FDA Adverse Event Malfunction Summary report: N

BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE

MDR report key: 13418705 · Received February 1, 2022

Report

Report Number
1920898-2022-00052
Event Type
Malfunction
Date Received
February 1, 2022
Date of Event
January 13, 2022
Report Date
February 15, 2022
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
PMA / PMN Number
K024112
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. INITIAL REPORTER ZIP CODE : (B)(6). 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: CUSTOMER RETURNED (8) 3/10CC, 8MM, 31G SYRINGES IN AN OPEN POLY BAG FROM LOT#: 1200339. CUSTOMER STATES THAT WHEN SHE DEPRESSED THE PLUNGER ROD, SHE SAW LIQUID COMING OUT OF THE NEEDLES. ALL RETURNED SYRINGES WERE EXAMINED AND NO MATERIAL WAS OBSERVED IN THE BARRELS OF THE SYRINGES. ALL SYRINGES WERE ALSO TESTED AND NO MATERIAL CAME OUT OF THE CANNULA OF ANY OF THE SYRINGES WHEN THE PLUNGER ROD WAS FULLY DEPRESSED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH#: 1200339 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.

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. INITIAL REPORTER ZIP CODE : (B)(6). A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD FOREIGN MATTER IN THE FLUID PATH. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER : THE CONSUMER STATED THAT WHEN DEPRESSING THE PLUNGER ROD TO SQUEEZE THE AIR OUT OF ONE OF THE NEW SYRINGES, A CLEAR LIQUID CAME OUT OF THE NEEDLE. DATE OF EVENT : UNKNOWN. SAMPLES : AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD FOREIGN MATTER IN THE FLUID PATH. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: THE CONSUMER STATED THAT WHEN DEPRESSING THE PLUNGER ROD TO SQUEEZE THE AIR OUT OF ONE OF THE NEW SYRINGES, A CLEAR LIQUID CAME OUT OF THE NEEDLE. DATE OF EVENT : UNKNOWN. SAMPLES: AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES HAD FOREIGN MATTER IN THE FLUID PATH. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER : THE CONSUMER STATED THAT WHEN DEPRESSING THE PLUNGER ROD TO SQUEEZE THE AIR OUT OF ONE OF THE NEW SYRINGES, A CLEAR LIQUID CAME OUT OF THE NEEDLE. DATE OF EVENT : UNKNOWN. SAMPLES : AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
975424 BD INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 1200339

Patients

Seq Age Sex Outcome Treatment
1 Unknown