BEUDAMED
    FDA Adverse Event Other Summary report: N

    BD NEXIVA CLOSED IV ACCESS SYSTEM

    MDR report key: 1031760 · Received April 18, 2008

    Report

    Report Number
    9610847-2008-00034
    Event Type
    Other
    Date Received
    April 18, 2008
    Date of Event
    April 4, 2008
    Report Date
    April 7, 2008
    Manufacturer
    BECTON DICKINSON INFUSION THERAPY SYSTEMS
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BE
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THE SAMPLE IS NOT AVAILABLE FOR THE INVESTIGATION. ADD'L INFO HAS BEEN REQUESTED FROM THE CUSTOMER. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

    Description of Event or Problem · 1

    THE EXTENSION TUBE DISCONNECTED FROM THE ADAPTER.

    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 6303967

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK