FDA Adverse Event Other Summary report: N

BD UF 30 G 1/2 CC SYRINGE

MDR report key: 1780904 · Received July 26, 2010

Report

Report Number
1920898-2010-00010
Event Type
Other
Date Received
July 26, 2010
Date of Event
July 1, 2010
Report Date
July 26, 2010
Manufacturer
BECTON DICKINSON
Product Code
FMF
PMA / PMN Number
K024112
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT RETURN IS ANTICIPATED AS COMPLAINT INDICATES THAT THE PRODUCT HAS BEEN DISCARDED. COMPLAINT HISTORY CHECK YIELDED NO OTHER COMPLAINTS FOR SIMILAR CONDITION FOR THE LOT REPORTED. NO OBVIOUS TRENDS WERE NOTED. DEVICE HISTORY REVIEW WAS CONDUCTED AND NO ANOMALIES NOTED. REGULATORY COMPLIANCE WILL CONTINUE TO MONITOR ON MONTHLY TREND REPORTS.

Description of Event or Problem · 1

CONSUMER REPORTED, THE NEEDLES HAVE BURRS AND CAUSES HER TO HAVE SCARS AND BRUISING. NO MEDICAL ATTENTION WAS RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BD UF 30 G 1/2 CC SYRINGE INSULIN SYRINGE FMF BECTON DICKINSON NA 0013938

Patients

Seq Age Sex Outcome Treatment
1 UNK Disability