BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QT MICRO SYSTEM

    MDR report key: 6348655 · Received February 20, 2017

    Report

    Report Number
    MW5067980
    Event Type
    Malfunction
    Date Received
    February 20, 2017
    Date of Event
    February 20, 2017
    Report Date
    February 20, 2017
    Manufacturer
    Q.I. MEDICAL, INC.
    Product Code
    LHI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PHARMACY TECHNICIAN OPENED QT MICRO SYSTEM CATALOG #TM6000, LOT# B16-2279, EXP. 02/2021 AND THE WHITE CAP WAS MISSING FROM THE PACKAGING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    126525 QT MICRO SYSTEM QT MICRO SYSTEM LHI Q.I. MEDICAL, INC. B16-2279

    Patients

    Seq Age Sex Outcome Treatment
    1