Brand Name | BD¿ 20 ML SYRINGE WITH NEEDLE |
Type of Device | PISTON SYRINGE |
Manufacturer (Section D) |
BECTON DICKINSON, S.A. |
cr mequinenza |
s/n |
fraga, huesca 22520 |
SP
22520 |
|
Manufacturer (Section G) |
BECTON DICKINSON, S.A. |
cr mequinenza |
s/n |
fraga, huesca 22520 |
SP
22520
|
|
Manufacturer Contact |
phillip
emmert
|
9450 south state street |
sandy, UT 84070
|
8015296192
|
|
MDR Report Key | 13112494 |
MDR Text Key | 285404088 |
Report Number | 3002682307-2021-00670 |
Device Sequence Number | 1 |
Product Code |
FMF
|
Combination Product (y/n) | N |
Reporter Country Code | CH |
PMA/PMN Number | NA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Other,Foreign,User Facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
03/07/2022 |
1 Device was Involved in the Event |
|
0 Patients were Involved in the Event: |
|
Date FDA Received | 12/29/2021 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
|
Device Catalogue Number | 301948 |
Device Lot Number | 2104153 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 03/07/2022 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 04/06/2021 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
|
|