| Brand Name | SYRINGE 0.5ML 31GA 8MM UFII 10BAG 500CS |
| Common Device Name | Needle, Hypodermic, Single Lumen |
| Manufacturer (Section D) |
| EMBECTA MEDICAL I LLC - HOLDREGE, NE |
| |
|
| Manufacturer Contact |
|
avital
merl
|
| 300 kimball dr. |
| parsippany, NJ 07054
|
|
| MDR Report Key | 50896848 |
| Report Number | 3024508819-2026-00140 |
| Device Sequence Number | 10761902 |
| Product Code |
FMI
|
| UDI-Device Identifier | 00382908468039 |
| UDI-Public | 00382908468039 |
| Combination Product (Y/N) | N |
| Initial Reporter State | TN |
| Initial Reporter Country | US |
| PMA/510(K) Number | K190054 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Type of Report
| Initial |
| Report Date (Section B) |
09/25/2026 |
| 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 Number | 328468 |
| Device Lot Number | 4065022 |
| Was Device Available for Evaluation? |
Yes
|
| 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 | 03/21/2025 |
| Initial Report FDA Received Date | 09/25/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|