FDA Adverse Event Malfunction Summary report: N

BD DISCARDIT¿ SYRINGE

MDR report key: 15789524 · Received November 14, 2022

Report

Report Number
2243072-2022-01939
Event Type
Malfunction
Date Received
November 14, 2022
Date of Event
July 11, 2022
Report Date
November 14, 2022
Manufacturer
BECTON DICKINSON
Product Code
FMF
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE MANUFACTURING LOCATION FOR THIS PRODUCT IS BAWAL, INDIA. THIS SITE IS NOT REGISTERED WITH THE FDA. THEREFORE, BD CORPORATE HEADQUARTERS IN (B)(4) HAS BEEN LISTED IN SECTIONS THE (B)(4) FDA REGISTRATION NUMBER HAS BEEN USED FOR THE MANUFACTURE REPORT NUMBER. INITIAL REPORTER PHONE#: UNKNOWN. INITIAL REPORTER E-MAIL: UNKNOWN. 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: THE TEN PHOTOS WERE RECEIVED BY BD FOR EVALUATION. A QUALITY ENGINEER WAS ABLE TO REVIEW THE PHOTO OF A DISCARDIT 2ML WITH 25GX1 NEEDLE FROM LOT #2150646 REGARDING ITEM # 302438 WITH THE REPORTED COMPLAINT OF MULTIPLE DEFECTS (BLACK SPOT, FOREIGN PARTICLES, AND HAIR PARTICLES) IN THE SYRINGE. THE INVESTIGATING TEAM HAS USED THE RETENTION SAMPLES OF LOT #2150646 REGARDING ITEM # 302438 FOR INVESTIGATING THE REPORTED DEFECT. THE INVESTIGATION AND SIMULATION WERE CARRIED OUT ON RETENTION SAMPLES WHERE THE INVESTIGATING TEAM HAS VISUALLY TESTED THE SAMPLES FOR DEFECTS NO DEFECT IN SYRINGE WAS FOUND IN THE RETENTION SAMPLES. THE INVESTIGATION WAS ALSO CARRIED OUT ON THE PHOTOGRAPH AS WELL. THE PHOTOGRAPH CONFIRMS THE REPORTED DEFECT IN THE SYRINGE. THE DHR OF MATERIAL NO. 302438 WITH BATCH NO. 2150646 WAS CHECKED AND THERE WAS NO QUALITY NOTIFICATION FOUND ON THIS LOT NO.

Description of Event or Problem · 0

IT WAS REPORTED THAT 111 BD DISCARDIT¿ SYRINGES' PACKAGING UNITS HAD POOR PERFORATION. THIS COMPLAINT WAS CREATED TO CAPTURE THE 4TH OF 6 RELATED INCIDENTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "(B)(4) UNITS HAVING DEFECTS LIKE BLACK SPOT, FOREIGN PARTICLES, MARKING DEFECTS.''

Description of Event or Problem · 0

IT WAS REPORTED THAT 111 BD DISCARD IT¿ SYRINGES' PACKAGING UNITS HAD POOR PERFORATION. THIS COMPLAINT WAS CREATED TO CAPTURE THE 4TH OF 6 RELATED INCIDENTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "15750 UNITS HAVING DEFECTS LIKE BLACK SPOT, FOREIGN PARTICLES, MARKING DEFECTS..."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
350334 BD DISCARDIT¿ SYRINGE PISTON SYRINGE FMF BECTON DICKINSON 2150646

Patients

Seq Age Sex Outcome Treatment
1 Unknown