BEUDAMED
    FDA Adverse Event Other Summary report: N

    B-D

    MDR report key: 545575 · Received November 12, 2003

    Report

    Report Number
    545575
    Event Type
    Other
    Date Received
    November 12, 2003
    Date of Event
    August 11, 2003
    Report Date
    November 10, 2003
    Manufacturer
    BD MEDICAL SUPTIMS
    Product Code
    FOZ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    NURSE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 B-D AUTOGUARD INSYTE FOZ BD MEDICAL SUPTIMS * 3085839

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other