MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 1999-06-30 for ANAEROBIC JAR COMPLETE 195130 manufactured by Becton Dickinson.
[127104]
While transporting an in-use anaerobic jar, the jar exploded injuring the person carrying the jar under her arm. Injuries incurred are unk but individual was sent to the emergency room for treatment.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1119779-1999-00004 |
| MDR Report Key | 229839 |
| Report Source | 05 |
| Date Received | 1999-06-30 |
| Date of Report | 1999-06-01 |
| Date of Event | 1999-06-01 |
| Date Mfgr Received | 1999-06-01 |
| Date Added to Maude | 1999-07-06 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ANAEROBIC JAR COMPLETE |
| Generic Name | GAS GENERATING DEVICE |
| Product Code | KZJ |
| Date Received | 1999-06-30 |
| Returned To Mfg | 1999-06-18 |
| Model Number | NA |
| Catalog Number | 195130 |
| Lot Number | NA |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 222905 |
| Manufacturer | BECTON DICKINSON |
| Manufacturer Address | 7 LOVETON CIRCLE SPARKS MD 21152 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 1999-06-30 |