BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HOSPIRA LIFESHIELD SYMBIQ 150 ML BURETTE SET

    MDR report key: 1845015 · Received September 22, 2010

    Report

    Report Number
    MW5017573
    Event Type
    Malfunction
    Date Received
    September 22, 2010
    Date of Event
    September 22, 2010
    Report Date
    September 22, 2010
    Manufacturer
    HOSPIRA
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    HOSPIRA LIFESHIELD SYMBIQ PUMP 150 ML BURETTE SET TUBING CAME APART WHILE PRIMING IV FLUID FOR ADMINISTRATION. LOT NUMBER IS 68070 5H.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOSPIRA LIFESHIELD SYMBIQ 150 ML BURETTE SET BURETTE SET FPA HOSPIRA 16014-01 68070 5H

    Patients

    Seq Age Sex Outcome Treatment
    1