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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TERUMO PHILIPPINES CORPORATION TERUMO SURGUARD3 SAFETY HYPODERMIC NEEDLE; NEEDLE, HYPODERMIC, SINGLE LUMEN

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TERUMO PHILIPPINES CORPORATION TERUMO SURGUARD3 SAFETY HYPODERMIC NEEDLE; NEEDLE, HYPODERMIC, SINGLE LUMEN Back to Search Results
Model Number N/A
Device Problem Break (1069)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/20/2024
Event Type  malfunction  
Event Description
The user facility reported that the involved needle was broken using risperdal consta.The product was not administered to the patient and the patient's health was not harm.The event occurred pre-treatment.The final patient impact was not harmed.The patient was not injured during the event and medical/surgical intervention was not needed.
 
Manufacturer Narrative
A1: patient identifier: requested, not provided.A2: age or date of birth: requested, not provided.A3a: sex: requested, not provided.A3b: gender: n/a.A4: weight: requested, not provided.A5: ethnicity: requested, not provided.A6: race: requested, not provided.D6a: implanted date: device was not implanted.D6b: explanted date: device was not explanted.E1: phone number: requested, unknown.E3: occupation: combo analyst iii, product quality vigilance.The actual device was not available for evaluation therefore; the details of the actual condition of the sample in unable to be determined.Retention samples were visually inspected and confirmed free from any tilted cannula, bent cannula, or damage to the cannula that might lead to the complaint.Our cannula is a supplied raw material that complies with iso 9626, particularly on stiffness and breakage.Prior to the supply of cannula (raw material) to the needle assembly process, qc conducts incoming inspection which includes dimensional inspection and verification of certificate of analysis according to material specification.A total of ten (10) complaints were received from the previous two fiscal years to the present for the same issue where the cause was not identified related to our product and production process.Retention samples were subjected to simulation.The syringe with the safety needle was punctured into the rubber cork.A manual cannula bending test was conducted wherein the needle was bent 45° from left to right forty (40) times.Result, the needle did not break even after 40x bending.The root cause of the complaint could not be identified to be related to our product or manufacturing process.A review of the product's lot history file revealed no issues that were encountered during the production of the reported lot and the retention samples met the required specifications.Our cannula is supplied with raw material that complies with iso 9626, particularly on stiffness and breakage.The retention samples were confirmed visually in good condition.Simulations were conducted on the samples wherein the needle did not break even after 40x bending which indicates that our needles have high resistance to breakage.Terumo medical products (tmp) (importer) registration no.(b)(4) is submitting this report on behalf of terumo (philippines) corporation (manufacturer) registration no.(b)(4).
 
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Brand Name
TERUMO SURGUARD3 SAFETY HYPODERMIC NEEDLE
Type of Device
NEEDLE, HYPODERMIC, SINGLE LUMEN
Manufacturer (Section D)
TERUMO PHILIPPINES CORPORATION
124 east main avenue
laguna technopark
binan
RP 
Manufacturer (Section G)
TERUMO PHILIPPINES CORPORATION
124 east main avenue
laguna, binan
RP  
Manufacturer Contact
gina digioia
265 davidson ave
suite 320
somerset, NJ 08873
6402040886
MDR Report Key18911506
MDR Text Key337744100
Report Number3003902955-2024-00015
Device Sequence Number1
Product Code FMI
UDI-Device Identifier34806017507771
UDI-Public34806017507771
Combination Product (y/n)N
Reporter Country CodeBE
PMA/PMN Number
K113422
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,User Facility,Company Representative
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 03/15/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue NumberSG3+2051
Device Lot Number221216C
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 02/23/2024
Initial Date FDA Received03/15/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured12/16/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
RISPERDAL CONSTA
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