MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-02-13 for BD? SYRINGE 3ML HEPARIN 10 UNIT 306413 manufactured by Bd Medical (bd West) Medical Surgical.
[100065462]
Date of event: unknown. The date received by manufacturer has been used for this field. The customer's address is unknown. (b)(6), usa has been used as a default. A device evaluation is anticipated, but has not yet begun. Upon completion of the investigation and/or device history review, a supplemental report will be filed.
Patient Sequence No: 1, Text Type: N, H10
[100065463]
It was reported that multiple times, the plunger of a bd? Syringe 3ml heparin 10 unit will? Come out? While drawing up medication. There was no report of exposure, injury or medical intervention.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1911916-2018-00062 |
| MDR Report Key | 7268220 |
| Date Received | 2018-02-13 |
| Date of Report | 2018-03-14 |
| Date of Event | 2017-11-28 |
| Date Mfgr Received | 2017-11-28 |
| Device Manufacturer Date | 2017-04-21 |
| Date Added to Maude | 2018-02-13 |
| 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 | 3 |
| Reporter Occupation | PATIENT |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | BDX BRETT WILKO |
| Manufacturer Street | 9450 SOUTH STATE STREET |
| Manufacturer City | SANDY UT 84070 |
| Manufacturer Country | US |
| Manufacturer Postal | 84070 |
| Manufacturer Phone | 8015652845 |
| Manufacturer G1 | BD MEDICAL (BD WEST) MEDICAL SURGICAL |
| Manufacturer Street | 1852 10TH AVENUE |
| Manufacturer City | COLUMBUS NE 68601 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 68601 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | BD? SYRINGE 3ML HEPARIN 10 UNIT |
| Generic Name | HEPARIN FLUSH |
| Product Code | NZW |
| Date Received | 2018-02-13 |
| Catalog Number | 306413 |
| Lot Number | 711169N |
| Device Expiration Date | 2018-10-31 |
| Operator | LAY USER/PATIENT |
| Device Availability | * |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BD MEDICAL (BD WEST) MEDICAL SURGICAL |
| Manufacturer Address | 1852 10TH AVENUE COLUMBUS NE 68601 US 68601 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2018-02-13 |