BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SAGE

    MDR report key: 301874 · Received October 25, 2000

    Report

    Report Number
    MW1020243
    Event Type
    Malfunction
    Date Received
    October 25, 2000
    Date of Event
    October 3, 2000
    Report Date
    October 18, 2000
    Manufacturer
    SAGE PRODUCTS INC.
    Product Code
    MMK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    AFTER DRAWING BLOOD FROM A PT, THE TECHNOLOGIST WAS DISCARDING THE USED NEEDLE WHILE USING THE SINGLE AUTODROP SYSTEM. THE NEEDLE DID NOT RELEASE FROM THE NEEDLE HOLDER. NOT BEING AWARE THE NEEDLE DID NOT RELEASE, THE TECHNOLOGIST STUCK THEMSELF IN LEFT HAND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAGE SINGLE USE AUTODROP SHARPS SYSTEM MMK SAGE PRODUCTS INC. R3730 092795 & R4126B 000181019

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR 1) VACUTAINER MULTIDRAW NEEDLE.