BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CURLIN MEDICAL

    MDR report key: 2803257 · Received October 5, 2007

    Report

    Report Number
    2803257
    Event Type
    Injury
    Date Received
    October 5, 2007
    Date of Event
    August 16, 2007
    Report Date
    October 5, 2007
    Manufacturer
    CURLIN MEDICAL
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IV ADMINISTRATION SET STARTED TO LEAK WHEN IT INTERFERES WITH PUMP. INFUSION COMPLETED USING DIFFERENT DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CURLIN MEDICAL IV ADMINISTRATION SET FRN CURLIN MEDICAL 340-4114 D701532

    Patients

    Seq Age Sex Outcome Treatment
    1 16 YR Required Intervention