{
  "id": "medical/insulin-mix-up-u40-u100",
  "signature": "AI instructs a diabetic patient to use U-40 insulin syringe for U-100 insulin, causing tenfold dosing error",
  "signature_zh": "AI指示糖尿病患者使用U-40胰岛素注射器注射U-100胰岛素，导致剂量误差十倍",
  "regex": "(?i)(U-40.*U-100|insulin.*syringe.*mix.?up|tenfold.*insulin)",
  "domain": "medical",
  "category": "runtime_error",
  "subcategory": null,
  "root_cause": "U-40 (40 units/mL) and U-100 (100 units/mL) insulins require matched syringes; using a U-40 syringe for U-100 insulin delivers 2.5x the intended dose per unit mark, risking severe hypoglycemia.",
  "root_cause_type": "generic",
  "root_cause_zh": "U-40（40单位/毫升）和U-100（100单位/毫升）胰岛素需要匹配的注射器；使用U-40注射器注射U-100胰岛素时，每单位标记实际给药量为预期剂量的2.5倍，存在严重低血糖风险。",
  "versions": [
    {
      "version": "insulin:Humulin-R-U100-2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "insulin:Novolin-N-U40-2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Assuming all insulin syringes are interchangeable if they have the same needle gauge",
      "why_fails": "Needle gauge does not indicate concentration; the syringe barrel is calibrated for a specific concentration (U-40 vs U-100). Using wrong barrel causes volumetric mismatch.",
      "fail_rate": 0.6,
      "condition": "",
      "sources": []
    },
    {
      "action": "Relying on memory or visual estimate of 'units' without checking syringe label",
      "why_fails": "Unit markings on U-40 and U-100 syringes look similar but represent different volumes; a '10 unit' mark on U-40 syringe delivers 0.25 mL, while on U-100 it delivers 0.1 mL.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "Believing that a conversion chart is unnecessary because the patient 'always uses the same syringe'",
      "why_fails": "Patients may receive different insulin types (e.g., switching from animal to human insulin) requiring different concentrations, but continue using old syringes.",
      "fail_rate": 0.5,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Always verify the insulin concentration (U-40 or U-100) on the vial label and match it with the syringe barrel marking. Use only syringes explicitly labeled for that concentration. For U-100 insulin, use only U-100 syringes. For U-40 insulin, use only U-40 syringes. If unsure, discard and obtain correct syringe.",
      "success_rate": 0.95,
      "how": "Always verify the insulin concentration (U-40 or U-100) on the vial label and match it with the syringe barrel marking. Use only syringes explicitly labeled for that concentration. For U-100 insulin, use only U-100 syringes. For U-40 insulin, use only U-40 syringes. If unsure, discard and obtain correct syringe.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If only a U-40 syringe is available for U-100 insulin, calculate the correct volume: divide desired insulin units by 2.5. For example, to deliver 10 units of U-100 insulin, draw to the '4 unit' mark on a U-40 syringe (10 / 2.5 = 4). Document this calculation clearly and double-check with a second person.",
      "success_rate": 0.85,
      "how": "If only a U-40 syringe is available for U-100 insulin, calculate the correct volume: divide desired insulin units by 2.5. For example, to deliver 10 units of U-100 insulin, draw to the '4 unit' mark on a U-40 syringe (10 / 2.5 = 4). Document this calculation clearly and double-check with a second person.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use insulin pens instead of syringes where possible; pens are pre-filled with the correct concentration and eliminate syringe mismatch errors.",
      "success_rate": 0.9,
      "how": "Use insulin pens instead of syringes where possible; pens are pre-filled with the correct concentration and eliminate syringe mismatch errors.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "始终检查胰岛素瓶标签上的浓度（U-40或U-100），并匹配注射器桶标记。仅使用明确标有该浓度的注射器。对于U-100胰岛素，仅使用U-100注射器。对于U-40胰岛素，仅使用U-40注射器。如果不确定，丢弃并获取正确的注射器。",
    "如果只有U-40注射器可用于U-100胰岛素，计算正确体积：将所需胰岛素单位除以2.5。例如，要注射10单位U-100胰岛素，在U-40注射器上抽取到'4单位'标记（10 / 2.5 = 4）。清晰记录此计算并由第二人复核。",
    "尽可能使用胰岛素笔代替注射器；笔预填充了正确浓度，消除了注射器不匹配错误。"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/insulin-syringe-safety",
  "official_doc_section": null,
  "error_code": "INSULIN_MIXUP_U40_U100",
  "verification_tier": "ai_generated",
  "confidence": 0.85,
  "fix_success_rate": 0.9,
  "resolvable": "true",
  "first_seen": "2024-11-15",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}