BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDLINE INSULIN SAFETY SYRINGE

    MDR report key: 8650165 · Received May 28, 2019

    Report

    Report Number
    MW5086949
    Event Type
    Malfunction
    Date Received
    May 28, 2019
    Date of Event
    May 15, 2019
    Report Date
    May 25, 2019
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    MEG
    UDI-DI
    10888277657298
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    MEDLINE INSULIN SAFETY SYRINGE SAFETY MECHANISM DOES NOT LOCK IN PLACE TO COVER THE NEEDLE. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    438301 MEDLINE INSULIN SAFETY SYRINGE SYRINGE, ANTISTICK MEG MEDLINE INDUSTRIES, INC. SYRSI101292 89718080001 10888277657298

    Patients

    Seq Age Sex Outcome Treatment
    1