FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SAFETY-LOK¿ BLOOD COLLECTION SET WITH PRE-ATTACHED HOLDER

MDR report key: 18652071 · Received February 6, 2024

Report

Report Number
1024879-2024-00097
Event Type
Malfunction
Date Received
February 6, 2024
Date of Event
January 1, 2024
Report Date
February 9, 2024
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
50382903686532
PMA / PMN Number
K980414
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D4. MEDICAL DEVICE LOT#: UNKNOWN D4. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN THERE WERE MULTIPLE 510K NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION IS AS FOLLOWS: G.5. PMA / 510(K)#: K991088 H.3. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED. H4. DEVICE MANUFACTURE DATE: UNKNOWN.

Additional Manufacturer Narrative · 0

AFTER FURTHER EVALUATION OF THE COMPLAINT, IT HAS BEEN DETERMINED THAT THE PREVIOUSLY SUBMITTED REPORT 1024879-2024-00097 WAS SENT IN ERROR. THIS COMPLAINT IS A DUPLICATE AND HAS ALREADY BEEN REPORTED ON MFR REPORT # 1024879-2024-00067.

Description of Event or Problem · 0

IT WAS REPORTED THAT WHILE USING BD VACUTAINER® SAFETY-LOK¿ BLOOD COLLECTION SET WITH PRE-ATTACHED HOLDER, THERE WAS INSUFFICIENT BLOOD FLOW SEEN IN 5 DEVICES. NO PATIENT IMPACT REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT WHILE USING BD VACUTAINER® SAFETY-LOK¿ BLOOD COLLECTION SET WITH PRE-ATTACHED HOLDER, THERE WAS INSUFFICIENT BLOOD FLOW SEEN IN 5 DEVICES. NO PATIENT IMPACT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
504688 BD VACUTAINER® SAFETY-LOK¿ BLOOD COLLECTION SET WITH PRE-ATTACHED HOLDER BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON & CO., (BD) UNKNOWN 50382903686532

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown