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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting a Smiths Medical CADD Legacy infusion pump when reported infusion rates appear incorrect or when staff report programming errors. Symptoms may include unexpected infusion behavior, incorrect rate entry, infusion stopping prematurely, or the pump refusing programmed settings.
The goal is to verify user setup, cassette configuration, and programming parameters before assuming a device malfunction.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Confirm the pump is not currently connected to a patient before beginning troubleshooting.
- If infusion accuracy is in question, move the patient to another verified infusion pump.
- This prevents risk of incorrect medication delivery while the device is being evaluated.
Verify the reported issue with the clinical user
- Ask the clinician what specifically occurred.
- Determine whether the pump delivered too quickly, too slowly, or would not accept the programmed values.
- Understanding the complaint helps determine whether the issue is programming, setup, or device behavior.
Check the infusion mode selected on the pump
- The CADD Legacy supports multiple infusion modes such as continuous infusion, PCA, or intermittent programs depending on configuration.
- Incorrect mode selection can cause infusion behavior that appears incorrect.
Verify programmed parameters
- Review the current settings including infusion rate, dose amount, reservoir volume, and lockout settings if PCA mode is used.
- Ensure the values entered match the physician’s order or intended programming.
Confirm the correct cassette or medication reservoir is installed
- Incorrect cassette types or improperly seated medication reservoirs can cause the pump to behave unexpectedly or restrict programming.
- Verify the cassette is properly installed and compatible with the pump configuration.
Power cycle the pump
- Remove the batteries and wait several seconds.
- Reinstall the batteries and power the pump back on.
- This can clear minor software glitches that may affect programming behavior.
Test programming with a known standard configuration
- Program a simple test infusion such as a low continuous rate using a test cassette or empty reservoir.
- Verify that the pump accepts the programmed values.
- Confirm the display shows the correct rate.
- Verify the pump begins operation normally.
Inspect the keypad for proper operation
- If certain numbers or keys do not respond correctly, programming errors may occur due to keypad failure.
- Press each button and verify that the correct input appears on the display.
Check for error messages or alerts
- Review the screen for system alerts such as cassette errors, occlusion alarms, or programming restrictions.
- These alerts can interfere with infusion setup or operation.
Verify battery condition
- Weak batteries can sometimes cause erratic behavior or display issues.
- Install fresh AA alkaline batteries and test programming again.
If the Problem Persists
If the pump continues to accept incorrect programming, fails to operate at the programmed rate, or behaves inconsistently after these checks, common external causes have been ruled out.
The issue may involve internal components such as keypad membrane failure, internal control board issues, software malfunction, or pump drive mechanism problems.
At this point the device should be removed from service, labeled Out of Service, and sent for repair or further bench evaluation.
Knowing when to escalate prevents unnecessary risk and is an important part of proper troubleshooting.
Clinical Use Tip
Never troubleshoot infusion pump programming while the pump is connected to a patient.
If infusion accuracy is in question, immediately transition the patient to another verified pump before beginning any troubleshooting.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Nursing reported that the CADD Legacy infusion pump appeared to deliver medication faster than the programmed rate and programming values did not match expected infusion behavior.”
Cause
What was observed during troubleshooting.
Example:
“During inspection, pump programming was verified and keypad testing revealed intermittent input errors when entering numerical values.”
Resolution
What action was taken.
Example:
“Pump was removed from service, labeled Out of Service, and sent for repair due to suspected keypad malfunction.”
Helpful Details to Include (If Known)
- Outlet tested if external power accessories were used
- Batteries replaced
- Cassette type verified
- Programming mode confirmed
- Keypad response checked
- Any error messages observed
- Final device status (returned to service or sent for repair)
Final Thought
When infusion behavior appears incorrect, many issues originate from programming configuration, cassette setup, or keypad input errors rather than internal pump failure. Systematically verifying external factors first ensures safe operation, prevents unnecessary repairs, and supports accurate documentation of the issue.
That is successful troubleshooting.