FDA Adverse Event Malfunction Summary report: N

BD PHASEAL¿ INJECTOR LUER LOCK N35

MDR report key: 14732333 · Received June 17, 2022

Report

Report Number
3003152976-2022-00273
Event Type
Malfunction
Date Received
June 17, 2022
Date of Event
May 23, 2022
Report Date
August 11, 2022
Manufacturer
BECTON DICKINSON, S.A.
Product Code
ONB
UDI-DI
30382905150037
PMA / PMN Number
K140591
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, 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. THERE WERE MULTIPLE LOT NUMBERS SUSPECTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: 2112006. MEDICAL DEVICE EXPIRATION DATE: 31-MAY-2024. DEVICE MANUFACTURE DATE: 03-DEC-2021. MEDICAL DEVICE LOT #: 2111009. MEDICAL DEVICE EXPIRATION DATE: 30-APR-2024. DEVICE MANUFACTURE DATE: 18-NOV-2021. MEDICAL DEVICE LOT #: 2110011. MEDICAL DEVICE EXPIRATION DATE: 31-MAR-2024. DEVICE MANUFACTURE DATE: 25-OCT-2021. MEDICAL DEVICE LOT #: 2111012. MEDICAL DEVICE EXPIRATION DATE: 30-APR-2024. DEVICE MANUFACTURE DATE: 30-NOV-2021. 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: D9: DEVICE AVAILABLE FOR EVAL: YES. D9: RETURNED TO MANUFACTURER ON: 09-JUN-2022. H6: INVESTIGATION SUMMARY: MULTIPLE SAMPLES WERE PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. ALL PRODUCT WAS INSPECTED, NO DAMAGE WAS OBSERVED ON THE PRODUCT AND ALL LUER DIMENSIONS WERE VERIFIED TO BE WITHIN THE REQUIRED SPECIFICATIONS. FUNCTIONAL TESTING WAS PERFORMED, CONNECTING THE INJECTORS TO A SYRINGE AND PROTECTOR ACCORDING TO THE INSTRUCTIONS FOR USE. IN ALL CASES, LIQUID INSIDE THE SYRINGE COULD MOVE TO THE VIAL AND BACK TO THE SYRINGE WITHOUT ISSUE AND NO DISCONNECTIONS BETWEEN THE LUER CONNECTION WERE OBSERVED. A DEVICE HISTORY REVIEW WAS PERFORMED FOR LOTS 2112006, 2111012, 2111009, AND 2110011, NO DEVIATIONS OR NON-CONFORMANCES WERE IDENTIFIED DURING THE MANUFACTURING PROCESS THAT COULD HAVE CONTRIBUTED TO THIS ISSUE.

Description of Event or Problem · 0

IT WAS REPORTED THAT AN UNSPECIFIED AMOUNT OF BD PHASEAL¿ INJECTORS LUER LOCK N35 WOULD NOT STAY THREADED ONTO THEIR ALARIS TUBING SETS WHILE TRANSPORTING THEM TO NURSING, CAUSING CHEMOTHERAPY LEAKAGE IN SOME CASES. LOTS 2112006, 2111009, 2110011, AND 2111012 WERE SUSPECTED OF BEING INVOLVED IN THE EVENT, BUT NO FURTHER CLARIFYING INFORMATION HAS BEEN RECEIVED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE HAVE HAD A NUMBER OF CHEMOTHERAPY SPILLS IN THE LAST 2 WEEKS AND FOR SURE THE TWO MOST RECENT HAVE BEEN RELATED TO THE PHASEAL CONNECTORS NOT STAYING THREADED." "WHEN I MET WITH THE PHARMACY TECHNICIANS TO REVIEW CLINICAL PRACTICE RELATED TO ATTACHING THE INJECTOR TO ALARIS TUBING WITH SPIN COLLARS I NOTICED THEY ALL DID NOT ATTACH PROPERLY BY PULLING THE SPIN COLLAR BACK, INSERTING THE MALE LUER INTO THE FEMALE END OF THE INJECTOR, GIVING IT A QUARTER TURN AND THEN SECURING SPIN COLLAR ONTO THE INJECTOR. I PROVIDED RE-TRAINING AND EDUCATION. NO REPORTED ADVERSE INCIDENT WAS REPORTED TO ME. THEY JUST STATED THAT THE INJECTOR WOULD FALL OFF THE TUBING DURING TRANSPORT TO NURSING FOR ADMINISTRATION."

Description of Event or Problem · 0

IT WAS REPORTED THAT AN UNSPECIFIED AMOUNT OF BD PHASEAL¿ INJECTORS LUER LOCK N35 WOULD NOT STAY THREADED ONTO THEIR ALARIS TUBING SETS WHILE TRANSPORTING THEM TO NURSING, CAUSING CHEMOTHERAPY LEAKAGE IN SOME CASES. LOTS 2112006, 2111009, 2110011, AND 2111012 WERE SUSPECTED OF BEING INVOLVED IN THE EVENT, BUT NO FURTHER CLARIFYING INFORMATION HAS BEEN RECEIVED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE HAVE HAD A NUMBER OF CHEMOTHERAPY SPILLS IN THE LAST 2 WEEKS AND FOR SURE THE TWO MOST RECENT HAVE BEEN RELATED TO THE PHASEAL CONNECTORS NOT STAYING THREADED." "WHEN I MET WITH THE PHARMACY TECHNICIANS TO REVIEW CLINICAL PRACTICE RELATED TO ATTACHING THE INJECTOR TO ALARIS TUBING WITH SPIN COLLARS I NOTICED THEY ALL DID NOT ATTACH PROPERLY BY PULLING THE SPIN COLLAR BACK, INSERTING THE MALE LUER INTO THE FEMALE END OF THE INJECTOR, GIVING IT A QUARTER TURN AND THEN SECURING SPIN COLLAR ONTO THE INJECTOR. I PROVIDED RE-TRAINING AND EDUCATION. NO REPORTED ADVERSE INCIDENT WAS REPORTED TO ME. THEY JUST STATED THAT THE INJECTOR WOULD FALL OFF THE TUBING DURING TRANSPORT TO NURSING FOR ADMINISTRATION."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
194940 BD PHASEAL¿ INJECTOR LUER LOCK N35 INTRAVASCULAR ADMINISTRATION SET ONB BECTON DICKINSON, S.A. 515003 SEE SECTION H10 30382905150037

Patients

Seq Age Sex Outcome Treatment
1 Unknown UNSPECIFIED BD ALARIS TUBING SET