FDA Adverse Event Malfunction Summary report: N

SYRINGE 0.5ML 31GA 8MM UFII 10BAG 500CS

MDR report key: 18685057 · Received February 12, 2024

Report

Report Number
1920898-2024-05027
Event Type
Malfunction
Date Received
February 12, 2024
Report Date
May 7, 2024
Manufacturer
BD MEDICAL - DIABETES CARE - HOLDREGE, NE / 68949
Product Code
FMF
UDI-DI
00382908468039
PMA / PMN Number
K190054
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY: NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED, THEREFORE, THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. THIS IS THE FIRST COMPLAINT FOR THE REPORTED LOT NUMBER. A REVIEW OF THE MANUFACTURING RECORDS WAS PERFORMED, AND NO NON-CONFORMANCES WERE RAISED IN ASSOCIATION WITH THIS TYPE OF EVENT FOR THIS LOT. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. IF SAMPLES ARE RECEIVED IN THE FUTURE THE COMPLAINT WILL BE REOPENED FOR FURTHER INVESTIGATION. BASED ON THE ABOVE, NO ADDITIONAL INVESTIGATION AND NO CORRECTIVE/PREVENTATIVE ACTION (CAPA) OR SITUATIONAL ANALYSIS (SA) IS REQUIRED AT THIS TIME.

Description of Event or Problem · 0

CONSUMER REPORTED, SOME OF HER NEEDLES ARE NOT DRAWING THE MEDICATION. STATED, SHE FOUND A "PLUNGER ONLY" IN HER PACKAGE BUT ALL OF THE OTHER PIECES THAT COMPLETE A SYRINGE WERE MISSING, (BARREL, SHIELD, NEEDLE, CAP). LOT: 3233304. CATALOG: 328468. DATE OF EVENT: UNKNOWN. SAMPLES: YES CL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1397786 SYRINGE 0.5ML 31GA 8MM UFII 10BAG 500CS SYRINGE, PISTON FMF BD MEDICAL - DIABETES CARE - HOLDREGE, NE / 68949 328468 3233304 00382908468039

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown