FDA Adverse Event Other Summary report: N

A BD 10 ML SYRINGE

MDR report key: 6165922 · Received December 9, 2016

Report

Report Number
MW5066624
Event Type
Other
Date Received
December 9, 2016
Report Date
September 26, 2016
Manufacturer
BECTON DICKINSON & CO.
Product Code
FMF
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

A BD 10ML SYRINGE WAS USED TO PREPARE A DOSE OF METHYLENE BLUE FOR A PT. FLUID WAS FOUND TO LEAK BEYOND THE SECOND RIB OF THE STOPPER INTO THE PORTION OF THE BARREL EXPOSED TO OUTSIDE AIR. THE BD REFERENCE NUMBER IS (B)(4) AND THE BARCODE NUMBER IS (B)(4). THE LOT NUMBER OF THE SYRINGE IS 6173682. (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
815218 A BD 10 ML SYRINGE A BD 10 ML SYRINGE FMF BECTON DICKINSON & CO. 6173682

Patients

Seq Age Sex Outcome Treatment
1