FDA Adverse Event
Malfunction
Summary report: N
VANISH POINT SYRINGE
MDR report key: 11737121
·
Received April 27, 2021
Report
- Report Number
- MW5101008
- Event Type
- Malfunction
- Date Received
- April 27, 2021
- Date of Event
- March 21, 2021
- Report Date
- April 26, 2021
- Manufacturer
- RETRACTABLE TECHNOLOGIES, INC.
- Product Code
- MEG
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Location
- US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
RETRACTABLE TECHNOLOGIES INC 1 ML 25G VANISH POINT SYRINGE REF# 10162 FOR COVID VACCINE ADMINISTRATION. USE FOR COVID-19 UNDER EMERGENCY USE AUTHORIZATION (EUA): MED ROOM RN FOUND SYRINGE WITH CROOKED RUBBER STOPPER. FDA SAFETY REPORT ID # (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 626682 | VANISH POINT SYRINGE | SYRINGE, ANTISTICK | MEG | RETRACTABLE TECHNOLOGIES, INC. | 10162 | G200915 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |