MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-01-29 for 03670LL manufactured by Hospira, Inc..
[176808334]
Went into med room to draw up patient's dose of valium. Another nurse in med room as well to witness waste. Plunger in valium syringe was in the wrong way. Grey piece came off and the contents spilled out of the other end of it. Med vial saved.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9641410 |
| MDR Report Key | 9641410 |
| Date Received | 2020-01-29 |
| Date of Report | 2020-01-21 |
| Date of Event | 2020-01-21 |
| Report Date | 2020-01-21 |
| Date Reported to FDA | 2020-01-21 |
| Date Reported to Mfgr | 2020-01-29 |
| Date Added to Maude | 2020-01-29 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Generic Name | INTRODUCER, SYRINGE NEEDLE |
| Product Code | KZH |
| Date Received | 2020-01-29 |
| Catalog Number | 03670LL |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | HOSPIRA, INC. |
| Manufacturer Address | HIGHWAY 301 NORTH ROCKY MOUNT NC 27801 US 27801 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-01-29 |