BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SURETRANS

    MDR report key: 679895 · Received February 22, 2006

    Report

    Report Number
    1213643-2006-00034
    Event Type
    Malfunction
    Date Received
    February 22, 2006
    Date of Event
    December 20, 2005
    Report Date
    January 16, 2006
    Manufacturer
    DAVOL INC., SUB. C.R. BARD, INC.
    Product Code
    CAC
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KS
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    NOT TRANSFER BLOOD FROM 800ML COLLECTION CONTAINER TO BLOOD TRANSFER BAG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SURETRANS AUTOTRANSFUSION APARATUS CAC DAVOL INC., SUB. C.R. BARD, INC. * 41HPN060

    Patients

    Seq Age Sex Outcome Treatment
    1 *