BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NUTRILINE

    MDR report key: 373965 · Received January 23, 2002

    Report

    Report Number
    MW1023892
    Event Type
    Injury
    Date Received
    January 23, 2002
    Date of Event
    January 10, 2002
    Report Date
    January 23, 2002
    Manufacturer
    VYGON CORP
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBING BECAME DISCONNECTED FROM THE HUB OF THE MIDLINE CATHETER. CATHETER REMOVED AND REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NUTRILINE MIDLINE CATHETER DQO VYGON CORP * A01A26

    Patients

    Seq Age Sex Outcome Treatment
    1 10 DAY Required Intervention