FDA Adverse Event Malfunction Summary report: N

BD SYRINGE 20ML LL SYRINGE ONLY MX BUN

MDR report key: 12805817 · Received November 12, 2021

Report

Report Number
9614033-2021-00134
Event Type
Malfunction
Date Received
November 12, 2021
Date of Event
October 4, 2021
Report Date
July 13, 2022
Manufacturer
BECTON DICKINSON DE MEXICO
Product Code
FMF
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION: PHOTO RECEIVED FOR INVESTIGATION, UPON VISUAL INSPECTION A 20 ML SYRINGE IS SHOWN, THE REPORTED BATCH 1071414 IS CONFIRMED IN THE BLISTER. IT IS NOT POSSIBLE TO APPRECIATE THE PIVOT IN DETAIL, SO IT IS NOT POSSIBLE TO DETERMINE IF THERE IS DAMAGE TO THE LUER LOCK CONNECTION. A DEVICE HISTORY RECORD REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. BASED ON THE AVAILABLE INFORMATION WE ARE NOT ABLE TO IDENTIFY A ROOT CAUSE FOR SYRINGE RELATED TO THE MANUFACTURING PROCESS AT THIS TIME.

Additional Manufacturer Narrative · 0

A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

THE INVESTIGATION WAS UPDATED DUE TO ADDITIONAL INFORMATION: H6: INVESTIGATION SUMMARY PHOTO RECEIVED FOR INVESTIGATION, UPON VISUAL INSPECTION A 20 ML SYRINGE IS SHOWN, THE REPORTED BATCH 1071414 IS CONFIRMED IN THE IMAGE. ADDITIONALLY, SAMPLE RECEIVED FOR INVESTIGATION. UPON VISUAL INSPECTION, LUER TIP APPEARS DEFORMED AND DAMAGED. A DEVICE HISTORY RECORD REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. POSSIBLE ROOT CAUSE IS ASSOCIATED WITH THE MOLDING PROCESS. THE LUER GETS STUCK IN THE NOZZLES GENERATING DAMAGE. ACTION WAS TAKEN TO REVIEW OF THE CORRECT OPERATION OF THE SENSOR IN THE MARKING MACHINE, REVIEW LUER FOR THIS MOLD TO ENSURE THERE IS NO DAMAGE, INCLUDE REVISION IN THE ANNUAL PREVENTIVE MAINTENANCE PROGRAM, REVIEW OF LUER TIP IN THE 20ML LINES, AND MANUFACTURING PERSONNEL HAVE BEEN NOTIFIED OF THIS INCIDENT TO INCREASE AWARENESS. H3 OTHER TEXT : SEE H10.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D9: DEVICE AVAILABLE FOR EVAL?: YES. D9: RETURNED TO MANUFACTURER ON: 1/27/2022.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD SYRINGE 20ML LL SYRINGE ONLY MX BUN, THE DEVICE EXPERIENCED THE TIP OF THE LUER OR THE SYRINGE CRACKED / DAMAGED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE REPORT OF VARIOUS SITUATIONS OF QUALITY AND SAFETY OF BD BRAND PLASTIC SYRINGES OF VARIOUS VOLUMES IS CARRIED OUT. THE SITUATIONS ARE MANUFACTURING DEFECTS AND THE PRESENCE OF EXTRANEOUS ELEMENTS. FOR THE 20ML SYRINGE IT IS REPORTED: "BD BRAND 20ML SYRINGE WITH DEFAULT, DEFORMATION IN THE LUER-LOCK SYSTEM. LOT 1071414."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD SYRINGE 20ML LL SYRINGE ONLY MX BUN, THE DEVICE EXPERIENCED THE TIP OF THE LUER OR THE SYRINGE CRACKED / DAMAGED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE REPORT OF VARIOUS SITUATIONS OF QUALITY AND SAFETY OF BD BRAND PLASTIC SYRINGES OF VARIOUS VOLUMES IS CARRIED OUT. THE SITUATIONS ARE MANUFACTURING DEFECTS AND THE PRESENCE OF EXTRANEOUS ELEMENTS. FOR THE 20ML SYRINGE IT IS REPORTED: "BD BRAND 20ML SYRINGE WITH DEFAULT, DEFORMATION IN THE LUER-LOCK SYSTEM. LOT 1071414."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD SYRINGE 20ML LL SYRINGE ONLY MX BUN, THE DEVICE EXPERIENCED THE TIP OF THE LUER OR THE SYRINGE CRACKED / DAMAGED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE REPORT OF VARIOUS SITUATIONS OF QUALITY AND SAFETY OF BD BRAND PLASTIC SYRINGES OF VARIOUS VOLUMES IS CARRIED OUT. THE SITUATIONS ARE MANUFACTURING DEFECTS AND THE PRESENCE OF EXTRANEOUS ELEMENTS. FOR THE 20ML SYRINGE IT IS REPORTED: "BD BRAND 20ML SYRINGE WITH DEFAULT, DEFORMATION IN THE LUER-LOCK SYSTEM. LOT 1071414."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD SYRINGE 20ML LL SYRINGE ONLY MX BUN, THE DEVICE EXPERIENCED THE TIP OF THE LUER OR THE SYRINGE CRACKED / DAMAGED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE REPORT OF VARIOUS SITUATIONS OF QUALITY AND SAFETY OF BD BRAND PLASTIC SYRINGES OF VARIOUS VOLUMES IS CARRIED OUT. THE SITUATIONS ARE MANUFACTURING DEFECTS AND THE PRESENCE OF EXTRANEOUS ELEMENTS. FOR THE 20ML SYRINGE IT IS REPORTED: "BD BRAND 20ML SYRINGE WITH DEFAULT, DEFORMATION IN THE LUER-LOCK SYSTEM. LOT 1071414."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1702310 BD SYRINGE 20ML LL SYRINGE ONLY MX BUN PISTON SYRINGE FMF BECTON DICKINSON DE MEXICO 1071414

Patients

Seq Age Sex Outcome Treatment
1 Unknown