FDA Adverse Event Malfunction Summary report: N

BD SYRINGE 5ML LS EMERALD

MDR report key: 10898355 · Received November 24, 2020

Report

Report Number
3002682307-2020-00362
Event Type
Malfunction
Date Received
November 24, 2020
Date of Event
October 29, 2020
Report Date
March 29, 2021
Manufacturer
BECTON DICKINSON, S.A.
Product Code
FMF
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY A DEVICE HISTORY RECORD REVIEW WAS PERFORMED FOR PROVIDED LOT NUMBER 2002140 AND THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION PROCESS THAT COULD HAVE CONTRIBUTED TO THIS REPORTED INCIDENT. AS SAMPLES WERE NOT RETURNED FOR THIS ISSUE, OUR QUALITY TEAM OBTAINED TWENTY RETAINED SAMPLES OF THE SAME LOT NUMBER FROM THE MANUFACTURING FACILITY FOR FURTHER EVALUATION. THE RETAINED SAMPLES WERE INSPECTED AND NO SIGNS OF BROWN/BLACK TAPE OR ANY TYPE OF FOREIGN MATTER WERE IDENTIFIED. BASED ON THE PROVIDED CUSTOMER FEEDBACK, IT IS POSSIBLE THAT A PIECE OF TAPE WAS INTRODUCED DURING THE PACKAGING PROCESS; HOWEVER, BASED ON THE INVESTIGATION FINDINGS, THIS EXACT CAUSE COULD NOT BE CONFIRMED.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D.10. DEVICE AVAILABLE FOR EVAL?: YES. D.10. RETURNED TO MANUFACTURER ON: 2/2/2021. H.6. INVESTIGATION: A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED LOT NUMBER 2002140. THE REVIEW DID NOT REVEAL ANY DETECTED ABNORMALITIES DURING THE PRODUCTION PROCESS THAT COULD HAVE CONTRIBUTED TO THIS DEFECT AND ALL QUALITY TESTS WERE FOUND TO BE WITHIN SPECIFICATION. TO AID IN THE INVESTIGATION OF THIS ISSUE, THE AFFECTED SAMPLE WAS RETURNED FOR EVALUATION BY OUR QUALITY ENGINEER TEAM. THROUGH EXAMINATION OF THE SAMPLE, FOREIGN MATTER WAS OBSERVED WITHIN THE BLISTER PACKAGING. THE FOREIGN MATERIAL WAS IDENTIFIED AS A PIECE OF PRODUCT PACKAGING. THE PRIMARY PACKAGING FOR THE EMERALD SYRINGES CONSISTS OF BOTH FILM AND PAPER WHICH ARE SEALED TOGETHER THROUGH USE OF PRESSURE AND TEMPERATURE. METAL CLIPS ARE USED TO MOVE THE BLISTER PACKAGING STRIPS THROUGH THE MANUFACTURING PROCESS, BY GRASPING THE OUTER PACKAGING. IT HAS BEEN DETERMINED THAT A PIECE OF THE PACKAGING REMAINED STUCK WITHIN THE METAL CLIP AND WENT UNDETECTED BY THE MACHINE OPERATOR. THIS PIECE OF PACKAGING MATERIAL WAS THEN RE-CIRCULATED WITHIN THE PACKAGING PROCESS AND ENDED UP WITHIN THE AFFECTED BLISTER PACKAGE. WE HAVE EVALUATED 20 RETAINED SAMPLES OF THE REPORTED LOT AND NO DEFECT WAS OBSERVED. NO BROWN/BLACK TAPE OR ANY KIND OF FOREIGN MATTER WAS FOUND. H3 OTHER TEXT : SEE H.10.

Description of Event or Problem · 0

IT WAS REPORTED THAT FOREIGN MATTER WAS DISCOVERED WITH A BD SYRINGE 5ML LS EMERALD. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: ALTHOUGH THE STERILE PACKAGING OF THE SYRINGE WAS SEALED, IT CONTAINED SOME DIRTY BROWN/BLACK TAPE.

Description of Event or Problem · 0

IT WAS REPORTED THAT FOREIGN MATTER WAS DISCOVERED WITH A BD SYRINGE 5ML LS EMERALD. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: ALTHOUGH THE STERILE PACKAGING OF THE SYRINGE WAS SEALED, IT CONTAINED SOME DIRTY BROWN/BLACK TAPE.

Additional Manufacturer Narrative · 1

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT FOREIGN MATTER WAS DISCOVERED WITH A BD SYRINGE 5ML LS EMERALD. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: ALTHOUGH THE STERILE PACKAGING OF THE SYRINGE WAS SEALED, IT CONTAINED SOME DIRTY BROWN/BLACK TAPE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1362491 BD SYRINGE 5ML LS EMERALD PISTON SYRINGE FMF BECTON DICKINSON, S.A. 2002140

Patients

Seq Age Sex Outcome Treatment
1