FDA Adverse Event Injury Summary report: N

ACCESS

MDR report key: 3133202 · Received May 29, 2013

Report

Report Number
1416980-2013-13502
Event Type
Injury
Date Received
May 29, 2013
Report Date
May 2, 2013
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FPA
PMA / PMN Number
K981792
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE EXACT DATE OF THIS EVENT IS UNKNOWN; HOWEVER, THE EVENT OCCURRED APPROXIMATELY AROUND (B)(6) 2013. AS THE SAMPLE WAS NOT AVAILABLE, AN EVALUATION COULD NOT BE PERFORMED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A CLEARLINK PACLITAXEL SET LEAKED FROM THE TUBING DURING PRIMING. THE DEVICE WAS BEING USED WITH AN UNKNOWN CHEMOTHERAPY SOLUTION, A BAG, AND A PUMP. REPORTEDLY, THE NURSE NOTICED A KINK IN THE TUBING, WHICH WAS LATER IDENTIFIED AS A CUT, AND WHEN SHE MOVED THE TUBING, CHEMOTHERAPY SOLUTION LEAKED ONTO HER HANDS. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235535 ACCESS SET, ADMINISTRATION, INTRAVASCULAR FPA BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1 Other