| Brand Name | BD SHARPS DISPOSAL |
| Common Device Name | HYPODERMIC SINGLE LUMEN NEEDLE |
| Manufacturer (Section D) |
| BD MEDICAL, MEDICATION DELIVERY SOLUTIONS |
| 1 becton drive |
| franklin lakes NJ 07417 |
|
| Manufacturer (Section G) |
| BD MEDICAL, MEDICATION DELIVERY SOLUTIONS |
| 1 becton drive |
|
| franklin lakes NJ 07417 |
|
| Manufacturer Contact |
|
helen
cox (mdr)
|
| 75 north fairway drive |
| vernon hills, IL 60061
|
|
8473935694
|
|
| MDR Report Key | 18169316 |
| Report Number | 2243072-2023-02066 |
| Device Sequence Number | 7687509 |
| Product Code |
FMI
|
| UDI-Device Identifier | 00382903054879 |
| UDI-Public | (01)00382903054879 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K943139 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
11/01/2023 |
| 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
|
| Operator of Device |
Other
|
| Device Catalogue Number | 305487 |
| Device Lot Number | 3132906 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/30/2023 |
| Initial Report FDA Received Date | 11/20/2023 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 05/22/2023 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |