FDA Adverse Event Malfunction Summary report: N

BD SYRINGE 5ML LL EURO 125 S/C

MDR report key: 18841532 · Received March 5, 2024

Report

Report Number
1213809-2024-00144
Event Type
Malfunction
Date Received
March 5, 2024
Date of Event
February 2, 2024
Report Date
May 23, 2024
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
FMF
UDI-DI
30382903096498
PMA / PMN Number
K110771
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ONE SAMPLE AND ONE PHOTO OF 5ML EUROGRAPHIC SYRINGE WERE RECEIVED AND EVALUATED. THE SAMPLE HAS DAMAGE TO THE BARREL. THE BARREL WAS TESTED AND LEAKAGE PAST STOPPER WAS OBSERVED AT THE DAMAGED AREA OF THE BARREL. THE PHOTO SHOWS THE BARREL DAMAGED AT THE 1ML GRADUATION LINE OF THE BARREL. THE CONDITION OBSERVED IS NON-CONFORMING PER PRODUCT SPECIFICATION. POTENTIAL ROOT CAUSE FOR THE DAMAGED BARREL AND LEAKAGE PAST STOPPER DEFECTS IS ASSOCIATED WITH THE ASSEMBLY PROCESS. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED BATCH NUMBER 3240901 SHOWING NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT.

Additional Manufacturer Narrative · 0

H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

ONE SAMPLE AND ONE PHOTO OF 5ML EUROGRAPHIC SYRINGE WERE RECEIVED AND EVALUATED. THE SAMPLE HAS DAMAGE TO THE BARREL. THE BARREL WAS TESTED AND LEAKAGE PAST STOPPER WAS OBSERVED AT THE DAMAGED AREA OF THE BARREL. THE PHOTO SHOWS THE BARREL DAMAGED AT THE 1ML GRADUATION LINE OF THE BARREL. THE CONDITION OBSERVED IS NON-CONFORMING PER PRODUCT SPECIFICATION. POTENTIAL ROOT CAUSE FOR THE DAMAGED BARREL AND LEAKAGE PAST STOPPER DEFECTS IS ASSOCIATED WITH THE ASSEMBLY PROCESS. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED BATCH NUMBER 3240901 SHOWING NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT.

Description of Event or Problem · 0

DESCRIPTION OF NON-CONFORMITY: DURING SAMPLING OF A RADIOPHARMACEUTICAL ([68GA]GA-PSMA), THE SYRINGE WAS FOUND TO BE SPLIT. THE RADIOPHARMACEUTICAL THEREFORE LEAKED OUT OF THE SYRINGE. THE DEVICE WAS QUARANTINED FOR RADIOACTIVE DECAY. IT IS NO LONGER RADIOACTIVE. IN ORDER TO BE ABLE TO DISPENSE THE PRESCRIBED [68GA]GA-PSMA, ANOTHER SYRINGE OF THE SAME REFERENCE AND BATCH WAS PREPARED, INCREASING STAFF IRRADIATION. NO PATIENTS WERE EXPOSED DURING THIS INCIDENT. DATE OF OCCURRENCE, FREQUENCY: 02/02/2024. THE DEVICE(S) CONCERNED ARE KEPT IN THE FOLLOWING CONDITION: USED DECONTAMINATED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD SYRINGE 5ML LL EURO 125 S/C BARREL/FLANGE WAS DAMAGED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER TRANSLATED FROM FRENCH TO ENGLISH: "DURING SAMPLING OF A RADIOPHARMACEUTICAL ([68GA]GA-PSMA), THE SYRINGE WAS FOUND TO BE SPLIT. THE RADIOPHARMACEUTICAL THEREFORE LEAKED OUT OF THE SYRINGE. THE DEVICE WAS QUARANTINED FOR RADIOACTIVE DECAY. IT IS NO LONGER RADIOACTIVE. IN ORDER TO BE ABLE TO DISPENSE THE PRESCRIBED [68GA]GA-PSMA, ANOTHER SYRINGE OF THE SAME REFERENCE AND BATCH WAS PREPARED, INCREASING STAFF IRRADIATION." NO PATIENTS WERE EXPOSED DURING THIS INCIDENT. DATE OF OCCURRENCE, FREQUENCY: 02/02/2024. THE DEVICE(S) CONCERNED ARE KEPT IN THE FOLLOWING CONDITION: USED DECONTAMINATED.

Description of Event or Problem · 0

DESCRIPTION OF NON-CONFORMITY: DURING SAMPLING OF A RADIOPHARMACEUTICAL ([68GA]GA-PSMA), THE SYRINGE WAS FOUND TO BE SPLIT. THE RADIOPHARMACEUTICAL THEREFORE LEAKED OUT OF THE SYRINGE. THE DEVICE WAS QUARANTINED FOR RADIOACTIVE DECAY. IT IS NO LONGER RADIOACTIVE. IN ORDER TO BE ABLE TO DISPENSE THE PRESCRIBED [68GA]GA-PSMA, ANOTHER SYRINGE OF THE SAME REFERENCE AND BATCH WAS PREPARED, INCREASING STAFF IRRADIATION. NO PATIENTS WERE EXPOSED DURING THIS INCIDENT. DATE OF OCCURRENCE, FREQUENCY: 02/02/2024 THE DEVICE(S) CONCERNED ARE KEPT IN THE FOLLOWING CONDITION: USED DECONTAMINATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1582572 BD SYRINGE 5ML LL EURO 125 S/C PISTON SYRINGE FMF BECTON DICKINSON MEDICAL SYSTEMS 3240901 30382903096498

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown