FDA Adverse Event Malfunction Summary report: N

BD ULTRA-FINE¿ NANO¿ PEN NEEDLES 4MM (5/32¿) 32G

MDR report key: 13159524 · Received January 4, 2022

Report

Report Number
2243072-2021-03023
Event Type
Malfunction
Date Received
January 4, 2022
Date of Event
December 6, 2021
Report Date
March 10, 2022
Manufacturer
BECTON DICKINSON
Product Code
FMI
UDI-DI
10885403928659
PMA / PMN Number
K933545
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. 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. DEVICE MANUFACTURE DATE: UNKNOWN.

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. 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. DEVICE MANUFACTURE DATE: UNKNOWN.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: B5: DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED THAT THE BD ULTRA-FINE¿ NANO¿ PEN NEEDLES 4MM (5/32¿) 32G WAS UNABLE TO DELIVER INSULIN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED NO INSULIN FLOW. D2: MEDICAL DEVICE BRAND NAME: BD ULTRA-FINE¿ NANO¿ PEN NEEDLES 4MM (5/32¿) 32G D2: COMMON DEVICE NAME: HYPODERMIC SINGLE LUMEN NEEDLE D4: UDI # (B)(6) G.5. PMA / 510(K)#: K933545 D4: MEDICAL DEVICE LOT #: 7264659 D4: MEDICAL DEVICE EXPIRATION DATE: 2023-11-30 H4: DEVICE MANUFACTURE DATE: 2017-11-10 D4: MEDICAL DEVICE LOT #: 7291740 D4: MEDICAL DEVICE EXPIRATION DATE: 2023-12-31 H4: DEVICE MANUFACTURE DATE: 2017-12-06 D4: MEDICAL DEVICE LOT #: 9121958 D4: MEDICAL DEVICE EXPIRATION DATE: 2024-04-30 H4: DEVICE MANUFACTURE DATE: 2019-05-01 D4: MEDICAL DEVICE LOT #: 9268398 D4: MEDICAL DEVICE EXPIRATION DATE: 2024-09-30 H4: DEVICE MANUFACTURE DATE: 2019-09-25 D10: DEVICE AVAILABLE FOR EVAL YES, D10: RETURNED TO MANUFACTURER ON: 2022-02-07 H6: INVESTIGATION SUMMARY CUSTOMER RETURNED (20) USED 32GX4MM BD PEN NEEDLES (4 FROM LOT# 7264659, 8 FROM LOT# 7291740, 4 FROM LOT# 9121958, 4 FROM LOT# 9268398). THE CUSTOMER REPORTED NO INSULIN FLOW AND THAT THE PATIENT END NEEDLE WAS BENT. THE RETURNED SAMPLES WERE EXAMINED, AND IT WAS OBSERVED THAT ALL 20 RETURNED PEN NEEDLES EXHIBITED A BENT NON-PATIENT END (NPE) CANNULA. NONE OF THE RETURNED PEN NEEDLES EXHIBITED A BENT/DAMAGED PATIENT END (PE) CANNULA. THE BENT NPE CANNULAS WOULD BE THE CAUSE FOR NO FLOW THROUGH THE PEN NEEDLES. SINCE THE SAMPLES WERE RETURNED AFTER USE, THE PROBABLE CAUSE OF THE BENT NPE CANNULAS IS USER RELATED. 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. BD WAS ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE (NPE CANNULA BENT). THE ROOT CAUSE FOR THIS ISSUE IS USER RELATED. THE NPE CANNULAS WERE BENT BY THE USER AFTER HANDLING THE PEN NEEDLES.

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. NO DHR REVIEW CAN BE CARRIED OUT AS LOT NUMBER IS UNKNOWN. H3 OTHER TEXT : SEE H10.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE UNSPECIFIED BD PEN NEEDLE WAS UNABLE TO DELIVER INSULIN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED NO INSULIN FLOW.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE UNSPECIFIED BD PEN NEEDLE WAS UNABLE TO DELIVER INSULIN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED NO INSULIN FLOW.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD ULTRA-FINE¿ NANO¿ PEN NEEDLES 4MM (5/32¿) 32G WAS UNABLE TO DELIVER INSULIN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED NO INSULIN FLOW.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE UNSPECIFIED BD PEN NEEDLE WAS UNABLE TO DELIVER INSULIN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED NO INSULIN FLOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1270623 BD ULTRA-FINE¿ NANO¿ PEN NEEDLES 4MM (5/32¿) 32G HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON 2865 SEE H10 10885403928659

Patients

Seq Age Sex Outcome Treatment
1 Unknown