Babies given wrong dose of Heparin @ Cedar Sinai

Siri,

Why were the babies in the hospital then? I assumed that they were preemies, but this picture shows apparently healthy babies who were definitely not in need of NICU care. What took both babies back to the hospital with a need for IV access?

Wait! Were these flushes??? Who is still using heparin flushes on their unit?? Wasn't there a similar mishape where babies died because of heparin flushes??

I think nurses are awesome people...but this is EXTREME carelessness.
So why do they NOT check the label three times?

Wait! Were these flushes??? Who is still using heparin flushes on their unit?? Wasn't there a similar mishape where babies died because of heparin flushes??

Some places do still use heparin flush; we are one.

We had a near miss w/this drug, the vials are unbelievably similar. One has a label in this color blue, the other has a label in this color blue. Honest, they are that close.

Despite the incident in the midwest and other near misses, the manufacturer continues to package them that way. One would suppose that continuing to report this issue to the FDA would have some effect, but apparently not.

A totally unnecessary tragedy for all concerned.