BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCUSURE

    MDR report key: 2123411 · Received December 17, 2008

    Report

    Report Number
    1039144-2008-00009
    Event Type
    Malfunction
    Date Received
    December 17, 2008
    Report Date
    December 10, 2008
    Manufacturer
    FEEL TECH
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    NV, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PHARMACY STATES THAT THE NEEDLE WAS GOING BACK INTO THE SYRINGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCUSURE INSULIN SYRINGE FMF FEEL TECH A07001

    Patients

    Seq Age Sex Outcome Treatment
    1