BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES
Report
- Report Number
- 1917413-2022-00566
- Event Type
- Malfunction
- Date Received
- September 14, 2022
- Date of Event
- August 18, 2022
- Report Date
- September 23, 2022
- Manufacturer
- BECTON, DICKINSON & CO. (BROKEN BOW)
- Product Code
- JKA
- UDI-DI
- 50382903678612
- PMA / PMN Number
- BK050036
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.
THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION:D9: DEVICE AVAILABLE FOR EVAL: YESD9: RETURNED TO MANUFACTURER ON: 2022-08-30H.6. INVESTIGATION SUMMARY: BD RECEIVED 2300 SAMPLES AND 2 PHOTOS FOR INVESTIGATION. THE SAMPLES AND PHOTOS WERE EVALUATED AND THE CUSTOMER¿S INDICATED FAILURE MODE FOR ADDITIVE ABNORMALITY WAS OBSERVED HOWEVER THE REPORTED ISSUE OF DAMAGE WAS NOT OBSERVED. 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. BD WAS ABLE TO CONFIRM THE CUSTOMER¿S INDICATED FAILURE MODE OF ADDITIVE ABNORMALITY WITH THE SAMPLES AND PHOTOS PROVIDED; HOWEVER, DAMAGE COULD NOT BE SEEN. BD DETERMINED THAT THE ROOT CAUSE OF THE INDICATED FAILURE MODE WAS ATTRIBUTED TO A MACHINE MISALIGNMENT WITHIN THE MANUFACTURING PROCESS. H3 OTHER TEXT : SEE H.10.
IT WAS REPORTED WHEN USING THE BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES HAVE ADDITIVE ABNORMALITY AND SEEMED DISCOLORED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "IT WAS REPORTED BY THE CUSTOMER THAT TUBES HAVE ADDITIVE ABNORMALITY AND SEEMED DISCOLORED."
IT WAS REPORTED WHEN USING THE BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES HAVE ADDITIVE ABNORMALITY AND SEEMED DISCOLORED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "IT WAS REPORTED BY THE CUSTOMER THAT TUBES HAVE ADDITIVE ABNORMALITY AND SEEMED DISCOLORED." (B)(6) : 2022-08-26 16:05:01 (GMT) SUBJECT: EMAIL 8/26/2022, 11:02:57 AM USER: (B)(6) CREATED ON: 2022-08-26 16:02:57 CALL ACTIVITY COMMENT: CUSTOMER STATES RETURNS WILL BE SENT OUT ON 8/26 (B)(6) : 2022-08-26 14:35:15 (GMT) SUBJECT: EMAIL 8/26/2022, 9:09:02 AM USER: (B)(6) CREATED ON: 2022-08-26 14:09:02 CALL ACTIVITY COMMENT: FEDEX LABEL SENT (B)(6) : 2022-08-25 12:57:10 (GMT) SUBJECT: EMAIL 8/25/2022, 7:42:38 AM USER: (B)(6) CREATED ON: 2022-08-25 12:42:39 CALL ACTIVITY COMMENT: REQUEST SHIPPING ADDRESS CONFIRMATION MATERIAL NO. 367861 BATCH NO. 2018857 IT WAS REPORTED BY THE CUSTOMER THAT TUBES HAVE ADDITIVE ABNORMALITY AND SEEMED DISCOLORED. (B)(6): 2022-08-23 16:06:56 (GMT) SUBJECT: EMAIL 8/23/2022, 10:58:12 AM USER: (B)(6) CREATED ON: 2022-08-23 15:58:12 CALL ACTIVITY COMMENT: SHIPPING ADDRESS CONFIRMATION REQUESTED (B)(6) : 2022-08-23 16:06:07 (GMT) CUSTOMER PROBLEM: CUSTOMER STATES TUBES HAVE BURN/MOLDY APPEARANCE. MANY TUBES ARE FOGGY AND THE EDTA SEEMS CLUMPED. STEPS TAKEN WITH