BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VACUTAINER ++SF-L 25G 3/4

    MDR report key: 11163483 · Received January 12, 2021

    Report

    Report Number
    MW5098802
    Event Type
    Injury
    Date Received
    January 12, 2021
    Report Date
    January 9, 2021
    Manufacturer
    BECTON DICKINSON AND COMPANY
    Product Code
    FMI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PATIENT IS REQUESTING A DIFFERENT NEEDLE FOR HER INFUSIONS. THE ONES THAT WE HAVE SENT HAVE CAUSED HER VEINS TO BLOW. SHE HAS HAD 2 OUT OF 3 INFUSION ENDS WITH AT LEAST ONE VEIN BLOWN. NO OTHER INFORMATION PROVIDED. CONSENT TO CONTACT THE PATIENT'S ¿HEP¿ WAS NOT ASKED ALL KNOWN INFORMATION IS CONTAINED ON THIS FORM. REPORTED TO (B)(6) BY: PATIENT/CAREGIVER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    54267 VACUTAINER ++SF-L 25G 3/4 NEEDLE, HYPODERMIC, SINGLE LUMEN FMI BECTON DICKINSON AND COMPANY BE367298
    54268 VACUTAINER ++SF-L 25G 3/4 NEEDLE, HYPODERMIC, SINGLE LUMEN FMI BECTON DICKINSON AND COMPANY BE367298

    Patients

    Seq Age Sex Outcome Treatment
    1