FDA Adverse Event Malfunction Summary report: N

BD® 10ML SYRINGE NRFIT¿ LOK (STERILE)

MDR report key: 15498951 · Received September 28, 2022

Report

Report Number
1213809-2022-00649
Event Type
Malfunction
Date Received
September 28, 2022
Date of Event
September 8, 2022
Report Date
November 12, 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
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DATE OF EVENT IS UNKNOWN; AWARENESS DATE HAS BEEN USED FOR THIS . INITIAL REPORTER NAME AND ADDRESS: ADDRESS INFORMATION WAS NOT ABLE TO BE OBTAINED, THEREFORE, (B)(6) WAS USED AS A PLACE HOLDER. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: ONE PHOTO WAS PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. THROUGH VISUAL INSPECTION, IT WAS OBSERVED THAT 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 PHOTO ANALYSIS THE SYMPTOM REPORTED IS CONFIRMED.

Additional Manufacturer Narrative · 0

(B)(4). FOLLOW UP #2 REPORT 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 WHILE USING BD® 10ML SYRINGE NRFIT¿ LOK (STERILE) THE TIP OF THE LUER WAS DEFORMED. THIS OCCURRED TWICE. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: ONE OF OUR TESTING SITES INITIALLY BELIEVED THE NRFIT SYRINGES TO BE INCOMPATIBLE WITH THE NRFIT NEEDLES; HOWEVER UPON CLOSER INSPECTION THEY CONFIRMED THE NRFIT SYRINGE CONTAINED A DEFECT.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD® 10ML SYRINGE NRFIT¿ LOK (STERILE) THE TIP OF THE LUER WAS DEFORMED. THIS OCCURRED TWICE. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: ONE OF OUR TESTING SITES INITIALLY BELIEVED THE NRFIT SYRINGES TO BE INCOMPATIBLE WITH THE NRFIT NEEDLES; HOWEVER UPON CLOSER INSPECTION THEY CONFIRMED THE NRFIT SYRINGE CONTAINED A DEFECT.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1885164 BD® 10ML SYRINGE NRFIT¿ LOK (STERILE) PISTON SYRINGE WITH NEURAXIAL CONNECTOR QEH BECTON DICKINSON MEDICAL SYSTEMS 400174 1041220 00382904001742

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown