BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BECTON DICKINSON

    MDR report key: 353690 · Received September 28, 2001

    Report

    Report Number
    353690
    Event Type
    Injury
    Date Received
    September 28, 2001
    Date of Event
    September 6, 2001
    Report Date
    September 25, 2001
    Manufacturer
    BECTON DICKINSON
    Product Code
    FPA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MN, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    LIPIDS HOOKED INTO INTRAVENOUS TUBING AT Y (INJECTION PORT) CONNECTOR WITH A B-D INTERLINK - LEVER LOCK CANNULA (CLOTHESPIN CONNECTOR). THE TUBING WAS CONNECTED AT THE INJECTION PORT, BUT BECAME DISCONNECTED AT WHAT WAS THOUGHT A MALE TO FEMALE LUER LOCK CONNECTION CONNECTING THE SECONDARY TUBING TO THE LEVER LOCK CANNULA. OBSERVED THAT THE FEMALE CONNECTOR OF THE LEVER LOCK CANNULA WAS NOT A LUER LOCK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    44042 BECTON DICKINSON INTRAVENOUS TUBING CONNECTOR FOR NEEDLESS SYSTEM FPA BECTON DICKINSON * *

    Patients

    Seq Age Sex Outcome Treatment
    1 15 MO Life Threatening| R