BD CAREFUSION / CAREFUSION 303, INC. BD ALARIS PUMP INFUSION SET; SET, ADMINISTRATION, INTRAVASCULAR
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Lot Number (10)20103025 |
Device Problem
Device Contamination with Chemical or Other Material (2944)
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Patient Problem
Appropriate Clinical Signs, Symptoms, Conditions Term / Code Not Available (4581)
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Event Date 07/20/2021 |
Event Type
Injury
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Event Description
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Rn was reattaching iv tubing she noticed something floating in the iv tubing.Rn told patient that she was going to get her new fluids and new tubing since she just got out of the shower and then removed the affected tubing from the patient's room.After visual inspection, the ns 1l bag was not expired and there was a visible particle in the iv tubing.From where the particle is located, it does not appear that this particle came from the ns bag.It appears to be at a ysite location.The pt had metoclopramide, prochlorperazine, and diphenhydramine ivpush administered during this 24 hr timeframe.None of these medications would be expected to cause this result in the iv tubing unless there was contamination while attaching the medication to the iv tubing.We would never be able to confirm or deny that.The most likely cause is that this particle was already present in the iv tubing before being removed from the package and used on the pt.The iv tubing used is bd alaris pump infusion set.Primary set ref (b)(4) and secondary set ref (b)(4).Fda safety report id# (b)(4).
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