FDA Adverse Event Malfunction Summary report: N

BD LUER-LOK¿ TIP SYRINGE

MDR report key: 12964056 · Received December 8, 2021

Report

Report Number
1911916-2021-01236
Event Type
Malfunction
Date Received
December 8, 2021
Date of Event
November 10, 2021
Report Date
November 30, 2021
Manufacturer
BD MEDICAL (BD WEST) MEDICAL SURGICAL
Product Code
FMF
UDI-DI
30382903096535
PMA / PMN Number
K110771
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. INVESTIGATION SUMMARY: IT WAS REPORTED THE SCALE MARKINGS ARE TWISTED. TO AID IN THE INVESTIGATION, ONE SAMPLE IN A PLASTIC BAG AND ONE PHOTO WERE RECEIVED FOR EVALUATION BY OUR QUALITY TEAM. A VISUAL INSPECTION WAS PERFORMED AND THE SCALE MARKING IS SKEWED. NO OTHER DEFECTS OR IMPERFECTIONS WERE OBSERVED. THE PHOTO PROVIDED SHOWS A SYRINGE WITH THE SCALE MARKING SKEWED. THIS DEFECT COULD OCCUR IF THERE WAS A JAM DURING THE BARREL PRINTING PROCESS INDUCING THE SYMPTOM REPORTED BY THE CUSTOMER. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED MATERIAL NUMBER 302832, LOT NUMBER 1180064. THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION OF THIS LOT THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. VERIFICATION OF THE PRINTING PROCESS WAS PERFORMED. THE SETTINGS WERE CORRECT AND THE FLOW OF PRODUCTS WAS GOOD. TO DATE, THERE HAVE BEEN NO OTHER SIMILAR EVENTS REPORTED FOR THIS LOT. BASED ON THE INVESTIGATION AND WITH THE RETURNED SAMPLE ANALYSIS THE SYMPTOM REPORTED BY THE CUSTOMER IS CONFIRMED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR QUALITY TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. INVESTIGATION SUMMARY: IT WAS REPORTED THE SCALE MARKINGS ARE TWISTED. TO AID IN THE INVESTIGATION, ONE SAMPLE IN A PLASTIC BAG AND ONE PHOTO WERE RECEIVED FOR EVALUATION BY OUR QUALITY TEAM. A VISUAL INSPECTION WAS PERFORMED AND THE SCALE MARKING IS SKEWED. NO OTHER DEFECTS OR IMPERFECTIONS WERE OBSERVED. THE PHOTO PROVIDED SHOWS A SYRINGE WITH THE SCALE MARKING SKEWED. THIS DEFECT COULD OCCUR IF THERE WAS A JAM DURING THE BARREL PRINTING PROCESS INDUCING THE SYMPTOM REPORTED BY THE CUSTOMER. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED MATERIAL NUMBER 302832, LOT NUMBER 1180064. THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION OF THIS LOT THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. VERIFICATION OF THE PRINTING PROCESS WAS PERFORMED. THE SETTINGS WERE CORRECT AND THE FLOW OF PRODUCTS WAS GOOD. TO DATE, THERE HAVE BEEN NO OTHER SIMILAR EVENTS REPORTED FOR THIS LOT. BASED ON THE INVESTIGATION AND WITH THE RETURNED SAMPLE ANALYSIS THE SYMPTOM REPORTED BY THE CUSTOMER IS CONFIRMED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR QUALITY TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD LUER-LOK¿ TIP SYRINGE HAD MISALIGNED SCALE MARKINGS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "THERE IS ANOTHER LOT NUMBER WITH AN ISSUE: 1180064 ¿ MARKINGS ARE TWISTED AROUND THE BARREL OF THE SYRINGE."

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD LUER-LOK¿ TIP SYRINGE HAD MISALIGNED SCALE MARKINGS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "HERE IS ANOTHER LOT NUMBER WITH AN ISSUE: 1180064 ¿ MARKINGS ARE TWISTED AROUND THE BARREL OF THE SYRINGE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1856797 BD LUER-LOK¿ TIP SYRINGE PISTON SYRINGE FMF BD MEDICAL (BD WEST) MEDICAL SURGICAL 309653 1180064 30382903096535

Patients

Seq Age Sex Outcome Treatment
1 Unknown