BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    3CC-E-CMB 23G X 1

    MDR report key: 595745 · Received June 15, 2004

    Report

    Report Number
    1017768-2004-00005
    Event Type
    Malfunction
    Date Received
    June 15, 2004
    Date of Event
    February 25, 2004
    Report Date
    June 11, 2004
    Manufacturer
    TYCO HEALTHCARE/KENDALL
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO TYCO HEALTHCARE/KENDALL THAT A CUSTOMER EXPERIENCED A PROBLEM WITH CO SYRINGES. THE CUSTOMER REPORTED THAT THERE WAS A MISPRINT WITH THE GRADUATION MARKINGS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 3CC-E-CMB 23G X 1 SYRINGE FMF TYCO HEALTHCARE/KENDALL * 335104

    Patients

    Seq Age Sex Outcome Treatment
    1 *