BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DIALYSIS ADMINISTRATION SET

    MDR report key: 39627 · Received September 24, 1996

    Report

    Report Number
    MW1009979
    Event Type
    Malfunction
    Date Received
    September 24, 1996
    Date of Event
    August 22, 1996
    Report Date
    September 12, 1996
    Manufacturer
    BAXTER HEALTHCARE CORP.
    Product Code
    FJX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER CAREGIVERS

    Narratives

    Description of Event or Problem · 1

    NO CLAMP ON VENOUS TUBE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DIALYSIS ADMINISTRATION SET DIALYSIS ADMINISTRATION SET FJX BAXTER HEALTHCARE CORP. 5M4484M YGE099

    Patients

    Seq Age Sex Outcome Treatment
    1 *