FDA Adverse Event Other Summary report: N

BD INSYTE AUTOGUARD SHIELDED IV CATHETER

MDR report key: 1023754 · Received March 24, 2008

Report

Report Number
1710034-2008-00033
Event Type
Other
Date Received
March 24, 2008
Date of Event
March 5, 2008
Report Date
March 12, 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

THE SAMPLE WAS REC'D ON 03/19/2008 AND IS CURRENTLY BEING DECONTAMINATED. UPON DECONTAMINATION AND COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IN 2008, A CLINICIAN WENT TO WITHDRAW THE NEEDLE OF THE CATHETER AND THE CATHETER SEPARATED FROM THE ADAPTER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD INSYTE AUTOGUARD SHIELDED IV CATHETER INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other