FDA Adverse Event Other Summary report: N

MEDISYSTEMS AV FISTULA NEEDLE

MDR report key: 474029 · Received July 23, 2003

Report

Report Number
MW1029101
Event Type
Other
Date Received
July 23, 2003
Manufacturer
MEDISYSTEM CORP
Product Code
FEI
Report Source
Voluntary report
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

WHEN PT WAS CANNULATED AND CONNECTED TO THEIR HIP THE VENOUS NEEDLE MADE A (POP) SOUND AND A BLOOD STREAM EXPRESSED FROM THE NEEDLE. LINES WERE CLAMPED, BLOOD CATHETER WERE DRAWN. THE LIFELINE NEEDLE WAS PULLED AND PT WAS RECANNULATED, AND CONNECTED TO TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MEDISYSTEMS AV FISTULA NEEDLE FISTULA NEEDLE FEI MEDISYSTEM CORP D9-2005MG 2612F1

Patients

Seq Age Sex Outcome Treatment
1 73 YR Other