BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCUSURE INSULIN SYRINGE 1CC 31G 5/16"

    MDR report key: 1230108 · Received November 12, 2008

    Report

    Report Number
    MW5008971
    Event Type
    Malfunction
    Date Received
    November 12, 2008
    Date of Event
    September 3, 2008
    Report Date
    November 12, 2008
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    NEEDLE RETRACTED INSIDE INSULIN SYRINGE AFTER ATTEMPTS TO INJECT INSULIN. DATES OF USE: 2008. DIAGNOSIS OR REASON FOR USE: INSULIN INJECTION. EVENT ABATED AFTER USE STOPPED OR DOSE REDUCED: YES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCUSURE INSULIN SYRINGE 1CC 31G 5/16" NONE FMF A07001

    Patients

    Seq Age Sex Outcome Treatment
    1