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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EMBECTA MEDICAL I LLC - HOLDREGE, NE SYRINGE 0.5ML 31GA 8MM 10 BAG 500 WAL; Syringe, Piston

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EMBECTA MEDICAL I LLC - HOLDREGE, NE SYRINGE 0.5ML 31GA 8MM 10 BAG 500 WAL; Syringe, Piston Back to Search Results
Model Number 328509
Medical Device Problem Code Device Markings/Labelling Problem (2911)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
Pharmacist reported issue on consumers behalf.Stated, there were 15 syringes without scale markings prior to injection.Stated, consumer discarded samples stated, pharmacy replaced box.Lot: 3352058 catalog: 328509 date of event: unknown samples: no cl this intake record was reviewed as part of capas #(b)(4) and #(b)(4) and deficiencies were identified.The following actions were taken fourteen additional complaint records were created for scale marking missing.With these actions completed, this intake record is now consistent with applicable procedures cp62096, cp92021, and regulatory requirements, and separate complaints were opened for each separate event.There was appropriate follow-up (if this was required), and each event is addressed based on the most current information.No further action is required at this time unless new information becomes available.(b)(6) 14-september-2026.
 
Additional Manufacturer Narrative
No samples (including photos) were returned therefore the complaint could not be confirmed and the root cause is undetermined.This is the 21st.Complaint for the reported lot number.A review of the manufacturing records was performed, and no non-conformances were raised in association with this type of event for this lot.Complaints received for this device and reported condition will continue to be tracked and trended.If samples are received in the future the complaint will be reopened for further investigation.Based on the above, no additional investigation and no corrective/preventative action (capa) or situational analysis (sa) is required at this time.This complaint record was reopened/opened and reviewed as part of capas #(b)(4) and #(b)(4).The review revealed that this complaint was determined to be a reportable event.The required activities for reporting this event were completed.The review confirmed that the complaint record is consistent with applicable procedures cp62096, cp92021, and regulatory requirements, and separate complaints were opened for each separate event.There was appropriate follow-up (if this was required), and each event is addressed based on the most current information.There are no additional events or updates that meet the fda mdr reporting requirements.No further action is required at this time unless new information becomes available.(b)(6) 25sep 2026.
 
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Brand Name
SYRINGE 0.5ML 31GA 8MM 10 BAG 500 WAL
Common Device Name
Syringe, Piston
Manufacturer (Section D)
EMBECTA MEDICAL I LLC - HOLDREGE, NE
Manufacturer Contact
avital merl
300 kimball dr.
parsippany, NJ 07054
MDR Report Key50916131
Report Number3024508819-2026-00254
Device Sequence Number14897612
Product Code FMF
UDI-Device Identifier00681131311762
UDI-Public00681131311762
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K190054
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Type of Report Initial
Report Date (Section B) 09/28/2026
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 Number328509
Device Lot Number3352058
Was Device Available for Evaluation? No
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 07/31/2024
Initial Report FDA Received Date09/28/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured12/18/2023
Is the Device Labeled for Single Use? (Y/N) Yes
Patient Sequence Number1
Patient SexUnknown
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