FDA Adverse Event Malfunction Summary report: N

ORAL SYRINGE

MDR report key: 15380320 · Received September 8, 2022

Report

Report Number
1416980-2022-04681
Event Type
Malfunction
Date Received
September 8, 2022
Report Date
October 7, 2022
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
KYX
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

CORRECTION MADE TO D1: BRAND NAME: ORAL SYRINGE (PREVIOUSLY SUBMITTED AS CUSTOM KIT); CORRECTION MADE TO D2A: COMMON DEVICE NAME: DISPENSER, LIQUID MEDICATION (PREVIOUSLY SUBMITTED AS SET, I.V. FLUID TRANSFER) ; CORRECTION MADE TO D2B: CLASSIFICATION CODE: KYX (PREVIOUSLY SUBMITTED AS (LHI); ADDITIONAL INFORMATION WAS ADDED TO H6 AND H10. H10: THE DEVICE WAS NOT RETURNED AND THE LOT NUMBER IS UNKNOWN; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SCALE OF THE PRODUCT'S MEASURING SYRINGE (ORAL LIQUID DISPENSER PROVIDED IN KIT) WORE OUT VERY QUICKLY DURING USE. THIS WAS IDENTIFIED ¿WHEN USING THE MEDICINE (FOR A CHILD) THAT THE SCALE ON THE SYRINGE DISAPPEARED DURING USE.¿ TO REMEDY THE ISSUE, THE CUSTOMER WENT TO THE HEALTH CENTER TO OBTAIN A NEW SYRINGE. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1531247 ORAL SYRINGE DISPENSER, LIQUID MEDICATION KYX BAXTER HEALTHCARE CORPORATION NA UNKNOWN
234551 ORAL SYRINGE DISPENSER, LIQUID MEDICATION KYX BAXTER HEALTHCARE CORPORATION NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown