FDA Adverse Event Malfunction Summary report: N

BD MICRO-FINE¿+ PRO PEN NEEDLE

MDR report key: 15929226 · Received December 6, 2022

Report

Report Number
9616656-2022-01322
Event Type
Malfunction
Date Received
December 6, 2022
Date of Event
November 11, 2022
Report Date
January 31, 2023
Manufacturer
BECTON DICKINSON AND CO.
Product Code
FMI
UDI-DI
00382903205592
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO RECEIVING ADDITIONAL INFORMATION FROM THE CUSTOMER: D.4. MEDICAL DEVICE LOT #: 2060475. D.4. MEDICAL DEVICE EXPIRATION DATE: 31-MAR-2027. H.4. DEVICE MANUFACTURE DATE: 01-MAR-2022. H.6. INVESTIGATION SUMMARY: SAMPLES WERE RECEIVED AND AN INVESTIGATION WAS PERFORMED. THIS IS THE 2ND 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. EMBECTA WAS ABLE TO DUPLICATE OR CONFIRM THE INDICATED ISSUE AND BASED ON TREND ANALYSIS NO FURTHER ACTION IS REQUIRED AT THIS TIME. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. BASED ON THE ABOVE, NO ADDITIONAL INVESTIGATION AND NO CORRECTIVE/PREVENTATIVE ACTION (CAPA) OR SITUATIONAL ANALYSIS (SA) IS REQUIRED AT THIS TIME.

Additional Manufacturer Narrative · 0

MEDICAL DEVICE EXPIRATION DATE: 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. DEVICE MANUFACTURE DATE: UNKNOWN.

Description of Event or Problem · 0

IT WAS REPORTED THAT FOREIGN MATTER WAS FOUND ON THE NON-PATIENT END OF THE BD MICRO-FINE¿+ PRO PEN NEEDLE. THIS COMPLAINT WAS CREATED TO CAPTURE THE 2ND OF 3 RELATED INCIDENTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM JAPANESE: "THIS IS A REPORT FROM THE PHARMACIST... WHEN CHECKING THE AFFECTED PRODUCT, THE PHARMACIST NOTICED THAT THE NP SIDE WAS COVERED WITH SOMETHING, WHICH MAY BE ASSOCIATED WITH THE FAILURE FOR THE DRUG SOLUTION TO COME OUT."

Description of Event or Problem · 0

IT WAS REPORTED THAT FOREIGN MATTER WAS FOUND ON THE NON-PATIENT END OF THE BD MICRO-FINE¿+ PRO PEN NEEDLE. THIS COMPLAINT WAS CREATED TO CAPTURE THE 2ND OF 3 RELATED INCIDENTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM JAPANESE: "THIS IS A REPORT FROM THE PHARMACIST... WHEN CHECKING THE AFFECTED PRODUCT, THE PHARMACIST NOTICED THAT THE NP SIDE WAS COVERED WITH SOMETHING, WHICH MAY BE ASSOCIATED WITH THE FAILURE FOR THE DRUG SOLUTION TO COME OUT."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2596115 BD MICRO-FINE¿+ PRO PEN NEEDLE HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON AND CO. 2060475 00382903205592

Patients

Seq Age Sex Outcome Treatment
1 Unknown