FDA Adverse Event Malfunction Summary report: N

BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE

MDR report key: 13013970 · Received December 15, 2021

Report

Report Number
1920898-2021-01311
Event Type
Malfunction
Date Received
December 15, 2021
Date of Event
November 18, 2021
Report Date
December 23, 2021
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
PMA / PMN Number
K170386
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MT, US
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. MEDICAL DEVICE EXPIRATION DATE : UNKNOWN. 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: 2021-12-31. H6: INVESTIGATION SUMMARY: CUSTOMER RETURNED 2 POLYBAGS ¿ 1 OPENED, 1 UNOPENED ¿ CONTAINING 0.3ML, 30 GAUGE, 8MM SYRINGES FROM LOT 9210961. THE OPENED POLYBAG CONTAINED 9 SYRINGES. NO OTHER PRODUCT OR PACKAGING TO COMPARE THESE SYRINGES TO WAS PROVIDED. THE ORIGINAL, INTENDED PRODUCT IS UNKNOWN. THE SYRINGES RETURNED WERE INSPECTED AND NO DAMAGE OR DISCREPANCIES WERE OBSERVED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 9210961. ALL INSPECTIONS AND CHALLENGES WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATIONS. THERE WERE ZERO (0) NOTIFICATIONS NOTED THAT PERTAINED TO THE COMPLAINT. BASED ON THE SAMPLES RECEIVED, BD WAS UNABLE TO CONFIRM THE CUSTOMER¿S INDICATED FAILURE OF DIFFERENT SYRINGES BEING INCLUDED, AS ALL SAMPLES OBSERVED ARE THE SAME. ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME AS THE ISSUE IS UNCONFIRMED. H3 OTHER TEXT : SEE H10.

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. MEDICAL DEVICE EXPIRATION DATE : UNKNOWN. 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 THAT 2 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD MIXED PRODUCT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: THE RELION CONSUMER REPORTED FINDING TWO PACKAGES IN THE BOX OF 100 THAT ARE DIFFERENT SIZE SYRINGES AND STATED THE INCORRECT SIZE WAS 3/10ML, 30G, 8MM (TWO BAGS). DATE OF EVENT: UNKNOWN. SAMPLES: AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT 2 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD MIXED PRODUCT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: THE RELION CONSUMER REPORTED FINDING TWO PACKAGES IN THE BOX OF 100 THAT ARE DIFFERENT SIZE SYRINGES AND STATED THE INCORRECT SIZE WAS 3/10ML, 30G, 8MM (TWO BAGS). DATE OF EVENT : UNKNOWN. SAMPLES : AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT 2 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD MIXED PRODUCT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: THE RELION CONSUMER REPORTED FINDING TWO PACKAGES IN THE BOX OF 100 THAT ARE DIFFERENT SIZE SYRINGES AND STATED THE INCORRECT SIZE WAS 3/10ML, 30G, 8MM (TWO BAGS). DATE OF EVENT: UNKNOWN. SAMPLES: AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1910158 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 9210961

Patients

Seq Age Sex Outcome Treatment
1 Unknown