BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD ECLIPSE NEEDLE 25 GAUGE 1"

    MDR report key: 9290699 · Received November 6, 2019

    Report

    Report Number
    MW5090925
    Event Type
    Malfunction
    Date Received
    November 6, 2019
    Date of Event
    November 5, 2019
    Report Date
    November 5, 2019
    Manufacturer
    BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. SA DE CV
    Product Code
    FMI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    MA ATTEMPTING TO CLOSE SAFETY DEVICE ON BD ECLIPSE 25G X 1 INCH INJECTION NEEDLE AND SAFETY DEVICE DETACHED FROM NEEDLE. NO INJURY TO PT OR EMPLOYEE. NEEDLE ATTACHED TO FLU VACCINE DISCARDED INTO SHARP BIN. LOT #8241495. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1078401 BD ECLIPSE NEEDLE 25 GAUGE 1" NEEDLE, HYPODERMIC, SINGLE LUMEN FMI BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. SA DE CV 113390, 8241495

    Patients

    Seq Age Sex Outcome Treatment
    1