BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NMT SAFETY SYRINGE

    MDR report key: 409827 · Received August 7, 2002

    Report

    Report Number
    MW1025793
    Event Type
    Malfunction
    Date Received
    August 7, 2002
    Date of Event
    August 2, 2002
    Report Date
    August 7, 2002
    Manufacturer
    NEW MEDICAL TECHNOLOGY INC
    Product Code
    FMF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    NMT SAFETY SYRINGE USED TO ADMINISTER HALDOL MEDICATION. DREW UP MEDICATION WITH NO PROBLEM. INJECTED INTO INTRAMUSCULAR SITE. PUSHED ON PLUNGER TO ADMINISTER MEDICATION. MEDICATION SQUIRTED OUT AROUND THE HUB OF THE NEEDLE. SAFETY MECHANISM NEEDLE WAS RETRACTED IN TO THE SYRINGE. NURSE ASSESSED THAT NO MEDICATION WAS INJECTED INTO THE CLIENT. DOSE WAS REPEATED USING A REGULAR SYRINGE AND NEEDLE. PRODUCT LABEL HAS NO RESTRICTIONS ON TYPE OF FLUID TO BE USED IN THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NMT SAFETY SYRINGE SYRINGE FMF NEW MEDICAL TECHNOLOGY INC * 100985

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Other