What's Wrong Here?

This image is a train-wreck of errors. The most glaring is the way the index finger is positioned above the needle, holding the gauze in place.

That's asking for a needlestick. The flow of blood in this image is already in process, so even if the index finger was used to stretch the skin above and below the intended puncture site as the needle was inserted (which it should never be, but that's another discussion), keeping the finger above the needle puts it in harm's way.

Also not the arm is bent. A slight bend is sometimes necessary to locate the vein, but the bend depicted here is far too extreme, making it impossible to effectively anchor the vein and stretch the skin. Also an issue is the manner in which the tube holder is being held. Since no needle should be inserted with movement, an unintended relocation that may be injurious, or at least render the draw unsuccessful.

Finally, the device is missing a safety feature and the collector's arms are not protected with sleeves. Other than all that, there's nothing wrong here.