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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SOL-MILLENNIUM MEDICAL INC. SOL-MILLENNIUM; SOL-M HYPODERMIC NEEDLE 25G*5/8"

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SOL-MILLENNIUM MEDICAL INC. SOL-MILLENNIUM; SOL-M HYPODERMIC NEEDLE 25G*5/8" Back to Search Results
Model Number 112506
Medical Device Problem Code Device-Device Incompatibility (2919)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/02/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
There is no evidence of quality issues associated with this complaint based on the return sample and archive sample analysis.Based on the determined risk priority number, the residual risk related to the complaint is considered acceptable.Sol millennium continues to monitor this kind of issue.Additional assessment will be taken if a significant pattern emerges.Unconfirmed.This report was initially submitted on 04/29/2024.Due to issues with displaying the initial submission, this submission contains both initial and supplemental information.
 
Event or Problem Description
"incident description: during direct intravenous injection of radiopharmaceutical medicine, healthcare provider notes that needle is biased in its cap.It's also hard to screw the needle hub on syringes, especially the luer-lock 2.5 ml ref (b)(4) manufactured by terumo, and also the luer-lock plastipak 5ml ref (b)(4) and 10ml (b)(4) becton dickinson manufacturer.It has been noted that needles were often sideways in their protective caps, that they were very soft and there is a looseness in the screw thread after the syringe has been screwed.".
 
Additional Manufacturer Narrative
This report when initially submitted encountered an internal issue potentially related to database connectivity.This issue was identified while implementing capa-57 which was opened following an fda inspection.
 
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Brand Name
SOL-MILLENNIUM
Common Device Name
SOL-M HYPODERMIC NEEDLE 25G*5/8"
Manufacturer (Section D)
SOL-MILLENNIUM MEDICAL INC.
311 south wacker drive
suite 4100
chicago IL 60606
Manufacturer (Section G)
ZHEJIANG KINDLY MEDICAL DEVICES CO., LTD.
no. 758, 5th binhai road binha
longwan district
wenzhou, zhejiang province 32502 5
CH   325025
Manufacturer Contact
jarryd
311 south wacker dr.
suite 4100
chicago 60606
MDR Report Key22035503
Report Number3014312726-2024-00209
Device Sequence Number8655791
Product Code FMI
UDI-Device Identifier00818392015140
UDI-Public(01)00818392015140(17)280817(10)02308023
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K112777
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 08/14/2025
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 Model Number112506
Device Lot Number02308023
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/10/2024
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date05/16/2025
Supplement Report FDA Received Date08/14/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/12/2023
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient SexUnknown
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