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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EMBECTA MEDICAL I LLC - HOLDREGE, NE SYRINGE 0.3ML 31G 6MM S/C U-100 RELION; Syringe, piston

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EMBECTA MEDICAL I LLC - HOLDREGE, NE SYRINGE 0.3ML 31G 6MM S/C U-100 RELION; Syringe, piston Back to Search Results
Model Number 328521
Medical Device Problem Codes Off-Label Use (1494); Volume Accuracy Problem (1675)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
Pet owner reported several issues with syringes.Stated, "scale markings/lines are crooked" stated, some "scale markings are missing" stated, needle is bent before injection lot: 4282062, 4191020, 4233018 catalog: 328521 date of event: unknown samples: no cl.
 
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.
 
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Brand Name
SYRINGE 0.3ML 31G 6MM S/C U-100 RELION
Common Device Name
Syringe, piston
Manufacturer (Section D)
EMBECTA MEDICAL I LLC - HOLDREGE, NE
Manufacturer Contact
anna garbowska-zakrzewski
300 kimball dr
parsippany, NJ 07054
MDR Report Key22143265
Report Number3024508819-2025-00247
Device Sequence Number15507831
Product Code FMF
UDI-Device Identifier00681131138383
UDI-Public00681131138383
Combination Product (Y/N)N
Initial Reporter StateAZ
Initial Reporter CountryUS
PMA/510(K) Number
K212499
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) 06/04/2025
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 Lay User/Patient
Device Model Number328521
Device Lot Number4191020
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 05/29/2025
Initial Report FDA Received Date06/04/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Patient Sequence Number1
Patient SexUnknown
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