BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CBCII W/QUICK DISCONNECT, 1/8

    MDR report key: 687328 · Received March 13, 2006

    Report

    Report Number
    2648666-2006-00014
    Event Type
    Injury
    Date Received
    March 13, 2006
    Date of Event
    February 17, 2006
    Report Date
    February 24, 2006
    Manufacturer
    STRYKER INSTRUMENTS PUERTO RICO
    Product Code
    CAC
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ND, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHILE REMOVING THE DRAIN TUBE FROM THE LEG THE TUBING WAS DIFFICULT TO REMOVE AND WHEN IT WAS PULLED OUT THE END OF THE TUBING WAS SHORTER. PATIENT WAS X-RAYED AND FOUND TO HAVE FRAGMENTED PIECES OF TUBING IN THE LEG. SURGERY WAS PERFORMED TO REMOVE THE FRAGMENTS OF TUBING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CBCII W/QUICK DISCONNECT, 1/8 APPARATUS, AUTO TRANSFUSION CAC STRYKER INSTRUMENTS PUERTO RICO * UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention