BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 130223 · Received November 4, 1997

    Report

    Report Number
    MW1012420
    Event Type
    Injury
    Date Received
    November 4, 1997
    Date of Event
    November 2, 1997
    Report Date
    November 4, 1997
    Manufacturer
    JOHNSON & JOHNSON PROFESSIONAL
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PIV RESTARTED IN RT ARM AT 1930 11/1/97 AND TRANSILLUMINATOR WAS USED TO IDENTIFY VEIN FOR CANNULIZATION. AT 0630 ON 11/2/97 AREA WHERE TRANSILLUMINATOR LIGHT WAS POSITIONED WAS NOTED TO BE BURNED (3/4" X 1/2") ON (RT) ARM NOT ELBOW, PT TREATED WITH HYDRAGRAM DRESSING TO AREA AFTER EXAMINATION BY PHYSICIAN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * TRANSILLUMINATOR CABLE IDE 708003 FSA JOHNSON & JOHNSON PROFESSIONAL * *

    Patients

    Seq Age Sex Outcome Treatment
    1 2 MO