FDA Adverse Event Malfunction Summary report: N

PLATE MUELLER HINTON II AGAR 150MM 24 EA

MDR report key: 12140151 · Received July 8, 2021

Report

Report Number
2243072-2021-01833
Event Type
Malfunction
Date Received
July 8, 2021
Date of Event
May 31, 2021
Report Date
July 1, 2021
Manufacturer
BECTON DICKINSON
Product Code
JTZ
PMA / PMN Number
PREAMENDMENT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THERE IS NO 510(K) FOR THIS DEVICE AS IT IS MANUFACTURED OUTSIDE THE US AND NOT SOLD IN THE US BUT IS CONSIDERED TO BE SUBSTANTIALLY SIMILAR TO THE LEGALLY U.S. MARKETED DEVICE BD BBL¿ MUELLER HINTON II AGAR CATALOG NUMBER 221177 WHICH IS A PREAMENDMENT DEVICE. INVESTIGATION SUMMARY: THE COMPLAINT WAS CONFIRMED AS THE REPORTED DEFECT ON A PICTURE. THE ISSUE WAS CONTAMINATION. NO ISSUE IN DHR. NO ISSUE IN RETENTION SAMPLE. NO TREND. WE WILL CONTINUE TO MONITOR THE TREND THIS ISSUE.

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE USING PLATE MUELLER HINTON II AGAR 150MM 24 EA BACTERIAL CONTAMINATION WAS OBSERVED BY THE LABORATORY PERSONNEL. THERE WAS NO INDICATION THAT RESULTS WERE REPORTED OUT AND THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "THIS IS A REPORT ABOUT CONTAMINATION OF THE MEDIA."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1032659 PLATE MUELLER HINTON II AGAR 150MM 24 EA CULTURE MEDIA, ANTIMICROBIAL SUSCEPTIBILITY TEST, MUELLER HINTON AGAR/BROTH JTZ BECTON DICKINSON 1055594

Patients

Seq Age Sex Outcome Treatment
1