Brand Name | ADD-VANTAGE |
Type of Device | SET, I.V. FLUID TRANSFER |
Manufacturer (Section D) |
|
MDR Report Key | 12924104 |
MDR Text Key | 282006781 |
Report Number | MW5105742 |
Device Sequence Number | 3 |
Product Code |
LHI
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
08/30/2021 |
7 Devices were Involved in the Event: |
1
2
3
4
5
6
7
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 12/02/2021 |
Patient Sequence Number | 1 |
Treatment | TAZICEF, MFR: HOSPIRA, INC., INJECTABLE VIAL, NDC: 0409-5093-14 |
|
|