BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VACUETTE

    MDR report key: 2182327 · Received July 22, 2011

    Report

    Report Number
    MW5021514
    Event Type
    Malfunction
    Date Received
    July 22, 2011
    Date of Event
    July 21, 2011
    Report Date
    July 22, 2011
    Manufacturer
    GREINER BIO-ONE GMBH
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WAS CLOSING A VACUETTE 23G NEEDLE AFTER PERFORMING A BLOOD DRAW ON A PT WHEN THE FRONT END SNAPPED OFF AND FELL TO THE FLOOR. THE NEEDLE WAS NOT ALL THE WAY COVERED. I HAVE BEEN USING THESE PARTICULAR NEEDLES FOR ALMOST A YEAR AND THIS HAS NEVER HAPPENED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VACUETTE BUTTERFLY JKA GREINER BIO-ONE GMBH 10H29

    Patients

    Seq Age Sex Outcome Treatment
    1