BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SYRINGE, PISTON

    MDR report key: 8662499 · Received May 31, 2019

    Report

    Report Number
    MW5087090
    Event Type
    Malfunction
    Date Received
    May 31, 2019
    Date of Event
    May 24, 2019
    Report Date
    May 24, 2019
    Manufacturer
    UNK
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PT HAS BEEN USING OCTREOTIDE SDV AND USING 1ML SYRINGES TO DRAW UP MEDICATION. SHE COULD DRAW UP THE 1ML OF MEDICATION INTO SYRINGE FINE BUT WHEN SHE INJECTS MEDICATION SUBCUTANEOUSLY SHE CAN ONLY GET HALF OF IT DELIVERED AND THE OTHER HALF GETS STUCK IN SYRINGE. NO MISSED DOSES YET AND NO SIDE EFFECTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    452144 SYRINGE, PISTON SYRINGE, PISTON FMF UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR