FDA Adverse Event Malfunction Summary report: N

NIPRO SAFETOUCH II AVF NEEDLE

MDR report key: 11041473 · Received December 18, 2020

Report

Report Number
8041145-2020-00021
Event Type
Malfunction
Date Received
December 18, 2020
Date of Event
November 21, 2020
Report Date
March 31, 2021
Manufacturer
NIPRO (THAILAND) CORP. LTD.
Product Code
FOZ
UDI-DI
00383790000062
PMA / PMN Number
K032777
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 0

SAFETOUCH II NEEDLE WOULD NOT RETRACT INTO THE SAFETY UPON REMOVAL. THIS WAS NOTICED UPON REMOVING THE NEEDLE POST TREATMENT. NO BLOOD WAS LOST, NO ADVERSE EVENTS OCCURRED, NO NEEDLE STICK RESULTED. THIS FACILITY HAS USED SAFETOUCH II SINCE (B)(6) 2019. THE CLINICAL SPECIALIST PROVIDED TRAINING ON WEDNESDAY, (B)(6) 2019, WEDNESDAY, (B)(6) 2019, AND WEDNESDAY, (B)(6) 2020 TO PROVIDE SUPPLEMENTAL TRAINING AND SUPPORT.

Description of Event or Problem · 1

SAFETOUCH II NEEDLE WOULD NOT RETRACT INTO THE SAFETY UPON REMOVAL. THIS WAS NOTICED UPON REMOVING THE NEEDLE POST TREATMENT. NO BLOOD WAS LOST, NO ADVERSE EVENTS OCCURRED, NO NEEDLE STICK RESULTED. THIS FACILITY HAS USED SAFETOUCH II SINCE (B)(6) 2019. THE CLINICAL SPECIALIST PROVIDED TRAINING ON WEDNESDAY, (B)(6) 2019, WEDNESDAY, (B)(6) 2019, AND WEDNESDAY, (B)(6) 2020 TO PROVIDE SUPPLEMENTAL TRAINING AND SUPPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1505925 NIPRO SAFETOUCH II AVF NEEDLE AVF NEEDLE FOZ NIPRO (THAILAND) CORP. LTD. FS+152530BC 20D16 00383790000062

Patients

Seq Age Sex Outcome Treatment
1 Other