| Brand Name | EXEL 10ML SYR ONLY L-L |
| Common Device Name | SYRINGE ONLY |
| Manufacturer (Section D) |
| EXELINT INTERNATIONAL, CO. |
| 2500 santa fe avenue |
| redondo beach CA 90278 |
|
| Manufacturer (Section G) |
| EXELINT INTERNATIONAL, CO. |
| 2500 santa fe avenue |
|
| redondo beach CA 90278 |
|
| Manufacturer Contact |
|
vu
doan
|
| 2500 santa fe avenue |
| redondo beach, CA 90278
|
|
3106490707
|
|
| MDR Report Key | 25119226 |
| Report Number | 1035907-2026-00051 |
| Device Sequence Number | 18739531 |
| Product Code |
FMF
|
| UDI-Device Identifier | 00020221262308 |
| UDI-Public | (01)00020221262308(17)291030(30)1(10)26265 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K251089 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup,Followup |
| Report Date (Section B) |
06/03/2026 |
| 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 Number | 26265 |
| Device Lot Number | 241130 |
| 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 | 04/09/2026 |
| Supplement Date Received by Manufacturer | Not provided Not provided
|
| Initial Report FDA Received Date | 05/07/2026 |
| Supplement Report FDA Received Date | 05/28/2026 06/03/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| 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 Number | 1 |
| Patient Sex | Unknown |
|
|