FDA Adverse Event Other Summary report: N

INSYTE IV CATHETER

MDR report key: 1062845 · Received June 18, 2008

Report

Report Number
1710034-2008-00075
Event Type
Other
Date Received
June 18, 2008
Date of Event
June 2, 2008
Report Date
June 6, 2008
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS
Product Code
FOZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. DATE SUBMITTED: 18 JUNE 2008.

Description of Event or Problem · 1

THE PATIENT HAD THE IV INSERTED IN 2008, AND A COLONOSCOPY WAS PERFORMED. THE CATHETER WAS REMOVED AND THE PATIENT WAS RELEASED. TWO DAYS LATER THE PATIENT RETURNED COMPLAINING OF PAIN AND SWELLING AT THE IV SITE. A MINOR PROCEDURE WAS COMPLETED AND A SMALL PIECE OF THE CATHETER WAS REMOVED. THE PATIENT WAS THEN DISCHARGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INSYTE IV CATHETER INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS NA 7179890

Patients

Seq Age Sex Outcome Treatment
1 UNK Other