BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STREAMLINE

    MDR report key: 39651 · Received August 30, 1996

    Report

    Report Number
    39651
    Event Type
    Malfunction
    Date Received
    August 30, 1996
    Date of Event
    August 4, 1996
    Report Date
    August 9, 1996
    Manufacturer
    MENLO CARE, INC.
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT RECEIVING ANTIBIOTIC THERAPY IN THE HOME. PT HAD 22G CATHETER PLACED IN LEFT HAND. AFTER FINISHING LAST DOSE OF THERAPY, PT WENT TO REMOVE CATHETER AND THE WHITE CATHETER DISCONNECTED FROM THE BLUE HUB. THE TIP OF THE CATHETER WAS STICKING OUT OF THE VEIN ENOUGH THAT THE PT WAS ABLE TO GRAB IT AND PULL IT OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STREAMLINE 22G WINGED HUB DQO MENLO CARE, INC. * 605162M

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Other