FDA Adverse Event Malfunction Summary report: N

SYRINGE 0.3ML 30GA 8MM 10BAG 500 L AMR

MDR report key: 19806269 · Received July 23, 2024

Report

Report Number
3024508819-2024-00208
Event Type
Malfunction
Date Received
July 23, 2024
Date of Event
June 28, 2024
Report Date
October 16, 2024
Manufacturer
EMBECTA MEDICAL I LLC - HOLDREGE, NE
Product Code
FMF
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY: NO PHYSICAL SAMPLES WERE RECEIVED HOWEVER THE INVESTIGATION WAS PERFORMED BASED ON THE PHOTO(S) PROVIDED. THIS IS THE 1ST COMPLAINT FOR THE REPORTED LOT NUMBER. A REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED, AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT. EMBECTA WAS ABLE TO DUPLICATE OR CONFIRM THE INDICATED ISSUE AND BASED ON TREND ANALYSIS NO FURTHER ACTION IS REQUIRED AT THIS TIME. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. IF SAMPLES ARE RECEIVED IN THE FUTURE THE COMPLAINT WILL BE REOPENED FOR FURTHER INVESTIGATION. BASED ON THE ABOVE, NO ADDITIONAL INVESTIGATION AND NO CORRECTIVE/PREVENTATIVE ACTION (CAPA) OR SITUATION ANALYSIS (SA) IS REQUIRED AT THIS TIME.

Description of Event or Problem · 0

EAN PRINTED INCORRECTLY. THE BARCODE NUMBERS CANNOT BE SEEN. MATERIAL: AG BD ULTRA FINE II 8MM 30UN MINI MATERIAL #: 328322 LOT: 1123322 B THE IMAGE IN ANNEX IS IN PHOTO #4.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1046378 SYRINGE 0.3ML 30GA 8MM 10BAG 500 L AMR SYRINGE, PISTON FMF EMBECTA MEDICAL I LLC - HOLDREGE, NE 328322 1123322

Patients

Seq Age Sex Outcome Treatment
1 NA Female