BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COLLECTION SWAB & VIRUS SAMPLING TUBE

    MDR report key: 10553050 · Received September 17, 2020

    Report

    Report Number
    MW5096725
    Event Type
    Injury
    Date Received
    September 17, 2020
    Date of Event
    September 4, 2020
    Report Date
    September 15, 2020
    Manufacturer
    JIANGSU KANGJIAN MEDICAL APPARATUS CO., LTD
    Product Code
    KXG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS SWABBED ORAL PHARYNGEAL FOR COVID-19 AND WHEN PULLED OUT, THE TIP OF SWAB HAD BROKEN AND WAS MISSING. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1011472 COLLECTION SWAB & VIRUS SAMPLING TUBE APPLICATOR, ABSORBENT TIPPED, STERILE KXG JIANGSU KANGJIAN MEDICAL APPARATUS CO., LTD 20200502

    Patients

    Seq Age Sex Outcome Treatment
    1 27 YR Required Intervention