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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MHC MEDICAL PRODCUTS, LLC. EASY TOUCH; INSULIN SYRINGE

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MHC MEDICAL PRODCUTS, LLC. EASY TOUCH; INSULIN SYRINGE Back to Search Results
Catalog Number 827555
Device Problem Detachment Of Device Component (1104)
Patient Problem No Code Available (3191)
Event Date 03/09/2018
Event Type  malfunction  
Event Description
Had problems with the syringes.In the last week customer had experienced (4) faulty syringes; as she was injecting the syringe, the tip detached from the unit, leaving the point/metal part in her skin.This has caused the over use of medicine.Customer wanted to know how to she can save the medicine or what she can do.
 
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Brand Name
EASY TOUCH
Type of Device
INSULIN SYRINGE
Manufacturer (Section D)
MHC MEDICAL PRODCUTS, LLC.
11930 kemper springs drive
cincinnati OH 45240
Manufacturer (Section G)
MHC MEDICAL PRODCUTS, LLC.
11930 kemper springs drive
cincinnati OH 45240
Manufacturer Contact
jennifer seiple
11930 kemper springs drive
cincinnati, OH 45240
MDR Report Key7636570
MDR Text Key112286119
Report Number3005798905-2018-00977
Device Sequence Number1
Product Code FMF
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K102178
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer
Reporter Occupation Other
Remedial Action Replace
Type of Report Initial
Report Date 06/25/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/25/2018
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Catalogue Number827555
Device Lot Number44191
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received03/09/2018
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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