BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VACUTAINER-ECLIPSE BLOOD COLLECTION NEEDLE

    MDR report key: 456744 · Received April 24, 2003

    Report

    Report Number
    MW1028255
    Event Type
    Malfunction
    Date Received
    April 24, 2003
    Date of Event
    April 23, 2003
    Report Date
    April 24, 2003
    Manufacturer
    B/D
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    AFTER DRAWING BLOOD AND ATTEMPTING TO THROW VACUTAINER NEEDLE AWAY PLASTIC SAFETY FELL OFF CAUSING NEEDLE TO STICK USER IN RIGHT PALM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VACUTAINER-ECLIPSE BLOOD COLLECTION NEEDLE VACUTAINER-ECLIPSE BLOOD COLLECTION NEEDLES 22G-1 1/4" JKA B/D * 2179850

    Patients

    Seq Age Sex Outcome Treatment
    1 22 YR