BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDEX

    MDR report key: 752427 · Received July 28, 2005

    Report

    Report Number
    MW1036154
    Event Type
    Other
    Date Received
    July 28, 2005
    Date of Event
    July 26, 2005
    Report Date
    July 26, 2005
    Manufacturer
    MEDEX INC
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MT, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PRODUCT: MEDEX INC. 18G 1 1/4" PROTECTIVE PLUS IV CATHETER. NEEDLE DOES NOT FULLY RETRACT, FELL FROM CATHETER RESULTING IN CONTAMINATED NEEDLE SKIN PUNCTURE OF HEALTH CARE PROVIDER NAMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDEX IV CATHETER FOZ MEDEX INC 3065 *

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Other