BEUDAMED
    FDA Adverse Event Summary report: N

    MW5075143

    MDR report key: 7259346 · Received February 8, 2018

    Report

    Report Number
    MW5075143
    Date Received
    February 8, 2018
    Report Date
    February 5, 2018
    Report Source
    Voluntary report
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PT WAS ON VACATION. PUMP WAS IN POUCH, WORKING FINE. PT TRIPPED ON A CURB AND POUCH HIT POLE. PUMP CRACKED SCREEN, DIDN'T BEEP, NO DISPLAY SHOWING. NO OTHER INFO PROVIDED. DOSE OR AMOUNT: 40 NKM, FREQUENCY: CONTINUOUS, ROUTE: IV. DATES OF USE: FROM (B)(6) 2013 TO ONGOING.

    Patients

    Seq Age Sex Outcome Treatment
    1