FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES

MDR report key: 16030080 · Received December 21, 2022

Report

Report Number
1024879-2022-00736
Event Type
Malfunction
Date Received
December 21, 2022
Date of Event
November 28, 2022
Report Date
April 20, 2023
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
50382903679886
PMA / PMN Number
BK050036
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO CORRECTED INFORMATION: D.4. MEDICAL DEVICE LOT #: 2181522. D.4. MEDICAL DEVICE EXPIRATION DATE: 2023-06-30. H.4. DEVICE MANUFACTURE DATE: 2022-06-30.

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: BD HAD NOT RECEIVED SAMPLES OR PHOTOS FOR EVALUATION. THEREFORE, RETENTION SAMPLES OF THE INCIDENT LOT WERE SELECTED FROM BD INVENTORY FOR EVALUATION AND UPON COMPLETION, THE INDICATED FAILURE MODE FOR FIBRIN WAS OBSERVED. THERE WERE NO DIFFICULTIES ENCOUNTERED DURING BLOOD COLLECTION AS ALL TUBES EXHIBITED PROPER FILL. BD WAS ABLE TO DUPLICATE THE CUSTOMER¿S INDICATED FAILURE MODE, FIBRIN, BECAUSE THE DEFECT WAS PRESENT IN THE TESTING OF THE COMPLAINT LOT SAMPLES. VISUAL OBSERVATIONS OF FIBRIN STRANDS WERE SEEN BUT VISUAL OBSERVATIONS OF FIBRIN MASS WERE NOT SEEN WITH RESPECT TO BOTH RETAIN AND CONTROL SAMPLES TESTED. BASED ON A REVIEW OF THE DEVICE HISTORY RECORD FOR THE INCIDENT LOT, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET. THERE WERE NO RELATED QUALITY ISSUES DURING MANUFACTURING OF THE PRODUCT. THIS COMPLAINT HAS BEEN CONFIRMED FOR THE INDICATED FAILURE MODE FIBRIN (FIBRIN STRANDS). BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Additional Manufacturer Narrative · 0

MEDICAL DEVICE EXPIRATION DATE: 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 WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBE THERE WAS A CLOGGED /BLOCKED INSTRUMENTATION PROBE AND MISSING ADDITIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "FIBRIN FROM TUBES IS CLOGGING THEIR NEW ROCHE INSTRUMENT." THERE WAS NO REPORT OF ERRONEOUS RESULTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBE THERE WAS A CLOGGED /BLOCKED INSTRUMENTATION PROBE AND MISSING ADDITIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "FIBRIN FROM TUBES IS CLOGGING THEIR NEW ROCHE INSTRUMENT." THERE WAS NO REPORT OF ERRONEOUS RESULTS.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® SST¿ BLOOD COLLECTION TUBE THERE WAS A CLOGGED /BLOCKED INSTRUMENTATION PROBE AND MISSING ADDITIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "FIBRIN FROM TUBES IS CLOGGING THEIR NEW ROCHE INSTRUMENT." THERE WAS NO REPORT OF ERRONEOUS RESULTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1630639 BD VACUTAINER® SST¿ BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON & CO., (BD) 367988 2181522 50382903679886

Patients

Seq Age Sex Outcome Treatment
1 Unknown