BD? SYRINGE HEPARIN 27GAX1.2 ML 324701

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-07-31 for BD? SYRINGE HEPARIN 27GAX1.2 ML 324701 manufactured by Bd Medical - Diabetes Care.

Event Text Entries

[115678654] Date of event: unknown. The date received by manufacturer has been used for this field. (b)(6). A device evaluation is anticipated, but has not yet begun. Upon completion of the investigation, a supplemental report will be filed.
Patient Sequence No: 1, Text Type: N, H10


[115678655] It was reported that bd? Syringe heparin 27gax1. 2 ml contained plastic like foreign matter. No serious injury or medical intervention reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1920898-2018-00552
MDR Report Key7735558
Date Received2018-07-31
Date of Report2018-08-27
Date of Event2018-07-11
Date Mfgr Received2018-07-11
Device Manufacturer Date2016-03-28
Date Added to Maude2018-07-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactBDX BRETT WILKO
Manufacturer Street9450 SOUTH STATE STREET
Manufacturer CitySANDY UT 84070
Manufacturer CountryUS
Manufacturer Postal84070
Manufacturer Phone8015652845
Manufacturer G1BD MEDICAL - DIABETES CARE
Manufacturer Street1329 WEST HIGHWAY 6
Manufacturer CityHOLDREGE NE 68949
Manufacturer CountryUS
Manufacturer Postal Code68949
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBD? SYRINGE HEPARIN 27GAX1.2 ML
Generic NameFLUSH
Product CodeNZW
Date Received2018-07-31
Returned To Mfg2018-07-09
Catalog Number324701
Lot Number6088621
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBD MEDICAL - DIABETES CARE
Manufacturer Address1329 WEST HIGHWAY 6 HOLDREGE NE 68949 US 68949


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-07-31

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