BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    IV BOTTLE

    MDR report key: 488777 · Received September 23, 2003

    Report

    Report Number
    MW1029631
    Event Type
    Malfunction
    Date Received
    September 23, 2003
    Date of Event
    July 27, 2003
    Report Date
    September 15, 2003
    Manufacturer
    ABBOTT LABORATORIES HPD
    Product Code
    KPE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    FOUND IV BOTTLE ON FLOOR WITH IV BOTTLE HANGER BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IV BOTTLE IV BOTTLE KPE ABBOTT LABORATORIES HPD 500 ML GLASS BOTTLE 01-428-DM-01

    Patients

    Seq Age Sex Outcome Treatment
    1 *