FDA Adverse Event Malfunction Summary report: N

BD MICRO-FINE¿+ PRO PEN NEEDLE

MDR report key: 13346183 · Received January 25, 2022

Report

Report Number
9616656-2022-00037
Event Type
Malfunction
Date Received
January 25, 2022
Date of Event
January 6, 2022
Report Date
February 23, 2022
Manufacturer
BECTON DICKINSON AND CO.
Product Code
FMI
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
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: D.9. DEVICE AVAILABLE FOR EVAL?: YES. D.9. RETURNED TO MANUFACTURER ON: 2/15/2022 . H.6. INVESTIGATION: TWO OPEN 32G X 4MM PEN NEEDLE SAMPLES AND FOUR PHOTOS WERE RETURNED FROM LOT. NO. 1012832, CAT. NO. 320559. VISUAL EXAMINATION WAS CARRIED OUT ON THE RETURNED SAMPLES AND A BROKEN NON PATIENT END OF CANNULA WAS OBSERVED ON BOTH SAMPLES. DUE TO THE CONDITION THE SAMPLES WERE RECEIVED NO CLOG TESTING COULD BE CARRIED OUT. 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. AS THE SAMPLES RETURNED WERE OPEN IT IS NOT POSSIBLE TO CONFIRM THIS DEFECT TO BE MANUFACTURING RELATED H3 OTHER TEXT : SEE H.10.

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

H.6. INVESTIGATION: NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. A REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT. H3 OTHER TEXT : SEE H.10.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD MICRO-FINE¿+ PRO PEN NEEDLE, THE DEVICE EXPERIENCED THE INABILITY TO DELIVER INSULIN. THIS EVENT OCCURRED TWO TIMES. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: ACCORDING TO THE PATIENT'S REPORT, THE PEN NEEDLE WAS ATTACHED TO THE PEN BUT THE DRUG SOLUTION DIDN'T COME OUT. THIS OCCURRED IN TWO PRODUCTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD MICRO-FINE¿+ PRO PEN NEEDLE, THE DEVICE EXPERIENCED THE INABILITY TO DELIVER INSULIN. THIS EVENT OCCURRED TWO TIMES. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: ACCORDING TO THE PATIENT'S REPORT, THE PEN NEEDLE WAS ATTACHED TO THE PEN BUT THE DRUG SOLUTION DIDN'T COME OUT. THIS OCCURRED IN TWO PRODUCTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD MICRO-FINE¿+ PRO PEN NEEDLE, THE DEVICE EXPERIENCED THE INABILITY TO DELIVER INSULIN. THIS EVENT OCCURRED TWO TIMES. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: ACCORDING TO THE PATIENT'S REPORT, THE PEN NEEDLE WAS ATTACHED TO THE PEN BUT THE DRUG SOLUTION DIDN'T COME OUT. THIS OCCURRED IN TWO PRODUCTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD MICRO-FINE¿+ PRO PEN NEEDLE, THE DEVICE EXPERIENCED THE INABILITY TO DELIVER INSULIN. THIS EVENT OCCURRED TWO TIMES. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: ACCORDING TO THE PATIENT'S REPORT, THE PEN NEEDLE WAS ATTACHED TO THE PEN BUT THE DRUG SOLUTION DIDN'T COME OUT. THIS OCCURRED IN TWO PRODUCTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
746289 BD MICRO-FINE¿+ PRO PEN NEEDLE HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON AND CO. 1012832

Patients

Seq Age Sex Outcome Treatment
1 Unknown