FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE W/ PRE-ATTACH HOLDER

MDR report key: 16938748 · Received May 16, 2023

Report

Report Number
1024879-2023-00299
Event Type
Malfunction
Date Received
May 16, 2023
Date of Event
April 21, 2023
Report Date
May 31, 2023
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
FMI
UDI-DI
50382903686501
PMA / PMN Number
K982541
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D9: DEVICE AVAILABLE FOR EVALUATION: YES, D9: RETURNED TO MANUFACTURER ON: 2023-05-23. H.6. INVESTIGATION SUMMARY: BD RECEIVED 46 SAMPLES (11 FROM LOT 2245305, 11 FROM LOT 2245312, 12 FROM LOT 2160115, AND 12 FROM LOT 2251982. NO SAMPLES FROM LOT 2145499) AND 1 PHOTO OF LOT 2245312 FOR INVESTIGATION. THE PHOTO WAS REVIEWED AND THE CUSTOMER¿S INDICATED FAILURE MODE FOR FOREIGN MATTER WAS OBSERVED. THE NATURE AND ORIGIN OF THE FOREIGN MATTER COULD NOT BE DETERMINED FROM THE PHOTO. THE FAILURE MODE OF DULL NEEDLE POINT WAS NOT OBSERVED FROM THE PHOTO. THE CUSTOMER SAMPLES WERE EVALUATED BY VISUAL EXAMINATION AND THE INDICATED FAILURE MODES FOR FOREIGN MATTER AND DULL NEEDLE POINT WITH THE INCIDENT LOT WAS NOT OBSERVED IN ANY OF THE SAMPLES. ADDITIONALLY, 30 RETENTION SAMPLES OF LOT 2145499 FROM BD INVENTORY WERE EVALUATED BY VISUAL EXAMINATION AND THE ISSUES OF FOREIGN MATTER AND DULL NEEDLE POINT WERE NOT OBSERVED. 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 FOREIGN MATTER FOR LOT 2245312. THIS COMPLAINT IS UNABLE TO BE CONFIRMED FOR THE INDICATED FAILURE MODE DULL NEEDLE POINT FOR LOT 2245312. THIS COMPLAINT IS UNABLE TO BE CONFIRMED FOR THE INDICATED FAILURE MODES FOREIGN MATTER AND DULL NEEDLE POINT FOR LOTS 2145499, 2245305, 2160115, 2251982. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODES. H3 OTHER TEXT : SEE H.10.

Additional Manufacturer Narrative · 0

THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: D.4. MEDICAL DEVICE LOT #: 2245305. D.4. MEDICAL DEVICE EXPIRATION DATE: 2025-08-31. H.4. DEVICE MANUFACTURE DATE: 2022-09-02. D.4. MEDICAL DEVICE LOT #: 2251982. D.4. MEDICAL DEVICE EXPIRATION DATE: 2025-08-31. H.4. DEVICE MANUFACTURE DATE: 2022-09-30. D.4. MEDICAL DEVICE LOT #: 2245312. D.4. MEDICAL DEVICE EXPIRATION DATE: 2025-08-31. H.4. DEVICE MANUFACTURE DATE: 2022-09-22. D.4. MEDICAL DEVICE LOT #: 2145499. D.4. MEDICAL DEVICE EXPIRATION DATE: 2025-05-31. H.4. DEVICE MANUFACTURE DATE: 2022-06-09. D.4. MEDICAL DEVICE LOT #: 2160115. D.4. MEDICAL DEVICE EXPIRATION DATE: 2025-06-30. H.4. DEVICE MANUFACTURE DATE: 2022-06-30. H.3. 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 WHEN USING THE BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE W/ PRE-ATTACH HOLDER THERE WAS FOREIGN MATTER ON THE DEVICE NEEDLE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE IS SOME EXTRA WHITE IN NEEDLES (SILICON)."

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE W/ PRE-ATTACH HOLDER THERE WAS FOREIGN MATTER ON THE DEVICE NEEDLE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER. THE CUSTOMER STATED: "THERE IS SOME EXTRA WHITE IN NEEDLES (SILICON).".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1165858 BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE W/ PRE-ATTACH HOLDER HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON, DICKINSON & CO., (BD) 368650 SEE H.10 50382903686501

Patients

Seq Age Sex Outcome Treatment
1 Unknown