FDA Adverse Event Malfunction Summary report: N

MICRO-MATE INTERCHANGEABLE GLASS SYRINGES

MDR report key: 3032728 · Received March 29, 2013

Report

Report Number
1213649-2013-00008
Event Type
Malfunction
Date Received
March 29, 2013
Date of Event
April 11, 2012
Report Date
April 11, 2012
Manufacturer
CADENCE INC.
Product Code
FMF
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS REPORT IS BEING FILED AFTER IT WAS IDENTIFIED AS NON-COMPLIANT DURING AN INTERNAL REVIEW OF OUR COMPLAINT FILES.

Description of Event or Problem · 1

ON (B)(6) 2011 THE CUSTOMER REPORTED THE GLASS SYRINGE WAS FOUND BROKEN WHEN THE BOX WAS OPENED. THERE WAS NO PT EXPOSURE AND NO INJURY TO THE USER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
130380 MICRO-MATE INTERCHANGEABLE GLASS SYRINGES SYRINGE FMF CADENCE INC. 5057 77873-01

Patients

Seq Age Sex Outcome Treatment
1 Other