BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HUMMI MICRO DRAW TRANSFER DEVICE

    MDR report key: 9745208 · Received February 24, 2020

    Report

    Report Number
    9745208
    Event Type
    Malfunction
    Date Received
    February 24, 2020
    Date of Event
    December 1, 2019
    Report Date
    January 6, 2020
    Manufacturer
    HUMMINGBIRD MED DEVICES INC
    Product Code
    KST
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    HUMMI MICRO-DRAW BLOOD TRANSFER DEVICE USED TO OBTAIN BLOOD GAS REPORTED TO BE DEFECTIVE WITH LEAK/CRACK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    210339 HUMMI MICRO DRAW TRANSFER DEVICE SYSTEM, BLOOD COLLECTION KST HUMMINGBIRD MED DEVICES INC 19129

    Patients

    Seq Age Sex Outcome Treatment
    1 4 DA