BEUDAMED
    FDA Adverse Event Injury Summary report: N

    3100 SYRINGE PUMP

    MDR report key: 514347 · Received March 2, 2004

    Report

    Report Number
    9612511-2004-00009
    Event Type
    Injury
    Date Received
    March 2, 2004
    Date of Event
    January 11, 2004
    Report Date
    March 2, 2004
    Manufacturer
    GRASEBY MEDICAL LTD.
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    NURSE RECEIVED AN ELECTRIC SHOCK WHILST ADJUSTING HEIGHT OF SYRINGE PUMP MOUNTED ON DRIPSTAND, NURSE INITIALLY IN A STATE OF SHOCK. THEY SUFFERED NO BURNS OR PERMANENT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 3100 SYRINGE PUMP SYRINGE PUMP FRN GRASEBY MEDICAL LTD. * 12756

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention