Skip links and keyboard navigation

CPCRE - Infusion Device Update

2016 Update - Niki issues

REM Systems, distributor of the Niki T34 and associated devices, issued a statement in early 2016 regarding reported issues with the devices.  

There had been reports of problems with medication potency in Niki devices taken outside, due to interaction of sunlight with materials in a newer version of the Niki, which in turn affected medications in the device.

REM advice, and longstanding best practice, is to ensure that where the Niki is taken into sunlight, that it be protected from direct light, e.g. by being kept in a pouch. There is no need for devices to be returned to REM.

Previous Infusion Device Changes

The Centre for Palliative Care Research and Education (CPCRE) worked with Palliative Care Queensland and Palliative Care Australia in 2007 to develop a nationally coordinated response to removal of the Graseby syringe driver from sale in Australia.

That response included the Report on Subcutaneous Infusion Devices, on the CPCRE and Palliative Care Australia websites, and the subcutaneous infusion device education pages launched in 2011. It includes information about alternative devices on the market. Together with Palliative Care Australia, CPCRE continues to monitor the situation. As anticipated, there have been no barriers to the continued use of Graseby syringe drivers in the community, though most services now will have transitioned to alternative devices.

Background

The Graseby Syringe Driver was in common use for many years where subcutaneous infusion of medications for palliative patients, particularly in the community, was required. Its popularity related to its ease of use for practitioners, portability, and relatively low cost in comparison with other available infusion devices. In addition, consumables such as extension tubing and syringes, were standard and low cost. It was withdrawn from sale after a number of serious medication errors related to user error/confusion, especially in the context of the different Graseby models. Regarding ongoing maintenance and service, Smiths Medical Australasia (SMA) announced on 24th August 2007 that:
SMA will continue to service these devices and support for them will continue for a minimum of 5 years.
Interesting article on the history of the syringe driver:
Graham, F., & Clark, D. (2005). The syringe driver and the subcutaneous route in palliative care: The inventor, the history and the implications. Journal of Pain and Symptom Management, 29(1), 32-40.
Last updated: 22 January 2018