BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VERIFUSE PUMP TUBING

    MDR report key: 24530 · Received August 17, 1995

    Report

    Report Number
    MW1006727
    Event Type
    Injury
    Date Received
    August 17, 1995
    Date of Event
    August 8, 1995
    Report Date
    August 14, 1995
    Manufacturer
    BLOCK MEDICAL,INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ME, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    TUBING LEAKS BREAKING STERILITY OF INFUSION SOLUTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VERIFUSE PUMP TUBING PUMP TUBING FPA BLOCK MEDICAL,INC. V021014 52649

    Patients

    Seq Age Sex Outcome Treatment
    1 22 YR Required Intervention