BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CLAVE NEEDLELESS CONNECTOR

    MDR report key: 279726 · Received May 25, 2000

    Report

    Report Number
    MW1019007
    Event Type
    Malfunction
    Date Received
    May 25, 2000
    Date of Event
    April 27, 2000
    Report Date
    May 15, 2000
    Manufacturer
    ICU MEDICAL, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PAIN MANAGEMENT RECOVERY ROOM LPN NOTED BACK FLOW OF BLOOD FROM CLAVE NEEDLELESS CONNECTOR. LPN REMOVED THE DEVICE FROM THE PT'S ARM AND APPLIED PRESSURE. NO ADVERSE OUTCOME TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CLAVE NEEDLELESS CONNECTOR NEEDLELESS CONNECTOR FPA ICU MEDICAL, INC. UNK S9CD23

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Other