BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEPARIN LOCK FLUSH SOLUTION USP

    MDR report key: 1156024 · Received September 9, 2008

    Report

    Report Number
    MW5008265
    Event Type
    Malfunction
    Date Received
    September 9, 2008
    Date of Event
    September 9, 2008
    Report Date
    September 9, 2008
    Manufacturer
    AMSINO MEDICAL USA
    Product Code
    NZW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RN WENT TO FLUSH LINE WITH A PREFILLED HEPARIN SYRINGE, AND MET WITH SOME RESISTANCE. NURSE EXAMINED SYRINGE AND FOUND THAT THE SYRINGE WAS FILLED WITH AIR. NURSE IMMEDIATELY NOTIFIED PHARMACY. ROUTE: IV. DATES OF USE: 2008. DIAGNOSIS OR REASON FOR USE: TO FLUSH LINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEPARIN LOCK FLUSH SOLUTION USP 10 UNITS/ML; 3ML IN 12ML SYRINGE NZW AMSINO MEDICAL USA KH02749

    Patients

    Seq Age Sex Outcome Treatment
    1