SYRINGE INTEGRA 3ML LL W/NDL 25X5/8 RB 305269

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,other report with the FDA on 2020-03-02 for SYRINGE INTEGRA 3ML LL W/NDL 25X5/8 RB 305269 manufactured by Becton Dickinson Medical Systems.

MAUDE Entry Details

Report Number1213809-2020-00155
MDR Report Key9776830
Report SourceDISTRIBUTOR,OTHER
Date Received2020-03-02
Date of Report2020-03-06
Date of Event2020-01-28
Date Mfgr Received2020-02-11
Device Manufacturer Date2019-01-18
Date Added to Maude2020-03-02
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
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 Phone8015652341
Manufacturer G1BECTON DICKINSON MEDICAL SYSTEMS
Manufacturer StreetROUTE 7 AND GRACE WAY
Manufacturer CityCANAAN CT 06018
Manufacturer CountryUS
Manufacturer Postal Code06018
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSYRINGE INTEGRA 3ML LL W/NDL 25X5/8 RB
Generic NamePISTON SYRINGE
Product CodeMEG
Date Received2020-03-02
Returned To Mfg2020-02-24
Model Number305269
Catalog Number305269
Lot Number9018575
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECTON DICKINSON MEDICAL SYSTEMS
Manufacturer AddressROUTE 7 AND GRACE WAY CANAAN CT 06018 US 06018


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-02

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