FDA Adverse Event Injury Summary report: N

VENFLON PRO SAFETY 20G 1.1MM

MDR report key: 3010966 · Received March 15, 2013

Report

Report Number
2243072-2013-00012
Event Type
Injury
Date Received
March 15, 2013
Date of Event
January 30, 2013
Report Date
March 15, 2013
Manufacturer
BECTON DICKINSON
Product Code
BSO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

A SAMPLE HAS NOT BEEN RECEIVED AND A ROOT CAUSE HAS NOT BEEN DETERMINED. IF A SAMPLE ARRIVES FOR INVESTIGATION A SUPPLEMENTAL WILL BE COMPLETED AND POTENTIAL ROOT CAUSE WILL BE DETERMINED.

Description of Event or Problem · 1

ON (B)(6) 2013, THE CUSTOMER WAS OPENING A PACKAGED DEVICE WHEN THE DEVICE SPRANG OUT OF THE PACKAGE AND THE NEEDLE PART OF THE DEVICE PENETRATED AND INJURED THEIR RIGHT EYE. ON AN UNK DATE, SURGERY WAS PERFORMED ON THE EYE TO CLEAN OUT THE BLOOD CLOT AND SUTURE THE REPAIR OF THE RETINA OF THE INJURED EYE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
110462 VENFLON PRO SAFETY 20G 1.1MM CATHETER BSO BECTON DICKINSON 2116422P02

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention