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What This Guide Helps With
Troubleshooting suspected uncontrolled flow, free-flow protection failure, post-occlusion bolus, or unexpected fluid delivery caused by tubing, loading, clamps, or setup.
Step-by-Step Troubleshooting
1. Ensure Patient Safety First
Do not investigate suspected free flow or unintended bolus delivery while the pump is connected to an active patient.
- Stop the infusion according to facility policy.
- Close the administration set’s roller clamp or other manual flow-control clamp.
- Disconnect the affected setup from the patient when clinically appropriate.
- Transfer therapy to another verified pump and administration set when continued infusion is required.
- Notify clinical staff immediately if unintended medication or fluid delivery may have occurred.
Expected outcome: The patient is protected from additional uncontrolled delivery.
A pump associated with suspected free flow or unintended bolus delivery must not remain in clinical service until evaluated.
2. Clarify the Reported Behavior
Determine whether the complaint involved:
- Fluid flowing while the pump door was open.
- Fluid continuing after the infusion was stopped.
- A sudden bolus after an occlusion cleared.
- Unexpected movement of fluid while loading or unloading the set.
- A loose, missing, damaged, or incorrectly positioned anti-free-flow component.
- A concern based only on fluid movement in the drip chamber or tubing rather than measured delivery.
Record the medication, programmed rate, approximate unintended volume, alarm messages, and whether the line was connected to a patient.
Expected outcome: The suspected free-flow or anti-bolus event is clearly defined before testing begins.
3. Identify the Agilia Pump Type and Approved Disposable
Confirm whether the device is an Agilia volumetric pump, such as an Agilia VP or VP MC, or an Agilia syringe pump.
Free-flow protection on Agilia volumetric pumps depends on the compatible administration set and its anti-free-flow device. Fresenius Kabi describes the Agilia VP MC SafeClip as preventing free flow when the pump door is open.
Verify that:
- The administration set is approved for the specific Agilia pump.
- The set is within its expiration date.
- The package was not damaged.
- The tubing has not been stretched, reused, or altered.
- No unsupported adapter, extension, or third-party set is affecting operation.
Expected outcome: The pump is being evaluated with the correct, undamaged disposable.
If the wrong set was used, replace it with an approved set and repeat the functional check. If operation is normal, document the disposable mismatch and stop.
4. Close the Manual Clamp Before Opening the Door
Before opening the pump door:
- Close the roller clamp or manual line clamp.
- Remove the line from any patient connection.
- Place the distal tubing into a graduated container or other controlled test setup.
Do not depend solely on the pump’s automatic free-flow protection while investigating a reported failure.
Expected outcome: Fluid cannot reach a patient or spill uncontrollably during set removal.
5. Inspect the Administration Set’s Free-Flow Protection
Remove the administration set and visually inspect the SafeClip or equivalent anti-free-flow component.
Check for:
- Cracks, distortion, or missing pieces.
- Dried medication or sticky residue.
- A clip that does not move freely.
- Tubing incorrectly routed through the clip.
- Tubing that is flattened, stretched, hardened, or damaged.
- A component that appears partially engaged after removal.
Do not lubricate, bend, reshape, or repair the disposable component.
Expected outcome: The free-flow mechanism is clean, intact, and able to close the tubing when removed from the pump.
If the component is damaged or questionable, discard the set and test with a new approved set.
6. Inspect the Pump Door and Tubing Channel
With the pump removed from service and powered off, inspect externally accessible areas for:
- Dried fluid or medication residue.
- Foreign material in the tubing channel.
- Damaged tubing guides.
- A loose or damaged door.
- A latch that does not close securely.
- Visible damage where the SafeClip interfaces with the pump.
- Evidence that the pump was dropped or struck.
Clean only according to the manufacturer-approved process. Do not insert tools into sensors or internal mechanisms.
Expected outcome: The door, latch, guides, and set-loading area are clean and visibly intact.
If mechanical damage is found, stop troubleshooting and send the pump for repair evaluation.
7. Load a New Approved Administration Set
Using a new compatible set:
- Close the roller clamp.
- Prime the set according to facility procedure.
- Position the tubing through each marked guide.
- Seat the pumping segment without stretching or twisting it.
- Fully position the SafeClip or anti-free-flow component.
- Close the door until the latch engages normally.
Fresenius Kabi’s Volumat administration sets use color-coded connectors and a silicone pumping segment intended to support correct loading and pumping performance.
Expected outcome: The set loads without force, the door closes normally, and no loading alarm appears.
If the door requires excessive force or the set will not remain properly seated, remove the pump from service.
8. Perform a Controlled Free-Flow Check
Perform this test without a patient connection and in accordance with facility policy.
- Suspend a compatible fluid container at a normal clinical height.
- Prime and load the approved set.
- Keep the distal end positioned over a graduated container.
- Confirm that the infusion is stopped.
- Close the roller clamp before opening the door.
- Open the pump door.
- Carefully open the roller clamp while observing the distal tubing.
The set’s anti-free-flow mechanism should prevent continuous gravity flow when properly engaged.
