BEUDAMED
    FDA Adverse Event Other Summary report: N

    2.7ML, LT.BLUE-CONVENTIONAL, NACITRATE TUBE

    MDR report key: 297993 · Received September 25, 2000

    Report

    Report Number
    1917413-2000-00021
    Event Type
    Other
    Date Received
    September 25, 2000
    Date of Event
    September 15, 2000
    Report Date
    September 25, 2000
    Manufacturer
    BECTON DICKINSON & CO.
    Product Code
    JKA
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    PHLEBOTOMIST

    Narratives

    Description of Event or Problem · 1

    A SYRINGE DRAW WAS PERFORMED. DIRECT TRANSFER FROM SYRINGE TO TUBE RESULTED IN TUBE TO BREAK. PHLEBOTOMIST WAS STUCK WITH HYPODERMIC NEEDLE AFTER BREAKAGE. BASELINE TESTING WAS DONE AND ANTI-VIRAL TREATMENT ADMINISTERED. ALL OTHER INFO OF RESULTS IS CONFIDENTIAL AS PER FACILITIES PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 2.7ML, LT.BLUE-CONVENTIONAL, NACITRATE TUBE CITRATE TUBE JKA BECTON DICKINSON & CO. NA 0158112

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other