BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CATHETER

    MDR report key: 100026 · Received June 24, 1997

    Report

    Report Number
    MW1011546
    Event Type
    Injury
    Date Received
    June 24, 1997
    Date of Event
    January 18, 1997
    Report Date
    March 17, 1997
    Manufacturer
    LUTHER MEDICAL PROD
    Product Code
    FOZ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT. HAD 20G 20 CM L-CATH BRAND MIDLINE PLACED ON 1-10-97. MOTHER OF PT. TRIPPED OVER CATHETER WHILE PT. PLAYING ON FLOOR. IV CATH WAS PULLED, AND MIDLINE BROKE 1" ABOVE HUB. IV WAS HELD IN PLACE BY STERI STRIPS AND DID NOT FLOAT INTO PT. ER-RN VISIT TO PT, MIDLINE DISCONTINUED AND NEW IV WAS RESTARTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CATHETER MIDLINE CATHETER FOZ LUTHER MEDICAL PROD * *

    Patients

    Seq Age Sex Outcome Treatment
    1 8 YR Required Intervention CLICK LOCK SYSTEM FOR CONNECTION