IV Extravasation – Vesicant Medications

IV Extravasation Hospital Errors

The most severe form of IV infiltration, which poses significant risks to patient health and well-being, often arises when potent and corrosive medications, referred to as vesicants, infiltrate the surrounding tissues at the IV insertion site. This detrimental occurrence, known as IV extravasation, initiates a cascade of adverse effects, including tissue burns and necrosis, thereby exacerbating the patient’s condition and necessitating immediate intervention to mitigate further harm.

Should you or a loved one find yourselves grappling with the aftermath of IV extravasation due to a hospital error, it is imperative to seek professional guidance and legal counsel to safeguard your rights and pursue appropriate recourse. Burnside Law Firm LLP stands ready to offer comprehensive support and advocacy, leveraging our expertise in handling medical negligence cases to ensure that you receive the compensation and justice you rightfully deserve. Contact us today to explore your options and embark on the path to securing fair compensation for the damages incurred. For a comprehensive list of the most common irritant and vesicant IV medications, visit www.IVACCESS.com.

List of Vesicants

• Acyclovir > 7mg/mL (Zovirax®)
• Aminophylline
• Calcium salts ( 100 mg/mL concentration)
• Chlorothiazide (Diuril®)
• Cisplatin (Platinol®)(in concentrations 0.5 mg/mL)
• Dactinomycin (Actinomycin-D, Cosmegen®)
• Daunorubicin (daunomycin, Cerubidine®)
• Dextrose solutions >10%
• Dobutamine (Dobutrex®)
• Dopamine (Intropin®)
• Doxorubicin (Adriamycin®)
• Epinephrine
• Epirubicin (Ellence™)
• Hydroxyzine (Vistacot™) Do NOT administer IV
• Idarubicin (Idamycin®)
• Mannitol (> 5% concentration)
• Mechlorethamine (nitrogen mustard, Mustargen®)
• Mitomycin C (Mutamycin®)
• Mitoxantrone (Novantrone®)
• Nitroglycerin
• Norepinephrine (Levophed®)
• Oxaliplatin (EloxatinTM)
• Phenylephrine
• Phenytoin (Dilantin®)
• Promethazine (Phenergan®)
• Sodium bicarbonate (>8.4% or > 1 mEq/mL)
• Thiopental (Pentothal®)
• Total parenteral nutrition (TPN)*
• Tromethamine (THAM®)
• Vasopressin (Pitressin®)
• Vinblastine (Velban ®)
• Vincristine (Oncovin ®)
• Vinorelbine (Navelbine ®)
• *TPN solutions containing amino acid solutions >5% and/or Dextrose >10% are considered
• Vesicants

Partial List of Other Irritants:

• Amiodarone (Cordarone®)
• Arsenic Trioxide (Trisenox®)
• Bleomycin (Blenoxane®)
• Bortezomib (VelcadeTM)
• Busulfan (Busulfex®)
• Calcium salts (< 100 mg/mL concentration)
• Conivaptan (Vaprisol®)
• Carboplatin (Paraplatin®)
• Carmustine (BiCNU®)
• Cisplatin (Platinol®) (< 0.5 mg/mL concentration)
• Cladribine (Leustatin®)
• Dacarbazine (DTIC-Dome®)
• Dalfopristin/quinupristin (Synercid®)
• Dextrose (< 10% concentration)
• Docetaxel (Taxotere®)
• Erythromycin
• Esmolol (Brevibloc®)
• Etoposide (VePesid®)
• Etoposide phosphate (Etopophos®)
• Fluorouracil
• Gemcitabine (Gemzar®)
• Gentamicin
• Ifosfamide (Ifex®)
• Irinotecan (Camptosar®)
• Liposomal cytarabine (DepoCyt®)
• Liposomal daunorubicin (DaunoXome®)
• Liposomal doxorubicin (Doxil™)
• Liposomal vincristine (Marqibo™)
• Melphalan (Alkeran®)
• Nafcillin (Nallpen®)
• Paclitaxel (Taxol®)
• Paclitaxel, nanoparticle albumin-bound (Abraxane®)
• Plicamycin (Mithracin®)
• Potassium chloride
• Sodium chloride ( 1% or 170 mEq/L)
• Streptozocin (Streptozotocin, Zanosar®)
• Teniposide (Vumon®)
• Thiotepa
• Topotecan (HycamtinTM)
• Vancomycin

The following chemotherapeutic agents are vesicants:

• actinomycin-D
• daunorubicin
• doxorubicin
• idarubicin
• mechlorethamine
• mitomycin-C
• paclitaxel
• streptozocin
• vinblastine
• vincristine
• vinorelbine

Some chemotherapeutic agents can cause pain or burning on administration, even though they may remain in the vasculature:

• carmustine (BCNU)
• dacarbazine (DTIC)

Pain or burning can be minimized by infusing these drugs slowly as dilute solutions (eg. 100-250ml over 30-60 minutes, as opposed to IV push injections)

If you suspect medical negligence, do not hesitate to contact our Augusta or Athens, Georgia, lawyer. We offer experienced, strategic advocacy in cases involving IV infiltration and IV injury. Call (706) 432-8320 or contact us by e-mail for an initial consultation.