BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD

    MDR report key: 2072933 · Received April 1, 2011

    Report

    Report Number
    1213809-2011-00001
    Event Type
    Malfunction
    Date Received
    April 1, 2011
    Date of Event
    February 8, 2011
    Report Date
    April 1, 2011
    Manufacturer
    BECTON DICKINSON DIVISION
    Product Code
    FMF
    PMA / PMN Number
    PRE-AMD
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CRACKED SYRINGE BARREL RESULTING IN LOSS OF MEDICATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD 10ML LUER LOK DISPOSABLE SYRINGE FMF BECTON DICKINSON DIVISION 10L10J

    Patients

    Seq Age Sex Outcome Treatment
    1