BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BD INSYTE AUTOGUARD

    MDR report key: 518582 · Received March 25, 2004

    Report

    Report Number
    MW4003658
    Event Type
    Injury
    Date Received
    March 25, 2004
    Date of Event
    February 9, 2004
    Report Date
    February 13, 2004
    Manufacturer
    BD MEDICAL SYSTEMS
    Product Code
    FOZ
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT ADMITTED THRU ED FOR ASTHMA. STAFF NOTED BLEEDING & HUB OF CATHETER MISSING & WAS UNABLE TO RETRIEVE PINK CATHETER TIP FROM IV SITE. SURGEON TOOK TO O.R. FOR RETRIEVAL OF CATHETER TIP FROM VEIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD INSYTE AUTOGUARD IV CATHETER FOZ BD MEDICAL SYSTEMS * *

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR Required Intervention