BEUDAMED
    FDA Adverse Event Other Summary report: N

    PERIFIX

    MDR report key: 621635 · Received July 13, 2005

    Report

    Report Number
    2523676-2005-00037
    Event Type
    Other
    Date Received
    July 13, 2005
    Report Date
    July 5, 2005
    Manufacturer
    B. BRAUN MEDICAL, INC.
    Product Code
    BSO
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TWO DIFFERENT ANESTHESIOLOGISTS, FIVE TO SIX DIFFERENT INCIDENTS IN WHICH LOR SYRINGE PLUNGER STUCK IN THE BARREL AND MADE IT DIFFICULT TO CONFIRM ACCURATE PLACEMENT. ONE INCIDENT CONTRIBUTED TO A HEADACHE AS A RESULT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERIFIX CUSTOM EPIDURAL ANESTHSIA TRAY BSO B. BRAUN MEDICAL, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other