MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; NEEDLE,25GX1.5",REG,BEVEL

Catalog Number	SYR100257
Medical Device Problem Code	Packaging Problem (3007)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	01/16/2023
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "the caps are coming off too easily on the needles.\"something appears to be loose\"".
Additional Manufacturer Narrative
The customer reported that the caps are coming off too easily on the needles and "something appears to be loose." medline received 3bx in new condition; upon a visual inspection of the samples, no manufacturing or other defects were found preventing the samples to work properly, and functional testing was performed by attaching each sample reviewed to a medline syringe.The safety caps remained firmly in place while attaching them to the syringe, no issues with the caps falling off were experienced, fluids were flushed out with no issues, and 30 samples were tested.The complaint was not confirmed, no root cause was identified, and the samples worked as intended.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: NEEDLE,25GX1.5",REG,BEVEL
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: connor klawikowski ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50818702
• Report Number: 1417592-2026-44644
• Device Sequence Number: 10713059
• Product Code: FMI
• UDI-Device Identifier: 40080196305576
• UDI-Public: 40080196305576
• Combination Product (Y/N): N
• Initial Reporter State: IN
• Initial Reporter Country: US
• PMA/510(K) Number: K112057
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/17/2026

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: SYR100257
• Device Lot Number: 211127
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 02/03/2023
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 01/16/2023
• Initial Report FDA Received Date: 09/18/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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