FDA Adverse Event Malfunction Summary report: N

BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM

MDR report key: 15835411 · Received November 21, 2022

Report

Report Number
3014704491-2022-00597
Event Type
Malfunction
Date Received
November 21, 2022
Date of Event
October 12, 2022
Report Date
November 26, 2022
Manufacturer
BD (SUZHOU)
Product Code
FOZ
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 2110901. 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.

Additional Manufacturer Narrative · 0

A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM EXPERIENCED A MISSING PRN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: AFTER THE INDWELLING NEEDLE WAS OPENED, IT WAS FOUND THAT THERE WAS NO HEPARIN CAP, WHICH COULD NOT BE USED NORMALLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM EXPERIENCED A MISSING PRN. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: AFTER THE INDWELLING NEEDLE WAS OPENED, IT WAS FOUND THAT THERE WAS NO HEPARIN CAP, WHICH COULD NOT BE USED NORMALLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
394942 BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM INTRAVASCULAR CATHETER FOZ BD (SUZHOU) 2110901

Patients

Seq Age Sex Outcome Treatment
1 Unknown