BEUDAMED
    FDA Adverse Event Other Summary report: N

    SYRINGE

    MDR report key: 5947128 · Received September 8, 2016

    Report

    Report Number
    MW5064712
    Event Type
    Other
    Date Received
    September 8, 2016
    Date of Event
    September 8, 2016
    Report Date
    September 8, 2016
    Product Code
    FMI
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PT HUMIRA PEN MISFIRED. HUMIRA, 40 MG. IS THE PRODUCT COMPOUNDED: NO. IS THE PRODUCT OVER THE COUNTER: NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    589955 SYRINGE SYRINGE FMI

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR