BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PROSORBA COLUMN

    MDR report key: 589749 · Received April 7, 2005

    Report

    Report Number
    3032792-2005-00006
    Event Type
    Injury
    Date Received
    April 7, 2005
    Date of Event
    March 14, 2005
    Manufacturer
    FRESENIUS HEMOCARE
    Product Code
    LQQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PATIENT ADMITTED TO HOSPITAL THE EVENING AFTER THEIR 2ND PC TREATMENT WITH FEVER CHEST PAIN AND RASH. TREATMENTS HAD BEEN DONE UTILIZING AN INTERAL JUGULAR CENTRAL LINE. PT DIAGNOSED WITH NON-OCCLUSIVE THROMBUS IN THE RIGHT INTERNAL JUGULAR VEIN AND PULMONARY EMBOLISM. CENTRAL LINE DISCONTINUED, PATIENT ANTICOAGULATED AND DISCHARGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PROSORBA COLUMN PROSORBA COLUMN LQQ FRESENIUS HEMOCARE 9798701 QHN001D

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Hospitalization CELEBREX, PREDNISONE, LORTAB.