FDA Adverse Event Other Summary report: N

NA

MDR report key: 741168 · Received July 24, 2006

Report

Report Number
2647836-2006-00008
Event Type
Other
Date Received
July 24, 2006
Date of Event
June 9, 2006
Report Date
July 18, 2006
Manufacturer
B. BRAUN MEDICAL, INC.
Product Code
FOZ
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE IN THE INCIDENT WAS NOT RETURNED FOR EVAL. THIRTY TWO UNUSED SAMPLES FROM THE REPORTED LOT WERE RETURNED. THE SAMPLES WERE PHYSICALLY TESTED AND SIX SAMPLES LEAKED DUE TO A HOLE IN THE LUER TAPER OF THE CATHETER PLUG. THESE PARTS ARE MANUFACTURED AND PURCHASED FROM SMITHS MEDICAL/MEDEX INC. THE SAMPLES AND ALL AVAILABLE INFO HAS BEEN FORWARDED TO SMITHS MEDICAL/MEDEX INC. FOR EVAL.

Description of Event or Problem · 1

AS REPORTED BY THE USER FACILITY: LEAKING OF BLOOD AND SALINE AT CONNECTION TO CATHETER. USED IN NUCLEAR MEDICINE LAB. RADIOACTIVE SPILL. ADDITIONAL INFO RECEIVED FROM THE FACILITY INDICATED NO PT INJURY OR EXPOSURE TO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NA EXTENDED IV CATHETER FOZ B. BRAUN MEDICAL, INC. NA 60812452

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other