BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DUALCAP

    MDR report key: 22149209 · Received June 5, 2025

    Report

    Report Number
    22149209
    Event Type
    Malfunction
    Date Received
    June 5, 2025
    Date of Event
    May 20, 2025
    Report Date
    May 29, 2025
    Manufacturer
    MERIT MEDICAL SYSTEMS, INC.
    Product Code
    QBP
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    RI
    Reporter Occupation
    501

    Narratives

    Description of Event or Problem · 0

    NO HARM TO PATIENT. 2 DUALCAPS NOTED WITHOUT FOAM INSERT. USED ALTERNATE CAP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    762055 DUALCAP CAP, DEVICE DISINFECTANT QBP MERIT MEDICAL SYSTEMS, INC. AO11159

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Male