BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BD INSYTE AUTOGUARD IV CATH 22G X 1.00

    MDR report key: 458728 · Received May 7, 2003

    Report

    Report Number
    MW1028377
    Event Type
    Injury
    Date Received
    May 7, 2003
    Date of Event
    April 25, 2003
    Report Date
    May 7, 2003
    Manufacturer
    BECTON AND DICKINSON & CO
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHEN IV CATHETER WAS REMOVED IT BROKE OFF AT THE HUB LEAVING A SMALL SECTION IN THE PT. PT TAKEN TO SURGERY AND BROKEN PIECE OF CATHETER WAS REMOVED. IV WAS PLACED IN 4/03 REMOVED TWO DAYS LATER. TOLERATED SURGERY WELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD INSYTE AUTOGUARD IV CATH 22G X 1.00 IV CATHETER FOZ BECTON AND DICKINSON & CO 381423 3003957

    Patients

    Seq Age Sex Outcome Treatment
    1 18 MO Hospitalization