FDA Adverse Event Injury Summary report: N

HEPARIN FLUSH 100 UNITS/ML

MDR report key: 1081417 · Received July 23, 2008

Report

Report Number
MW5007790
Event Type
Injury
Date Received
July 23, 2008
Date of Event
July 14, 2008
Report Date
July 23, 2008
Manufacturer
AM USA - AMSINO MEDICAL
Product Code
NZW
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
VA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

ABOUT 90 MINS AFTER USING A 100 UNIT HEPARIN FLUSH I SUDDENLY STARTED TO SHAKE VIOLENTLY, GET BURNING HOT, AND CHILLS, NAUSEA AND MY BLOOD PRESSURE WAS ABOUT 90/38 FOR AN EXTENDED TIME. I HAD TO CALL 911 AND WAS TAKEN TO HOSPITAL. BLOOD TESTS AND URINALYSIS WERE DONE, BUT NO EXPLANATION FOR THE EVENT WAS DETERMINED. I ALSO TAKE CUBICIN FOR DISCITIS, BUT THE LAST DOSE HAD BEEN ALMOST 20 HRS EARLIER. DOSE OR AMOUNT: 2 DOSES 3ML, FREQUENCY: 2 TIMES A DAY, ROUTE: IV. DATES OF USE: 2008. DIAGNOSIS OR REASON FOR USE: FLUSHING IV TUBE. EVENT REAPPEARED AFTER REINTRODUCTION? NO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEPARIN FLUSH 100 UNITS/ML NONE NZW AM USA - AMSINO MEDICAL KH02775

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization SINGLE DOSE SYRINGE| SODIUM CHLORIDE FLUSH SYRINGE| CUBICIN 500 MG