BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DISPENSER, LIQUID MEDICATION

    MDR report key: 17534109 · Received August 12, 2023

    Report

    Report Number
    MW5141012
    Event Type
    Malfunction
    Date Received
    August 12, 2023
    Report Date
    March 20, 2020
    Manufacturer
    KYX
    Product Code
    KYX
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 0

    PATIENT REPORTED ON (B)(6) 2020 THAT RECEIVED A BOX WITH A BROKEN VIAL OF HEPARIN. N/A. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1215675 DISPENSER, LIQUID MEDICATION DISPENSER, LIQUID MEDICATION KYX KYX

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown