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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EMBECTA PENEL LIMITED - DUN LAOGHAIRE, IRELAND PEN NDL 32G 6MM 3B TW 100CT US; Needle, hypodermic, single lumen

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EMBECTA PENEL LIMITED - DUN LAOGHAIRE, IRELAND PEN NDL 32G 6MM 3B TW 100CT US; Needle, hypodermic, single lumen Back to Search Results
Model Number 320749
Medical Device Problem Code Delivered as Unsterile Product (1421)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This medwatch submission is both an initial and supplemental filing.Investigation of the results can be seen below: investigation summary: no samples (including photos) were returned therefore the complaint could not be confirmed and the root cause is undetermined.This is the 1st complaint for the reported lot number.A review of the manufacturing records was performed, and no non-conformances were raised in association with this type of event for this lot.Complaints received for this device and reported condition will continue to be tracked and trended.If samples are received in the future the complaint will be reopened for further investigation.Based on the above, no additional investigation and no corrective/preventative action (capa) or situational analysis (sa) is required at this time.
 
Event or Problem Description
Consumer reported, "tear drop labels" were not attached to some pen needles in the box before use.Consumer did not use the pen needles that he found without "tear drop labels" attached.Stated, the labels were loose in the box.Lot: 4128060 catalog: 320749 date of event: unknown.Samples: no cl.
 
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Brand Name
PEN NDL 32G 6MM 3B TW 100CT US
Common Device Name
Needle, hypodermic, single lumen
Manufacturer (Section D)
EMBECTA PENEL LIMITED - DUN LAOGHAIRE, IRELAND
EI 
Manufacturer Contact
avital merl
300 kimball dr.
parsippany, NJ 07054
MDR Report Key21693967
Report Number3023359743-2025-00234
Device Sequence Number8774315
Product Code FMI
UDI-Device Identifier00382903207497
UDI-Public00382903207497
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K213478
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 03/25/2025
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 Lay User/Patient
Device Model Number320749
Device Lot Number4128060
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/04/2025
Initial Report FDA Received Date03/25/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Unknown
Patient Sequence Number1
Patient SexPrefer Not To Disclose
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