FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® ECLIPSE¿ SIGNAL¿ BLOOD COLLECTION NEEDLE

MDR report key: 17936256 · Received October 13, 2023

Report

Report Number
9617032-2023-01461
Event Type
Malfunction
Date Received
October 13, 2023
Date of Event
September 20, 2023
Report Date
May 1, 2024
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
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, D.9:DEVICE EVAL BY MANUFACTURER? YES, D9: RETURNED TO MANUFACTURER ON: 01-MAY-2024. H.6 INVESTIGATION SUMMARY MATERIAL #: 368838, LOT/BATCH #: 3142293, BD RECEIVED 1 SAMPLE FOR INVESTIGATION. THE SAMPLE WAS EVALUATED BY VISUAL EXAMINATION AND THE INDICATED FAILURE MODE FOR BROKEN CANNULA WITH THE INCIDENT LOT WAS OBSERVED. ADDITIONALLY, 10 RETENTION SAMPLES FROM BD INVENTORY WERE EVALUATED BY VISUAL EXAMINATION AND FUNCTIONAL TESTING AND THE ISSUE OF BROKEN CANNULA WAS 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 BROKEN CANNULA. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED.

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: "MATERIAL #: 368838, LOT/BATCH #: 3142293. BD HAD NOT RECEIVED SAMPLES OR PHOTOS FOR INVESTIGATION. THEREFORE, 10 RETENTION SAMPLES FROM BD INVENTORY WERE EVALUATED BY FUNCTIONAL TESTING, EACH USED TO DRAW 6 VACUTAINER TUBES, AND NO ISSUES WERE OBSERVED RELATING TO CANNULA BREAKS OFF AS ALL SAMPLES MET SPECIFICATIONS. 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 IS UNABLE TO BE CONFIRMED FOR THE INDICATED FAILURE MODE CANNULA BREAKS OFF. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS."

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USAGE OF BD VACUTAINER® ECLIPSE¿ SIGNAL¿ BLOOD COLLECTION NEEDLE TEH CANNULA BREAKS OFF OR PULLS OUT. THE FOLLOWING WAS REPORTED BY THE INITIAL REPORTER: THE NEEDLE BROKE OFF IN THE ARTERIAL LINE SAMPLING PAD. THE HEMODIALYSIS DEPARTMENT HAS INFORMED ME OF AN INCIDENT INVOLVING THE USE OF A 22G ECLIPSE BLACK SAFETY NEEDLE REF368838 ON A DIALYSIS LINE. DURING SAMPLING, THE NEEDLE BROKE OFF IN THE ARTERIAL LINE SAMPLING PAD, SENDING AIR INTO THE EXTRACORPOREAL CIRCUIT DURING DIALYSIS. THE SESSION WAS STOPPED IN ORDER TO REASSEMBLE A CIRCUIT ON ANOTHER DIALYSIS MACHINE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USAGE OF BD VACUTAINER® ECLIPSE¿ SIGNAL¿ BLOOD COLLECTION NEEDLE TEH CANNULA BREAKS OFF OR PULLS OUT. THE FOLLOWING WAS REPORTED BY THE INITIAL REPORTER: THE NEEDLE BROKE OFF IN THE ARTERIAL LINE SAMPLING PAD. THE HEMODIALYSIS DEPARTMENT HAS INFORMED ME OF AN INCIDENT INVOLVING THE USE OF A 22G ECLIPSE BLACK SAFETY NEEDLE REF368838 ON A DIALYSIS LINE. DURING SAMPLING, THE NEEDLE BROKE OFF IN THE ARTERIAL LINE SAMPLING PAD, SENDING AIR INTO THE EXTRACORPOREAL CIRCUIT DURING DIALYSIS. THE SESSION WAS STOPPED IN ORDER TO REASSEMBLE A CIRCUIT ON ANOTHER DIALYSIS MACHINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1717025 BD VACUTAINER® ECLIPSE¿ SIGNAL¿ BLOOD COLLECTION NEEDLE BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 3142293

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown