BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM

    MDR report key: 8962137 · Received September 4, 2019

    Report

    Report Number
    3006948883-2019-00725
    Event Type
    Malfunction
    Date Received
    September 4, 2019
    Date of Event
    July 20, 2019
    Report Date
    September 12, 2019
    Manufacturer
    BD (SUZHOU)
    Product Code
    FOZ
    PMA / PMN Number
    N/A
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    H.6. INVESTIGATION: A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 8171142. OUR RECORDS SHOW THAT THIS IS THE ONLY INSTANCE OF THIS ISSUE OCCURRING IN THIS PRODUCTION BATCH. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED WITHOUT DEFECTS BEING NOTED DURING THE FINAL ASSEMBLY OR VISUAL INSPECTIONS. UNFORTUNATELY A SAMPLE COULD NOT BE OBTAINED FOR EVALUATION AND TESTING. WITHOUT THE ABILITY TO INVESTIGATE THE AFFECTED UNIT OUR QUALITY ENGINEERS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT. H3 OTHER TEXT : SEE H.10.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT AFTER INSERTION IT WAS DISCOVERED THAT THE CATHETER WAS DAMAGED AND THERE WAS BLOOD LEAKAGE WITH A BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE TO ENGLISH: THE PATIENT WAS ADMITTED TO THE HOSPITAL FOR POSTERIOR CIRCULATION ISCHEMIA AND WAS TREATED BY INFUSION. OPERATING NURSES USED VENOUS INDWELLING NEEDLE TO PUNCTURE AND ESTABLISH VENOUS PASSAGE ON PATIENT¿S RIGHT FOREARM. AFTER SUCCESSFUL PUNCTURE, BLOOD EXUDATION WAS FOUND AT THE TRIGEMINAL POINT OF THE INDWELLING NEEDLE CATHETER. THE EXAMINATION FOUND THAT THERE WAS DAMAGE. AFTER COMMUNICATION WITH PATIENTS, THE INDWELLING NEEDLE WAS TAKEN OUT IMMEDIATELY AND REPLACED WITH THE INDWELLING NEEDLE TO PERFORM PUNCTURE AND INFUSION TREATMENT. WHICH DID NOT AFFECT THE PATIENTS.

    Additional Manufacturer Narrative · 1

    INITIAL REPORTER PHONE #: UNKNOWN. A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT AFTER INSERTION IT WAS DISCOVERED THAT THE CATHETER WAS DAMAGED AND THERE WAS BLOOD LEAKAGE WITH A BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM (B)(6) TO ENGLISH: THE PATIENT WAS ADMITTED TO THE HOSPITAL FOR POSTERIOR CIRCULATION ISCHEMIA AND WAS TREATED BY INFUSION. OPERATING NURSES USED VENOUS INDWELLING NEEDLE TO PUNCTURE AND ESTABLISH VENOUS PASSAGE ON PATIENT¿S RIGHT FOREARM. AFTER SUCCESSFUL PUNCTURE, BLOOD EXUDATION WAS FOUND AT THE TRIGEMINAL POINT OF THE INDWELLING NEEDLE CATHETER. THE EXAMINATION FOUND THAT THERE WAS DAMAGE. AFTER COMMUNICATION WITH PATIENTS, THE INDWELLING NEEDLE WAS TAKEN OUT IMMEDIATELY AND REPLACED WITH THE INDWELLING NEEDLE TO PERFORM PUNCTURE AND INFUSION TREATMENT. WHICH DID NOT AFFECT THE PATIENTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    757046 BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM INTRAVASCULAR CATHETER FOZ BD (SUZHOU) 8171142

    Patients

    Seq Age Sex Outcome Treatment
    1 Other