FDA Adverse Event Malfunction Summary report: N

SYRINGE 0.3ML 31GA 6MM HALFUNIT 10BAGSLA

MDR report key: 21789257 · Received April 7, 2025

Report

Report Number
3024508819-2025-00167
Event Type
Malfunction
Date Received
April 7, 2025
Date of Event
March 13, 2025
Report Date
April 7, 2025
Manufacturer
EMBECTA MEDICAL I LLC - HOLDREGE, NE
Product Code
FMF
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THIS MEDWATCH REPORT IS BOTH AN INITIAL AND FINAL SUBMISSION AS THE INVESTIGATION HAS BEEN COMPLETED. INVESTIGATION SUMMARY: NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. THIS IS THE 2ND 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. 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 SITUATIONAL ANALYSIS (SA) IS REQUIRED AT THIS TIME.

Description of Event or Problem · 0

I USED A SYRINGE WITH PROBLEM YESTERDAY (B)(6) 2025. WHEN I WENT TO PRESS THE INSULIN, THE SYRINGE DID NOT PUSH THE INSULIN. LOT 3325073 C 2024 01-02 2028 - 12-31.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
658587 SYRINGE 0.3ML 31GA 6MM HALFUNIT 10BAGSLA Syringe, piston FMF EMBECTA MEDICAL I LLC - HOLDREGE, NE 324916 3325073

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown