BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    3 GANG HI-FLO STOPCOCK ANESTHESIA SET

    MDR report key: 2894580 · Received December 26, 2012

    Report

    Report Number
    2894580
    Event Type
    Malfunction
    Date Received
    December 26, 2012
    Date of Event
    January 1, 2012
    Report Date
    December 26, 2012
    Manufacturer
    SMITHS MEDICAL ASD, INC
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBING LEAK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 3 GANG HI-FLO STOPCOCK ANESTHESIA SET IV TUBING, STOPCOCK SET FPA SMITHS MEDICAL ASD, INC * 2245400

    Patients

    Seq Age Sex Outcome Treatment
    1 *