FDA Adverse Event Other Summary report: N

BD L-CATH PERIPHERALLY INSERTED CENTRAL CATHETER

MDR report key: 1518974 · Received October 28, 2009

Report

Report Number
1710034-2009-00194
Event Type
Other
Date Received
October 28, 2009
Date of Event
September 10, 2009
Report Date
October 13, 2009
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC.
Product Code
LJS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE HAS BEEN RECEIVED AND IS CURRENTLY BEING INVESTIGATED. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

THE CATHETER WAS INSERTED ON (B)(6)2009 AND WAS FOUND LEAKING AT THE WHITE Y CONNECTOR WHEN FLUSHING. THE CATHETER WAS REMOVED ON (B)(6)2009.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD L-CATH PERIPHERALLY INSERTED CENTRAL CATHETER PERCUTANEOUS CATHETER LJS BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC. NA 7269480

Patients

Seq Age Sex Outcome Treatment
1 UNK Other CHEMOTHERAPY