BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SYMBIQ

    MDR report key: 2073538 · Received April 14, 2011

    Report

    Report Number
    2073538
    Event Type
    Malfunction
    Date Received
    April 14, 2011
    Date of Event
    March 23, 2011
    Report Date
    April 14, 2011
    Manufacturer
    HOSPIRA
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    KY, US

    Narratives

    Description of Event or Problem · 1

    NURSE WAS PRIMING THE IV TUBING WITH LIPIDS. THE NURSE BEGAN "TO FLICK" THE IV TUBING IN ORDER TO GET THE LIPIDS TO ADVANCE THROUGH THE LINE. THE NURSE ALSO STRETCHED THE TUBING TO ASSIST WITH THIS TASK. THE TUBING SNAPPED OFF AT THE LAST PART JOINT. NURSE SURMISED THAT IT WAS A "BONDING ISSUE". TUBING SENT TO MATERIAL MANAGEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SYMBIQ INTRAVASCULAR TUBING FPA HOSPIRA * *

    Patients

    Seq Age Sex Outcome Treatment
    1 3 MO