FDA Adverse Event Injury Summary report: N

NEEDLE

MDR report key: 9106590 · Received September 23, 2019

Report

Report Number
MW5089987
Event Type
Injury
Date Received
September 23, 2019
Date of Event
July 11, 2019
Report Date
August 7, 2018
Manufacturer
HTL-STREFA, INC.
Product Code
FMI
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
WY, US
Reporter Occupation
PHARMACIST

Narratives

Description of Event or Problem · 1

(B)(6) YEAR DM2 OLD PATIENT D/C FROM LOCAL HOSPITAL (B)(6) 2018 ON INSULIN PENS AND COMMON BRAND SHORT PEN NEEDLES. PEN NEEDLES WERE SUBSTITUTED BY OUR FACILITY WITH GENERIC DROPLET PEN NEEDLES 29G, 12MM (MFG. HTL STREFA) PATIENT USED THE BRAND NAME PEN NEEDLES HE WAS ORIGINALLY GIVEN INSTEAD OF GENERIC SUBSTITUTE. PATIENT HAD EXCELLENT DM CONTROL, WITH FASTING AM BLOOD SUGARS BETWEEN 80/120. HE THEN WANTED TO BE SUPPLIED WITH BN PEN NEEDLES THROUGH OUR FACILITY. HE WAS INSTEAD SWITCHED TO GENERIC DROPLET PEN NEEDLES 31G, 8MM (MFG. HTL STREFA). THE DAY AFTER STARTING THEN PEN NEEDLES, HIS FASTING SUGAR WAS 266 UP FROM 133 THE DAY BEFORE. EVERY DAY SINCE THEN HIS SUGARS HAVE RANGED FROM 250-365 FASTING WHEN THEY WERE WELL CONTROLLED BEFORE. PATIENT HAS CALLED THE CLINIC TEAM AT HIS LOCAL CLINIC WHERE PCP IS SEVERAL TIMES AND HAS COME IN 2-3 TIMES IN THE LAST 2 MONTHS TO SEE PCP OR THE NURSE ABOUT THE HIGH SUGARS AND THEY HAVE ADVISED HIM TO LEAVE THE NEEDLE IN THE SKIN LONGER AND THE OTHER ADAPTIVE MEASURES. HE HAS TRIED THESE MEASURES AND STILL HIS SUGARS ARE OUT OF CONTROL. IN ADDITION, HE RELATES THAT NO MATTER HOW LONG HE LEAVES THE NEEDLE IN, THERE IS STILL INSULIN DRIPPING FROM THE NEEDLE WHEN HE PULLS IT OUT OF THE SKIN. THERE HAVE BEEN SEVERAL OTHER PATIENT COMPLAINTS REGARDING THIS BRAND OF PEN NEEDLES. SYMPTOMS: SYMPTOMS: 1 HYPERGLYCEMIA. NEEDLE DOSE: 1 UNIT: UNITS FREQ: HS ROUTE: SQ.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
896361 NEEDLE NEEDLE, HYPODERMIC, SINGLE LUMEN FMI HTL-STREFA, INC.

Patients

Seq Age Sex Outcome Treatment
1 87 YR Other