BEUDAMED
    FDA Adverse Event Other Summary report: N

    BD L-CATH PERIPHERALLY INSERTED CENTRAL CATHETER

    MDR report key: 955798 · Received April 27, 2007

    Report

    Report Number
    1710034-2007-00033
    Event Type
    Other
    Date Received
    April 27, 2007
    Report Date
    April 26, 2007
    Manufacturer
    BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC.
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    THE SAMPLE IS NOT AVAILABLE FOR EVALUATION. ATTEMPTS ARE BEING MADE TO RETRIEVE ADDITIONAL INFORMATION REGARDING THE INCIDENT. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE COMPLETED.

    Description of Event or Problem · 1

    THE CATHETER BROKE WHILE INDWELLING. THE FACILITY BELIEVED THE INCIDENT WAS USER RELATED, SO THE SAMPLE WAS DISCARDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD L-CATH PERIPHERALLY INSERTED CENTRAL CATHETER PERCUTANEOUS CATHETER LJS BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 YR Other