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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TRIVIDIA HEALTH INC SYRINGES; PISTON SYRINGE

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TRIVIDIA HEALTH INC SYRINGES; PISTON SYRINGE Back to Search Results
Model Number SYR, NPD 1.0CC 29G 100CT1/2" 8/CS
Medical Device Problem Code No Flow (2991)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/18/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Internal report reference number: (b)(4).Syringes were not returned for evaluation.Note: manufacturer contacted customer in several follow-up calls to ensure the replacement products resolved the initial concern - unable to establish contact with customer at this time.
 
Event or Problem Description
Consumer reported complaint for the trueplus single-use insulin syringes.Customer states that the syringe will not draw up the medication.Per customer 1 out of 6 wasn't working.Per customer the package had not been open or damaged when received.The customer started using the syringes 1 month ago.At the time of the call the customer felt well and did not report any symptoms.Customer did not claim to be injured while using the pen needles and no medical intervention related to the use of the product was reported.
 
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Brand Name
SYRINGES
Common Device Name
PISTON SYRINGE
Manufacturer (Section D)
TRIVIDIA HEALTH INC
2400 nw 55th court
fort lauderdale FL 33309
Manufacturer Contact
juliana arias
2400 nw 55th court
fort lauderdale, FL 33309
MDR Report Key24605207
Report Number1000113657-2026-00116
Device Sequence Number15709994
Product Code FMF
UDI-Device Identifier00021292005825
UDI-Public(01)00021292005825(17)281105(10)NP23173
Combination Product (Y/N)N
PMA/510(K) Number
K993017
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Remedial Action Replace
Type of Report Initial,Followup
Report Date (Section B) 05/13/2026
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 NumberSYR, NPD 1.0CC 29G 100CT1/2" 8/CS
Device Lot NumberNP23173
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Distributor Facility Aware Date02/18/2026
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 02/18/2026
Supplement Date Received by Manufacturer04/21/2026
Initial Report FDA Received Date03/16/2026
Supplement Report FDA Received Date05/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
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
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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