inforMED
MalfunctionBTC

SIMS DELTEC CADD MEDICATION CASSETTE RESERVOIR

Received Jan 6, 1999 · Event occurred Nov 19, 1998

Report 2183502-1998-00034 · MDR key 206483

Device

Generic name

Medication Reservoir

Manufacturer

Sims Deltec, Inc.

Model number

21-7002

Catalog number

21-7002

Lot number

64501

Product problems

  • Backflow
  • Coagulation in Device or Device Ingredient
  • Blood in tubing

Patient

43 YR

  • Dyspnea
  • Thrombus
  • Therapy/non-surgical treatment, additional

Narrative

Description of Event or Problem

THE PT NOTED BLOOD BACKING UP INTO HER CENTRAL VENOUS CATHETER. THE PT CHECKED THE CONNECTIONS AND THEY WERE SECURE. THE PT WAS INSTRUCTED TO PROCEED TO AN EMERGENCY ROOM FOR ASSESSMENT. THE PT WAS FOUND TO HAVE A CLOT IN HER HICKMAN. THE CLOT WAS EVACUATED AND HER THERAPY RESUMED.