BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MICROPORE SINGLE USE PAPER TAPE

    MDR report key: 2704728 · Received December 22, 2009

    Report

    Report Number
    2704728
    Event Type
    Injury
    Date Received
    December 22, 2009
    Date of Event
    December 12, 2009
    Report Date
    December 18, 2009
    Manufacturer
    3-M HEALTHCARE
    Product Code
    KGX
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT WAS ASLEEP AND WHEN SHE AWOKE, SHE BENT HER ARM AND DISLODGED HER VENOUS NEEDLE AND IT CAME OUT. ESTIMATED BLOOD LOSS WAS 300C. PT WAS RECANNULATED AND RESUMED TREATMENT. POST TREATMENT VITAL SIGNS STABLE. PT ALERT AND ORIENTED POST EPISODE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICROPORE SINGLE USE PAPER TAPE PAPER TAPE KGX 3-M HEALTHCARE

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR