BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BECTON DICKINSON

    MDR report key: 3143252 · Received March 22, 2013

    Report

    Report Number
    3143252
    Event Type
    Malfunction
    Date Received
    March 22, 2013
    Date of Event
    March 20, 2013
    Report Date
    March 31, 2013
    Manufacturer
    BD
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A 20 GAUGE NEXIA CATHETER BROKE WHEN IT WAS REMOVED. IT BROKE APPROX 1/4" FROM THE HUB. ANOTHER PART WAS THEN REMOVED. A THIRD PART REQUIRED A LOCAL SURGICAL INTERVENTION. THE PT WAS UNHARMED. IV WAS IN THE LEFT ANTECUBITAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    120947 BECTON DICKINSON ANGIOCATH FOZ BD 243360

    Patients

    Seq Age Sex Outcome Treatment
    1 Other