FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES

MDR report key: 15243189 · Received August 17, 2022

Report

Report Number
1917413-2022-00505
Event Type
Malfunction
Date Received
August 17, 2022
Date of Event
July 27, 2022
Report Date
October 27, 2022
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
50382903678612
PMA / PMN Number
BK050036
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: 2109087. MEDICAL DEVICE EXPIRATION DATE: 2023-08-31. DEVICE MANUFACTURE DATE: 2022-04-19. MEDICAL DEVICE LOT #: 2080662. MEDICAL DEVICE EXPIRATION DATE: 2023-07-31. DEVICE MANUFACTURE DATE: 2022-03-21. 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 HAVE BEEN UPDATED WITH ADDITIONAL INFORMATION: D9: DEVICE AVAILABLE FOR EVALUATION: YES. D9: RETURNED TO MANUFACTURER ON: 8.12.2022. H.6. INVESTIGATION SUMMARY: BD RECEIVED 10 CUSTOMER SAMPLES FOR INVESTIGATION. THE CUSTOMER SAMPLES WERE EVALUATED ALONG WITH RETENTION SAMPLES OF THE INCIDENT LOT SELECTED FROM BD INVENTORY. THE SAMPLES WERE TESTED AND NO ISSUES RELATING TO CLOTTING WERE OBSERVED. 100 RETENTION SAMPLES FROM BOTH LOTS WERE INSPECTED WITH NO ISSUES BEING IDENTIFIED. NO DIFFICULTIES WERE ENCOUNTERED DURING BLOOD COLLECTION AND ALL TUBES APPEARED TO EXHIBIT PROPER FILL. BD WAS UNABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE (CLOTTING) BECAUSE THE DEFECT WAS NOT EVIDENT IN THE TESTING OF THE COMPLAINT LOT SAMPLES. ALL VISUAL OBSERVATIONS OF BOTH CUSTOMER AND CONTROL SAMPLES TESTED DEMONSTRATED CLINICALLY ACCEPTABLE PERFORMANCE. ALL TUBES PERFORMED AS EXPECTED. 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 CLOTTING. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE FACTORS THAT MAY CONTRIBUTE TO CLOTTING WERE EVALUATED THROUGH A CLINICAL STUDY TO VERIFY THE DESIGN OF THE DEVICE MET IT¿S INTENDED USE. THE RESULT OF THE STUDY SHOWED THAT THE DEVICE PERFORMED AS EXPECTED AND WE WERE UNABLE TO DETERMINE ANY EXTERNAL CONTRIBUTOR TO THIS REPORTED ISSUE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES ARE EXPERIENCING CLOTTING. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER IS A COMMERCIAL REFERENCE LAB REPORTING CLOTTING ISSUES WITH 4.0 ML EDTA TUBES 367861 AT MULTIPLE DRAW STATIONS/LOCATIONS.CUSTOMER HAS HAD TO RECOLLECT PATIENTS. STEPS TAKEN WITH CUSTOMER/TROUBLESHOOTING: AFFECTED LOT#S 2109087 AND 2080662"

Description of Event or Problem · 0

IT WAS REPORTED THAT BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES ARE EXPERIENCING CLOTTING. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER IS A COMMERCIAL REFERENCE LAB REPORTING CLOTTING ISSUES WITH 4.0 ML EDTA TUBES 367861 AT MULTIPLE DRAW STATIONS/LOCATIONS.CUSTOMER HAS HAD TO RECOLLECT PATIENTS. STEPS TAKEN WITH CUSTOMER/TROUBLESHOOTING: AFFECTED LOT#S 2109087 AND 2080662."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1915373 BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON & CO., (BD) 367861 SEE H.10 50382903678612

Patients

Seq Age Sex Outcome Treatment
1 Unknown