BEUDAMED
    FDA Adverse Event Other Summary report: N

    B BRAUN

    MDR report key: 755497 · Received June 8, 2005

    Report

    Report Number
    MW1035672
    Event Type
    Other
    Date Received
    June 8, 2005
    Date of Event
    June 5, 2005
    Report Date
    June 8, 2005
    Manufacturer
    B. BRAUN
    Product Code
    FPB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    TPN FILTER SEPARATED FROM TUBING PORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 B BRAUN SMALLBORE FILTERED EXTENSION SET FPB B. BRAUN 352205 *

    Patients

    Seq Age Sex Outcome Treatment
    1 1 MO Other