BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE

    MDR report key: 3100468 · Received May 8, 2013

    Report

    Report Number
    1416980-2013-11726
    Event Type
    Injury
    Date Received
    May 8, 2013
    Date of Event
    April 9, 2013
    Report Date
    April 15, 2013
    Manufacturer
    BAXTER HEALTHCARE
    Product Code
    KDJ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). ADDITIONAL INFORMATION PROVIDED: THE PATIENT EXPERIENCED RECURRENT PERITONITIS. THE CAUSE OF PERITONITIS WAS AGAIN BREAK IN ASEPTIC TECHNIQUE/TOUCH CONTAMINATION. THE PATIENT WAS TREATED WITH VANCOMYCIN 1 GRAM TIMES 4 DOSES (ROUTE NOT REPORTED).

    Additional Manufacturer Narrative · 1

    (B)(4). UNKNOWN DATE IN 1978. THE CAUSE OF THIS PERITONITIS WAS USE ERROR. PER BAXTER LABELING, USERS ARE INSTRUCTED TO USE ASEPTIC TECHNIQUE WHEN PERFORMING PERITONEAL DIALYSIS THERAPY. A FORMAL REVIEW OF THE LABEL FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

    Description of Event or Problem · 1

    THIS IS A REPORT OF A HOME PATIENT (HP) WHO WAS DIAGNOSED WITH PERITONITIS. THE CAUSE OF PERITONITIS WAS BREAK IN ASEPTIC TECHNIQUE. THE HP WAS TREATED VANCOMYCIN (DOSE, FREQUENCY AND ROUTE UNKNOWN). THE HP WAS RE TRAINED AND WAS REPORTED TO BE RECOVERING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    201791 SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE KDJ BAXTER HEALTHCARE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other DIANEAL AND HOMECHOICE