FDA Adverse Event
Summary report: N
EQUASHIELD
MDR report key: 1920569
·
Received November 17, 2010
Report
- Report Number
- 1920569
- Date Received
- November 17, 2010
- Date of Event
- October 27, 2010
- Report Date
- November 17, 2010
- Manufacturer
- EQUASHIELD
- Product Code
- FPA
- Report Source
- User Facility report
- Reporter Location
- OH, US
- Reporter Occupation
- RISK MANAGER
Narratives
Description of Event or Problem · 1
WHILE GIVING IV PUSH CHEMOTHERAPY THROUGH THE DEVICE, THERE WAS A FLUID LEAK.====================== HEALTH PROFESSIONAL'S IMPRESSION======================CHEMO LEAKED THROUGH THE DEVICE AND ONTO THE BED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | EQUASHIELD | EQUASHIELD | FPA | EQUASHIELD | REF:LL-1 | 10-2110 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 27 YR | CHEMOTHERAPY |