{"entity":{"id":"closed-system-transfer-devices","kind":"technology","name":"Closed-system transfer devices for hazardous drugs (PhaSeal, ChemoLock, Equashield)","aka":[],"tldr":"Sealed connectors that let a pharmacist or nurse draw up and give chemotherapy without any drug vapour or droplet escaping, protecting the staff who handle these drugs every day.","summary":"Chemotherapy is hazardous to the people who prepare and administer it; surface contamination and detectable drug in the urine of pharmacy and nursing staff were documented from the 1990s. A closed-system transfer device mechanically prevents the transfer of contaminants into the system and the escape of drug or vapour out of it: a vial adaptor with an expansion chamber or filter equalises pressure as the syringe draws, and double-membrane connectors seal the syringe and infusion line ends so that the drug path is never open. BD's PhaSeal, from the Swedish company Carmel Pharma, was the first widely adopted design; ICU Medical's ChemoLock and ChemoClave, Equashield's fully enclosed syringe unit, Simplivia's Tevadaptor (sold as OnGuard by B. Braun in the United States) and Baxter's and Corvida's devices followed. United States Pharmacopeia chapter 800 requires a CSTD for administration of antineoplastic hazardous drugs and recommends one for compounding, and the devices are paired with compounding robots (Loccioni's APOTECAchemo, Omnicell's IV systems, Equashield Pro), biological safety cabinets and isolators inside the pharmacy.\n\nThe evidence is that CSTDs reduce surface contamination and staff exposure, though designs differ in how well they contain vapour, the NIOSH test protocol for certifying them has remained a draft, they add cost and plastic waste to every dose, and they do not eliminate exposure from spills, excreta or aerosolised drug during PIPAC and HIPEC.","status":"standard-of-care","asOf":"2026-09-17","links":[{"label":"NIOSH: hazardous drug exposures in healthcare, closed system drug-transfer devices","url":"https://www.cdc.gov/niosh/healthcare/hazardous-drugs/"},{"label":"Wikipedia: closed system drug transfer device","url":"https://en.wikipedia.org/wiki/Closed_system_drug_transfer_device"}],"tags":["machines-wave2"],"related":["hipec-pipac-devices","scalp-cooling","generic-drug-shortage-response"],"cancers":["breast-cancer","colorectal","non-hodgkin-lymphoma","nsclc"],"sections":["chemotherapy","devices","supportive-care"],"technologies":["cytotoxic-chemotherapy","pharmacy-automation","infusion-devices-vascular-access"],"targets":[],"drugs":[],"companies":["becton-dickinson","icu-medical","equashield","b-braun","baxter","loccioni","omnicell"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Pressure-equalising vial adaptors and double-membrane leak-proof connectors keep the drug path closed during reconstitution, transfer and administration, preventing escape of aerosol, vapour and droplets and entry of contaminants.","strengths":["Reduces surface contamination and staff exposure","Required by USP 800 for administration","Pairs with compounding robots and isolators"],"limitations":["Designs vary in vapour containment","No finalised certification test","Cost and plastic waste per dose"],"since":1999},"route":"/technologies/closed-system-transfer-devices/","neighbours":{"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"generic-drug-shortage-response","kind":"technology","name":"Generic oncology drug supply and shortage mitigation","route":"/technologies/generic-drug-shortage-response/"},{"id":"hipec-pipac-devices","kind":"technology","name":"HIPEC perfusion pumps and PIPAC nebulisers","route":"/technologies/hipec-pipac-devices/"},{"id":"infusion-devices-vascular-access","kind":"technology","name":"Infusion pumps, ports, and ambulatory chemotherapy devices","route":"/technologies/infusion-devices-vascular-access/"},{"id":"pharmacy-automation","kind":"technology","name":"Oncology pharmacy automation and compounding robots","route":"/technologies/pharmacy-automation/"},{"id":"scalp-cooling","kind":"technology","name":"Scalp cooling (cold caps: DigniCap, Paxman)","route":"/technologies/scalp-cooling/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"company":[{"id":"b-braun","kind":"company","name":"B. Braun","route":"/companies/b-braun/"},{"id":"baxter","kind":"company","name":"Baxter International","route":"/companies/baxter/"},{"id":"becton-dickinson","kind":"company","name":"BD (Becton, Dickinson and Company)","route":"/companies/becton-dickinson/"},{"id":"equashield","kind":"company","name":"Equashield","route":"/companies/equashield/"},{"id":"icu-medical","kind":"company","name":"ICU Medical","route":"/companies/icu-medical/"},{"id":"loccioni","kind":"company","name":"Loccioni","route":"/companies/loccioni/"},{"id":"omnicell","kind":"company","name":"Omnicell","route":"/companies/omnicell/"}]}}