BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BD INSYTE AUTOGUARD

    MDR report key: 1881926 · Received October 20, 2010

    Report

    Report Number
    MW5017874
    Event Type
    Injury
    Date Received
    October 20, 2010
    Date of Event
    October 8, 2010
    Report Date
    October 20, 2010
    Manufacturer
    BECTON DICKINSON
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KS, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT'S IV DISCONTINUED, BUT CATHETER NOT ATTACHED TO HUB. ULTRASOUND WAS OBTAINED OF ARM WHICH WAS NEGATIVE. DR. INFORMED OF FINDINGS. CT OF CHEST NEGATIVE. UNABLE TO LOCATE PLASTIC CATHETER FROM IV.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD INSYTE AUTOGUARD IV CATHETER FOZ BECTON DICKINSON 381412

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Disability