Missed connections happen all the time--just consult Craigslist. When it comes to making the wrong tubing connections, however, the results are dire.

Although not a new concern for hospital personnel, mixing up tubing connections is a problem that has persisted in healthcare environments and unnecessarily endangered many patients. Addressing this seemingly fixable problem, a recent article from the New York Times, "U.S. Inaction Lets Look-Alike Tubes Kill Patients," examines the issue of tubing connection mishaps, ultimately drawing it out from talks in the industry trades to the mainstream.

The issue at hand is that of tubing misconnections, which can occur when a nurse or other healthcare worker accidentally confuses tubing that delivers oxygen, food, or IV fluids, for example. The consequences of such an action can be deadly. For example, the article cites a fatal tubing misconnection that occurred when a nurse unintentionally connected IV fluids to oxygen-delivery tubes, resulting in suffocation.

In an editorial I wrote several years ago, I addressed this troublesome issue and how, at the core of it, is the use of standardized luers and connectors for tubing sets. Because these components are standardized, they permit nurses to make mistakes. "This is a deadly design failure in healthcare," Debora Simmons, a registered nurse at the University of Texas Health Science Center who studies medical errors told the Times. "Everybody has put out alerts about this, but nothing has happened from a regulatory standpoint."

Standards are being developed and suppliers of tubing connectors are taking initiative to offer products that may prevent these mishaps. But ultimately, it's up to OEMs to send safer products to market. What are you going to do about it, and what's the hold up? Let us know in the comments section.

Check out the article from the New York Times and my editorial to get more background on this subject.