FDA Adverse Event Malfunction Summary report: N

BD SAFE-CLIP

MDR report key: 12871646 · Received November 24, 2021

Report

Report Number
2243072-2021-02828
Event Type
Malfunction
Date Received
November 24, 2021
Date of Event
October 29, 2021
Report Date
January 24, 2022
Manufacturer
BECTON DICKINSON
Product Code
FMI
UDI-DI
00382903282357
PMA / PMN Number
K943683
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D10: DEVICE AVAILABLE FOR EVAL YES, D10: RETURNED TO MANUFACTURER ON: 2021-12-31 H6: INVESTIGATION SUMMAR CUSTOMER RETURNED A SINGLE SAFECLIP NEEDLE TRIMMER FROM LOT 9192035. THERE WERE NO IMMEDIATELY OBSERVABLE DEFECTS TO THE TRIMMER. WHILE NEEDLE REMNANTS COULD BE HEARD RATTLING IN THE DEVICE, THERE WAS NO INDICATION THAT THE SAFECLIP HAD LOST FUNCTIONALITY. THE NEEDLE PORT DID NOT SHOW SIGNS OF WEAR UNDER MAGNIFICATION. THE SAFECLIP WAS TESTED ON A SPARE PEN NEEDLE AND WAS FOUND TO BE ABLE TO TRIM NEEDLES WITHOUT DIFFICULTY. NO DEFECTS WERE OBSERVED AND THE DEVICE FUNCTIONS AS INTENDED. A LOT HISTORY REVIEW WAS CARRIED OUT AND NO RELATED NON CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS PACKAGED LOT CONCLUDING ALL INSPECTIONS WERE PERFORMED AS PER THE APPLICABLE OPERATIONS AND MET QC SPECIFICATIONS. BASED ON THE SAMPLES RECEIVED, BD WAS UNABLE TO CONFIRM THE CUSTOMER¿S INDICATED FAILURE OF THE NEEDLE TRIMMER NOT TRIMMING NEEDLES. ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME AS THE ISSUE IS UNCONFIRMED. H3 OTHER TEXT : SEE H10.

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 REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED, AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT. A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 9192035. H3 OTHER TEXT : SEE H10.

Additional Manufacturer Narrative · 0

THE MANUFACTURING LOCATION FOR THIS PRODUCT IS FLEXTRONICS. THIS SITE IS AN OEM MANUFACTURING SITE. 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. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. MEDICAL DEVICE EXPIRATION DATE: NA. A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED BD SAFE-CLIP WOULD NOT CLIP THE NEEDLE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CONSUMER REPORTED THAT THE BD SAFE CLIP NEEDLE CLIPPER DOES NOT CLIP THE ENTIRE NEEDLE. SHE STATED THAT A PART OF THE NEEDLE REMAINS ON THE SYRINGE AFTER CLIPPING."

Description of Event or Problem · 0

IT WAS REPORTED BD SAFE-CLIP WOULD NOT CLIP THE NEEDLE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CONSUMER REPORTED THAT THE BD SAFE CLIP NEEDLE CLIPPER DOES NOT CLIP THE ENTIRE NEEDLE. SHE STATED THAT A PART OF THE NEEDLE REMAINS ON THE SYRINGE AFTER CLIPPING."

Description of Event or Problem · 0

IT WAS REPORTED BD SAFE-CLIP WOULD NOT CLIP THE NEEDLE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CONSUMER REPORTED THAT THE BD SAFE CLIP NEEDLE CLIPPER DOES NOT CLIP THE ENTIRE NEEDLE. SHE STATED THAT A PART OF THE NEEDLE REMAINS ON THE SYRINGE AFTER CLIPPING."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1766694 BD SAFE-CLIP HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON 328235 9192035 00382903282357

Patients

Seq Age Sex Outcome Treatment
1 Unknown