FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES

MDR report key: 14408462 · Received May 16, 2022

Report

Report Number
1024879-2022-00270
Event Type
Malfunction
Date Received
May 16, 2022
Date of Event
May 6, 2022
Report Date
June 20, 2022
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
00382903679881
PMA / PMN Number
BK050036
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION HAS BEEN PROVIDED. ADDITIONAL LOT NUMBERS WERE RECEIVED UPDATING THE PREVIOUS MDR SUBMISSION. THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: D.4. MEDICAL DEVICE LOT #: 1312507. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-11-30. H.4. DEVICE MANUFACTURE DATE: 2021-11-08. D.4. MEDICAL DEVICE LOT #: 1326277. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-11-30. H.4. DEVICE MANUFACTURE DATE: 2021-11-22 D.4. MEDICAL DEVICE LOT #: 1333110. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-11-30. H.4. DEVICE MANUFACTURE DATE: 2021-11-29 D.4. MEDICAL DEVICE LOT #: 2039096. D.4. MEDICAL DEVICE EXPIRATION DATE: 2023-02-28. H.4. DEVICE MANUFACTURE DATE: 2022-02-08. D.4. MEDICAL DEVICE LOT #: 2031111. D.4. MEDICAL DEVICE EXPIRATION DATE: 2023-01-31. H.4. DEVICE MANUFACTURE DATE: 2022-01-31. D.4. MEDICAL DEVICE LOT #:1326291. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-11-30. H.4. DEVICE MANUFACTURE DATE: 2021-11-22. D.4. MEDICAL DEVICE LOT #: 1340600. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-12-31. H.4. DEVICE MANUFACTURE DATE: 2021-12-06. D.4. MEDICAL DEVICE LOT #: 1305657. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-10-31. H.4. DEVICE MANUFACTURE DATE: 2021-11-01. D.4. MEDICAL DEVICE LOT #: 1340598. D.4. MEDICAL DEVICE EXPIRATION DATE: 2022-11-30. H.4. DEVICE MANUFACTURE DATE: 2021-12-06.

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY : BD HAD NOT RECEIVED SAMPLES OR PHOTOS FOR EVALUATION. THE CUSTOMER HAS ACKNOWLEDGED AN ISSUE WITH SAMPLE INTEGRITY (EXCESSIVE EVAPORATION) TO BE THE CAUSE OF THEIR REPORTED DEFECT (ERRONEOUS RESULTS) AFTER CONSULTATION WITH BD'S TECHNICAL SERVICE TEAM. BASED ON A REVIEW OF THE DEVICE HISTORY RECORD FOR THE INCIDENT LOT, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET. THERE WERE NO RELATED QUALITY ISSUES DURING MANUFACTURING OF THE PRODUCT. THIS COMPLAINT IS UNABLE TO BE CONFIRMED FOR ERRONEOUS RESULTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES, THE DEVICE EXPERIENCED ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: IT WAS REPORTED THAT TUBES WERE EXPERIENCING ERRONEOUS RESULTS. CUSTOMER PROBLEM: SM 367988 - DISCREPANT RESULTS. DISCREPANT RESULTS : DOES NOT MATCH CLINICAL CONDITION.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES, THE DEVICE EXPERIENCED ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: IT WAS REPORTED THAT TUBES WERE EXPERIENCING ERRONEOUS RESULTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES, THE DEVICE EXPERIENCED ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: IT WAS REPORTED THAT TUBES WERE EXPERIENCING ERRONEOUS RESULTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2030821 BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON & CO., (BD) SEE H.10. 00382903679881

Patients

Seq Age Sex Outcome Treatment
1 Unknown