BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE WITH PRE-ATTACHED HOLDER

    MDR report key: 18613838 · Received January 31, 2024

    Report

    Report Number
    1024879-2024-00071
    Event Type
    Malfunction
    Date Received
    January 31, 2024
    Date of Event
    January 10, 2024
    Report Date
    June 11, 2024
    Manufacturer
    BECTON, DICKINSON & CO., (BD)
    Product Code
    FMI
    UDI-DI
    50382903686501
    PMA / PMN Number
    K982541
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THE FOLLOWING FIELD HAVE BEEN UPDATED WITH A CORRECTION: E.4: MEDWATCH REPORT (B)(4). THE INITIAL REPORTER NOTIFIED THE FDA ON: 01-DEC-2023. AFTER FURTHER EVALUATION OF THE COMPLAINT, IT HAS BEEN DETERMINED THAT, THE PREVIOUS MEDWATCH REPORT # PROVIDED ON E.4: "THE INITIAL REPORTER NOTIFIED THE FDA ON DD-MMM-YYYY. MEDWATCH REPORT # (B)(4)" WAS SENT IN ERROR, THE CORRECT REPORT # IS (B)(4). THE EXACT DAY WAS UNKNOWN, SO 1ST DAY OF THE MONTH HAS BEEN USED. H.6. INVESTIGATION SUMMARY: MATERIAL #: 368650, LOT/BATCH #: 3223399. BD HAD NOT RECEIVED SAMPLES OR PHOTOS FOR INVESTIGATION. THEREFORE, 20 RETENTION SAMPLES FROM BD INVENTORY WERE EVALUATED BY FUNCTIONAL TESTING, EACH HAVING THEIR ECLIPSE SHIELD ACTIVATED, AND NO ISSUES WERE OBSERVED RELATING TO DEFECTIVE LOCKING MECHANISM 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 DEFECTIVE LOCKING MECHANISM. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE.

    Additional Manufacturer Narrative · 0

    THE FOLLOWING FIELDS HAVE BEEN UPDATED WITH CORRECTED INFORMATION: H10: RELATED REPORT NUMBER: (B)(4).

    Additional Manufacturer Narrative · 0

    E.4: THE INITIAL REPORTER NOTIFIED THE FDA ON DD-MMM-YYYY. MEDWATCH REPORT # (B)(4)H.3. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT WHILE USING BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE WITH PRE-ATTACHED HOLDER, THE SAFETY SHIELD DETACHED FROM TWO NEEDLES. NO PATIENT IMPACT REPORTED.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT WHILE USING BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE WITH PRE-ATTACHED HOLDER, THE SAFETY SHIELD DETACHED FROM TWO NEEDLES. NO PATIENT IMPACT REPORTED.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT WHILE USING BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE WITH PRE-ATTACHED HOLDER, THE SAFETY SHIELD DETACHED FROM TWO NEEDLES. NO PATIENT IMPACT REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1246761 BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE WITH PRE-ATTACHED HOLDER HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON, DICKINSON & CO., (BD) 3223399 50382903686501

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown