BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ENTERAL ONLY

    MDR report key: 292507 · Received August 23, 2000

    Report

    Report Number
    MW1019781
    Event Type
    Malfunction
    Date Received
    August 23, 2000
    Date of Event
    August 11, 2000
    Report Date
    August 23, 2000
    Manufacturer
    CHILDREN'S MEDICAL VENTURES
    Product Code
    LZH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DESCRIBE EVENT OR PROBLEM: HUB LEAKS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENTERAL ONLY EXTENSION SET 60" LZH CHILDREN'S MEDICAL VENTURES * 12784

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other