FDA Adverse Event Malfunction Summary report: N

BD BBL¿ SENSI-DISC¿ CEFMETAZOLE - 30 ¿G JAPAN

MDR report key: 18548851 · Received January 20, 2024

Report

Report Number
2647876-2024-00009
Event Type
Malfunction
Date Received
January 20, 2024
Date of Event
December 26, 2023
Report Date
May 24, 2024
Manufacturer
BECTON DICKINSON CARIBE LTD.
Product Code
JTN
PMA / PMN Number
SEE H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H.6 INVESTIGATION SUMMARY: A COMPLAINT INVESTIGATION DUE TO INCORRECT PRODUCT PACKED FOR CEFMETAZOLE CATALOG 296785 BATCH NO.: 3058521 WAS REQUESTED. THIS CATALOG IS MANUFACTURED IN BD CAYEY FOR BD JAPAN REGION UNDER CATALOG NUMBER 231666. CATALOG 231666 IS RELABELED BY BD JAPAN UNDER CATALOG 296785. NEVERTHELESS, INVESTIGATION WAS PERFORMED TO CEFMETAZOLE RETENTION SAMPLES, BD CAYEY CATALOG NUMBER 231666 BATCH NUMBER 3058521. THE INVESTIGATION REQUIRED TO PERFORM VISUAL INSPECTION AND BATCH RECORD REVIEW. NO DISCREPANCIES OBSERVED. PRODUCT WAS IDENTIFIED CORRECTLY. BATCH RECORD REVIEW DID NOT SHOW ANY EVIDENCE OF INCORRECT LABELING/PRODUCT. RETURNED GOODS WERE NOT RECEIVED FROM CUSTOMER. PHOTO RECEIVED FROM CUSTOMER WAS EVALUATED. IT WAS OBSERVED THAT THE CARTRIDGE BELONGS TO AMPICILLIN BATCH 2276051 AND BD JAPAN OUTSIDE CARTRIDGE LABEL REFERRED TO CEFMETAZOLE (CMZ-30). COMPLAINT INVESTIGATION WAS EXTENDED TO BD JAPAN. A CAPA REPORT WAS CREATED. THE POSSIBLE CAUSES DERIVED FROM THE FACTS ARE THEY MIXED UP 1SP (10EA PACK) BETWEEN TWO PRODUCT LOTS AND SENT THEM TO THE PROCESS FOR SPLIT PACKING. THERE WAS NO PROCESS TO CHECK THE CONTENT OF THE LABEL ON THE CARTRIDGE IN THE BLISTER PACK, THEY WERE NOT ABLE TO FIND THE ISSUE IN-PROCESS.

Additional Manufacturer Narrative · 0

E1. INITIAL REPORTER FACILITY NAME: (B)(6) HOSPITAL G5. THERE IS NO 510(K) FOR THIS DEVICE AS IT IS MANUFACTURED OUTSIDE THE US AND NOT SOLD IN THE US, BUT IS CONSIDERED TO BE SUBSTANTIALLY SIMILAR TO THE LEGALLY U.S. MARKETED DEVICE BD BBL¿ SENSI-DISC¿ CEFMETAZOLE - 30 G, CATALOG NUMBER 231666, WITH 510K #K895679.

Description of Event or Problem · 0

IT WAS REPORTED THAT PRIOR TO USE WITH THE BD BBL¿ SENSI-DISC¿ CEFMETAZOLE - 30 G JAPAN, THE BOX CONTAINED INCORRECT PRODUCT. THERE WAS NO REPORT OF PATIENT IMPACT.

Description of Event or Problem · 0

IT WAS REPORTED THAT PRIOR TO USE WITH THE BD BBL¿ SENSI-DISC¿ CEFMETAZOLE - 30 G JAPAN, THE BOX CONTAINED INCORRECT PRODUCT. THERE WAS NO REPORT OF PATIENT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1141520 BD BBL¿ SENSI-DISC¿ CEFMETAZOLE - 30 ¿G JAPAN SUSCEPTIBILITY TEST DISCS, ANTIMICROBIAL JTN BECTON DICKINSON CARIBE LTD. 3058521

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown