BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BD INTEGRA SYRINGE

    MDR report key: 3820449 · Received May 15, 2014

    Report

    Report Number
    MW5036142
    Event Type
    Injury
    Date Received
    May 15, 2014
    Date of Event
    May 13, 2014
    Report Date
    May 13, 2014
    Manufacturer
    BD
    Product Code
    FMF
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NV, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    I INJECTED MY MEDICINE INTO MY THIGH USING A BD INTEGRA SYRINGE WITH RETRACTING BD PRECISIONGLIDE NEEDLE. BEFORE THE INJECTION OF THE DRUG FINISHED THE PLUNGER BROKE THROUGH THE RUBBER AND INJECTED THE NEEDLE INTO MY THIGH. I WAS ABLE TO DIG IT OUT WITH TWEEZERS AND DIDN'T HAVE TO GO TO THE ER. BD ORDER # REF (B)(4), LOT # 0023680 CAV 12 MFR DATE ON: 06/2012, 3ML 25G X 1 DG (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    289551 BD INTEGRA SYRINGE SYRINGE FMF BD REF 305270 0023680

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Other