BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CADD TPN ADMINISTRATION SET

    MDR report key: 11807 · Received March 2, 1994

    Report

    Report Number
    MW1000934
    Event Type
    Malfunction
    Date Received
    March 2, 1994
    Date of Event
    February 22, 1994
    Report Date
    March 1, 1994
    Manufacturer
    PHARMACIA DELTEC, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE DISTAL TUBING CRACKED AND BROKE OFF AT THE HUB. THERE WAS NO PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CADD TPN ADMINISTRATION SET FPA PHARMACIA DELTEC, INC. 20305

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR