BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HAMILTON

    MDR report key: 562909 · Received January 30, 2005

    Report

    Report Number
    2915796-2004-00015
    Event Type
    Injury
    Date Received
    January 30, 2005
    Date of Event
    December 3, 2004
    Report Date
    December 3, 2004
    Manufacturer
    HAMILTON CO.
    Product Code
    FMF
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IN 2004, HAMILTON COMPANY RECEIVED A REPORT THAT A GLASS SYRINGE (LABELED NOT FOR HUMAN IN-VIVO USE) SHATTERED, AND A LAB TECHNICIAN WENT TO THE EMERGENCY ROOM FOR TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HAMILTON 1005TLL 5ML SYRINGE FMF HAMILTON CO. 1005%LL 302747

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Required Intervention