FDA Adverse Event Other Summary report: N

BD NEXIVA CLOSED IV ACCESS SYSTEM

MDR report key: 1023717 · Received April 2, 2008

Report

Report Number
1710034-2008-00039
Event Type
Other
Date Received
April 2, 2008
Date of Event
March 10, 2008
Report Date
March 20, 2008
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS
Product Code
FOZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO WAS REQUESTED FROM THE CUSTOMER, HOWEVER, NO INFO WAS AVAILABLE. THE SAMPLE WAS DISCARDED BY THE HOSPITAL. UPON COMPLETION OF THE NO SAMPLE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. DATE SUBMITTED: 04/01/2008.

Description of Event or Problem · 1

THE NURSE SAID THE BD NEXIVA TUBING SEPARATED FROM THE SECUREMENT PLATFORM. THE CATHETER SECUREMENT ASSEMBLY REMAINED IN THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD NEXIVA CLOSED IV ACCESS SYSTEM INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other