BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NMT SAFTEY SYRINGE

    MDR report key: 507796 · Received January 20, 2004

    Report

    Report Number
    507796
    Event Type
    Injury
    Date Received
    January 20, 2004
    Date of Event
    July 18, 2003
    Report Date
    January 16, 2004
    Manufacturer
    NEW MEDICAL TECHNOLOGY, INC.
    Product Code
    FMF
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    HI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ATTEMPTED TO USE PRODUCT, NEEDLE FAILED. STAFF MEMBER GOT A NEEDLESTICK

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NMT SAFTEY SYRINGE 27GX 1/2" SYRINGE FMF NEW MEDICAL TECHNOLOGY, INC. 20017 (SEE ATTACHED) 08-2005

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR Required Intervention