BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SAFETY-MONOVETTE NEEDLE 22G

    MDR report key: 17065 · Received September 13, 1994

    Report

    Report Number
    17065
    Event Type
    Injury
    Date Received
    September 13, 1994
    Date of Event
    August 30, 1994
    Report Date
    September 9, 1994
    Manufacturer
    SARSTEDT, INC.
    Product Code
    FMI
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MS, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    NEEDLE BROKE OFF IN PT'S ARM WHILE BLOOD WORK WAS BEING DRAWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAFETY-MONOVETTE NEEDLE 22G NEEDLE FMI SARSTEDT, INC. 85.1441.050 14152120

    Patients

    Seq Age Sex Outcome Treatment
    1 26 YR Required Intervention