BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SHAMROCK SAFETY BLOOD COLLECTION SET

    MDR report key: 29068 · Received December 26, 1995

    Report

    Report Number
    MW1007992
    Event Type
    Malfunction
    Date Received
    December 26, 1995
    Date of Event
    November 22, 1995
    Report Date
    December 4, 1995
    Manufacturer
    RYAN MEDICAL, INC.
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RPTR USED BUTTERFLY NEEDLE AND VACUTAINER TO DRAW BLOOD. THE VACUTAINER WAS PULLED UP OVER THE NEEDLE. IT DOES NOT LOCK IN PLACE. THE EMPLOYEE WENT TO DISPOSE OF THE NEEDLE. THE BACK VACUTAINER SLIPPED BACK EXPOSING THE NEEDLE WHICH STUCK HIM IN THE THUMB.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SHAMROCK SAFETY BLOOD COLLECTION SET BLOOD COLLECTION SET JKA RYAN MEDICAL, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other