BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD INSTYE AUTOGUARD

    MDR report key: 562922 · Received September 10, 2003

    Report

    Report Number
    562922
    Event Type
    Malfunction
    Date Received
    September 10, 2003
    Date of Event
    September 1, 2003
    Report Date
    September 10, 2003
    Manufacturer
    BD MEDICAL SYSTEMS
    Product Code
    FOZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD INSTYE AUTOGUARD INSYTE AUTOGUARD 20GA - 1.00IN 1.1 X 25MM 65ML/MIN FOZ BD MEDICAL SYSTEMS 381433 3059657

    Patients

    Seq Age Sex Outcome Treatment
    1 *