BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IVAC

    MDR report key: 162789 · Received March 26, 1998

    Report

    Report Number
    162789
    Event Type
    Injury
    Date Received
    March 26, 1998
    Date of Event
    December 4, 1997
    Report Date
    January 10, 1998
    Manufacturer
    IVAC CORPORATION
    Product Code
    FRN
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    125 MGM. CARDIZEM IN 100 ML. DSW INFUSED WITHIN ONE HOUR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IVAC VOLUMETRIC INFUSION PUMP FRN IVAC CORPORATION 7100 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR Life Threatening| R