FDA Adverse Event Malfunction Summary report: N

LANTUS SOLO STAR ULTRA FINE NEEDLE

MDR report key: 3231293 · Received July 11, 2013

Report

Report Number
MW5030891
Event Type
Malfunction
Date Received
July 11, 2013
Report Date
July 11, 2013
Manufacturer
CANAMCARE
Product Code
FMI
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

EMPLOYEE WAS ATTACHING A NEEDLE TO CUSTOMER'S INSULIN PEN. NEEDLE WAS DEFECTIVE - HAD AN ADDITIONAL NEEDLE THAT WAS STICKING OUT OF THE SIDE OF THE NEEDLE CAP. NO NEEDLE STICK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
320782 LANTUS SOLO STAR ULTRA FINE NEEDLE INSULIN PEN NEEDLE FMI CANAMCARE 121043-04

Patients

Seq Age Sex Outcome Treatment
1