NERVE BLOCK TRAY
Received Feb 23, 2024 · Event occurred Feb 2, 2024
Report 1417592-2024-00103 · MDR key 18768013
Device
Generic name
Nerve Block Tray
Manufacturer
Medline Industries, LpCatalog number
DYNJRA0898A
Lot number
23IB0899, 23JBU344
Product problems
- Break
- Break
Patient
NA · Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
UPDATE D4: LOT NUMBER. UPDATE D9: RETURNED TO MANUFACTURER, DATE RETURNED TO MANUFACTURER. UPDATE H3: DEVICE EVALUATED BY MANUFACTURER. UPDATE H6: TYPE OF INVESTIGATION, INVESTIGATION CONCLUSIONS.
Description of Event or Problem
ACCORDING TO THE CUSTOMER, ON (B)(6) 2024 WHILE ADVANCING THE PLUNGER TO ADMINISTER MEDICATION FOR A "TRANSFORAMINAL EPIDURAL STEROID INJECTION" USING THE SYRINGE AND A "22G SPINAL NEEDLE PLACED IN THE LUMBAR SPINE OR SACROILIAC AREA", THE PLUNGER "BENT SIDEWAYS AND SNAPPED".
Additional Manufacturer Narrative
ACCORDING TO THE CUSTOMER, ON (B)(6) 2024 WHILE ADVANCING THE PLUNGER TO ADMINISTER MEDICATION FOR A "TRANSFORAMINAL EPIDURAL STEROID INJECTION" USING THE SYRINGE AND A "22G SPINAL NEEDLE PLACED IN THE LUMBAR SPINE OR SACROILIAC AREA", THE PLUNGER "BENT SIDEWAYS AND SNAPPED". ACCORDING TO THE CUSTOMER, AFTER THE REPORTED INCIDENT, THE PHYSICIAN USED ANOTHER SYRINGE IN ORDER TO COMPLETE THE PROCEDURE. THE CUSTOMER REPORTED "NO TREATMENT REQUIRED" RELATED TO THE REPORTED INCIDENT. THE CUSTOMER REPORTED NO SERIOUS INJURY, MEDICAL INTERVENTION/ATTENTION, OR FOLLOW-UP CARE NEEDED RELATED TO THE REPORTED INCIDENT. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. IT HAS BEEN DETERMINED THAT THE REPORTED EVENT COULD CAUSE OR CONTRIBUTE TO SERIOUS INJURY IF IT WERE TO OCCUR AGAIN. 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.