BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BECTON DICKINSON

    MDR report key: 490136 · Received October 7, 2003

    Report

    Report Number
    MW1029742
    Event Type
    Injury
    Date Received
    October 7, 2003
    Date of Event
    August 13, 2003
    Report Date
    October 7, 2003
    Manufacturer
    *
    Product Code
    LOX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PROCEDURE - LESION SYMPATHETECTOMY- PERFORMED AND COMPLETED BY PHYSICIAN IN THE USUAL MANNER. ONCE THE NEEDLES WERE REMOVED IT WAS NOTED THAT ONLY THE HUB OF THE 16G, 1.16 INCH -ANGIOCATH BY BECTON DICKINSON #908334- DISPOSABLE NEEDLE WAS ATTACHED TO THE DISPOSABLE 10MM BLUNTIP RFK NEEDLE. THE CATHETER WAS LEFT UNDER THE SKIN ON THE RIGHT SIDE OF THE LOWER BACK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BECTON DICKINSON ANGIOCATH LOX * 908334 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Hospitalization| R