This is a really great post. Thanks for the detail. I can tell you right up front that even medically trained surgeons still fuck it up in exactly the same way. The primary cause seems to be that doctors and surgeons tend to think they know what’s up and will ignore instructions even if they are given them. I’ve seen this over and over.
To break it down specifically, I’ve never seen a doctor actually follow the all-important instruction of tenting the skin to ensure the needle remains in the fascia. They just ram the needle in and it always ends up way too deep and usually catty-wumpus orientation.
Maybe if there were instructions, your pediatrician friend may have followed them? Maybe? Somehow I doubt it though. I’ve just never seen it. We actually have instructions for professionals here;
I also created a video for VivoKey Spark (basically an x-series) installation here;
I would be very curious what your friend thinks of this documentation.