BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SURE COMFORT INS SYR 0.3 ML DISP SYRIN 31G5

    MDR report key: 8687521 · Received June 10, 2019

    Report

    Report Number
    MW5087255
    Event Type
    Injury
    Date Received
    June 10, 2019
    Date of Event
    June 4, 2019
    Report Date
    June 4, 2019
    Manufacturer
    ALLISON MEDICAL, INC.
    Product Code
    FMF
    UDI-DI
    86227065035
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    TWO MISSED DOSES IN LAST 3 MONTHS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    475079 SURE COMFORT INS SYR 0.3 ML DISP SYRIN 31G5 SYRINGE, PISTON FMF ALLISON MEDICAL, INC. 86227065035

    Patients

    Seq Age Sex Outcome Treatment
    1 6 YR