BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    UNSPECIFIED BD SYRINGE

    MDR report key: 11286685 · Received February 5, 2021

    Report

    Report Number
    2243072-2021-00234
    Event Type
    Malfunction
    Date Received
    February 5, 2021
    Date of Event
    January 14, 2021
    Report Date
    February 8, 2021
    Manufacturer
    BECTON DICKINSON
    Product Code
    FMF
    PMA / PMN Number
    UNKNOWN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    CORRECTION: D.3. MEDICAL DEVICE MANUFACTURER: FRANKLIN LAKES, NJ. G.2. MANUFACTURING LOCATION: FRANKLIN LAKES, NJ.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT 5 UNSPECIFIED BD¿ SYRINGES HAD BROKEN PLUNGER RODS, 1 SYRINGE LEAKED DURING USE, AND 1 SYRINGE CAUSED AN OCCLUSION ALARM WHILE CONNECTED TO A PUMP. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "IT WAS REPORTED VIA SURVEY RESPONSE THAT THE CLINICIAN ENCOUNTERED LEAKAGE, PLUNGER ROD BROKEN/DAMAGED AND SYRINGE MALFUNCTIONED/CAUSED OCCLUSION ALARM WHILE ON A PUMP RELATED TO LUER LOK AND LUER SLIP TIP SYRINGES."

    Additional Manufacturer Narrative · 1

    UNKNOWN MANUFACTURER: THERE ARE MULTIPLE BD LOCATIONS WHERE THIS UNSPECIFIED BD DEVICE MAY HAVE BEEN MANUFACTURED. A CATALOG AND LOT NUMBER COULD NOT BE CONFIRMED FOR THIS INCIDENT AND WITHOUT THIS INFORMATION WE ARE UNABLE TO DETERMINE WHERE THE DEVICE WAS MANUFACTURED. THEREFORE, BD CORPORATE HEADQUARTERS IN (B)(4) HAS BEEN LISTED AND THE (B)(4) FDA REGISTRATION NUMBER HAS BEEN USED FOR THE MANUFACTURE REPORT NUMBER. DATE OF EVENT: UNKNOWN. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE MANUFACTURE DATE: UNKNOWN. (B)(4). INVESTIGATION SUMMARY: BD WAS UNABLE TO PERFORM A THOROUGH INVESTIGATION AS NO SAMPLE, LOT, OR BATCH NUMBER WERE PROVIDED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED MONTHLY. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT 5 UNSPECIFIED BD¿ SYRINGES HAD BROKEN PLUNGER RODS, 1 SYRINGE LEAKED DURING USE, AND 1 SYRINGE CAUSED AN OCCLUSION ALARM WHILE CONNECTED TO A PUMP. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "IT WAS REPORTED VIA SURVEY RESPONSE THAT THE CLINICIAN ENCOUNTERED LEAKAGE, PLUNGER ROD BROKEN/DAMAGED AND SYRINGE MALFUNCTIONED/CAUSED OCCLUSION ALARM WHILE ON A PUMP RELATED TO LUER LOK AND LUER SLIP TIP SYRINGES."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    186708 UNSPECIFIED BD SYRINGE PISTON SYRINGE FMF BECTON DICKINSON UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1