CUSTOMER/TROUBLESHOOTING: CUSTOMER REPLIED TO QUESTIONS. DID THE SPECIMEN(S) NEED TO BE RECOLLECTED? NOT CUSTOMERS KNOWLEDGE. DID EXPOSURE TO BLOOD/ BF OCCUR? NOT CUSTOMERS KNOWLEDGE. IF EXPOSURE OCCURRED WAS THERE ANY POST EXPOSURE TESTING OR MEDICAL INTERVENTION? NOT CUSTOMERS KNOWLEDGE. NEXT STEPS (IF NECESSARY): PROCESS FEDEX LABEL FOR RETURNS. RESOLUTION ACHIEVED (Y/N)? : Y SHIPMENT/STORAGE/CONDITION UPON RECEIPT: SHIPMENT: UNKNOWN TEMPERATURE (WE DON¿T TEMP REGULAR DELIVERIES AT THE WW DOCK). NOTHING OUT OF THE ORDINARY IN REGARD THE CONDITION OF THE CASES. STORAGE: OUR BACKSTOCK LOCATION IS AT THE DOCK WHERE TEMPS FLUCTUATE BASED ON SEASON ANYWHERE BETWEEN 68-74 DEGREES. WE HAVE NOT HAD ANY DAYS IN THE LAST FEW MONTHS OUTSIDE OF THIS RANGE. QUANTITY RECEIVED AND QUANTITY AFFECTED: 3 CASES EXHIBIT DAMAGE SHIPMENT METHOD (DIRECTLY OR VIA DISTRIBUTOR): UNKNOWN PHOTOS OR RETURNS REQUESTED?: PHOTOS ATTACHED. RETURNS REQUESTED (3 CASES AVAILABLE FOR RETURN ) FOLLOW UP REQUIRED Y/N?: N REVIEWED SMAX CASE HISTORY: Y. (B)(6) : 2022-08-23 14:33:23 (GMT) SUBJECT: EMAIL 8/23/2022, 9:18:30 AM USER: (B)(6) CREATED ON: 2022-08-23 14:18:30 CALL ACTIVITY COMMENT: RETURNS AVAILABLE (B)(6) : 2022-08-23 14:32:50 (GMT) CUSTOMER STATES 3 CASES AVAILABLE FOR RETURN. AWAITING RESPONSE TO REMAINING QUESTIONS. (B)(6) : 2022-08-22 19:52:06 (GMT) SUBJECT: EMAIL 8/22/2022, 2:31:40 PM USER: (B)(6) CREATED ON: 2022-08-22 19:31:40 CALL ACTIVITY COMMENT: ADDITIONAL INFORMATION REQUESTED (B)(6) : 2022-08-22 19:50:38 (GMT) CUSTOMER PROBLEM: CUSTOMER STATES TUBES HAVE BURN/MOLDY APPEARANCE. MANY TUBES ARE FOGGY AND THE EDTA SEEMS CLUMPED. STEPS TAKEN WITH CUSTOMER/TROUBLESHOOTING: ASKED CUSTOMER FOR ADDITIONAL INFORMATION DID THE SPECIMEN(S) NEED TO BE RECOLLECTED? PENDING DID EXPOSURE TO BLOOD/ BF OCCUR? PENDING IF EXPOSURE OCCURRED WAS THERE ANY POST EXPOSURE TESTING OR MEDICAL INTERVENTION? PENDING NEXT STEPS (IF NECESSARY): AWAITING CUSTOMER RESPONSE RESOLUTION ACHIEVED (Y/N)? : N SHIPMENT/STORAGE/CONDITION UPON RECEIPT: PENDING QUANTITY RECEIVED AND QUANTITY AFFECTED: 3 CASES EXHIBIT DAMAGE SHIPMENT METHOD (DIRECTLY OR VIA DISTRIBUTOR): PENDING IF IT IS A DISTRIBUTOR OR DIRECTLY FROM BD ¿ WHO IS IT? PENDING PHOTOS OR RETURNS REQUESTED?: PHOTOS ATTACHED. RETURNS REQUESTED FOLLOW UP REQUIRED Y/N?: Y. REVIEWED SMAX CASE HISTORY: Y. (B)(6) : 2022-08-22 19:41:47 (GMT) CUSTOMER STATES TUBES HAVE BURNT APPEARANCE AND MANY TUBES HAVE CLUMPED MEDIA AND SEEM FOGGY AND MOLDY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2411119 | BD VACUTAINER® K2 EDTA (K2E) 7.2MG BLOOD COLLECTION TUBES | BLOOD SPECIMEN COLLECTION DEVICE | JKA | BECTON, DICKINSON & CO. (BROKEN BOW) | 367861 | 2018857 | 50382903678612 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |