BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD SYR NED UFLN SHRT 0.5ML 31G 5/16

    MDR report key: 2033272 · Received March 24, 2011

    Report

    Report Number
    MW5019964
    Event Type
    Malfunction
    Date Received
    March 24, 2011
    Date of Event
    March 10, 2011
    Report Date
    March 14, 2011
    Manufacturer
    BD
    Product Code
    FMI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PT STATES SEVERAL OF THE BD SYRINGE NEEDLES WERE BENT. THERAPY DATES: (B)(6) 2010 TO PRESENT, USE 5 PER DAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD SYR NED UFLN SHRT 0.5ML 31G 5/16 SYRINGE NEEDLE FMI BD 0298506

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR SYMLIN VIALS| NOVOLOG VIALS| LANTUS VIALS