FDA Adverse Event Other Summary report: N

ILLUMENA-SYR-W/HF-150ML (LINDEN LUER)

MDR report key: 1572610 · Received January 7, 2010

Report

Report Number
9610849-2010-00001
Event Type
Other
Date Received
January 7, 2010
Report Date
December 11, 2009
Manufacturer
COVIDIEN
Product Code
DXT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PENDING INVESTIGATION. UPON RECEIPT OF INVESTIGATION, A MEDWATCH 3500A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

COVIDIEN (B)(4) RA REPORTS VIA E-MAIL, CUSTOMER FOUND A HAIR IN THE SYRINGE PRIOR TO USE. NO PT INVOLVED OR HARMED. NO OTHER INFO HAS BEEN MADE AVAILABLE BY CUSTOMER IN (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ILLUMENA-SYR-W/HF-150ML (LINDEN LUER) EMPTY DISPOSABLE SYRINGE DXT COVIDIEN 900103 9114158

Patients

Seq Age Sex Outcome Treatment
1 UNK