| Brand Name | NEEDLE 27GA 5/8IN |
| Common Device Name | Needle, Hypodermic, Single Lumen |
| Manufacturer (Section D) |
| BD MEDICAL (BD WEST) MEDICAL SURGICAL |
| 1852 10th avenue |
| columbus NE 68601 |
|
| Manufacturer (Section G) |
| BD MEDICAL (BD WEST) MEDICAL SURGICAL |
| 1852 10th avenue |
|
| columbus NE 68601 |
|
| Manufacturer Contact |
|
helen
cox (mdr)
|
| 75 north fairway drive |
| vernon hills, IL 60061
|
|
+1(847)393-5694
|
|
| MDR Report Key | 50794663 |
| Report Number | 1911916-2026-00495 |
| Device Sequence Number | 16084417 |
| Product Code |
FMI
|
| UDI-Device Identifier | 50382903028851 |
| UDI-Public | (01)50382903028851(10)6208267 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MO |
| Initial Reporter Country | US |
| PMA/510(K) Number | K021475 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/16/2026 |
| 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 |
Health Professional
|
| Device Catalogue Number | 302885 |
| Device Lot Number | 6208267 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/09/2026 |
| Initial Report FDA Received Date | 09/16/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 07/27/2026 |
| 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 Number | 1 |
| Patient Sex | Unknown |