BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BECTON DICKINSON

    MDR report key: 1998796 · Received February 15, 2011

    Report

    Report Number
    MW5019448
    Event Type
    Injury
    Date Received
    February 15, 2011
    Date of Event
    January 28, 2011
    Report Date
    February 15, 2011
    Manufacturer
    BECTON DICKINSON AND CO., BECTON DICKINSON
    Product Code
    FMI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    BD 30G 1" PRECISION BROKE OFF OF SYRINGE INSIDE PT AFTER 5TH PASS OF LIDOCAINE INJECTIONS ON (B)(6) 2011.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BECTON DICKINSON NEEDLE HYPODERMIC FMI BECTON DICKINSON AND CO., BECTON DICKINSON 0210910

    Patients

    Seq Age Sex Outcome Treatment
    1 Disability