FDA Adverse Event Other Summary report: N

SAF-T-INTIMA SHIELDED IV CATHETER

MDR report key: 1193529 · Received October 8, 2008

Report

Report Number
9610847-2008-00078
Event Type
Other
Date Received
October 8, 2008
Date of Event
September 6, 2008
Report Date
September 23, 2008
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS
Product Code
FOZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE IS NOT AVAILABLE FOR THE INVESTIGATION. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CATHETER WAS INSERTED IN 2008. DURING THE NIGHT OF THE FOLLOWING DAY, THE PT PRESENTED SIGNS OF SEPTIC SHOCK: RED AND WARM AT THE LEFT OF THE SIDE, FEVER 100.4 DEGREES FAHRENHEIT. THE CATHETER WAS REMOVED. ELEVEN DAYS AFTER, THE LESION CONTINUED TO EVOLVE BECAUSE THE LEFT SIDE OF THE ABDOMEN WAS ABSCESSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SAF-T-INTIMA SHIELDED IV CATHETER INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other