FDA Adverse Event Malfunction Summary report: N

BD¿ 20 ML SYRINGE WITH NEEDLE

MDR report key: 13023475 · Received December 16, 2021

Report

Report Number
3002682307-2021-00659
Event Type
Malfunction
Date Received
December 16, 2021
Date of Event
July 20, 2021
Report Date
March 9, 2022
Manufacturer
BECTON DICKINSON, S.A.
Product Code
FMF
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
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

H6: INVESTIGATION SUMMARY: A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED MATERIAL NUMBER 301948 AND LOT NUMBER 2101172. THE REVIEW ESTABLISHED THAT ALL PRODUCTION AND QUALITY PROCESSES WERE CARRIED OUT NORMALLY AND NO ABNORMALITIES OR QUALITY NOTIFICATIONS RELATED TO THIS REPORTED INCIDENT WERE IDENTIFIED. AS SAMPLES WERE UNAVAILABLE FOR RETURN, TWENTY RETAINED SAMPLES WERE OBTAINED FOR FURTHER EVALUATION BY OUR QUALITY ENGINEER TEAM. THROUGH EXAMINATION OF THE RETAINED SAMPLES, NO SIGNS OF DEFECT COULD BE IDENTIFIED. BASED ON THE LIMITED INVESTIGATION RESULTS, AN EXACT CAUSE FOR THE REPORTED INCIDENT COULD NOT BE DETERMINED.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD¿ 20 ML SYRINGE WITH NEEDLE, THE DEVICE EXPERIENCED DIFFICULT PLUNGER MOVEMENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE PLUNGER WAS DIFFICULT BOLUS DURING USE.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD¿ 20 ML SYRINGE WITH NEEDLE, THE DEVICE EXPERIENCED DIFFICULT PLUNGER MOVEMENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: THE PLUNGER WAS DIFFICULT BOLUS DURING USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1920881 BD¿ 20 ML SYRINGE WITH NEEDLE PISTON SYRINGE FMF BECTON DICKINSON, S.A. 2101172

Patients

Seq Age Sex Outcome Treatment
1 Unknown