BEUDAMED
    FDA Adverse Event Other Summary report: N

    BBRAUN MEDICAL

    MDR report key: 2667090 · Received December 23, 2005

    Report

    Report Number
    9611612-2005-00005
    Event Type
    Other
    Date Received
    December 23, 2005
    Date of Event
    March 15, 2004
    Report Date
    September 29, 2005
    Manufacturer
    PAJUNK GMBH
    Product Code
    BSP
    Removal / Correction Number
    UNK
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE 20 GA INTRODUCER PLACED IN THE PT'S BACK. NEEDLE DISCONNECTED FROM HUB. PHYSICIAN TURNED TO GET HEMOSTATS TO REMOVE REMAINING NEEDLE WHEN PT MOVED, CAUSING NEEDLE TO MIGRATE INTO PT'S SKIN. NEEDLE HAD TO BE REMOVED WITH SCALPEL / SURGICAL PROCEDURE. PT RECOVERED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BBRAUN MEDICAL INTRODUCER CANNULA 24 G BSP BSP PAJUNK GMBH 021151-30LB 60473291

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention