BEUDAMED
    FDA Adverse Event Other Summary report: N

    MCGAW TRIMED ADD ON FILTER 0.22

    MDR report key: 284511 · Received June 29, 2000

    Report

    Report Number
    MW1019217
    Event Type
    Other
    Date Received
    June 29, 2000
    Date of Event
    June 27, 2000
    Report Date
    June 28, 2000
    Manufacturer
    B. BRAUN MEDICAL, INC.
    Product Code
    FPB
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    RN WAS CALLED BY PT TO REPORT CHEMO LEAK IN IV TUBING. SEEMED TO BE COMING FROM FILTER PORTION OF LINE. RN VISIT MADE (PT HAD TURNED OFF PUMP/CLAMPED LINE AT TIME OF INITIAL REPORT). FILTER REPLACED AND INFUSION RESUMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MCGAW TRIMED ADD ON FILTER 0.22 ADD ON IV FILTER FPB B. BRAUN MEDICAL, INC. * 060102499

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Other