FDA Adverse Event Malfunction Summary report: N

BD DURASAFE¿ TRAY

MDR report key: 15713422 · Received November 2, 2022

Report

Report Number
3014704491-2022-00533
Event Type
Malfunction
Date Received
November 2, 2022
Date of Event
September 30, 2022
Report Date
November 15, 2022
Manufacturer
BD (SUZHOU)
Product Code
CAZ
PMA / PMN Number
K012584
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(6). 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

H6: INVESTIGATION SUMMARY: A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 2102680. OUR RECORDS SHOW THAT THIS IS THE ONLY INSTANCE OF THIS ISSUE OCCURRING IN THIS PRODUCTION BATCH. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED WITHOUT DEFECTS BEING NOTED DURING THE FINAL ASSEMBLY OR VISUAL INSPECTIONS. A SAMPLE COULD NOT BE OBTAINED FOR EVALUATION AND TESTING; IN LIEU OF THE AFFECTED DEVICE, FUNCTIONAL TESTING WAS PERFORMED ON RETENTION SAMPLES FOR THIS LOT, THE RESULTS OF THESE SHOW THAT THE TESTED UNITS PERFORMED WITHIN PRODUCT SPECIFICATIONS. UNFORTUNATELY WITHOUT THE ABILITY TO INVESTIGATE THE AFFECTED UNIT OUR QUALITY ENGINEERS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT. H3 OTHER TEXT: SEE H10.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD DURASAFE¿ TRAY EXPERIENCED LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: IN THE DEPARTMENT OF ANESTHESIOLOGY, SYRINGE IN THE ANESTHESIA BAG WAS FOUND TO LEAK DURING THE USE OF THE PRODUCT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD DURASAFE¿ TRAY EXPERIENCED LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: IN THE DEPARTMENT OF ANESTHESIOLOGY, SYRINGE IN THE ANESTHESIA BAG WAS FOUND TO LEAK DURING THE USE OF THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2873879 BD DURASAFE¿ TRAY ANESTHESIA CONDUCTION KIT CAZ BD (SUZHOU) 2102680

Patients

Seq Age Sex Outcome Treatment
1 Unknown