BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SAF-T WING BLOOD COLLECTION SET DEVICE

    MDR report key: 1020704 · Received February 29, 2008

    Report

    Report Number
    1217052-2008-00047
    Event Type
    Malfunction
    Date Received
    February 29, 2008
    Date of Event
    September 2, 2007
    Report Date
    February 5, 2008
    Manufacturer
    MFG FOR SMITHS MED BY: SMITHS HEALTHCARE MFG S.A. DE C.V.
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    USER ALLEGES ONE EVENT OF THE NEEDLE STICK, WHEN USING THIS DEVICE. TREATMENT WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAF-T WING BLOOD COLLECTION SET DEVICE 75 JKA - TRAY, BLOOD COLLECTION JKA MFG FOR SMITHS MED BY: SMITHS HEALTHCARE MFG S.A. DE C.V. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *