BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MONOJET SYRINGE 6CC WITH 21G NEEDLE

    MDR report key: 4093773 · Received September 11, 2014

    Report

    Report Number
    4093773
    Event Type
    Malfunction
    Date Received
    September 11, 2014
    Date of Event
    August 15, 2014
    Report Date
    September 11, 2014
    Manufacturer
    COVIDIEN
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US

    Narratives

    Description of Event or Problem · 1

    ANESTHESIA TECH WAS COLLECTING MONOJECT 21G SYRINGES TO STOCK AN ANESTHESIA CART. WHILE COLLECTING A NUMBER OF SYRINGES FROM THE STOCK PILE, HE WAS STUCK BY A CAPLESS SYRINGE THAT WAS SENT BY THE COMPANY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    563374 MONOJET SYRINGE 6CC WITH 21G NEEDLE SYRINGE, PISTON FMF COVIDIEN * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * NO PATIENT WAS AFFECTED.