BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BECTON DICKINSON AND COMPANY

    MDR report key: 1303351 · Received February 2, 2009

    Report

    Report Number
    MW5009846
    Event Type
    Injury
    Date Received
    February 2, 2009
    Date of Event
    January 28, 2009
    Report Date
    February 2, 2009
    Manufacturer
    BECTON DICKINSON AND COMPANY
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PRIMAXIN ADMIN VIA PICC LINE X28 MIN WHEN BLOOD STARTED TO BACK FILL FROM PICC LINE THROUGH TUBING INTO SYRINGE. PICC LINE CLAMPED A 2ND RN CALLED TO BEDSIDE AND UPON INVESTIGATION, FOUND THAT THE SYRINGE HAD A CRACK IN IT. PICC LINE FLUSHED, BLOOD SUGAR WNL AND MAP 32. PHARMACY NOTIFIED THE NURSE MANAGER AS WELL. DATES OF USE: 2009.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BECTON DICKINSON AND COMPANY SYRINGE FMF BECTON DICKINSON AND COMPANY 309603 8016685

    Patients

    Seq Age Sex Outcome Treatment
    1 27 DA Disability