FDA Adverse Event Malfunction Summary report: N

BD NANO¿ 2ND GEN PEN NEEDLES 4MM X 32G

MDR report key: 13548673 · Received February 17, 2022

Report

Report Number
9616656-2022-00192
Event Type
Malfunction
Date Received
February 17, 2022
Date of Event
February 7, 2022
Report Date
February 17, 2022
Manufacturer
BECTON DICKINSON AND CO.
Product Code
FMI
UDI-DI
00382903205509
PMA / PMN Number
K182320
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT IS UNKNOWN; AWARENESS DATE HAS BEEN USED FOR THIS FIELD. A SAMPLE IS AVAILABLE FOR EVALUATION. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

DATE OF EVENT IS UNKNOWN; AWARENESS DATE HAS BEEN USED FOR THIS FIELD. A SAMPLE IS AVAILABLE FOR EVALUATION. 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 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.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD NANO¿ 2ND GEN PEN NEEDLES 4MM X 32G THE NEEDLE WAS UNABLE TO DELIVER ITS MEDICATION. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO: 320550 BATCH NO: 1132267 IT WAS REPORTED NO INSULIN FLOW.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD NANO¿ 2ND GEN PEN NEEDLES 4MM X 32G THE NEEDLE WAS UNABLE TO DELIVER ITS MEDICATION. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO: 320550, BATCH NO: 1132267. IT WAS REPORTED NO INSULIN FLOW.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD NANO¿ 2ND GEN PEN NEEDLES 4MM X 32G THE NEEDLE WAS UNABLE TO DELIVER ITS MEDICATION. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO: 320550, BATCH NO: 1132267. IT WAS REPORTED NO INSULIN FLOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1862210 BD NANO¿ 2ND GEN PEN NEEDLES 4MM X 32G HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON AND CO. 320550 1132267 00382903205509

Patients

Seq Age Sex Outcome Treatment
1 Unknown