FDA Adverse Event Malfunction Summary report: N

BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE

MDR report key: 13238023 · Received January 12, 2022

Report

Report Number
1920898-2021-01394
Event Type
Malfunction
Date Received
January 12, 2022
Date of Event
December 16, 2021
Report Date
February 24, 2022
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
PMA / PMN Number
K170386
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
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

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D10: DEVICE AVAILABLE FOR EVAL YES. D10: RETURNED TO MANUFACTURER ON: 2022-02-07. H6: INVESTIGATION SUMMARY CUSTOMER RETURNED (10) 1ML BD INSULIN SYRINGES IN AN UNOPENED POLYBAG FROM LOT# 1193441. THE CUSTOMER REPORTED THAT THE NEEDLE BROKE OFF AT THE HUB, NEEDLES WERE FLIMSY, AND NEEDLE WERE BENT WHEN REMOVING THE NEEDLE SHIELD. THE RETURNED SYRINGES WERE EXAMINED, AND IT WAS OBSERVED THAT NONE OF THE CANNULAS WERE BENT AFTER THE CANNULA SHIELDS WERE REMOVED. THE SYRINGES WERE THEN TESTED FOR NEEDLE LENGTH, POINT GEOMETRY, OUTER DIAMETER AND LUBE COVERAGE. ALL TESTED SAMPLES MEASURED WITHIN SPECIFICATION. NO DEFECTS WERE OBSERVED, THEREFORE, THE ALLEGED DEFECT COULD NOT BE CONFIRMED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 1193441. ALL INSPECTIONS WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATIONS. THERE WERE ZERO (0) NOTIFICATIONS NOTED THAT PERTAINED TO THE COMPLAINT. ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME AS THE ISSUE IS UNCONFIRMED. H3 OTHER TEXT : SEE H10.

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY: NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 1193441. ALL INSPECTIONS WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATION. THERE WERE ZERO (0) NOTIFICATIONS NOTED THAT PERTAINED TO THE COMPLAINT. H3 OTHER TEXT : SEE H10.

Description of Event or Problem · 0

IT WAS REPORTED THAT 1 BD INSULIN SYRINGE WITH BD ULTRA-FINE¿ NEEDLE CANNULA BROKE OFF. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER : THE CONSUMER REPORTED 1 NEEDLE THAT BROKE OFF AT THE HUB AND JUST THE CANNULA AND STAYED IN THE SKIN SITE. THE CONSUMER WAS ABLE TO REMOVE WITH FINGER NAILS. DATE OF EVENT : (B)(6) 2021. SAMPLE STATUS : DISCARDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT 1 BD INSULIN SYRINGE WITH BD ULTRA-FINE¿ NEEDLE CANNULA BROKE OFF. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER : THE CONSUMER REPORTED 1 NEEDLE THAT BROKE OFF AT THE HUB AND JUST THE CANNULA AND STAYED IN THE SKIN SITE. THE CONSUMER WAS ABLE TO REMOVE WITH FINGER NAILS. DATE OF EVENT : (B)(6) 2021; SAMPLE STATUS : DISCARDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT 1 BD INSULIN SYRINGE WITH BD ULTRA-FINE¿ NEEDLE CANNULA BROKE OFF. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER : THE CONSUMER REPORTED 1 NEEDLE THAT BROKE OFF AT THE HUB AND JUST THE CANNULA AND STAYED IN THE SKIN SITE. THE CONSUMER WAS ABLE TO REMOVE WITH FINGER NAILS. DATE OF EVENT : (B)(6) 2021. SAMPLE STATUS : DISCARDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1102194 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 1193441

Patients

Seq Age Sex Outcome Treatment
1 Unknown