BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEPARIN 100 UNITS/ML (3ML IN 12 ML SYRINGE)

    MDR report key: 1022051 · Received March 31, 2008

    Report

    Report Number
    MW5006062
    Event Type
    Malfunction
    Date Received
    March 31, 2008
    Date of Event
    March 27, 2008
    Report Date
    March 31, 2008
    Product Code
    NZW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PT DEVELOPED NAUSEA/VOMITING STARTING IN 2008. SHE IS FEELING WEAK. DOSE OR AMOUNT: 3ML, FREQUENCY: UN/BID. ROUTE: IV. DATES OF USE: DEVICE #1 - 2008. DEVICE #2 - 2008.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEPARIN 100 UNITS/ML (3ML IN 12 ML SYRINGE) NONE NZW H107332
    2 HEPARIN 100 UNITS/ML ( 3ML IN 12ML SYRINGE) NONE NZW H108106

    Patients

    Seq Age Sex Outcome Treatment
    1 CEFTRIAXONE 2GM