BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NOVALON IV CATHETER/NEEDLE UNIT

    MDR report key: 144671 · Received January 12, 1998

    Report

    Report Number
    MW1012818
    Event Type
    Injury
    Date Received
    January 12, 1998
    Date of Event
    January 8, 1998
    Report Date
    January 8, 1998
    Manufacturer
    BECTON DICKINSON VASCULAR ACCESS, INC.
    Product Code
    FOZ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IV'S DISCONTINUED. UPON REMOVING ANGIOCATH THE TIP BROKE OFF IN ARM. TOURNIQUET APPLIED ABOVE IV SITE. PHYSICIAN NOTIFIED. PHYSICIAN PERFORMED A CUT DOWN RT ANTECUBITAL AND CATHETER TIP REMOVED. IV STARTED 1/5/98 AT 1530.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NOVALON IV CATHETER/NEEDLE UNIT 16 GA 1 1/4 IN ANGIO CATH 1.7 MM 3.2 CM FOZ BECTON DICKINSON VASCULAR ACCESS, INC. * UNABLE TO OBTAIN

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Required Intervention UNRELATED