FDA Adverse Event
Other
Summary report: N
3CC SAF. SYR 20X1-1/2
MDR report key: 318691
·
Received March 1, 2001
Report
- Report Number
- 1650158-2001-00001
- Event Type
- Other
- Date Received
- March 1, 2001
- Date of Event
- January 9, 2001
- Report Date
- February 23, 2001
- Manufacturer
- KENDALL HEALTHCARE PRODUCTS
- Product Code
- MEG
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MI, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
IT WAS REPORTED TO KENDALL HEALTHCARE PRODUCTS IN 2/2001 THAT LPN WENT TO GIVE INJECTION AND THE SHIELD FELL BACK. LPN STATES THAT LPN HAS HAD EXPERIENCE WITH THEM AND NEVER HAD THIS PROBLEM. LPN IS ALMOST SURE LPN LOCKED IT BUT CANNOT SAY FOR SURE. SAMPLE WAS DISPOSED OF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 8683 | 3CC SAF. SYR 20X1-1/2 | SAFETY SYRINGE | MEG | KENDALL HEALTHCARE PRODUCTS | * | 707908 OR 705057 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Other |