BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VACUETTE QUICKSHIELD SAFETY TUBE HOLDER

    MDR report key: 14429795 · Received May 18, 2022

    Report

    Report Number
    14429795
    Event Type
    Malfunction
    Date Received
    May 18, 2022
    Date of Event
    April 20, 2022
    Report Date
    May 5, 2022
    Manufacturer
    GREINER BIO-ONE NORTH AMERICA, INC.
    Product Code
    FMI
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    AFTER BLOOD DRAW I WENT TO PUSH SAFETY OVER THE NEEDLE ON A 22G X 1 1/4" GREINER BIO-ONE STRAIGHT NEEDLE AND THE NEEDLE BENT/BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2639054 VACUETTE QUICKSHIELD SAFETY TUBE HOLDER NEEDLE, HYPODERMIC, SINGLE LUMEN FMI GREINER BIO-ONE NORTH AMERICA, INC. 21D19C

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown