BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD INSYTE AUTOGUARD H3120A

    MDR report key: 562924 · Received September 15, 2003

    Report

    Report Number
    562924
    Event Type
    Malfunction
    Date Received
    September 15, 2003
    Date of Event
    July 21, 2003
    Report Date
    September 15, 2003
    Manufacturer
    BD MEDICAL SYSTEMS
    Product Code
    FMI
    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 INSYTE AUTOGUARD H3120A NEEDLE FMI BD MEDICAL SYSTEMS * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *