BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BECTON DICKINSON AND COMPANY (BD)

    MDR report key: 1702671 · Received May 26, 2010

    Report

    Report Number
    MW5016103
    Event Type
    Malfunction
    Date Received
    May 26, 2010
    Date of Event
    April 23, 2010
    Report Date
    May 14, 2010
    Manufacturer
    BECTON DICKINSON AND CO.
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT UNDERGOING PERSANTINE STRESS TEST. BD 60ML SYRINGE UTILIZED TO INJECT PERSANTINE. DEVICE MALFUNCTIONED. SOME OF THE MEDICATION ON WRONG SIDE OF PLUNGER. PT DID NOT RECEIVE ALL MEDICATION, APPROX 3-5 MLS NOT RECEIVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BECTON DICKINSON AND COMPANY (BD) 60ML SYRINGE FMF BECTON DICKINSON AND CO.

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR