Potentially Dangerous Fracture of the Needleless Interlink Vial Access Cannula

The “needle-less” Interlink Vial Access Cannula manufactured by Becton Dickinson and Co. (Franklin Lanes, New Jersey; part No. 303405) is being commonly used at a large number of institutions in the United States. It minimizes the use of needles and thereby limits the risks of needle-stick injuries. To our knowledge, there are no risks to the patient that have as yet been reported from the use of this needleless system.

The Interlink Vial Access Cannula consists of a syringe, a cannula, and a blue plastic dart within the cannula. The dart pierces the vial, allowing the cannula to enter the vial for aspiration of drugs. After the drug is aspirated, the blue dart is retained within the vial, and the cannula along with the syringe is withdrawn (fig. 1).

We report two incidences in the ambulatory surgery center of the same institution where the blue dart of the Interlink Vial Access Cannula was fractured during the process of aspiration of drugs. This resulted in breakage of a small segment of the distal-most part of the dart. The broken end of the blue dart was retained in the syringe (fig. 2). This is seen floating in the syringe in figure 2. These incidents occurred using the 10-ml syringes on two separate occasions in a period of 3 weeks with two different anesthesiologists.

Although the blue color of the dart helps to identify the broken piece, it is possible that such incidents may occur and go unrecognized. Accidental injection of broken plastic pieces may occur through peripheral or central veins and result in injury to the patient. We have removed this product from our clinical practice until modifications in the manufacturing of needleless systems are made.

* Stony Brook University, Stony Brook, New York. neeti.kohli@stonybrook.edu