BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MINIBORE PCA EXTENSION SET -67 I

    MDR report key: 4284347 · Received November 21, 2014

    Report

    Report Number
    MW5039303
    Event Type
    Injury
    Date Received
    November 21, 2014
    Date of Event
    September 11, 2014
    Report Date
    November 21, 2014
    Manufacturer
    HOSPIRA
    Product Code
    LJS
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    MINIBORE PCA EXTENSION SET 67 INCH. HOSPIRA # (B)(4) WAS PRIMED WITH MORPHINE 1MG/ML FROM PCAIDE ALL THE WAY TO THE OPTION LOCK MALE ADAPTER. THE INSTRUCTIONS ARE CORRECT ON THE PACKAGE TO ONLY PRIME TO THE Y-SITE. THERE IS NO MARKING AT THE Y-SITE TO WARN YOU THAT YOU HAVE REACHED THAT POINT. THUS IT EASY PRIME PAST THIS POINT. ON (B)(6), 2014, 15:30 STOP AT 16:25 MINIBORE PCA EXTENSION SET 67 INCH. HOSPIRA (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    756819 MINIBORE PCA EXTENSION SET -67 I MINIBORE PCA EXTENSION SET -67 I LJS HOSPIRA 14277-28

    Patients

    Seq Age Sex Outcome Treatment
    1 3 MO Hospitalization