BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TEVADAPTOR SYRINGE ADAPTOR

    MDR report key: 5707048 · Received June 6, 2016

    Report

    Report Number
    MW5062733
    Event Type
    Injury
    Date Received
    June 6, 2016
    Date of Event
    May 18, 2016
    Report Date
    June 6, 2016
    Manufacturer
    B.BRAUN
    Product Code
    FJP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TRABECTEDIN TUBING FOUND TO BE DEATTACHED FROM WHITE CHEMO ADAPTER, SMALL BLOOD PUDDLE FOUND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    356231 TEVADAPTOR SYRINGE ADAPTOR ADAPTOR FJP B.BRAUN M7286P15

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Required Intervention