FDA Adverse Event Malfunction Summary report: N

BD INTIMA-II CLOSED IV CATHETER SYSTEM

MDR report key: 17295179 · Received July 10, 2023

Report

Report Number
3014704491-2023-00339
Event Type
Malfunction
Date Received
July 10, 2023
Date of Event
June 14, 2023
Report Date
July 23, 2023
Manufacturer
BD (SUZHOU)
Product Code
FOZ
UDI-DI
00382903830831
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H6: INVESTIGATION SUMMARY: IN RESPONSE TO THE EVENT REPORTED A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 3052844. OUR RECORDS SHOW THAT THIS IS THE ONLY INSTANCE OF THIS ISSUE OCCURRING IN THIS PRODUCTION BATCH. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED WITHOUT DEFECTS BEING NOTED DURING THE FINAL ASSEMBLY OR VISUAL INSPECTIONS. A SAMPLE COULD NOT BE OBTAINED FOR EVALUATION AND TESTING; IN LIEU OF THE AFFECTED DEVICE, FUNCTIONAL TESTING WAS PERFORMED ON RETENTION SAMPLES FOR THIS LOT, THE RESULTS OF THESE SHOW THAT THE TESTED UNITS PERFORMED WITHIN PRODUCT SPECIFICATIONS. UNFORTUNATELY WITHOUT THE ABILITY TO INVESTIGATE THE AFFECTED UNIT OUR QUALITY ENGINEERS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT.

Additional Manufacturer Narrative · 0

H.3. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD INTIMA-II CLOSED IV CATHETER SYSTEM LEAKAGE OCCURRED. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: WATER LEAKS AFTER THE CLOSED VENOUS INDWELLING NEEDLE INTERFACE IS CONNECTED TO THE INFUSION SET.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD INTIMA-II CLOSED IV CATHETER SYSTEM LEAKAGE OCCURRED. THERE WAS NO REPORT OF PATIENT IMPACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: WATER LEAKS AFTER THE CLOSED VENOUS INDWELLING NEEDLE INTERFACE IS CONNECTED TO THE INFUSION SET.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1921729 BD INTIMA-II CLOSED IV CATHETER SYSTEM INTRAVASCULAR CATHETER FOZ BD (SUZHOU) 3052844 00382903830831

Patients

Seq Age Sex Outcome Treatment
1 Unknown