BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INTROCAN SAFETY

    MDR report key: 3952671 · Received July 18, 2014

    Report

    Report Number
    2523676-2014-00277
    Event Type
    Malfunction
    Date Received
    July 18, 2014
    Date of Event
    May 12, 2014
    Report Date
    July 2, 2014
    Manufacturer
    B. BRAUN MELSUNGEN AG
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    AS REPORTED BY THE USER FACILITY: CUSTOMER REPORTS: NURSE HAD SUCCESSFUL ATTEMPT TO START IV. SAFETY CLIP DID DEPLOY. WHILE CLEANING UP, HAD A NEEDLE STICK. NO SAMPLE SAVED. MFR - 9610825-2014-00277.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    423318 INTROCAN SAFETY I.V. SAFETY CATHETER FOZ B. BRAUN MELSUNGEN AG NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK