FDA Adverse Event Malfunction Summary report: N

BD CONNECTA¿ 3-WAY STOPCOCK

MDR report key: 17733244 · Received September 12, 2023

Report

Report Number
9610847-2023-00259
Event Type
Malfunction
Date Received
September 12, 2023
Date of Event
August 28, 2023
Report Date
November 10, 2023
Manufacturer
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
Product Code
FMG
PMA / PMN Number
K974083
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D.4. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. H.3. A DEVICE EVALUATION IS ANTICIPATED BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. H.4. DEVICE MANUFACTURE DATE: UNKNOWN.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D4: MEDICAL DEVICE LOT #: 1152280 D4: MEDICAL DEVICE EXPIRATION DATE: 21-MAY-2024 H4: DEVICE MANUFACTURE DATE: 18-AUG-2021

Additional Manufacturer Narrative · 0

OUR QUALITY ENGINEER INSPECTED THE 3 PHOTOS SUBMITTED FOR EVALUATION. THE REPORTED ISSUE OF LOOSE COMPONENT NO LEAK WAS NOT CONFIRMED UPON INSPECTION OF THE PHOTOS. THE DEFECT REPORTED COULD NOT BE SEEN IN THE SAMPLE PHOTOS SUPPLIED. BD CANNOT CONFIRM THE CAUSE OF THE FAILURE TO OUR MANUFACTURING PROCESS SINCE NO SAMPLE WAS RETURNED FOR EVALUATION. WE WOULD BE VERY INTERESTED IN EXAMINING PRODUCT THAT DOES NOT MEET YOUR EXPECTATIONS AND OUR QUALITY STANDARDS. EXAMINATION OF THE ACTUAL PRODUCT INVOLVED MAY PROVIDE CLARIFICATION AS TO THE CAUSE OF THE REPORTED FAILURE. A REVIEW OF OUR RISK MANAGEMENT DOCUMENTATION WAS PERFORMED AND INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY. WE APPRECIATE YOU TAKING THE TIME TO BRING THIS OBSERVATION TO OUR ATTENTION. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS. WE REGRET ANY INCONVENIENCES THIS INCIDENT MAY HAVE CAUSED YOU AND YOUR FACILITY. H3 OTHER TEXT : SEE NARRATIVE BELOW.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD CONNECTA¿ 3-WAY STOPCOCK HAD A LOOSE CONNECTION DURING USE. THIS OCCURRED WITH 10 STOPCOCKS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: "THE NURSE MANAGER REPORTED THAT THE NUTS WERE FOUND TO BE UNTIGHTENED DURING USE."

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD CONNECTA¿ 3-WAY STOPCOCK HAD A LOOSE CONNECTION DURING USE. THIS OCCURRED WITH 10 STOPCOCKS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: "THE NURSE MANAGER REPORTED THAT THE NUTS WERE FOUND TO BE UNTIGHTENED DURING USE."

Description of Event or Problem · 0

BATCH NUMBER SUPPLIED. THE NURSE MANAGER REPORTED THAT THE NUTS WERE FOUND TO BE UNTIGHTENED DURING USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1231614 BD CONNECTA¿ 3-WAY STOPCOCK STOPCOCK FMG BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. 1152280

Patients

Seq Age Sex Outcome Treatment
1 Unknown