Expected outcome: No sustained uncontrolled flow occurs with the door open.
A small isolated drop caused by tubing movement may not represent continuous free flow. Sustained flow, however, is unacceptable.
If sustained flow occurs:
- Immediately close the roller clamp.
- Repeat the test once with a second new approved set.
- If the second set also permits flow, remove the pump from service.
- If only one set fails, retain the set and packaging information according to facility complaint procedures.
9. Check Stop and Pause Behavior
Reload the set, close the door, and program a low-risk test infusion using appropriate test fluid.
Verify that:
- The pump starts normally.
- The pump stops when commanded.
- The pumping mechanism stops moving.
- Fluid does not continue at a clinically significant rate after stopping.
- No door, set-loading, or clamp alarm occurs.
Expected outcome: Pumping stops promptly and the line remains controlled.
If delivery continues after a stop command, remove the pump from service immediately.
10. Evaluate the Reported Anti-Bolus Concern
Anti-bolus concerns commonly involve fluid released after downstream pressure has accumulated during an occlusion.
Using an approved infusion-device analyzer or controlled test fixture:
- Load a new compatible set.
- Program the pump according to the facility’s approved test procedure.
- Create a controlled downstream occlusion.
- Confirm that the pump detects and alarms for the occlusion.
- Observe the line and analyzer when the occlusion is released.
- Compare any measured post-occlusion delivery with the manufacturer’s applicable specifications and facility acceptance criteria.
Do not release a pressurized line toward a patient. Clamp or isolate the line before clearing an occlusion in clinical use.
Expected outcome: The pump alarms appropriately, and any post-occlusion volume remains within approved performance limits.
If an analyzer is unavailable, do not estimate anti-bolus performance by watching the drip chamber. Send the device for bench evaluation.
11. Inspect Setup Conditions That Can Mimic a Pump Failure
Review whether the reported event could have resulted from:
- The roller clamp being left open during loading or unloading.
- The set being removed before the SafeClip fully engaged.
- Incorrect tubing placement.
- Use of a nonapproved administration set.
- A pressurized fluid container.
- A syringe, flush device, or secondary source connected to the same line.
- Gravity flow through an alternate path.
- A downstream occlusion being opened without first isolating the patient.
- The fluid container being positioned unusually high above the patient.
- An administration set used beyond its approved duration.
Expected outcome: External setup factors are either identified and corrected or ruled out.
If correcting the setup resolves the concern and the pump passes all functional tests, return it to service only according to facility policy.
12. Review Available Event Information
Record or review, when available:
- Exact alarm messages.
- Programmed rate and volume.
- Stop, pause, and restart events.
- Occlusion alarms.
- Door-open or set-loading alarms.
- Date and time of the event.
- Drug-library or configuration profile.
- Pump serial number and software version.
Agilia Partner maintenance software can support biomedical configuration, testing, and pump log analysis where available.
Expected outcome: Available evidence either supports an external setup problem or identifies the need for technical evaluation.
Do not clear logs or alter configuration before preserving relevant event information.
If the Problem Persists
If the pump permits sustained free flow with multiple new approved sets, fails to stop delivery, does not detect an occlusion correctly, or produces excessive post-occlusion delivery, common external causes have been ruled out.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or qualified bench evaluation.
- Tested using the applicable Fresenius Kabi service procedure and calibrated infusion-device analyzer.
- Reported through facility safety and complaint channels when unintended patient delivery may have occurred.
Retain the administration set, packaging, lot number, and event details when a disposable-device failure is suspected.
Knowing when to stop and escalate is proper troubleshooting.
Clinical Use Tip
Never open an infusion pump door or clear an occlusion while the line remains open to a patient. Clamp and isolate the line first, then transfer therapy to a verified device when necessary.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that fluid continued flowing after the Agilia pump door was opened and expressed concern about free-flow protection."
Cause
What was observed during troubleshooting.
Example:
"Testing found that the administration set’s SafeClip was damaged and did not fully occlude the tubing when removed from the pump."
Resolution
What action was taken.
Example:
"Removed the defective set, verified pump operation with two new approved sets, completed a controlled free-flow and delivery test, and returned the pump to service."
Helpful Details to Include (If Known)
- Patient connected when event occurred
- Medication or fluid involved
- Estimated unintended volume
- Pump type and serial number
- Software or configuration version
- Administration set part number
- Administration set lot number
- Set expiration date
- Roller-clamp position
- SafeClip condition
- Door and latch condition
- Exact alarm behavior
- Occlusion test results
- Post-occlusion bolus measurement
- Infusion analyzer used
- Environmental factors
- Indicator lights
- Event log retained
- Final device status
Final Thought
Suspected free flow or unintended bolus delivery requires immediate attention because even a small uncontrolled volume may be clinically significant. Protect the patient first, verify the disposable and loading technique, perform controlled testing, and escalate any repeatable failure. Thorough CCR documentation supports patient-safety review and helps distinguish pump failure from administration-set or setup problems.
That is successful troubleshooting.