BEUDAMED
    FDA Adverse Event Other Summary report: N

    INTERLINK THREADED LOCK CANNULA

    MDR report key: 52575 · Received July 30, 1996

    Report

    Report Number
    52575
    Event Type
    Other
    Date Received
    July 30, 1996
    Date of Event
    June 13, 1996
    Report Date
    June 25, 1996
    Manufacturer
    BECTON DICKINSON & CO.
    Product Code
    FPA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    MOTHER OF PT NOTED THAT MALE END OF 30 INCH EXTENSION SET DISCONNECTED FROM FEMALE END OF MFR'S CANNULA CONNECTED TO A SUBCLAVIAN LINE. HYPERALIMENTATION AND LIPIDS WERE INFUSING. A SIGNIFICANT AMOUNT OF THE HAL AND LIPIDS WERE WASTED, AND THERE WAS AN APPROX 10 CC BLOOD LOSS. CBC AND BLOOD GLUCOSE PERFORMED. PT STABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INTERLINK THREADED LOCK CANNULA CANNULA FPA BECTON DICKINSON & CO. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 19 MO Other ABBOTT EXTENSION SET - 30 INCH WITH OPTION LOCK