BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SYRINGE TIP

    MDR report key: 2875444 · Received December 7, 2012

    Report

    Report Number
    MW5028087
    Event Type
    Malfunction
    Date Received
    December 7, 2012
    Report Date
    December 7, 2012
    Manufacturer
    BD
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PHASEAL SYRINGE TIP LEAKED AT JUNCTION FURTHEST FROM SYRINGE. PT RECEIVED ADEQUATE DRUG. NURSE AND PT WERE NOT EXPOSED. NURSE DONNED APPROPRIATE CLOTHING AND PATIENT WAS NOT PHYSICALLY EXPOSED. DATE OF USE: (B)(6) 2012. REASON FOR USE: SCT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SYRINGE TIP SYRINGE TIP FMF BD

    Patients

    Seq Age Sex Outcome Treatment
    1