FDA Adverse Event Malfunction Summary report: N

BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE

MDR report key: 13204063 · Received January 10, 2022

Report

Report Number
3002682307-2021-00682
Event Type
Malfunction
Date Received
January 10, 2022
Date of Event
November 4, 2021
Report Date
February 22, 2022
Manufacturer
BECTON DICKINSON, S.A.
Product Code
FMI
PMA / PMN Number
K100209
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE MANUFACTURE DATE: UNKNOWN. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED, BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY AS A LOT NUMBER WAS UNKNOWN FOR THIS INCIDENT AND A SAMPLE WAS UNAVAILABLE, NEITHER A PRODUCTION HISTORY REVIEW NOR A THOROUGH SAMPLE ANALYSIS COULD BE COMPLETED BY OUR QUALITY ENGINEER TEAM. BASED ON THE CURRENT INVESTIGATION RESULTS, AN EXACT CAUSE FOR THE REPORTED INCIDENT COULD NOT BE DETERMINED.

Additional Manufacturer Narrative · 0

CORRECTION; H6: IMDRF ANNEX A GRID: A1206 - MISCONNECTION.

Additional Manufacturer Narrative · 0

MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE MANUFACTURE DATE: UNKNOWN. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED, BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE WAS DIFFICULT TO CONNECT TO THE MATING COMPONENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "NEEDLE-SYRINGE MISMATCH AFTER ADMINISTRATION, WHEN SECURING THE NEEDLE. NEEDLE DROPPED UNSECURED ON CAREGIVER'S FOOT (NO SEA). NO CLINICAL CONSEQUENCES. "

Description of Event or Problem · 0

IT WAS REPORTED THAT BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE WAS DIFFICULT TO CONNECT TO THE MATING COMPONENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "NEEDLE-SYRINGE MISMATCH AFTER ADMINISTRATION, WHEN SECURING THE NEEDLE. NEEDLE DROPPED UNSECURED ON CAREGIVER'S FOOT (NO SEA). NO CLINICAL CONSEQUENCES. "

Description of Event or Problem · 0

IT WAS REPORTED THAT BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE WAS DIFFICULT TO CONNECT TO THE MATING COMPONENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "NEEDLE-SYRINGE MISMATCH AFTER ADMINISTRATION, WHEN SECURING THE NEEDLE. NEEDLE DROPPED UNSECURED ON CAREGIVER'S FOOT (NO SEA). NO CLINICAL CONSEQUENCES. "

Description of Event or Problem · 0

IT WAS REPORTED THAT BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE WAS DIFFICULT TO CONNECT TO THE MATING COMPONENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "NEEDLE-SYRINGE MISMATCH AFTER ADMINISTRATION, WHEN SECURING THE NEEDLE. NEEDLE DROPPED UNSECURED ON CAREGIVER'S FOOT (NO SEA). NO CLINICAL CONSEQUENCES. "

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1169145 BD ECLIPSE HYPODERMIC NEEDLE WITH PROTECTION DEVICE HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON, S.A. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown