BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 1031945 · Received April 8, 2008

    Report

    Report Number
    1031945
    Event Type
    Malfunction
    Date Received
    April 8, 2008
    Date of Event
    April 1, 2008
    Report Date
    April 8, 2008
    Manufacturer
    BECTON DICKINSON
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    SC, US

    Narratives

    Description of Event or Problem · 1

    THE SAFETY DEVICE ON THE BD VACUTAINER BLOOD COLLECTION NEEDLE WITH THE PRE-ATTACHED 21 GAUGE HOLDER CAME OFF WHEN PROPERLY ENGAGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * BLOOD COLLECTION DEVICE JKA BECTON DICKINSON * 7236594

    Patients

    Seq Age Sex Outcome Treatment
    1 *