FDA Adverse Event Malfunction Summary report: N

BD LUER-LOK

MDR report key: 18544724 · Received January 19, 2024

Report

Report Number
9614033-2024-00003
Event Type
Malfunction
Date Received
January 19, 2024
Date of Event
December 20, 2023
Report Date
April 1, 2024
Manufacturer
BECTON DICKINSON DE MEXICO
Product Code
FMF
UDI-DI
00382903033102
PMA / PMN Number
K151766
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D.4. OTHER LOT NUMBER INCLUDES 3012143 AND OTHER EXPIRATION DATE INCLUDES 2028-01-31. OTHER LOT NUMBER INCLUDES 3012142 AND OTHER EXPIRATION DATE INCLUDES 2028-01-31. OTHER LOT NUMBER INCLUDES 2098110 AND OTHER EXPIRATION DATE INCLUDES 2027-04-30. OTHER LOT NUMBER INCLUDES 9015947 AND OTHER EXPIRATION DATE INCLUDES 2024-01-31. OTHER LOT NUMBER INCLUDES 2098112 AND OTHER EXPIRATION DATE INCLUDES 2027-04-30. H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED. H.4. OTHER LOT NUMBER DEVICE MANUFACTURE DATE IS 2023-03-15. OTHER LOT NUMBER DEVICE MANUFACTURE DATE IS 2023-03-15. OTHER LOT NUMBER DEVICE MANUFACTURE DATE IS 2022-06-16. OTHER LOT NUMBER DEVICE MANUFACTURE DATE IS 2019-03-21. OTHER LOT NUMBER DEVICE MANUFACTURE DATE IS 2022-06-18.

Additional Manufacturer Narrative · 0

SEVEN SAMPLES AND PHOTO RECEIVED FOR INVESTIGATION. THROUGH VISUAL INSPECTION, IT CAN BE OBSERVED THAT THE SYRINGE IS LUBRICATED WITH WHAT APPEARS TO BE SILICONE. TESTING WAS PERFORMED, RESULTS VERIFIED EXCESS AMOUNT OF SILICONE ON THREE SYRINGES. A DEVICE HISTORY REVIEW WAS PERFORMED FOR REPORTED LOTS, NO DEVIATIONS OR NON-CONFORMANCES WERE IDENTIFIED DURING THE MANUFACTURING PROCESS THAT COULD HAVE CONTRIBUTED TO THIS ISSUE. LUBRICANT IS EMPLOYED DURING THE SYRINGE ASSEMBLY PROCESS TO LUBRICATE THE CYLINDERS IN THE SILICONE STATION. THE SILICONE EMPLOYED IN THIS PRODUCT IS A MEDICAL GRADE SILICONE AUTHORIZED FOR PRODUCT USE. SILICONE CONTENT TESTS ARE PERFORMED DURING THE MANUFACTURING PROCESS OF EACH LOT NUMBER. RESULTS WERE REVIEWED FOR REPORTED LOTS AND FOUND TO BE WITHIN SPECIFICATION. BASED ON THE INVESTIGATION RESULTS EXCESS SILICONE CAN OCCUR DUE TO A FAILURE IN THE SPRAYER THAT DOSES THE SILICONE INSIDE THE BARRELS. MAINTENANCE PLAN FOR SILICONE NOZZLES WILL BE UPDATED. FINAL PRODUCTS IN THIS MANUFACTURING LINE, FOR THIS REFERENCE ARE SAMPLED AND THEY ARE SUBJECTED TO VISUAL AND FUNCTIONAL INSPECTIONS DURING THE DIFFERENT MANUFACTURING SUB-PROCESSES ACCORDING TO PROCEDURES.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD LUER-LOK SYRINGES CONTAINED FOREIGN MATTER. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "MOISTURE INSIDE OF THE 20ML SYRINGES (LAWSON# 319377) ACROSS MULTIPLE LOT NUMBERS. ALL 20ML SYRINGES FROM OSC RWC HAVE BEEN PULLED FROM THE PAR CART AND HELD IN THE SUPPLY CHAIN OFFICE." ITEM: 303310. HERE ARE THE LOT NUMBERS FOR THE AFFECTED 20ML SYRINGES. 3012143, 3012142, 2098110, 2669632, 2339636, 9015947, 2098112, 3272892, 2179663, 2298216. ADDITIONAL INFORMATION RECEIVED ON 01/12/24: 1. ARE YOU ABLE TO PROVIDE THE DATES OF THE EVENTS IN THE FORMAT OF MM-DD-YYYY? IF UNKNOWN, CAN STATE UNKNOWN. (B)(6) 2023. 2. HOW WAS THE PATIENT OUTCOME? ARE THERE ANY CLINICAL SIGNS, HEALTH CONSEQUENCES OR IMPACT? ALL STOCK WAS PUT ON HOLD PENDING A CONFIRMATION THAT THIS DEVIATION IS NOT A HEALTH CONCERN. 3. ANY PHYSICAL SAMPLE OR PHOTO AVAILABLE FOR INVESTIGATION? IF YES, ARE YOU ABLE TO PROVIDE THE ADDRESS OF THE FACILITY FOR US TO SHIP THE RETURN LABEL? IF YOU NEED SAMPLES IT IS NEEDED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2406974 BD LUER-LOK SYRINGE, PISTON FMF BECTON DICKINSON DE MEXICO 2339636 00382903033102

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown