BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MINICAP DISCONNECT CAP

    MDR report key: 206381 · Received January 7, 1999

    Report

    Report Number
    1423500-1999-00015
    Event Type
    Injury
    Date Received
    January 7, 1999
    Date of Event
    September 8, 1998
    Report Date
    December 11, 1998
    Manufacturer
    BAXTER HEALTHCARE CORP.
    Product Code
    KDJ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    REGISTERED NURSE REPORTED A HOME PT WAS DIAGNOSED WITH PERITONITIS ON 09/08/1998 AND TREATED WITH ANTIBIOTICS. NO PRODUCT FAILURE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MINICAP DISCONNECT CAP MINICAP KDJ BAXTER HEALTHCARE CORP. NA NA01

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other