BEUDAMED
    FDA Adverse Event Death Summary report: N

    LIFE SITE

    MDR report key: 491388 · Received August 26, 2003

    Report

    Report Number
    491388
    Event Type
    Death
    Date Received
    August 26, 2003
    Report Date
    July 28, 2003
    Manufacturer
    VASCA
    Product Code
    MSD
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    7/2003 PT WITH LIFE SITE ACCESS SENT TO E.R. POST DIALYSIS & POST VANCOMYCIN DUE TO TEMP PRE TX 101 AND POST TX TEMP 100.6. PT ALSO HAD DIARRHEA. PT WAS ADMITTED POST E.R. VISIT. 7/2003 11:40 PM PT EXPIRED WITHOUT CONTINUED ANTIBIOTIC THERAPY, BLOOD CULTURES & +STAPH AUREUS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFE SITE DIALYSIS ACCESS MSD VASCA * *

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Death