BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDSTREAM TUBING SET

    MDR report key: 7289246 · Received February 21, 2018

    Report

    Report Number
    MW5075446
    Event Type
    Malfunction
    Date Received
    February 21, 2018
    Date of Event
    February 14, 2018
    Report Date
    February 19, 2018
    Manufacturer
    UNK
    Product Code
    LKK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    TUBING SET WITH SPEC IN TUBING. PRODUCT # MS755, LOT# 20270905, EXP: 09/2020, 92 INCH, 20DR FLOW REGULATOR, 15 MICRON FILTER TUBING SET. PO# (B)(6), ORDER DATE: (B)(6) 2018. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    130544 MEDSTREAM TUBING SET MEDSTREAM TUBING SET LKK UNK 20170905

    Patients

    Seq Age Sex Outcome Treatment
    1