BEUDAMED
    FDA Adverse Event Death Summary report: N

    30 TAMCO

    MDR report key: 375652 · Received February 7, 2002

    Report

    Report Number
    375652
    Event Type
    Death
    Date Received
    February 7, 2002
    Date of Event
    October 27, 2001
    Report Date
    February 6, 2002
    Manufacturer
    TAMCO
    Product Code
    KOC
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BICARBONATE JUG FILLED WITH 1% BLEACH SOLUTION DURING TREATMENT. TREATMENT IMMEDIATELY ENDED. ERROR CORRECTED. TREATMENT RESUMED. MD NOTIFIED. PT CARDIAC ARREST AT NURSING HOME AT 1900. TAKEN TO HOSPITAL ER FOR FURTHER TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 30 TAMCO BICARBONATE MIXER KOC TAMCO NONE LISTED *

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Death 1% BLEACH MIXED IN MIXER AS DISINFECTANT PROTOCOL.| SOLUTION USED BY MISTAKE FOR BICARBONATE.