FDA Adverse Event Malfunction Summary report: N

BD INSYTE¿ AUTOGUARD¿ SHIELDED IV CATHETER

MDR report key: 16587672 · Received March 21, 2023

Report

Report Number
1710034-2023-00294
Event Type
Malfunction
Date Received
March 21, 2023
Date of Event
February 17, 2023
Report Date
September 19, 2023
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
UDI-DI
00382903818235
PMA / PMN Number
K952861
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 SINCE NO SAMPLES DISPLAYING THE CONDITION REPORTED WERE AVAILABLE FOR EXAMINATION, WE WERE UNABLE TO FULLY INVESTIGATE THIS INCIDENT. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D10: DEVICE AVAILABLE FOR EVAL YES, D10: RETURNED TO MANUFACTURER ON: 24-AUG-2023. H6: INVESTIGATION SUMMARY OUR QUALITY ENGINEER INSPECTED THE SAMPLE SUBMITTED FOR EVALUATION. BD RECEIVED ONE USED 22G X 1.00IN. INSYTE AUTOGUARD UNIT FROM LOT NUMBER 2312415. A GROSS VISUAL INSPECTION OF THE RETURNED UNIT FOUND THAT THE NEEDLE WAS PARTIALLY RETRACTED, AND THE NEEDLE WAS BENT AT THE NOTCH. IT IS LIKELY THAT THE BEND WAS CAUSED POST-USE, DURING TRANSIT OF THE PRODUCT, AS YOUR REPORT DOES NOT REPORT A BENT NEEDLE. THE UNIT WAS FURTHER INSPECTED MICROSCOPICALLY TO DETERMINE WHAT WAS PREVENTING THE NEEDLE FROM RETRACTING. MICROSCOPIC INSPECTION FOUND THAT THE END OF THE GRIP, WHICH COUPLES WITH THE BARREL, WAS DEFORMED. THE DEFORMATION WAS BENDING IN, PREVENTING THE NEEDLE HUB FROM RELEASING FULLY INTO THE BARREL. THE REPORTED ISSUE WAS CONFIRMED AND DETERMINED TO BE MANUFACTURING RELATED. DURING MANUFACTURING, THIS TYPE OF DAMAGE MAY OCCUR DUE TO A MACHINE MISALIGNMENT. OPERATORS PERFORM TESTING FOR NEEDLE RETRACTION PER THE QUALITY CONTROL PLAN TO MITIGATE THE OCCURRENCE OF THIS DEFECT. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH.

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.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD INSYTE¿ AUTOGUARD¿ SHIELDED IV CATHETER NEEDLE WOULD NOT RETRACT AFTER PLACING THE KTC. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM FRENCH: "FOR THE FOLLOWING REASON: IT WAS NOT POSSIBLE TO RETRACT THE NEEDLE AFTER THE PLACEMENT OF THE KTC: THE NURSE ALMOST PRICKED HERSELF. PATIENT CONCERNED? NO".

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD INSYTE¿ AUTOGUARD¿ SHIELDED IV CATHETER NEEDLE WOULD NOT RETRACT AFTER PLACING THE KTC. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM FRENCH: "FOR THE FOLLOWING REASON: IT WAS NOT POSSIBLE TO RETRACT THE NEEDLE AFTER THE PLACEMENT OF THE KTC: THE NURSE ALMOST PRICKED HERSELF. PATIENT CONCERNED? NO."

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD INSYTE¿ AUTOGUARD¿ SHIELDED IV CATHETER NEEDLE WOULD NOT RETRACT AFTER PLACING THE KTC. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM FRENCH: "FOR THE FOLLOWING REASON: IT WAS NOT POSSIBLE TO RETRACT THE NEEDLE AFTER THE PLACEMENT OF THE KTC: THE NURSE ALMOST PRICKED HERSELF. PATIENT CONCERNED? NO".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
11884 BD INSYTE¿ AUTOGUARD¿ SHIELDED IV CATHETER INTRAVASCULAR CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 381823 2312415 00382903818235

Patients

Seq Age Sex Outcome Treatment
1 Unknown