FDA Adverse Event Malfunction Summary report: N

SEE H10

MDR report key: 15032550 · Received July 15, 2022

Report

Report Number
1920898-2022-00453
Event Type
Malfunction
Date Received
July 15, 2022
Date of Event
June 15, 2022
Report Date
July 20, 2022
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
UDI-DI
00382903249091
PMA / PMN Number
K212499
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

MEDICAL DEVICE BRAND NAME: BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLE 3/10ML 6MM. INVESTIGATION SUMMARY: NO SAMPLES OR PHOTOS WERE RETURNED FOR EVALUATION. THEREFORE, THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE COULD NOT BE DETERMINED. THIS IS THE 1ST COMPLAINT FOR THE REPORTED LOT NUMBER. A REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. IF SAMPLES ARE RECEIVED IN THE FUTURE THE COMPLAINT WILL BE REOPENED FOR FURTHER INVESTIGATION. A COMPLAINT LOT HISTORY CHECK WAS PERFORMED ON LOT # 1200343 FOR DIFFICULT/UNABLE TO OPERATE (NOT DRAWING). THIS IS THE 1ST RELATED COMPLAINT FOR DIFFICULT/UNABLE TO OPERATE (NOT DRAWING) ON LOT # 1200343. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 1200343. ALL INSPECTIONS AND CHALLENGES WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATIONS. THERE WAS ONE (1) NOTIFICATION [200974343] NOTED THAT DID NOT PERTAIN TO THE COMPLAINT. SINCE NO SAMPLES AND/OR PHOTO(S) OF THE SAMPLES WERE RECEIVED FOR INVESTIGATION, EMBECTA WAS NOT ABLE TO REPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE. THE ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME. THE ISSUE CANNOT BE CONFIRMED AS NO SAMPLES OR IMAGES WERE RETURNED FOR EVALUATION. BASED ON THE ABOVE, NO ADDITIONAL INVESTIGATION AND NO CORRECTIVE/PREVENTATIVE ACTION (CAPA) OR SITUATIONAL ANALYSIS (SA) IS REQUIRED AT THIS TIME.

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: CUSTOMER RETURNED (2) 0.3ML BD INSULIN SYRINGES FROM LOT# 1200343. THE CUSTOMER REPORTED THAT THEY WERE UNABLE TO PUSH ALL THE AIR INTO THEIR VIAL WHEN DRAWING INSULIN, AND GETS A LARGE VOID WHEN DRAWING INTO THE SYRINGE. BOTH SAMPLES WERE EXAMINED, THEN TESTED FOR FLOW: BOTH SYRINGES WERE ABLE TO DRAW AND EXPEL PROPERLY. NO DEFECTS TO THE STOPPER OR PLUNGER ROD WERE OBSERVED ON EITHER SYRINGE. THE ALLEGED ISSUES COULD NOT BE CONFIRMED BASED ON THE SAMPLES PROVIDED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 1200343. ALL INSPECTIONS AND CHALLENGES WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATIONS. EMBECTA WAS NOT ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED MONTHLY. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS. H3 OTHER TEXT : SEE H.10.

Description of Event or Problem · 0

IT WAS REPORTED THAT 2 BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES 3/10ML 6MM EXPERIENCED DIFFICULT PLUNGER MOVEMENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED 2 SYRINGES WHERE WHEN PLACING THE AIR EQUAL AMOUNTS AIR VERSES INSULIN, CANT PUSH ALL THE AIR INTO VIAL.

Description of Event or Problem · 0

IT WAS REPORTED THAT 2 BD VEO¿ INSULIN SYRINGES WITH BD ULTRA-FINE¿ NEEDLES 3/10ML 6MM EXPERIENCED DIFFICULT PLUNGER MOVEMENT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CONSUMER REPORTED 2 SYRINGES WHERE WHEN PLACING THE AIR EQUAL AMOUNTS AIR VERSES INSULIN, CANT PUSH ALL THE AIR INTO VIAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2884952 SEE H10 PISTON SYRINGE FMF BD MEDICAL - DIABETES CARE 324909 1200343 00382903249091

Patients

Seq Age Sex Outcome Treatment
1 Unknown