BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DPS HYPODERMIC SYRINGE LUER LOCK

    MDR report key: 11998676 · Received June 14, 2021

    Report

    Report Number
    MW5101869
    Event Type
    Malfunction
    Date Received
    June 14, 2021
    Report Date
    June 11, 2021
    Manufacturer
    DPS BARE / DUOPROSS MEDITECH CORPORATION
    Product Code
    MEG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    [DPS BARE HYPODERMIC SYRINGE] USE FOR COVID-19 UNDER EMERGENCY USE AUTHORIZATION (EUA): STATE ANCILLARY SUPPLIES- DPS BARE HYPODERMIC SYRINGE, 1ML. LOT # 20110012, EXP DATE: 11-15-2025. SYRINGE BARREL HAS HUGE HOLE IN IT. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    886405 DPS HYPODERMIC SYRINGE LUER LOCK SYRINGE, ANTISTICK MEG DPS BARE / DUOPROSS MEDITECH CORPORATION 2011012

    Patients

    Seq Age Sex Outcome Treatment
    1