BEUDAMED
    FDA Adverse Event Injury Summary report: N

    25-0101 ST NEEDLE CTR DBL MAG 20CT 1PK

    MDR report key: 297282 · Received September 20, 2000

    Report

    Report Number
    1046367-2000-00031
    Event Type
    Injury
    Date Received
    September 20, 2000
    Date of Event
    April 16, 2000
    Report Date
    September 15, 2000
    Manufacturer
    DEROYAL
    Product Code
    MMK
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    NEEDLE STICK. UPON COMPLETION OF PROCEDURE, CLEANING UP BACK TABLE, NEEDLE COUNTER WAS CLOSED. NEEDLES SLIPPED OUT WHEN SNAPPING COUNTER TOGETHER-HINGE ON NEEDLE COUNTER NOT WORKING CAUSING NEEDLES TO "POP" OUT. LOT NUMBERS GIVEN ARE: 199779, 206385, AND 210358.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 25-0101 ST NEEDLE CTR DBL MAG 20CT 1PK 4B4 NEEDLE COUNTERS MMK DEROYAL * NA

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Life Threatening