FDA Adverse Event Malfunction Summary report: N

BD LUER-LOK¿ SYRINGE

MDR report key: 12857501 · Received November 22, 2021

Report

Report Number
1213809-2021-00778
Event Type
Malfunction
Date Received
November 22, 2021
Date of Event
October 26, 2021
Report Date
December 20, 2021
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
FMF
UDI-DI
30382903095781
PMA / PMN Number
K980987
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

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

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 FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D10: DEVICE AVAILABLE FOR EVAL YES. D10: RETURNED TO MANUFACTURER ON: 2021-12-08. D4: MEDICAL DEVICE LOT #: 1076679. D4: MEDICAL DEVICE EXPIRATION DATE: 2026-02-28. H4: DEVICE MANUFACTURE DATE: 2021-03-17. D4: MEDICAL DEVICE LOT #: 6062957. D4: MEDICAL DEVICE EXPIRATION DATE: 2021-02-28. H4: DEVICE MANUFACTURE DATE: 2016-03-02. INVESTIGATION SUMMARY: THIRTY-TWO 3ML SYRINGES (P/N 309578) SEALED IN THEIR BLISTER PACKAGES WERE RECEIVED. THE SAMPLES WERE VISUALLY EVALUATED. TWENTY-EIGHT SAMPLES WERE FROM BATCH #0122568, TWO WERE FROM BATCH #1076679, AND TWO WERE FROM BATCH #6062957. THE SAMPLES WERE FOUND TO HAVE NO CRACKS OR VISIBLE DEFECTS PRESENT. BATCH #6062957 WAS EXPIRED AS OF FEBRUARY 2021 AND BD DOES NOT MAKE CLAIMS ABOUT THE PERFORMANCE OR EFFICACY OF EXPIRED PRODUCTS. SINCE THE SAMPLES RECEIVED DID NOT DISPLAY THE REPORTED CONDITION A POTENTIAL ROOT CAUSE COULD NOT BE DEFINED, AND CORRECTIVE ACTIONS ARE NOT NECESSARY. 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. H3 OTHER TEXT : SEE H10.

Description of Event or Problem · 0

IT WAS REPORTED BD LUER-LOK¿ SYRINGE WAS DAMAGED, CAUSING LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE RECENTLY FOUND TROUBLE WITH A SPECIFIC LOT OF SYRINGES... WHERE THE SYRINGES HAVE A CRACK IN THEM. THIS IS DANGEROUS, AS WE FOUND WHEN A CRACK IN A SYRINGE CAUSED SOME MEDICATION TO SPRAY OUT...".

Description of Event or Problem · 0

IT WAS REPORTED BD LUER-LOK¿ SYRINGE WAS DAMAGED, CAUSING LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE RECENTLY FOUND TROUBLE WITH A SPECIFIC LOT OF SYRINGES... WHERE THE SYRINGES HAVE A CRACK IN THEM. THIS IS DANGEROUS, AS WE FOUND WHEN A CRACK IN A SYRINGE CAUSED SOME MEDICATION TO SPRAY OUT...".

Description of Event or Problem · 0

IT WAS REPORTED BD LUER-LOK¿ SYRINGE WAS DAMAGED, CAUSING LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE RECENTLY FOUND TROUBLE WITH A SPECIFIC LOT OF SYRINGES... WHERE THE SYRINGES HAVE A CRACK IN THEM. THIS IS DANGEROUS, AS WE FOUND WHEN A CRACK IN A SYRINGE CAUSED SOME MEDICATION TO SPRAY OUT...".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1754185 BD LUER-LOK¿ SYRINGE PISTON SYRINGE FMF BECTON DICKINSON MEDICAL SYSTEMS 309578 SEE H10 30382903095781

Patients

Seq Age Sex Outcome Treatment
1 Unknown