BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDICATION CASSETTE RESERVOIR

    MDR report key: 5529010 · Received March 23, 2016

    Report

    Report Number
    MW5061271
    Event Type
    Injury
    Date Received
    March 23, 2016
    Date of Event
    March 22, 2016
    Report Date
    March 23, 2016
    Manufacturer
    SMITHS MEDICAL ASB, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    THE TOP ON THE CASSETTE WHERE THE TUBE EXITS OPENS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    176848 MEDICATION CASSETTE RESERVOIR MEDICATION CASSETTE RESERVOIR FPA SMITHS MEDICAL ASB, INC. 21-7300-24 16X071

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention