BEUDAMED
    FDA Adverse Event Other Summary report: N

    PMSET 1DT-XX 1SAFEDRAW

    MDR report key: 1673930 · Received April 30, 2010

    Report

    Report Number
    8020616-2010-00009
    Event Type
    Other
    Date Received
    April 30, 2010
    Date of Event
    March 2, 2010
    Report Date
    March 25, 2010
    Manufacturer
    BECTON DICKINSON CRITICAL CARE SYSTEMS PTE LTD.
    Product Code
    DRS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    AFTER RECEIPT OF SAMPLE AND INVESTIGATION, A FOLLOW-UP REPORT WILL BE FILED. (B)(4).

    Description of Event or Problem · 1

    THE TUBING DETACHED FROM THE BLOOD SAMPLING PORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PMSET 1DT-XX 1SAFEDRAW DTX PLUS DRS BECTON DICKINSON CRITICAL CARE SYSTEMS PTE LTD. NA 910029

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK