I’m reaching out to see how other institutions are handling the use of B. Braun Add‑EASE® / container connector systems when the attached vial contains a liquid medication (not powder).
We recently encountered concerns suggesting that an Add‑EASE® phenylephrine bag may not have been activated prior to administration.

This has prompted us to re‑evaluate whether these systems are appropriate for high‑alert medications or liquid formulations, where there may not be a clear visual cue that activation has occurred.
I’m interested in learning from others:

Are your institutions using B. Braun Add‑EASE® or similar connector systems with liquid medications such as:

Phenylephrine
Levetiracetam (Keppra®)
Lacosamide (Vimpat®)
Other IV liquid medications?

If so:

What safeguards are in place to ensure activation occurs?
Are these products restricted to pharmacy activation only?
Is there education or labeling to differentiate liquid vs. powder vials?

Alternatively:

Have you removed or restricted these systems for certain medications (e.g., vasopressors or high‑alert drugs)?
Have you transitioned to ready‑to‑use premixed products or alternative packaging as a risk‑reduction strategy?

We’re trying to understand best practices and whether others have seen similar issues or taken formal action based on safety concerns or ISMP recommendations.
Appreciate any insight or shared experiences.
Thank you,
Jennifer