BEUDAMED
    FDA Adverse Event Other Summary report: N

    BAXTER

    MDR report key: 748608 · Received June 30, 2005

    Report

    Report Number
    MW1035950
    Event Type
    Other
    Date Received
    June 30, 2005
    Date of Event
    June 22, 2005
    Report Date
    June 29, 2005
    Manufacturer
    BAXTER -CLINTEC NUTRITION DIVISION
    Product Code
    KPE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHILE STARTING PT GRAVITY ARALAST INFUSION, IV BAG STARTED TO DRIP MEDICATION SLOWY DOWN THE SIDE OF IV BAG. RN HAD TO STOP INFUSION AND USE ASEPTIC TECHNIQUE TO REMOVE MEDICTION FROM IV BAG AND PLACE INTO A NEW IV BAG. MEDICATION APPEARED TO BE LEAKING IN THE SEAM OF THE IV BAG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER VIA FLEX CONTAINER KPE BAXTER -CLINTEC NUTRITION DIVISION * *

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Other