BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HUBER NEEDLE

    MDR report key: 33343 · Received June 7, 1996

    Report

    Report Number
    MW1009254
    Event Type
    Injury
    Date Received
    June 7, 1996
    Date of Event
    June 5, 1996
    Report Date
    June 5, 1996
    Manufacturer
    CHURCHILL MEDICAL SYSTEMS, INC.
    Product Code
    FMI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    HUBER NEEDLE WINGS BECAME DETACHED COMPLETELY FROM NEEDLE AND TUBING. RN REPLACED (RE-ACCESSED) PORT WITH ANOTHER NEEDLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HUBER NEEDLE HUBER NEEDLE FMI CHURCHILL MEDICAL SYSTEMS, INC. 6B38

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Required Intervention