Clinical medical devices are designed with the explicit assumption that trained medical team members will operate them in appropriate hospital environments. As technological complexity increases, along with the possibility to create specific ward configurations, the potential for unusual interaction combinations poses challenges for safety and training. Resilience engineering proposes that a system should cope with disturbances and unexpected conditions. Consequently, an important consideration for design is to examine medical device interactions that can be considered ‘non-routine’. In recognition of the localised nature of clinical practice, and in order to investigate the broad range and type of non-routine occurrences, a novel interview approach was adopted involving medical researchers and practitioners. Examples of non-routine interaction were obtained across a diverse range of localities. Covert patient interactions and dangerous configuration combinations were identified which adversely affected treatment. Drawing on these concerns the potential role of patient involvement in bolstering system resilience is discussed.