BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SAF SITE

    MDR report key: 13733 · Received June 2, 1994

    Report

    Report Number
    MW1002328
    Event Type
    Injury
    Date Received
    June 2, 1994
    Date of Event
    April 30, 1994
    Report Date
    May 17, 1994
    Manufacturer
    B. BRAUN MEDICAL, INC.
    Product Code
    FPA
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT HEMORRHAGED FROM PERIPHERAL IV SITE AT THE CONNECTION OF IV HUB AND HUB OF Y-CONNECTOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAF SITE SMALL BORE Y EXTENSION SET FPA B. BRAUN MEDICAL, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 8 DAY Life Threatening