0.5ML NEOCONNECT PHARMACY SYRINGE, NON-STERILE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other,user facility report with the FDA on 2019-02-27 for 0.5ML NEOCONNECT PHARMACY SYRINGE, NON-STERILE manufactured by Neomed, Inc.

Event Text Entries

[138253310] Sus voluntary event report number mw5082682 stated this has caused adverse events, however, did not document the detail of any adverse events. To date, neomed has not be able to identify the reporting facility based on the information provided in report number mw5082682. We contacted facilities our "senior engineer" visited in (b)(6) of 2018. All facilities contacted stated they did not file this sus voluntary event report. Neomed does not have any additional information pertaining to report number mw5082682.
Patient Sequence No: 1, Text Type: N, H10


[138253311] Complaint reported via sus voluntary event report number mw5082682, received via (b)(6) from fda on (b)(6) 2019. No initial reporter information provided. Report stated 0. 5ml enfit syringes had been observed with a displacement of fluid syringe contents after placing the neomed syringe tip cap onto the syringe.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006520777-2019-00001
MDR Report Key8374550
Report SourceOTHER,USER FACILITY
Date Received2019-02-27
Date of Report2019-02-25
Report Date2018-12-28
Date Reported to FDA2018-12-28
Date Mfgr Received2019-01-28
Date Added to Maude2019-02-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer ContactMRS. MELINDA SMITH
Manufacturer Street100 LONDONDERRY COURT SUITE 112
Manufacturer CityWOODSTOCK 30188
Manufacturer CountryUS
Manufacturer Postal30188
Manufacturer Phone7704855188
Manufacturer G1SYNECCO, CO., LTD.
Manufacturer StreetB801 RONGAN PLAZA, NO. 700 SOUTH TIANTONG ROAD
Manufacturer CityYINZHOU DISTRICT, NINGBO 315100
Manufacturer CountryCH
Manufacturer Postal Code315100
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name0.5ML NEOCONNECT PHARMACY SYRINGE, NON-STERILE
Generic NameENTERAL SYRINGES WITH ENTERAL SPECIFIC CONNECTORS
Product CodePNR
Date Received2019-02-27
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerNEOMED, INC
Manufacturer Address100 LONDONDERRY COURT SUITE 112 WOODSTOCK, GA GA 30188 US 30188


Patients

Patient NumberTreatmentOutcomeDate
10 2019-02-27

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