BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    B D INTERLINK ACCESS DEVICE

    MDR report key: 317285 · Received February 20, 2001

    Report

    Report Number
    MW1021139
    Event Type
    Malfunction
    Date Received
    February 20, 2001
    Date of Event
    February 2, 2001
    Report Date
    February 20, 2001
    Manufacturer
    B D
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OK, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    VIAL ACCESS CANNULA BROKE OFF AND WAS PULLED INTO THE SYRINGE. THE NURSE IDENTIFIED FOREIGN MATERIAL IN THE SYRINGE AND DID NOT ADMINISTER TO THE PT. THE VALIUM WAS WASTED AND THE SYRINGE WAS GIVEN TO PHARMACY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    6594 B D INTERLINK ACCESS DEVICE NEEDLESS ACCESS DEVICE FPA B D * 0199937-41

    Patients

    Seq Age Sex Outcome Treatment
    1 *