FDA Adverse Event Other Summary report: N

BD NEXIVA CLOSED IV ACCESS SYSTEM

MDR report key: 1553128 · Received December 4, 2009

Report

Report Number
1710034-2009-00208
Event Type
Other
Date Received
December 4, 2009
Date of Event
November 12, 2009
Report Date
November 16, 2009
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC.
Product Code
FOZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO HAS BEEN REQUESTED FROM THE REPORTER. THE SAMPLE HAS BEEN RECEIVED, UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

DEVICE LEAKED DURING CHEMOTHERAPY INFUSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD NEXIVA CLOSED IV ACCESS SYSTEM INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC. NA 9187219

Patients

Seq Age Sex Outcome Treatment
1 UNK Other CHEMOTHERAPY DRUGS