FDA Adverse Event Malfunction Summary report: N

BD® PLASTIC NRFIT¿ SYRINGE

MDR report key: 15395696 · Received September 9, 2022

Report

Report Number
1213809-2022-00552
Event Type
Malfunction
Date Received
September 9, 2022
Date of Event
August 16, 2022
Report Date
November 13, 2024
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
QEH
UDI-DI
00382904001742
PMA / PMN Number
K192538
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
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. 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

INVESTIGATION SUMMARY: EIGHTY-THREE SAMPLES AND FIVE PHOTOS WERE PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. THROUGH VISUAL INSPECTION, IT WAS OBSERVED THAT NINETEEN SAMPLE HAD 10ML LUER LOCK STANDARD BARREL INSTEAD OF 10ML NRFIT LOCK BARREL. POTENTIAL ROOT CAUSE FOR THE MIXED PRODUCT DEFECT IS ASSOCIATED WITH INADEQUATE LINE CLEARANCE ON THE MARKING MACHINERY. A CORRECTIVE ACTION PROJECT WAS OPENED TO FURTHER INVESTIGATE THESE DEFECT. MANUFACTURING PERSONNEL WILL BE NOTIFIED OF THIS INCIDENT AND ADDITIONAL TRAINING WILL BE PROVIDED. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED LOT NUMBER 1041220. A REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. BASED ON THE INVESTIGATION WITH THE SAMPLES ANALYSIS THE SYMPTOM REPORTED IS CONFIRMED.

Additional Manufacturer Narrative · 0

(B)(4) FOLLOW UP REPORT #2 FOR CORRECTION. THE EVENT/PRODUCT PROBLEM WAS INCORRECT IN THE INITIAL MDR. CORRECT EVENT/PRODUCT PROBLEM IS MIXED PRODUCT / LOTS. ANNEX A CODE WAS INCORRECT IN THE INITIAL MDR. ANNEX A CODE SHOULD BE A2101 - DEVICE MARKINGS / LABELING PROBLEM.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD® PLASTIC NRFIT¿ SYRINGE WAS WITH OR WITHOUT LUERLOCK. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM DUTCH TO ENGLISH: WE HAVE FOUND THAT FOR ITEM NUMBER 400174 WITH LOT NUMBER 1041220, THERE ARE PRODUCTS WITH AND WITHOUT LUERLOCK.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD® PLASTIC NRFIT¿ SYRINGE WAS WITH OR WITHOUT LUERLOCK. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM DUTCH TO ENGLISH: WE HAVE FOUND THAT FOR ITEM NUMBER 400174 WITH LOT NUMBER 1041220 THERE ARE PRODUCTS WITH AND WITHOUT LUERLOCK.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2215848 BD® PLASTIC NRFIT¿ SYRINGE PISTON SYRINGE QEH BECTON DICKINSON MEDICAL SYSTEMS 400174 1041220 00382904001742

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown