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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES LP MEDLINE; DBQ-SYR W/NDLE,SAFETY,INSLN,1ML,29GX0.5

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MEDLINE INDUSTRIES LP MEDLINE; DBQ-SYR W/NDLE,SAFETY,INSLN,1ML,29GX0.5 Back to Search Results
Catalog Number SYRSI101292
Medical Device Problem Code Appropriate Device Problem Term/Code Not Available (3191)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 03/25/2026
Type of Reportable Event Malfunction
Event or Problem Description
Syringes get "air locks".
 
Additional Manufacturer Narrative
It was reported that "safety insulin syringes purchased are absolutely horrible they get air locks all the time".To date, no information has been received to indicate that a user or a patient experienced a death, serious injury, medical intervention, follow-up care, or other adverse health impact associated with the reported problem/issue.In an abundance of caution, and in response to an fda 483 issued for cfn 1417592 on 22-jan-2024, this medwatch is being filed for the reported problem/issue.If additional relevant information becomes available a supplemental medwatch will be filed.
 
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Brand Name
MEDLINE
Common Device Name
DBQ-SYR W/NDLE,SAFETY,INSLN,1ML,29GX0.5
Manufacturer (Section D)
MEDLINE INDUSTRIES LP
three lakes drive
northfield IL 60093
Manufacturer (Section G)
MEDLINE INDUSTRIES LP
three lakes drive
northfield IL 60093
Manufacturer Contact
kelly zampella
three lakes drive
northfield, IL 60093
MDR Report Key24887367
Report Number1417592-2026-00445
Device Sequence Number9852021
Product Code MEG
UDI-Device Identifier10888277657298
UDI-Public10888277657298
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K231907
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Nurse Practitioner
Type of Report Initial
Report Date (Section B) 04/15/2026
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
Device Catalogue NumberSYRSI101292
Device Lot Number89725030003
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/09/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/25/2026
Initial Report FDA Received Date04/15/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/01/2025
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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