BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    J-TIP SYRINGE

    MDR report key: 2401935 · Received January 5, 2012

    Report

    Report Number
    2401935
    Event Type
    Malfunction
    Date Received
    January 5, 2012
    Date of Event
    October 12, 2011
    Report Date
    October 28, 2011
    Manufacturer
    NATIONAL MEDICAL PRODUCTS, INC.
    Product Code
    KZE
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US

    Narratives

    Description of Event or Problem · 1

    THE PRESSURIZED J-TIP SYRINGE BROKE INTO SEVERAL PIECES ON ACTIVATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 J-TIP SYRINGE J-TIP 0.25 SYRINGE KZE NATIONAL MEDICAL PRODUCTS, INC. * NMP LOT # 1104001

    Patients

    Seq Age Sex Outcome Treatment
    1 *