BEUDAMED
    FDA Adverse Event Other Summary report: N

    B-D INTERLINK THREADED LOCK CANNULA

    MDR report key: 19202 · Received January 27, 1995

    Report

    Report Number
    MW1004898
    Event Type
    Other
    Date Received
    January 27, 1995
    Date of Event
    January 6, 1995
    Report Date
    January 10, 1995
    Manufacturer
    BECTON DICKINSON AND CO.
    Product Code
    FPA
    Report Source
    Voluntary report
    Reporter Location
    IN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WAS RECEIVING CONTINOUS INFUSION OF CHEMO (5FU) VIA PUMP. TUBING FROM PUMP WAS CONNECTED TO PT'S PORT TUBING BY WAY OF A THREADED LOCK CANNULA. THE CANNULA BECAME UNSCREWED FROM THIS PORT AND TUBING RESULTING IN BLOOD BACK UP INTO IV TUBING. PT WAS ON AN ANTICOAGULANT AND THIS HAPPENED BEFORE PT WENT TO BED FOR THE EVENING, AROUND 10:30 PM. PT WAS ALERT AND ORIENTED, CLAMPED HIS LINE AND CALLED HIS NURSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 B-D INTERLINK THREADED LOCK CANNULA IV TUBING CONNECTOR FPA BECTON DICKINSON AND CO.

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Other CODD ONE PUMP-PHARMACIA DELTEC, HUBER NEEDLE WITH| W/TUBING-PARMACIA DELTEC, CHRUCHILL MEAL SYSTEMS,| INC-EXTENSION SET.