FDA Adverse Event Malfunction Summary report: N

SOL-MILLENNIUM

MDR report key: 22035476 · Received May 16, 2025

Report

Report Number
3014312726-2024-00192
Event Type
Malfunction
Date Received
May 16, 2025
Date of Event
January 26, 2024
Report Date
August 13, 2025
Manufacturer
SOL-MILLENNIUM MEDICAL INC.
Product Code
QNQ
UDI-DI
00818392018165
PMA / PMN Number
K242291
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THERE IS NO EVIDENCE OF QUALITY ISSUES ASSOCIATED WITH THIS COMPLAINT BASED ON THE ARCHIVE SAMPLE ANALYSIS. BASED ON THE DETERMINED RISK PRIORITY NUMBER, THE RESIDUAL RISK RELATED TO THE COMPLAINT IS CONSIDERED ACCEPTABLE. SOL MILLENNIUM CONTINUES TO MONITOR THIS KIND OF ISSUE. ADDITIONAL ASSESSMENT WILL BE TAKEN IF A SIGNIFICANT PATTERN EMERGES. UNCONFIRMED. THIS REPORT WAS INITIALLY SUBMITTED ON 04/08/2024. DUE TO ISSUES WITH DISPLAYING THE INITIAL SUBMISSION, THIS SUBMISSION CONTAINS BOTH INITIAL AND SUPPLEMENTAL INFORMATION.

Additional Manufacturer Narrative · 0

THIS REPORT WHEN INITIALLY SUBMITTED ENCOUNTERED AN INTERNAL ISSUE POTENTIALLY RELATED TO DATABASE CONNECTIVITY. THIS ISSUE WAS IDENTIFIED WHILE IMPLEMENTING CAPA-57 WHICH WAS OPENED FOLLOWING AN FDA INSPECTION.

Description of Event or Problem · 0

"CUSTOMER REPORTED: WE RECEIVED A COMPLAINT FROM RIVM FOR ITEM P180001PP WITH BATCH 04105025. IT HAD SEVERAL DEFECTS: SYRINGE WITHOUT GRADUATION MARKS: 1 PIECE. SYRINGE WITHOUT PLUNGER: 1 PIECE. CLOSED PACKAGING WITHOUT SYRINGE: 1 PIECE. SYRINGE EXPANDED AND WITH FISSURES; FRACTURE CRACKS: 3 PIECES."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
132442 SOL-MILLENNIUM SOL-M 1ML LUER LOCK SYRINGE W/O NEEDLE QNQ SOL-MILLENNIUM MEDICAL INC. P180001PP 04105025 00818392018165

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown