FDA Adverse Event Malfunction Summary report: N

SINGLE SHOT

MDR report key: 2935958 · Received January 28, 2013

Report

Report Number
2935958
Event Type
Malfunction
Date Received
January 28, 2013
Date of Event
January 7, 2013
Report Date
January 18, 2013
Manufacturer
KIMBERLY CLARK CORP.
Product Code
CAZ
Product Problem
Yes
Report Source
User Facility report
Reporter Location
WI, US

Narratives

Description of Event or Problem · 1

EPIDURAL INJECTION TRAY WAS OPENED WHILE SETTING UP FOR THE PROCEDURE AND IT WAS NOTED THAT THE 10 ML AMPULE CONTAINING NACL WAS BROKEN. THERE WAS NO FLUID IN THE AMPULE OR THE TRAY. GLASS SHARDS CAN BE SEEN IN THE TRAY. THIS TYPE OF EVENT HAS NOT BEEN REPORTED IN THE PAST. TRAYS ARE RECEIVED IN MATERIALS MANAGEMENT AND TRANSPORTED TO THE CLEAN SUPPLY ROOM IN THE DEPARTMENT WHERE THEY ARE STORED UNTIL USED. NO OUTWARD EVIDENCE THAT THE PACKAGE HAD BEEN DAMAGED IN ANY WAY. NO PATIENT HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
38048 SINGLE SHOT TRAY, EPIDURAL CAZ KIMBERLY CLARK CORP. * 0200732433

Patients

Seq Age Sex Outcome Treatment
1 *