BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SYRINGE 10ML SALINE FILL CHINA SP

    MDR report key: 18694698 · Received February 13, 2024

    Report

    Report Number
    1911916-2024-00088
    Event Type
    Malfunction
    Date Received
    February 13, 2024
    Date of Event
    January 30, 2024
    Report Date
    February 19, 2024
    Manufacturer
    BECTON DICKINSON
    Product Code
    NGT
    UDI-DI
    30382903065951
    PMA / PMN Number
    K021475
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    (B)(4) FOLLOW UP A DEVICE HISTORY RECORD REVIEW WAS COMPLETED BY OUR QUALITY ENGINEER TEAM FOR PROVIDED MATERIAL NUMBER 306595 AND LOT NUMBER 3142712. THE REVIEW DID NOT REVEAL ANY DETECTED ABNORMALITIES DURING THE PRODUCTION PROCESS THAT COULD HAVE CONTRIBUTED TO THIS DEFECT AND ALL QUALITY TESTS WERE FOUND TO BE WITHIN SPECIFICATION. AS A SAMPLE WAS UNAVAILABLE FOR RETURN, A THOROUGH SAMPLE INVESTIGATION COULD NOT BE COMPLETED. BASED ON THE INVESTIGATION RESULTS, AN EXACT CAUSE FOR THIS INCIDENT COULD NOT BE IDENTIFIED. SHOULD YOU AGAIN EXPERIENCE ANY PROBLEMS WITH OUR PRODUCT WE WOULD APPRECIATE THE OPPORTUNITY TO CONDUCT A THOROUGH ANALYSIS. THERE ARE QUALITY CONTROLS CURRENTLY IN PLACE TO DETECT THIS TYPE OF DEFECT DURING THE PRODUCTION PROCESS. FURTHER ACTION HAS NOT BEEN DETERMINED NECESSARY AT THIS TIME. H3 OTHER TEXT : SEE H10 NARRATIVE.

    Additional Manufacturer Narrative · 0

    (B)(4): INITIAL MDR SUBMISSION. A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED. H3 OTHER TEXT : SEE H10 MANUFACTURE NARRATIVE

    Description of Event or Problem · 0

    NO ADDITIONAL INFORMATION RECEIVED THE SALESPERSON REPORTED A COMPLAINT ABOUT FREIXI PRODUCTS AND FOUND THAT THE SYRINGE OF THE IRRIGATOR WAS DAMAGED AFTER OPENING THE PRE-FILLED PACKAGING BOX. GREEN CLAIMS ARE REQUIRED, A COMPLAINT RESPONSE LETTER IS REQUIRED, AND A COMPLAINT ACCEPTANCE LETTER IS REQUIRED PHOTOS ARE PROVIDED AND SAMPLES CAN BE RETURNED IN 15 PIECES.

    Description of Event or Problem · 0

    THE SALESPERSON REPORTED A COMPLAINT ABOUT FREIXI PRODUCTS AND FOUND THAT THE SYRINGE OF THE IRRIGATOR WAS DAMAGED AFTER OPENING THE PRE-FILLED PACKAGING BOX. GREEN CLAIMS ARE REQUIRED, A COMPLAINT RESPONSE LETTER IS REQUIRED, AND A COMPLAINT ACCEPTANCE LETTER IS REQUIRED PHOTOS ARE PROVIDED AND SAMPLES CAN BE RETURNED IN 15 PIECES

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2137007 SYRINGE 10ML SALINE FILL CHINA SP SALINE, VASCULAR ACCESS FLUSH NGT BECTON DICKINSON 3142712 30382903065951

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown