BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM

    MDR report key: 17990710 · Received October 23, 2023

    Report

    Report Number
    3014704491-2023-00671
    Event Type
    Malfunction
    Date Received
    October 23, 2023
    Date of Event
    August 18, 2023
    Report Date
    October 25, 2023
    Manufacturer
    BD (SUZHOU)
    Product Code
    FOZ
    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

    H.6. INVESTIGATION SUMMARY: A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 3052847. 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. ADDITIONALLY, THE PROVIDED PHOTOGRAPH DISPLAYED A SMALL WHITE PARTICLE ON THE STEEL CANNULA. THIS NONCONFORMANCE HAS BEEN CONFIRMED. ALTHOUGH PHOTOS WERE SUBMITTED FOR EVALUATION, THE AFFECTED 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 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 FOREIGN MATTER WAS FOUND IN THE FLUID PATH OF THE BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: "THE PATIENT UNDERWENT INFUSION THERAPY IN OUR DEPARTMENT ON (B)(6) 2023, AND NEEDED AN INTRAVENOUS INDWELLING NEEDLE FOR INFUSION. AFTER SUCCESSFUL PUNCTURE, THE LIQUID DID NOT DRIP, SO THE INDWELLING NEEDLE WAS REPLACED AND PUNCTURED AGAIN." VIA BD INVESTIGATION TEAM: "QE IDENTIFIED FM IN THE FLUID PATHWAY DURING ANALYSIS OF THE PHOTOGRAPH."

    Description of Event or Problem · 0

    IT WAS REPORTED THAT FOREIGN MATTER WAS FOUND IN THE FLUID PATH OF THE BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE: "THE PATIENT UNDERWENT INFUSION THERAPY IN OUR DEPARTMENT ON (B)(6) 2023, AND NEEDED AN INTRAVENOUS INDWELLING NEEDLE FOR INFUSION. AFTER SUCCESSFUL PUNCTURE, THE LIQUID DID NOT DRIP, SO THE INDWELLING NEEDLE WAS REPLACED AND PUNCTURED AGAIN." VIA BD INVESTIGATION TEAM: "QE IDENTIFIED FM IN THE FLUID PATHWAY DURING ANALYSIS OF THE PHOTOGRAPH."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1980628 BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM INTRAVASCULAR CATHETER FOZ BD (SUZHOU) 3052847

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown