BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANGEL WING 23GX3 /4X12IN TUBING

    MDR report key: 634594 · Received September 14, 2005

    Report

    Report Number
    1282497-2005-00017
    Event Type
    Other
    Date Received
    September 14, 2005
    Report Date
    August 24, 2005
    Manufacturer
    TYCO HEALTHCARE/KENDALL
    Product Code
    GJE
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO TYCO HEALTHCARE/KENDALL IN 08/2005 THAT A CUSTOMER HAD A PROBLEM WITH A BLOOD COLLECTION NEEDLE. ACCORDING TO THE CUSTOMER, THE SAFETY DID NOT ENGAGE AND THE TECH RECEIVED A CONTAMINATED NEEDLE STICK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANGEL WING 23GX3 /4X12IN TUBING BLOOD COLLECTION NEEDLE GJE TYCO HEALTHCARE/KENDALL UNK 5133320

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other