FDA Adverse Event Malfunction Summary report: N

BD ULTRA-FINE¿ MINI PEN NEEDLES 5MM (3/16¿) 31G

MDR report key: 13551096 · Received February 17, 2022

Report

Report Number
9616656-2022-00200
Event Type
Malfunction
Date Received
February 17, 2022
Date of Event
February 7, 2022
Report Date
March 17, 2022
Manufacturer
BECTON DICKINSON AND CO.
Product Code
FMI
UDI-DI
10885403811012
PMA / PMN Number
K162516
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, 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. THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH ADDITIONAL LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: UNKNOWN. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE MANUFACTURE DATE: UNKNOWN.

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. THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH ADDITIONAL LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: UNKNOWN. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE MANUFACTURE DATE: UNKNOWN.

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: (B)(6) 2022. H.6. INVESTIGATION: CUSTOMER RETURNED A TOTAL OF 48 USED 5MM, 31 GAUGE PEN NEEDLES. NO TEAR DROP LABELS WERE RETURNED FOR LOT IDENTIFICATION. OF THE 48 SAMPLES RETURNED, 36 WERE FOUND TO HAVE SOME MEASURE OF DAMAGE TO THE NON-PATIENT END. 35 CANNULAS WERE BENT AND 1 WAS BROKEN ON THIS SIDE. THIS DAMAGE WOULD PREVENT TESTING FOR CLOGS SINCE THE NEEDLE CANNOT PROPERLY ATTACH TO THE PEN. AS A RESULT, THE PEN NEEDLES APPEAR TO BE CLOGGED DURING USE. BASED ON THE DAMAGE PRESENT, THE NEEDLES BENDING OR BREAKING MAY HAVE OCCURRED ACCIDENTALLY WHILE THE USER WAS PREPARING THE PEN NEEDLE FOR USE, POTENTIALLY IF THE PEN WAS NOT PROPERLY ALIGNED WITH THE CANNULA. THE REMAINING 12 SAMPLES WERE ATTACHED TO A TEST PEN FILLED WITH SALINE. SALINE WAS PUSHED THROUGH THE SYSTEM AND OUT THE DISTAL TIP OF THE REMAINING PEN NEEDLES. NO ISSUES WERE FOUND WITH THE REMAINING PEN NEEDLES. 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. ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME AS THE ISSUE IS UNCONFIRMED.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD ULTRA-FINE¿ MINI PEN NEEDLES 5MM (3/16¿) 31G A 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: 320119 BATCH NO: 1202183 & UNKNOWN.   IT WAS REPORTED BY THE CONSUMER THE NEEDLE CLOGGED DURING THE INJECTION.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD ULTRA-FINE¿ MINI PEN NEEDLES 5MM (3/16¿) 31G A 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: 320119 BATCH NO: 1202183 & UNKNOWN. IT WAS REPORTED BY THE CONSUMER THE NEEDLE CLOGGED DURING THE INJECTION.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD ULTRA-FINE¿ MINI PEN NEEDLES 5MM (3/16¿) 31G A 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: 320119 BATCH NO: 1202183 & UNKNOWN.   IT WAS REPORTED BY THE CONSUMER THE NEEDLE CLOGGED DURING THE INJECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1937386 BD ULTRA-FINE¿ MINI PEN NEEDLES 5MM (3/16¿) 31G HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON AND CO. 8110 1202183 10885403811012

Patients

Seq Age Sex Outcome Treatment
1 Unknown