Safety Alert Notification for IV Administration Sets - For Health Professionals

1a Close roller clamp

1b Insert into pump

1c Using a fingertip, firmly push tubing toward back of air-inline detector

1d Close door

1e While holding the door closed, gently lower the door latch

1f Ensure door is closed, then open roller clamp

2. Removing administration set from pump:

• Close roller clamp
• Open pump module door

Note: When door is opened, the administration set Safety clamp fitment will automatically close to help prevent accidental free-flow

When the white clamp is extended, it is in the "closed" position to prevent flow

2 Safety clamp fitment automatically closes

3. Reloading administration set into pump:

Note: Safety clamp fitment is closed (white clamp is extended) when removed from pump

• Ensure roller clamp is closed
• Insert set into pump, per directions for use, leaving white clamp on Safety lamp fitment extended
• Close pump module door
• Open roller clamp

3a Close roller clamp

3b Re-insert set into pump

3c Using a fingertip, firmly push tubing toward back of air-inline detector

3d Close door

3e While holding the door closed, gently lower the door latch

3f Ensure door is closed, then open roller clamp

For more information, please contact Customer Advocacy at 800.854.7128, ext. 7812. In Canada at 800.387.8309. Or visit our website at cardinalhealth.com.

Understanding the Safety clamp* and the Gemini Infusion Pump

Alairs^® products

Gemini Infusion Pump

1. Loading a new administration set:

• Prime set and close roller clamp
• POWER ON the system

1a Close roller clamp

1b Position upper fitment into fitment recess

1c Insert the Safety clamp fitment into recess

1d Using a fingertip, firmly push tubing toward back of Air-in-Line Detector

2. Removing administration set from pump:

• Close roller clamp
• Open pump module door

Note: When door is opened, the administration set Safety clamp fitment will automatically close to help prevent accidental free-flow

2a Remove the Safety Clamp fitment by gently pulling tubing (below the Air-in-Line Detector) forward and out

2b Lift upper fitment vertically from upper fitment recess

3. Reloading administration set into pump:

Note: Safety clamp fitment is closed (white clamp is extended) when removed from pump

• Ensure roller clamp is closed
• Insert set into pump, per directions for use, leaving white clamp on Safety clamp fitment extended
• Close pump module door
• Open roller clamp

3a Ensure roller clamp is closed

3b Re-insert set into pump

CUSTOMER RESPONSE CARD

Please assist us in making the Safety Alert follow-up process efficient and convenient for you by completing and returning this card.

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(Check if Applicable)

Safety Alert Receipt Verification:

• We have received the Safety Alert Notification for the IV Administration Sets for use with the Alaris^® Pump module (aka Medley™ Pump module) and the Gemini™ Infusion Pumps.
• We have posted the Tip Sheet provided in the Safety Alert Notification in appropriate location(s) to reinforce the IV Administration Set Directions for Use.
• We have not received the Tip Sheet and/or require additional Tip Sheets. Please send (qty) Tip Sheets to the address noted below.

Location Verification for Alaris^® Pump module (aka Medley™ Pump module) & Gemini™ Infusion Pump:

• Alaris^® Pump modules (aka Medley™ Pump modules) & Gemini™ Infusion Pumps are no longer owned by or located at this facility.
  • They have been destroyed or transferred to an unknown location.
  • They have been transferred to the following location:

Signed: (Signature and Title)
Date:
(Please Print Name)
(Phone)

DISTRIBUTOR RESPONSE CARD

Please assist us in making the Safety Alert follow-up process efficient and convenient for you by completing and returning this card.

(Check if Applicable)

Safety Alert Receipt Verification:

• We have received the Safety Alert Notification for the IV Administration Sets for use with the Alaris^® Pump module (aka Medley™ Pump module) and the Gemini™ Infusion Pumps.
• As a distributor, we have forwarded copies of the Safety Alert Notification and Tip Sheet to our customers who purchase IV Administration Sets for use with the Alaris^® Pump module (aka Medley™ Pump module) & Gemini™ Infusion Pumps.
• We have not received the Tip Sheet or Customer Response Cards and/or require additional copies. Please send (qty) Tip Sheets and Customer Response Cards to the address noted below.

Distributor Verification:

• We distribute IV Administration Sets for use with the Alaris^® Pump module (aka Medley™ Pump module) & Gemini™ Infusion Pumps.
• We DO NOT distribute IV Administration Sets for use with the Alaris^® Pump module (aka Medley™ Pump module) & Gemini™ Infusion Pumps.

Signed: (Signature and Title)
Date:
(Please Print Name)
(Phone)

IV Administration Sets - Intended for Use with Alaris^® Pump module (aka Medley™ Pump module) and Gemini™ Infusion Pumps