FDA Adverse Event Malfunction Summary report: N

BD INSULIN SYRINGE, 3/10ML 31G X 8MM

MDR report key: 11140998 · Received January 8, 2021

Report

Report Number
1920898-2021-00013
Event Type
Malfunction
Date Received
January 8, 2021
Date of Event
December 8, 2020
Report Date
July 15, 2021
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
UDI-DI
00311917048154
PMA / PMN Number
K024112
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. A DEVICE HISTORY REVIEW COULD NOT BE COMPLETED AS NO BATCH NUMBER WAS PROVIDED. H3 OTHER TEXT : SEE H10.

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: 7/13/2021. H.6. INVESTIGATION: CUSTOMER RETURNED (35) LOOSE 3/10CC, 8MM SYRINGES. CUSTOMER STATES THAT THE PLUNGER DID NOT WORK, THAT THE NEEDLES BROKE AND THAT THE NEEDLES WERE BENDING WHEN INSERTED INTO THE VIAL. ALL RETURNED SYRINGES WERE TESTED AND ALL WERE ABLE TO DRAW AND EXPEL PROPERLY WITHOUT ANY DEFECTS OBSERVED WITH THE PLUNGER RODS. ALL RETURNED SYRINGES WERE EXAMINED AND NO BROKEN CANNULA WAS OBSERVED. THIRTY OUT OF 35 RETURNED SYRINGES WERE TESTED FOR POINT GEOMETRY, LUBE, AND CANNULA OD. ALL OBSERVATIONS FELL WITHIN SPECIFICATIONS. UNABLE TO PERFORM DHR CHECK DUE TO UNKNOWN LOT NUMBER. ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME AS THE ISSUE IS UNCONFIRMED.

Description of Event or Problem · 0

IT WAS REPORTED THAT WHILE USING BD INSULIN SYRINGE, 3/10ML 31G X 8MM THE PLUNGER WAS DIFFICULT TO MOVE AND CANNULA BROKE OFF. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: HI WE HAVE A PATIENT THAT USES OUR INSULIN SYRINGES WIC 654882 NDC 11917-0048-15. THEY HAVE HAD ABOUT 2-5 IN EACH OF THE LAST COUPLE OF BOXES THAT HAVE BEEN DEFECTIVE. THE PLUNGER DID NOT WORK, THE NEEDLES BROKE WERE THE COMMON COMPLAINTS. THEY ARE GOING TO BRING A COUPLE IN IF YOU WOULD LIKE TO INVESTIGATE THEM. HOWEVER, THIS DOES NOT SEEM TO REFLECT HIGH QUALITY AS ADVERTISED.

Description of Event or Problem · 0

IT WAS REPORTED THAT WHILE USING BD INSULIN SYRINGE, 3/10ML 31G X 8MM THE PLUNGER WAS DIFFICULT TO MOVE AND CANNULA BROKE OFF. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: HI, WE HAVE A PATIENT THAT USES OUR INSULIN SYRINGES WIC 654882 NDC 11917-0048-15. THEY HAVE HAD ABOUT 2-5 IN EACH OF THE LAST COUPLE OF BOXES THAT HAVE BEEN DEFECTIVE. THE PLUNGER DID NOT WORK, THE NEEDLES BROKE WERE THE COMMON COMPLAINTS. THEY ARE GOING TO BRING A COUPLE IN IF YOU WOULD LIKE TO INVESTIGATE THEM. HOWEVER, THIS DOES NOT SEEM TO REFLECT HIGH QUALITY AS ADVERTISED.

Additional Manufacturer Narrative · 1

MEDICAL DEVICE EXPIRATION DATE: UNKNOWN A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE USING BD INSULIN SYRINGE, 3/10ML 31G X 8MM THE PLUNGER WAS DIFFICULT TO MOVE AND CANNULA BROKE OFF. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: HI WE HAVE A PATIENT THAT USES OUR INSULIN SYRINGES WIC 654882 NDC 11917-0048-15. THEY HAVE HAD ABOUT 2-5 IN EACH OF THE LAST COUPLE OF BOXES THAT HAVE BEEN DEFECTIVE. THE PLUNGER DID NOT WORK, THE NEEDLES BROKE WERE THE COMMON COMPLAINTS. THEY ARE GOING TO BRING A COUPLE IN IF YOU WOULD LIKE TO INVESTIGATE THEM. HOWEVER, THIS DOES NOT SEEM TO REFLECT HIGH QUALITY AS ADVERTISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
34886 BD INSULIN SYRINGE, 3/10ML 31G X 8MM PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 928858 UNKNOWN 00311917048154

Patients

Seq Age Sex Outcome Treatment
1