Potential Med Error Avoided
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Circulator Mark Davis was in a case and observed the "kit" label read
1. Bupivacaine 0.25% 30 ml vial
2. Epinephrine 1mg/ml ampule
However he discovered the kit included vial of 0.5% Bupivacaine 30ml vial, not 0.25% as the label read
Thanks Mark for your attention to detail and catching the discrepancy before it could reach a patient.