FDA Adverse Event Other Summary report: N

PHASEAL INFUSION ADAPTER

MDR report key: 1210282 · Received October 22, 2008

Report

Report Number
9615998-2008-00006
Event Type
Other
Date Received
October 22, 2008
Date of Event
September 29, 2008
Report Date
October 20, 2008
Manufacturer
CARMEL PHARMA AB,
Product Code
LHI
PMA / PMN Number
K023747
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION INITIATED. ON-GOING ATTEMPTS TO RETRIEVE ADDITIONAL INFORMATION REGARDING THE REPORTED INCIDENT.

Description of Event or Problem · 1

"A NURSE RECEIVED AN INFUSION BAG OF IRINOTECAN, WITH THE INFUSION ADAPTER ATTACHED BY PHARMACY. THE NURSE OPENED THE FLAP ON THE INFUSION ADAPTER IN ORDER TO SPIKE WITH THE IV TUBING AND THE MEDICATION SPLASHED OUT OF THE DISTAL END OF THE INFUSION ADAPTER. THE NURSE WAS SPLASHED WITH MEDICATION ON HER FACE AND IN HER EYES. EXPOSURE PROTOCOL WAS FOLLOWED WITH FLUSH AND EYEWASH. NURSE STATES NO INJURY OCCURRED."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHASEAL INFUSION ADAPTER INTRAVASCUALR ADMINISTRATION SET LHI CARMEL PHARMA AB, C100 UNK

Patients

Seq Age Sex Outcome Treatment
1