| Date Initiated by Firm | September 22, 2017 |
| Create Date | April 24, 2019 |
| Recall Status1 |
Open3, Classified |
| Recall Number | Z-1217-2019 |
| Recall Event ID |
80547 |
| 510(K)Number | K123987 |
| Product Classification |
Needle, hypodermic, single lumen - Product Code FMI
|
| Product | Prevent G Safety Winged Blood Collection Set Glide - Rx Only -Sterile/EO - Product Usage: The IMPROSAFE Blood Collection Set is single-use, sterile, winged needle bonded to a flexible tubing with luer adapter. The needle consists of (1) a winged needle, (2) a flexible tubing, (3) a luer adaptor. (4) a safety shield, The products and evacuated blood collection tube/ syringe are used together for the collection of venous blood. |
| Code Information |
Serial # 102030178 / Lot # 160815 |
| FEI Number |
3008449424
|
Recalling Firm/ Manufacturer |
Guangzhou Improve Medical Instruments Co., Ltd. NO. 102 Kaiyuan Avenue Science City Guangzhou China
|
Manufacturer Reason for Recall | Complain due to the hub needle came out when the nurse draw the blood and removed the tube. |
FDA Determined Cause 2 | Nonconforming Material/Component |
| Action | Several e-mails dated May 2017 thru June 2017between the manufacturer and the sole distributor for this lot are documented. |
| Quantity in Commerce | 550,000 |
| Distribution | US Nationwide distribution in the state of Kansas. |
| Total Product Life Cycle | TPLC Device Report |
|
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls. 2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall. 3 The manufacturer has initiated the recall and not all products have been corrected or removed. This record will be updated as the status changes.
|
| 510(K) Database | 510(K)s with Product Code = FMI
|