FDA Adverse Event Other Summary report: N

BD INTERLINK

MDR report key: 1339374 · Received March 9, 2009

Report

Report Number
2618282-2009-00003
Event Type
Other
Date Received
March 9, 2009
Date of Event
February 10, 2009
Report Date
February 12, 2009
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS
Product Code
FGY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS RECEIVED ON (B)(6) 2009 AND IS CURRENTLY BEING DECONTAMINATED. UPON DECONTAMINATION AND COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

WHEN USING THE SAMPLE CONNECTED TO LOCK SYRINGE, THE FEMALE OF LEVER LOCK BROKE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD INTERLINK THREADED LOCK CANNULA FGY BECTON DICKINSON INFUSION THERAPY SYSTEMS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other