MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1997-06-26 for BECTON DICKINSON 21261 manufactured by Becton Dickinson Microbiology Systems.
[62064]
Agar plates received are hemolized.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1011565 |
| MDR Report Key | 101017 |
| Date Received | 1997-06-26 |
| Date of Report | 1997-06-25 |
| Date Added to Maude | 1997-06-30 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Reporter Occupation | MEDICAL TECHNOLOGIST |
| Health Professional | 3 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BECTON DICKINSON |
| Generic Name | BLOOD AGAR PLATES, BRUCELLA AGAR |
| Product Code | GSM |
| Date Received | 1997-06-26 |
| Model Number | NA |
| Catalog Number | 21261 |
| Lot Number | F4R4MM/E2NTJL |
| ID Number | * |
| Device Expiration Date | 1997-08-12 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 99520 |
| Manufacturer | BECTON DICKINSON MICROBIOLOGY SYSTEMS |
| Manufacturer Address | PO BOX 243 COCKEYSVILLE MD 21030 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1997-06-26 | |
| 2 | 0 | 1997-06-26 |