General-purpose infusion pumps deliver liquid medications and other solutions to patients through intravenous (i.v.) or epidural routes at specified flows. They are most often used when greater accuracy or higher flows are needed than can be provided by manually adjusted gravity systems. In this Evaluation (which updates our February 1997 and April-May 1998 studies), we present our findings for four newly evaluated pumps from three suppliers: the Abbott Plum A+, the Alaris Medley Medication Safety System (MSS), and the Baxter Colleague CX and 3 CX. We also summarize our findings and update our ratings for 22 additional models. As our findings show, the factors that distinguish one pump from another are not performance issues, but rather patient safety considerations. Most of the currently available pumps perform reliably and accurately when properly used. However, not all models offer the same level of protection against pump programming errors and other events that can lead to i.v. medication errors. The pumps that we now recommend for consideration all incorporate a new type of safety feature that warns users when a programmed dose falls outside pre-defined "safe" limits. We call this feature a dose error reduction system. In addition, the recommended models all offer set-based free-flow protection that cannot be defeated. Pumps that lack one or both of these features are now rated either Not Recommended or Unacceptable.