BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOSPIRA / ICU MEDICAL

    MDR report key: 2702043 · Received August 10, 2012

    Report

    Report Number
    MW5026504
    Event Type
    Injury
    Date Received
    August 10, 2012
    Manufacturer
    SET SOURCE
    Product Code
    FPA
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WITH CHRONIC LEFT KNEE BURSITIS, HOSPITALIZED, SURGERY (I & D); DISCHARGED HOME WITH RIGHT PICC AND WOUND VAC TO KNEE. LEFT FA PERIPHERAL IV (B)(6). RIGHT PICC FOR HOME ANTIBIOTICS. IN (B)(6), RETURNED TO ED WITH REDNESS, PAIN, PALPABLE CORD, WARMTH IN LFA. HOME WITH ANTIBIOTIC THERAPY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOSPIRA / ICU MEDICAL 7" PRESSURE INFUSION EXT SET FPA SET SOURCE NA 13-038-JW

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization MEDLINE IV START KIT