BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDI-JECTOR (MJ6)

    MDR report key: 211252 · Received February 18, 1999

    Report

    Report Number
    2182861-1999-00002
    Event Type
    Other
    Date Received
    February 18, 1999
    Report Date
    January 29, 1999
    Manufacturer
    MEDI-JECT CORP.
    Product Code
    KZE
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS ADMITTED TO THE HOSPITAL WITH BLOOD SUGARS IN THE 500S. PATIENT'S FATHER STATES THAT HE DOESN'T KNOW IF PATIENT WAS RECEIVING ALL OF HIS INSULIN AS THE DEVICE WASN'T SERVICED IN A WHILE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDI-JECTOR (MJ6) NEEDLE-FREE INSULIN DELIVERY SYSTEM KZE MEDI-JECT CORP. 100430-001 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 14 YR Hospitalization