FDA Adverse Event Malfunction Summary report: N

SURECAN SAFETY II

MDR report key: 13500349 · Received February 9, 2022

Report

Report Number
9612452-2022-00006
Event Type
Malfunction
Date Received
February 9, 2022
Date of Event
January 17, 2022
Report Date
August 3, 2022
Manufacturer
B. BRAUN MEDICAL FRANCE
Product Code
PTI
UDI-DI
04046964857737
PMA / PMN Number
K170897
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN MEDICAL INC. INTERNAL REPORT NUMBER (B)(4). THE INVESTIGATION INTO THIS REPORTED EVENT IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE RESULTS OF THE INVESTIGATION ARE AVAILABLE.

Additional Manufacturer Narrative · 0

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN MEDICAL INC. INTERNAL REPORT NUMBER: (B)(4). WE HAVE CHECKED THE MANUFACTURING FILE OF BATCH: NR20F09G8670 WHICH COMPLIES WITH OUR SPECIFICATIONS AND DOES NOT PRESENT ANY DISCREPANCY. ANOTHER SIMILAR COMPLAINT FROM THE SAME END CUSTOMER HAS BEEN REPORTED TO US ON THIS BATCH OF 7000 NEEDLES RELEASED IN OCTOBER 2020. WITHOUT THE COMPLAINT SAMPLE FOR INVESTIGATION NO THOROUGH INVESTIGATION IS POSSIBLE AND WE CANNOT CONCLUDE ON THE REAL CAUSE OF THE INCIDENT. IF NEW ELEMENTS BECOME AVAILABLE IN THE FUTURE, WE WILL REOPEN THIS COMPLAINT. THIS TYPE OF INCIDENT IS A KNOWN RISK OF THE USE OF NEEDLES. THE SURECAN SAFETY II HAS A MANUALLY ACTIVATED SAFETY MECHANISM THAT IS DESIGNED TO DEPLOY UPON NEEDLE REMOVAL AND TO SHIELD THE TIP, TO REDUCE NEEDLESTICK INJURIES. SURECAN SAFETY II'S FEATURES INCLUDE A GREEN DOT, WHICH APPEARS THROUGH THE CLEAR BOTTOM PLATE WHEN THE SAFETY MECHANISM IS SUCCESSFULLY ENGAGED. REVIEWED THE DHR FOR THE BATCH NO. 20F09G8670, NO RELATED DEFECT WAS OBSERVED DURING THE IN-PROCESS AND FINAL CONTROL INSPECTION. BATCH SIZE: 7000 BATCH RELEASED DATE: 2020-10-16.

Description of Event or Problem · 0

AS REPORTED BY THE USER FACILITY: "THE NEEDLE COVER WOULD NOT LOCK INTO PLACE RESULTING IN A NURSE GETTING STUCK WITH THE NEEDLE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
60300 SURECAN SAFETY II NON-CORING (HUBER) NEEDLE PTI B. BRAUN MEDICAL FRANCE 4447000-02 20F09G8670 04046964857737

Patients

Seq Age Sex Outcome Treatment
1 Unknown