BEUDAMED
    FDA Adverse Event Summary report: N

    QUICK TEST SYSTEM

    MDR report key: 35803 · Received August 20, 1996

    Report

    Report Number
    MW1009771
    Date Received
    August 20, 1996
    Manufacturer
    Q.I. MEDICAL, INC.
    Product Code
    JTO
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    A BLACK FIBER FOREIGN OBJECT ABOUT 1/8" LONG IS IN THE LUMEN OF THE "TAIL" PIECE OF PLASTIC TUBING. THE FOREIGN OBJECT CAN BE MADE TO MOVE BY STOPPING THE UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUICK TEST SYSTEM TESTING IV SOLUTIONS JTO Q.I. MEDICAL, INC. * L5K008

    Patients

    Seq Age Sex Outcome Treatment
    1 *