inforMED
MalfunctionHWQ

AR-13995N MULTIFIRE SCORPION NDL BLACK

Received Apr 26, 2021 · Event occurred Mar 19, 2021

Report 3032391-2021-00007 · MDR key 11723455

Device

Generic name

Ar-13995n Multifire Scorpion Ndl Black

Manufacturer

Medline Renewal

Catalog number

AR13995NR

Lot number

439696

Product problems

  • Break
  • Entrapment of Device

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

ONE DEVICE WAS RECEIVED FROM THE END-USER FACILITY FOR EVALUATION. UPON INSPECTION, IT WAS OBSERVED THAT THE TIP OF THE DEVICE HAD BROKEN OFF. THE BROKEN TIP WAS NOT RETURNED WITH THE DEVICE. THE REPORTED ISSUE WAS CONFIRMED. THE EXACT ROOT CAUSE OF THE DEVICE FAILURE COULD NOT BE DETERMINED. NO ADDITIONAL INFORMATION IS AVAILABLE. DUE TO THE REPORTED INCIDENT AND IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED OR OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

Additional Manufacturer Narrative

IT WAS REPORTED THAT THE SCORPION NEEDLE BROKE INSIDE THE PATIENT DURING PATIENT USE. NO ADDITIONAL DETAILS ARE AVAILABLE RELATED TO THE CUSTOMER REPORTED ISSUE. NO SERIOUS INJURY OR FOLLOW UP MEDICAL CARE WAS REPORTED RELATED TO THE CUSTOMER REPORTED ISSUE. THE PATIENT WAS UNDER GENERAL ANESTHESIA AT THE TIME OF THE INCIDENT, HOWEVER NO ADDITIONAL MEDICATION WAS REQUIRED. THERE WAS NO REPORT OF ANY ADVERSE PATIENT CONSEQUENCE, NO EFFECT ON THE PATIENT'S STABILITY, AND NO MEDICAL INTERVENTION REQUIRED AS A RESULT OF THE INCIDENT. DESPITE MULTIPLE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE CUSTOMER CONTACT WAS UNABLE OR UNWILLING TO PROVIDE FURTHER INCIDENT DETAILS TO THE MANUFACTURER. NO SAMPLE WAS RETURNED FOR EVALUATION. DUE TO THE REPORTED INCIDENT AND IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ADDITIONAL RELEVANT INFORMATION BECOMES AVAILABLE A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Description of Event or Problem

IT WAS REPORTED THAT THE SCORPION NEEDLE BROKE INSIDE THE PATIENT DURING USE.