BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD NEXIVA 18 GA 1.25 IN 1.3X32MM

    MDR report key: 2050759 · Received April 5, 2011

    Report

    Report Number
    2050759
    Event Type
    Malfunction
    Date Received
    April 5, 2011
    Date of Event
    April 5, 2011
    Report Date
    April 5, 2011
    Manufacturer
    BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA, US

    Narratives

    Description of Event or Problem · 1

    STARTED 18 GAUGE IV IN RIGHT ACROMIOCLAVICULAR (AC). IV WAS DEFECTIVE. BLOOD LEAKED FROM EXTERNAL PART OF IV. WHEN FLUSHED THE FLUID POURED OUT OF THE WHITE TIP AT END OF IV. IV HAD TO BE REMOVED AND ANOTHER STARTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD NEXIVA 18 GA 1.25 IN 1.3X32MM BD NEXIVA CLOSED IV CATHETER SYSTEM FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC * 8275429

    Patients

    Seq Age Sex Outcome Treatment
    1 *