MAUDE Adverse Event Report: ARROW INTERNATIONAL INC. STIMUQUIK: 22G X 5CM (2") PNB NEEDLE; ANESTHESIA CONDUCTION KIT

Catalog Number AB-22050-SS

Device Problems Fluid/Blood Leak (1250); Tear, Rip or Hole in Device Packaging (2385)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 08/14/2019

Event Type  malfunction  

Manufacturer Narrative

(b)(4).The device has not been returned for investigation.Teleflex will continue to monitor and trend related events.

Event Description

It was reported that while using a nerve block needle this morning while performing an interscalene nerve block on a patient it was noticed that there was fluid leaking from the tubing.The needle was immediately removed.A hole was visualized in the tubing at the hub of the needle.The needle and packaging were saved.Another nurse then reported that last week they had to replace a block needle because air was aspirated.They believed there was a hole in that tubing as well.That needle was not saved unfortunately.

Manufacturer Narrative

Qn#(b)(4).After an additional medical review, a determination was made to re-classify the complaint as a malfunction.Complaint(b)(4) is being reported as a malfunction.There was no serious injury.

• Brand Name: STIMUQUIK: 22G X 5CM (2") PNB NEEDLE
• Type of Device: ANESTHESIA CONDUCTION KIT
• Manufacturer (Section D): ARROW INTERNATIONAL INC.; reading PA
• MDR Report Key: 8977277
• MDR Text Key: 156976560
• Report Number: 3011137372-2019-00300
• Device Sequence Number: 1
• Product Code: CAZ
• Combination Product (y/n): N
• PMA/PMN Number: K173321
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional,user faci
• Type of Report: Initial,Followup
• Report Date: 08/22/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 09/09/2019
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: AB-22050-SS
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 10/08/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1