FDA Adverse Event Malfunction Summary report: N

BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR

MDR report key: 16235508 · Received January 24, 2023

Report

Report Number
2243072-2023-00055
Event Type
Malfunction
Date Received
January 24, 2023
Date of Event
January 11, 2023
Report Date
March 7, 2023
Manufacturer
BECTON DICKINSON IND. CIRURGICAS LTDA
Product Code
JKA
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO CORRECTED INFORMATION: B.5 DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED WHEN USING THE BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR THERE WAS ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE WERE ISSUES WITH BHCG TEST RESULTS WHEN USING THE ANALYZER OF ANOTHER COMPANY. WHEN THE COMPANY WAS CONTACTED TO PROVIDE A RESPONSE REGARDING THE RESULTS, IT WAS REPORTED THAT THE ISSUE WAS IN REGARD TO THE BD TUBES." D2: COMMON DEVICE NAME: BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR. D2: MEDICAL DEVICE TYPE: JKA. D.3 MEDICAL DEVICE MANUFACTURER: BECTON DICKINSON IND. CIRURGICAS LTDA. D.4. UNIQUE IDENTIFIER (UDI) #:(B)(4). G.1. MANUFACTURING LOCATION: BECTON DICKINSON IND. CIRURGICAS LTDA.

Additional Manufacturer Narrative · 0

UNKNOWN MANUFACTURER: THERE ARE MULTIPLE BD LOCATIONS WHERE THIS UNSPECIFIED BD DEVICE MAY HAVE BEEN MANUFACTURED. A CATALOG AND LOT NUMBER COULD NOT BE CONFIRMED FOR THIS INCIDENT AND WITHOUT THIS INFORMATION WE ARE UNABLE TO DETERMINE WHERE THE DEVICE WAS MANUFACTURED. (B)(4). MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. DEVICE EVALUATED BY MFR: 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.

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: BD HAD NOT RECEIVED SAMPLES OR PHOTOS FOR EVALUATION. ADDITIONALLY, BD WAS UNABLE TO DETERMINE THE SPECIFIC LOT NUMBER ASSOCIATED WITH THIS COMPLAINT; THEREFORE, A REVIEW OF THE DEVICE HISTORY RECORD COULD NOT BE CONDUCTED. THIS COMPLAINT IS UNABLE TO BE CONFIRMED. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THIS COMPLAINT WILL BE REOPENED TO ASSESS THE LEVEL OF INVESTIGATION NEEDED.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR THERE WAS ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE WERE ISSUES WITH BHCG TEST RESULTS WHEN USING THE ANALYZER OF ANOTHER COMPANY. WHEN THE COMPANY WAS CONTACTED TO PROVIDE A RESPONSE REGARDING THE RESULTS, IT WAS REPORTED THAT THE ISSUE WAS IN REGARD TO THE BD TUBES."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE UNSPECIFIED BD VACUTAINER TUBE THERE WAS ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE WERE ISSUES WITH BHCG TEST RESULTS WHEN USING THE ANALYZER OF ANOTHER COMPANY. WHEN THE COMPANY WAS CONTACTED TO PROVIDE A RESPONSE REGARDING THE RESULTS, IT WAS REPORTED THAT THE ISSUE WAS IN REGARD TO THE BD TUBES."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR THERE WAS ERRONEOUS RESULTS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE WERE ISSUES WITH BHCG TEST RESULTS WHEN USING THE ANALYZER OF ANOTHER COMPANY. WHEN THE COMPANY WAS CONTACTED TO PROVIDE A RESPONSE REGARDING THE RESULTS, IT WAS REPORTED THAT THE ISSUE WAS IN REGARD TO THE BD TUBES."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
389625 BD TUBE SST PLH 13X75 3.5 PLBL GOLD BR BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON DICKINSON IND. CIRURGICAS LTDA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown