FDA Adverse Event Malfunction Summary report: N

BD MICRO-FINE ULTRA¿ PEN NEEDLE

MDR report key: 15924608 · Received December 6, 2022

Report

Report Number
9616656-2022-01308
Event Type
Malfunction
Date Received
December 6, 2022
Date of Event
November 9, 2022
Report Date
January 10, 2023
Manufacturer
BECTON DICKINSON AND CO.
Product Code
FMI
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. THIS IS THE 1ST RELATED COMPLAINT FOR THE REPORTED LOT NUMBER. A REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT.

Additional Manufacturer Narrative · 0

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. 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

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D10: DEVICE AVAILABLE FOR EVAL? YES. D10: RETURNED TO MANUFACTURER ON: 05-JAN-2023. H6. INVESTIGATION SUMMARY: FIFTY FOUR SEALED 31G X 8MM PEN NEEDLE SAMPLES WERE RETURNED FROM LOT. NO. 2060492, CAT. NO. 325108. A CLOG TEST WAS CARRIED OUT ON THIRTY SAMPLES AND NO ISSUES WERE OBSERVED. NO SAMPLES WERE RETURNED FROM LOT. NO. 2110734. A LOT HISTORY REVIEW WAS CARRIED OUT AND NO RELATED NON CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS PACKAGED LOT CONCLUDING ALL INSPECTIONS WERE PERFORMED AS PER THE APPLICABLE OPERATIONS AND MET QC SPECIFICATIONS. NO ISSUES WERE OBSERVED WITH THE RETURNED SAMPLES THEREFORE NO ROOT CAUSE CAN BE IDENTIFIED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD MICRO-FINE ULTRA¿ PEN NEEDLE WAS UNABLE TO DELIVER MEDICATION. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER HAS HAD TO PRICK HIMSELF SEVERAL TIMES, BECAUSE HE CANNOT MAKE HIS INJECTION. HE HAS TO TAKE A NEW NEEDLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD MICRO-FINE ULTRA¿ PEN NEEDLE WAS UNABLE TO DELIVER MEDICATION. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER HAS HAD TO PRICK HIMSELF SEVERAL TIMES, BECAUSE HE CANNOT MAKE HIS INJECTION. HE HAS TO TAKE A NEW NEEDLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD MICRO-FINE ULTRA¿ PEN NEEDLE WAS UNABLE TO DELIVER MEDICATION. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: CUSTOMER HAS HAD TO PRICK HIMSELF SEVERAL TIMES, BECAUSE HE CANNOT MAKE HIS INJECTION. HE HAS TO TAKE A NEW NEEDLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
314766 BD MICRO-FINE ULTRA¿ PEN NEEDLE HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON AND CO. 2060492

Patients

Seq Age Sex Outcome Treatment
1 Unknown