestick injuries. The Food and Drug Administration (FDA) is warning health care professionals that some prefilled glass syringes will not work properly with Luer-activated valve (LAV) connectors, which have an internal pin mechanism.

A November 2022 FDA alert provides a link to an example of this problem that occurred with prefilled glass syringes of naloxone, reported April 8, 2021, from the Institute for Safe Medication Practices (see http://www.ismp.org/resources/do-not-use-dr-reddys-prefilled-glass-naloxone-syri). In this example, one hospital discovered that using the prefilled glass syringe of naloxone from Dr. Reddy's Laboratories with a Clave or MicroClave needleless connector caused the pin in the MicroClave LAV access system to break off or clog the glass syringe's tip, preventing the medication from being ejected from the syringe. The article also noted that a similar style LAV connector is made by Bectin Dickinson, B. Braun, and Vygon. (At that time, none of these products had been implicated in an incident involving an incompatible glass syringe.) The new FDA warning does not elaborate on which products have been associated with incompatibilities.

In 2011, the FDA reported incompatibility issues with prefilled glass syringes for adenosine and amiodarone and LAV connectors. Since that time, the agency has been working to finalize guidance for manufacturers to correct this incompatibility problem.

Nurses should be aware that some prefilled glass syringes may not be compatible with the LAV connector used in their organization. These incompatibilities can lead to potentially critical delays in drug administration, since the nurse would need to troubleshoot the problem and come up with a workaround during an emergency. Nurses need to be active on product evaluation committees to help guide their organization to avoid the purchase of equipment incompatible with other products, which can cause a potential safety risk to patients.

For a list of suggestions from the FDA to address this problem, go to http://www.fda.gov/drugs/drug-safety-and-availability/fda-alerts-health-care-pro. To read the FDA alert regarding compatibility issues with prefilled glass syringes and certain LAV connectors, go to http://www.fda.gov/drugs/drug-safety-and-availability/fda-alerts-health-care-pro.