MAUDE Adverse Event Report: CARDINAL HEALTH SAFETY NEEDLE 25 G X 1"; SYRINGE, PISTON

Model Number	8881833510
Medical Device Problem Code	Fail-Safe Problem (2936)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
An investigation is currently underway.Upon completion, the results will be forwarded.
Event or Problem Description
As reported by ecri, an anonymous ecri member reported that the safety doesn't engage all the way, so the tip of the needle is still exposed.It will click making you think it's locked and fully over the needle when it isn't.They are also extremely flimsy.The needles feel as if the safety is fully engaged but a small part of the needle remains unsheathed.They also noticed if the safety is pushed further to attempt to engage more, the needle begins to bend.
Additional Manufacturer Narrative
Samples were not received for the investigation.A device history record review could not be performed because the reported lot number is invalid.A lot number was not received with the complaint.As part of our manufacturing process, all device history records are reviewed and approved by quality, prior to release of product.Because a sample was not returned, we were unable to perform a follow up investigation to include functional and visual evaluations to confirm the reported issue and determine the root cause, therefore a corrective action is not applicable at this time.If a sample is received at a later date, this complaint will be reopened for further investigation.This complaint will be used for tracking and trending purposes.

• Brand Name: SAFETY NEEDLE 25 G X 1"
• Common Device Name: SYRINGE, PISTON
• Manufacturer (Section D): CARDINAL HEALTH; 777 west street; mansfield MA 02048
• Manufacturer (Section G): CARDINAL HEALTH; 2010 east international speedw; deland FL 32724
• Manufacturer Contact: jill saraiva ; 777 west street; mansfield, MA 02048 ; 5086183640
• MDR Report Key: 18097398
• Report Number: 1017768-2023-01100
• Device Sequence Number: 12189850
• Product Code: FMF
• UDI-Device Identifier: 10192253024746
• UDI-Public: 10192253024746
• Combination Product (Y/N): N
• Initial Reporter State: PA
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: User Facility,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 12/20/2023

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 Model Number: 8881833510
• Device Catalogue Number: 8881833510
• Device Lot Number: 210665
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 10/20/2023
• Supplement Date Received by Manufacturer: 10/20/2023
• Initial Report FDA Received Date: 11/08/2023
• Supplement Report FDA Received Date: 12/21/2023
• Is the Device Labeled for Single Use? (Y/N): Yes
• Usage of Device: A
• Patient Sequence Number: 1
• Patient Sex: Unknown