FDA Adverse Event Injury Summary report: N

JELCO NEEDLE-PRO EDGE NEEDLE

MDR report key: 1831947 · Received September 7, 2010

Report

Report Number
2183502-2010-00364
Event Type
Injury
Date Received
September 7, 2010
Report Date
August 19, 2010
Manufacturer
SMITHS MEDICAL ASD, INC.
Product Code
FMI
PMA / PMN Number
K011925
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: THE DEVICE IS CURRENTLY BEING EVALUATED; THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION ONCE IT IS COMPLETED.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT STATED A NURSE RECEIVED A NEEDLE STICK. THE REPORT STATED THAT THE NURSE ATTEMPTED TO RECAP A NEEDLE, WHEN SLIDING THE NEEDLE INWARD IT SEEMS TO CATCH FORCING THE NEEDLE TO GO THROUGH THE PLASTIC AND STICKS THE NURSE. THE REPORT DOES NOT INDICATE THAT THE STICK WAS A FAILURE OF THE SAFETY DEVICE; THE REPORT SPECIFIES THAT THE STICK OCCURRED DURING A RECAPPING ACTIVITY. THERE WAS NO REPORT OF INCIDENT RELATED MEDICAL SEQUELAE AND NO TREATMENT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 JELCO NEEDLE-PRO EDGE NEEDLE FMI - NEEDLE, HYPODERMIC, SINGLE LUMEN FMI SMITHS MEDICAL ASD, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other