BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CARPUJECT HOLDER

    MDR report key: 6812864 · Received August 23, 2017

    Report

    Report Number
    MW5071755
    Event Type
    Malfunction
    Date Received
    August 23, 2017
    Date of Event
    August 21, 2017
    Report Date
    August 21, 2017
    Manufacturer
    HOSPIRA
    Product Code
    IQG
    UDI-DI
    0409189003
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    NURSE PULLED MORPHINE 2MG INJECTION AND IT WAS SEALED (NOT TAMPERED WITH) BUT DISCOVERED IT ONLY CONTAINED 1MG. PROVIDER WAS ALSO IN THE ROOM WHEN THE NURSE PULLED OPIOID. CHARGED NURSE WAS CONTACTED AND EVENT WAS RECORDED TO HOSPITAL REPORTING SYSTEM. MORPHINE 2MG/ML, DOSE OR AMOUNT: 1 MG, FREQUENCY: PRN, ROUTE: INTRAVENOUS, FOR 2 DAYS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    595432 CARPUJECT HOLDER ADAPTER, HOLDER, SYRINGE IQG HOSPIRA 71515LL 0409189003

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR