To the Editor.—
There have been multiple reports of contamination of large-volume intravenous solutions by a wide variety of particulate matter, including asbestos fibers1 and rubber particles.2 We have previously reported contamination of 2-ml and 5-ml ampules by grossly visible glass fragments that fall back into solution after ampules are snapped open at the color-break marking on the ampule neck.3 One can presume that smaller, invisible fragments are probably also present. It is unlikely that the fragments in these small volumes can cause harm when administered intravenously, although there have been reports of pulmonary microemboli, thrombi, and granulomas after large-volume multiliter infusions. We have also noted glass fragments that have fallen into opened 20-ml and 30-ml ampules of local anesthetic solutions packaged for epidural and caudal anesthesia (Figure). It is possible that granuloma formation and foreign body reaction to these particles might occur if injected into the epidural
Katz H, Borden H, Hirscher D. Glass Particle Contamination of Solutions. JAMA. 1974;229(9):1169. doi:10.1001/jama.1974.03230470021016
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