BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INTROCAN SAFETY

    MDR report key: 2040045 · Received March 29, 2011

    Report

    Report Number
    2040045
    Event Type
    Malfunction
    Date Received
    March 29, 2011
    Date of Event
    March 23, 2011
    Report Date
    March 29, 2011
    Manufacturer
    B. BRAUN
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US

    Narratives

    Description of Event or Problem · 1

    SAFETY IV CATHETER SIZE 22, INSERTED WITH GOOD BLOOD RETURN; CATHETER WOULD NOT ADVANCE OVER NEEDLE. REMOVED AND NOTED THAT NEEDLE HAD GONE THROUGH CATHETER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INTROCAN SAFETY IV CATHETER FOZ B. BRAUN 4251519-02 0/17258302

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR NO OTHER THERAPIES