FDA Adverse Event Malfunction Summary report: N

BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ 6MM X 31G NEEDLE

MDR report key: 13290811 · Received January 19, 2022

Report

Report Number
1920898-2021-01410
Event Type
Malfunction
Date Received
January 19, 2022
Date of Event
December 24, 2021
Report Date
February 25, 2022
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
UDI-DI
00382903249091
PMA / PMN Number
K024112
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
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. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D.4. MEDICAL DEVICE LOT #: 8043556, D.4. MEDICAL DEVICE EXPIRATION DATE: 3/31/2023, H.4. DEVICE MANUFACTURE DATE: 8/12/2018. D.9. DEVICE AVAILABLE FOR EVAL?: YES. D.9. RETURNED TO MANUFACTURER ON: 2/24/2022. H.6. INVESTIGATION: CUSTOMER RETURNED A SINGLE SYRINGE IN A POLYBAG FOR 0.3ML, 31 GAUGE, 6MM SYRINGES FROM LOT 8043556. THE SYRINGE HAD ITS NEEDLE SHIELD AND HUB SEPARATE FROM THE BARREL. THE HUB HAS BECOME LODGED INSIDE THE SHIELD. THERE IS NO DAMAGE TO EITHER THE CONNECTOR AT THE DISTAL TIP OF THE BARREL OR ITS RESPECTIVE NEEDLE HUB. NO SIGNS OF USE AND NO OTHER DEFECTS FOUND. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 8043556. 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 ABLE TO CONFIRM THE CUSTOMER¿S INDICATED FAILURE OF NEEDLE HUB SEPARATION. CAPA#1630423 WAS INITIATED.

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. DUE TO THE BATCH BEING UNKNOWN, NO DHR REVIEW CAN BE COMPLETED.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ 6MM X 31G NEEDLE THE NEEDLE SEPARATED FROM THE HUB. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO. 324909. IT WAS REPORTED THAT NEEDLE HUB SEPARATES INTO NEEDLE SHIELD. BD VEO INSULIN SYRINGES 3/10 ML,6 MM, 31G FOR U-100 INSULIN THE NEEDLE DEVICE GOT STUCK INTO THE ORANGE CAP AND CAN NOT BE REMOVED. THIS HAPPENED TO TWO MORE SYRINGES MAKING THEM USELESS.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ 6MM X 31G NEEDLE THE NEEDLE SEPARATED FROM THE HUB. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO. 324909. IT WAS REPORTED THAT NEEDLE HUB SEPARATES INTO NEEDLE SHIELD. BD VEO INSULIN SYRINGES 3/10 ML,6 MM, 31G FOR U-100 INSULIN THE NEEDLE DEVICE GOT STUCK INTO THE ORANGE CAP AND CAN NOT BE REMOVED. THIS HAPPENED TO TWO MORE SYRINGES MAKING THEM USELESS.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ 6MM X 31G NEEDLE THE NEEDLE SEPARATED FROM THE HUB. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO. 324909. IT WAS REPORTED THAT NEEDLE HUB SEPARATES INTO NEEDLE SHIELD. BD VEO INSULIN SYRINGES 3/10 ML,6 MM, 31G FOR U-100 INSULIN THE NEEDLE DEVICE GOT STUCK INTO THE ORANGE CAP AND CAN NOT BE REMOVED. THIS HAPPENED TO TWO MORE SYRINGES MAKING THEM USELESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
635875 BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ 6MM X 31G NEEDLE PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 324909 SEE H.10 00382903249091

Patients

Seq Age Sex Outcome Treatment
1 Unknown