BEUDAMED
    FDA Adverse Event Other Summary report: N

    PERIFIX

    MDR report key: 645638 · Received November 8, 2005

    Report

    Report Number
    2523676-2005-00070
    Event Type
    Other
    Date Received
    November 8, 2005
    Date of Event
    October 17, 2005
    Report Date
    November 1, 2005
    Manufacturer
    B. BRAUN MEDICAL, INC.
    Product Code
    CAZ
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    LOR STICKY, CAUSED ONE "WET TAP" TODAY. HAS BEEN OCCURRING SINCE LAST WEEK. FURTHER INFO PROVIDED BY THE FACILITY INDICATED THAT THE PT SUFFERED NO ADVERSE SEQUELA ASSOCIATED WITH THIS INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERIFIX SINGLE DOSE EPIDURAL ANESTHESIA TRAY CAZ B. BRAUN MEDICAL, INC. SD18TDCD 60777436

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other