BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    C-GON / NUTRISAFE 5 ML FEEDING SYRINGE

    MDR report key: 6636315 · Received June 9, 2017

    Report

    Report Number
    MW5070354
    Event Type
    Malfunction
    Date Received
    June 9, 2017
    Date of Event
    June 7, 2017
    Report Date
    June 9, 2017
    Manufacturer
    VYGON
    Product Code
    FPD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHILE DRAWING UP STERILE WATER FOR A FEEDING, THE NURSE NOTICED A SHARD OF PURPLE PLASTIC IN THE BARREL OF THE SYRINGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    410376 C-GON / NUTRISAFE 5 ML FEEDING SYRINGE TUBE, FEEDING FPD VYGON H80117

    Patients

    Seq Age Sex Outcome Treatment
    1