BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    J TIP NEEDLE-FREE INJECTION SYSTEM WITH LUER ADAPTER

    MDR report key: 1876144 · Received October 1, 2010

    Report

    Report Number
    MW5017751
    Event Type
    Malfunction
    Date Received
    October 1, 2010
    Date of Event
    September 20, 2010
    Report Date
    October 1, 2010
    Manufacturer
    NATIONAL MEDICAL PRODUCTS, INC.
    Product Code
    KZE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    NURSE WENT TO APPLY J-TIP. STATES SHE APPLIED J-TIP APPROPRIATELY AND THE LIDOCAINE SPRAYED AT LEAST 12 INCHES AND SPLASHED HER IN BOTH EYES. NURSE WAS SEEN IN ASSOCIATE HEALTH DEPARTMENT. NO NEGATIVE SEQUELAE NOTED TO DATE FROM SPLASH INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 J TIP NEEDLE-FREE INJECTION SYSTEM WITH LUER ADAPTER J TIP KZE NATIONAL MEDICAL PRODUCTS, INC. 1003001

    Patients

    Seq Age Sex Outcome Treatment
    1