BEUDAMED
    FDA Adverse Event Injury Summary report: N

    17612

    MDR report key: 17612 · Received August 11, 1994

    Report

    Report Number
    17612
    Event Type
    Injury
    Date Received
    August 11, 1994
    Date of Event
    January 27, 1994
    Report Date
    February 3, 1994
    Manufacturer
    N/A
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THIS PATIENT WAS GIVEN A TEST DOSE OF 25MG IV OF INFED OVER 5 MIN. PATIENT STATED HE FELT FUNNY AND STOPPED BREATHING. THE PHYSICIAN WAS PRESENT AND CR WAS STARTED. THE CARDIAC MONITOR SHOWED PVC'S. SOLU-MEDROL 125MG IV - ADRENALIN 1CC OF 1:1000 AND 1 AMP OF BECAIB WERE GIVEN. THE JPATIENT RESPONDED QUICKLY AND WAS SENT TO THE HOSP. HE IS BACK AT THE FACILITY. THIS PATIENT REC. A TEST DOSE A FEW MONTHS AGO WITHOUT A PROB. THE SERIES WAS NOT CONT. AT THAT TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 N/A N/A

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Hospitalization