BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VANISHPOINT SYRINGE 1ML / VANISH POINT RETRACTABLE SYRINGE

    MDR report key: 11628191 · Received April 6, 2021

    Report

    Report Number
    MW5100592
    Event Type
    Injury
    Date Received
    April 6, 2021
    Date of Event
    April 2, 2021
    Report Date
    April 2, 2021
    Manufacturer
    RETRACTABLE TECHNOLOGIES, INC.
    Product Code
    MEG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    AT THE (B)(6) COVID CLINIC, A NURSE VOLUNTEER REPORTED TO ME THAT THE NEEDLE WAS STUCK IN THE PATIENT'S ARM UPON RECEIPT OF THE PFIZER VACCINE. THE PATIENT WAS SENT TO (B)(6) MEDICAL CENTER ED AND HAD AN X-RAY THAT CONFIRMED THAT THE NEEDLE WAS STUCK. THE ED TEAM WAS UNABLE TO GET THE NEEDLE OUT, AND REFERRED THE PATIENT TO A SPECIALIST. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    522979 VANISHPOINT SYRINGE 1ML / VANISH POINT RETRACTABLE SYRINGE SYRINGE, ANTISTICK MEG RETRACTABLE TECHNOLOGIES, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Required Intervention