FDA Adverse Event Malfunction Summary report: N

BD PLASTIPAK¿ LUER-LOK¿ SYRINGE

MDR report key: 16261523 · Received January 28, 2023

Report

Report Number
3002682307-2023-00008
Event Type
Malfunction
Date Received
January 28, 2023
Date of Event
January 11, 2023
Report Date
March 10, 2023
Manufacturer
BECTON DICKINSON, S.A.
Product Code
FMF
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AFTER FURTHER REVIEW, THE PRODUCT NUMBER PROVIDED BY THE CUSTOMER DID NOT CORRESPOND WITH THE EVENT DESCRIPTION. AS A RESULT, THE FOLLOWING FIELDS HAVE BEEN UPDATED WITH CORRECTIONS: B.5. DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED THAT 10 BD PLASTIPAK¿ LUER-LOK¿ SYRINGES' PLUNGER RODS HAD OILY FOREIGN MATTER ON THEM. D.1. MEDICAL DEVICE BRAND NAME: BD PLASTIPAK¿ LUER-LOK¿ SYRINGE D.2. MEDICAL DEVICE CATALOG#: 301229 D.3. MEDICAL DEVICE MANUFACTURER: BECTON DICKINSON, S.A. (SAN AGUSTIN, SPAIN) D.5. UNIQUE IDENTIFIER (UDI) #: (B)(4). G.2. MANUFACTURING LOCATION: BECTON DICKINSON, S.A. (SAN AGUSTIN, SPAIN) H.4. DEVICE MANUFACTURE DATE: 20-JUN-2022

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.

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY: NO PHOTOS OR PHYSICAL SAMPLES THAT DISPLAY THE REPORTED CONDITION HAVE BEEN PROVIDED FOR EVALUATION. A DEVICE HISTORY REVIEW WAS PERFORMED FOR REPORTED LOT 2206110, NO DEVIATIONS OR NON-CONFORMANCES WERE IDENTIFIED DURING THE MANUFACTURING PROCESS THAT COULD HAVE CONTRIBUTED TO THIS ISSUE. TEN RETAINED SAMPLES OF LOT 2206110 WERE USED FOR ADDITIONAL EVALUATION. THE PRODUCTS WERE VISUALLY INSPECTED, NO FOREIGN MATTER OR OTHER LIQUID WAS OBSERVED INSIDE ANY OF THE SYRINGES. IT IS POSSIBLE THE LIQUID THAT WAS DESCRIBED TO BE OBSERVED IN THE SYRINGE WAS SILICONE. LUBRICANT IS EMPLOYED DURING THE SYRINGE ASSEMBLY PROCESS TO LUBRICATE THE CYLINDERS IN THE SILICONE STATION. THE SILICONE EMPLOYED IN THIS PRODUCT IS A MEDICAL GRADE SILICONE AUTHORIZED FOR PRODUCT USE. SILICONE CONTENT TESTS ARE PERFORMED DURING THE MANUFACTURING PROCESS OF EACH LOT NUMBER. RESULTS WERE REVIEWED FOR LOT 2206110 AND FOUND TO BE WITHIN SPECIFICATION. SILICONE CAN BE VISIBLE DUE TO ISSUES RELATED TO POOR DISTRIBUTION INSIDE THE BARREL. AS NO DEFECT WAS OBSERVED IN THE RETAINED SAMPLES AND DEVICE RECORDS DO NOT INDICATE ANY ISSUES OCCURRED DURING MANUFACTURING, A DEFINITIVE ROOT CAUSE RELATED TO OUR MANUFACTURING PROCESS CANNOT BE IDENTIFIED AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD PLASTIPAK¿ LUER-LOK¿ SYRINGES' PLUNGER RODS HAD OILY FOREIGN MATTER ON THEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM DUTCH: "PARENTS OF THE PATIENT USED 30ML SYRINGES OF BD TO ADMINISTER SCIG. THEY NOTICED THAT, WHEN PULLED UP, THERE WAS A SMALL 'OIL' LIKE SUBSTANCE IN THE SYRINGE. THEY PULLED THE PLUNGER OUT OF THE SYRINGE AND FELT AN OILY SUBSTANCE AT THE END OF THE PLUNGER, BLACK , RUBBER PART. I MYSELF DROVE TO THE PATIENT AND ALSO REMOVED THE PLUNGER AND IT FELT LIKE THERE IS SOME MOISTURE/OIL (HARD TO TELL BECAUSE OF THE AMOUNT) PRESENT IN THE SYRINGE."

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD EMERALD¿ SYRINGES' PLUNGER RODS HAD OILY FOREIGN MATTER ON THEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM DUTCH: "PARENTS OF THE PATIENT USED 30ML SYRINGES OF BD TO ADMINISTER SCIG. THEY NOTICED THAT, WHEN PULLED UP, THERE WAS A SMALL 'OIL' LIKE SUBSTANCE IN THE SYRINGE. THEY PULLED THE PLUNGER OUT OF THE SYRINGE AND FELT AN OILY SUBSTANCE AT THE END OF THE PLUNGER, BLACK , RUBBER PART. I MYSELF DROVE TO THE PATIENT AND ALSO REMOVED THE PLUNGER AND IT FELT LIKE THERE IS SOME MOISTURE/OIL (HARD TO TELL BECAUSE OF THE AMOUNT) PRESENT IN THE SYRINGE."

Description of Event or Problem · 0

IT WAS REPORTED THAT 10 BD PLASTIPAK¿ LUER-LOK¿ SYRINGES' PLUNGER RODS HAD OILY FOREIGN MATTER ON THEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM DUTCH: "PARENTS OF THE PATIENT USED 30ML SYRINGES OF BD TO ADMINISTER SCIG. THEY NOTICED THAT, WHEN PULLED UP, THERE WAS A SMALL 'OIL' LIKE SUBSTANCE IN THE SYRINGE. THEY PULLED THE PLUNGER OUT OF THE SYRINGE AND FELT AN OILY SUBSTANCE AT THE END OF THE PLUNGER, BLACK , RUBBER PART. I MYSELF DROVE TO THE PATIENT AND ALSO REMOVED THE PLUNGER AND IT FELT LIKE THERE IS SOME MOISTURE/OIL (HARD TO TELL BECAUSE OF THE AMOUNT) PRESENT IN THE SYRINGE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
401348 BD PLASTIPAK¿ LUER-LOK¿ SYRINGE PISTON SYRINGE FMF BECTON DICKINSON, S.A. 2206110

Patients

Seq Age Sex Outcome Treatment
1 Unknown