BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VANISHPOINT SYRINGE 25GX1

    MDR report key: 3470165 · Received November 8, 2013

    Report

    Report Number
    MW5032776
    Event Type
    Malfunction
    Date Received
    November 8, 2013
    Date of Event
    November 7, 2013
    Report Date
    November 7, 2013
    Manufacturer
    RTRACTABLE TECHNLLOGIES
    Product Code
    MEG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    PRODUCT, VANISH POINT SYRINGE 3ML 25GX1" MALFUNCTIONED AT USE OF ADMINISTRATION. THE SYRINGE DID NOT AUTO RETRACT NEEDLE AND BARREL ACTUALLY EXPLODED, CAME APART. NDC IS (B)(4), LOT NUMBER A130404, (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    578725 VANISHPOINT SYRINGE 25GX1 SYRINGE MEG RTRACTABLE TECHNLLOGIES A130404

    Patients

    Seq Age Sex Outcome Treatment
    1