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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MYCO MEDICAL SUPPLIES, INC MCKESSON BRANDS; NEEDLE, SPINAL QUINCKE 22GX5"

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MYCO MEDICAL SUPPLIES, INC MCKESSON BRANDS; NEEDLE, SPINAL QUINCKE 22GX5" Back to Search Results
Catalog Number 4633V2
Medical Device Problem Code Complete Blockage (1094)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported by the customer that they were experiencing an issue during an injection; the spinal needle would not allow the medication to deploy, even after attempting to reinsert the stylet into the needle.No information was received regarding a serious injury as a result of this product issue.
 
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Brand Name
MCKESSON BRANDS
Common Device Name
NEEDLE, SPINAL QUINCKE 22GX5"
Manufacturer (Section D)
MYCO MEDICAL SUPPLIES, INC
158 toverview court
cary NC 27513
MDR Report Key21512393
Report Number1451040-2025-00007
Device Sequence Number4400680
Product Code BSP
UDI-Device Identifier10612479201597
UDI-Public10612479201597
Combination Product (Y/N)N
Initial Reporter StateNE
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Importer
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 03/04/2025
Report Date (Section F) 03/04/2025
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 Health Professional
Device Catalogue Number4633V2
Device Lot Number2208889
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? Yes
Distributor Facility Aware Date02/12/2025
Device Age12 MO
Event Location Outpatient Treatment Facility
Date Report to Manufacturer03/04/2025
Initial Date Received by Manufacturer Not provided
Initial Report FDA Received Date03/04/2025
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient SexUnknown
Date Report Sent to FDA03/04/2025
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