BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEPARIN LOCK FLUSH 60 UNIT/6 ML

    MDR report key: 4935905 · Received July 17, 2015

    Report

    Report Number
    MW5044650
    Event Type
    Malfunction
    Date Received
    July 17, 2015
    Date of Event
    July 17, 2015
    Report Date
    July 17, 2015
    Manufacturer
    BD
    Product Code
    NZW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    AFTER ADMINISTERING 2ML OF HEPARIN FLUSH 10U/ML (6ML SYRINGE) INTO A PICC LINE, THE SYRINGE WAS NOTED TO HAVE PRECIPITATE/SEDIMENT FLOATING INSIDE. NO PARTICLES WERE VISUALIZED ENTERING THE PT. NO OTHER MEDICATIONS WERE REPORTEDLY ADMINISTERED IMMEDIATELY BEFORE AND AFTER THIS FLUSH SOLUTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    465814 HEPARIN LOCK FLUSH 60 UNIT/6 ML HEPARIN LOCK FLUSH 60 UNIT/6 ML NZW BD 506811N

    Patients

    Seq Age Sex Outcome Treatment
    1 13 YR Other