BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD EXTENSION SET SMALLBORE TUBING FILTER

    MDR report key: 17409681 · Received July 26, 2023

    Report

    Report Number
    MW5120212
    Event Type
    Malfunction
    Date Received
    July 26, 2023
    Date of Event
    July 17, 2023
    Report Date
    July 24, 2023
    Manufacturer
    BECTON DICKINSON AND COMPANY
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    LEAKING LIPIDS (IN CENTRAL LINE OF PATIENT) AT FILTER. PRODUCT BECTON DICKINSON AND COMPANY EXTENSION SET SMALLBORE TUBING 1.2 MICRON LOW PROTEIN BINDING FILTER. LOT (10)22019236.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1458105 BD EXTENSION SET SMALLBORE TUBING FILTER SET, ADMINISTRATION, INTRAVASCULAR FPA BECTON DICKINSON AND COMPANY 01 10885403234903 (10)22019236

    Patients

    Seq Age Sex Outcome Treatment
    1 7 DA Female