FDA Adverse Event Other Summary report: N

LUER LOK TIP 60 ML SYRINGE

MDR report key: 6144370 · Received December 2, 2016

Report

Report Number
MW5066487
Event Type
Other
Date Received
December 2, 2016
Report Date
September 23, 2016
Manufacturer
BECTON DICKINSON & CO.
Product Code
FMF
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

DESCRIPTION: THE CHEMOTHERAPY TECH WAS WITHDRAWING RITUXAN FROM THE VIAL INTO A BD-60 ML LUER LOK TIP SYRINGE LOT #6182677, EXP 06/2021. THE RITUXAN LEAKED AROUND THE BLACK PLUNGER STOPPER. THE TECH HAD TO DISCARD THE TREATMENT AND REMAKE DUE TO THE LEAKAGE AND POSSIBLE CONTAMINATION. MEDICATION ADMINISTERED TO OR USED BY THE PT. OUTCOME: THE TECH HAD TO DISCARD THE TREATMENT AND REMAKE DUE TO THE LEAKAGE AND POSSIBLE CONTAMINATION. PT COUNSELING PROVIDED: UNK. SEVERITY: CIRCUMSTANCES OR EVENTS HAVE CAPACITY TO CAUSE ERROR. (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
793971 LUER LOK TIP 60 ML SYRINGE LUER LOK TIP 60 ML SYRINGE FMF BECTON DICKINSON & CO. 6182677

Patients

Seq Age Sex Outcome Treatment
1