BEUDAMED
    FDA Adverse Event Death Summary report: N

    *

    MDR report key: 549833 · Received August 4, 2004

    Report

    Report Number
    MW1032898
    Event Type
    Death
    Date Received
    August 4, 2004
    Date of Event
    April 6, 2004
    Report Date
    July 30, 2004
    Manufacturer
    UNK
    Product Code
    DXN
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT SELF CONNECTED BLOOD PRESSURE TUBING THAT WAS CONNECTED TO AN AUTOMATIC BEDSIDE MONITOR TO AN IV NEEDLELESS PORT. WHEN THE BLOOD PRESSURE MONITOR CYCLED FRO A BLOOD PRESSURE READING THE AIR WAS EXPELLED THROUGH THE IV NEEDLELESS PORT AND INTO THE IV CATHETER LINE. THE PT DID NOT SURVIVE THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * BLOOD PRESSURE TUBING DXN UNK * *

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Death DEVICE/CONNECTOR.| NOT THE ACTUAL DEVICE BUT AN EXAMPLE OF THE