BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MIDLINE LANDMARK

    MDR report key: 45363 · Received October 28, 1996

    Report

    Report Number
    MW1010175
    Event Type
    Injury
    Date Received
    October 28, 1996
    Date of Event
    October 5, 1996
    Report Date
    October 14, 1996
    Manufacturer
    MENLO CARE
    Product Code
    FOZ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    24 GAUGE CATHETER INSERTED INTO RIGHT MEDIAN CUBITAL VEIN WITH BLOOD FLASH BACK. 5CC NSS ATTACHED TO MIDLINE WITH STYLET REMOVAL CATHETER SECURED. PT WITHOUT COMPLICATIONS. 2ND 5CC NSS SYRINGE ATTACHED AND FLUSHED. UPON FLUSHING, 30 SEC LATER, PT COMPLAINED OF NAUSEA, TIGHTNESS IN CHEST, FACE RED, DIAPHORETIC VS TAKEN-HR 102, BP 100/110, RESP 22, HR PALPITATIONS/IRREGULAR. ALL CALLED. PARAMEDICS ARRIVED, VS TAKEN AGAIN; 108/60,92,18 AND HRR IRREGULAR WITH PVCS EVERY 7TH AND 8TH BEAT. TAKEN TO ER FOR FURTHER FOLLOW UP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MIDLINE LANDMARK MIDLINE CATHETER FOZ MENLO CARE * *

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Hospitalization