FDA Adverse Event Malfunction Summary report: N

BD ULTRASAFE PASSIVE NEEDLE GUARD

MDR report key: 19003723 · Received March 29, 2024

Report

Report Number
3009081593-2024-00012
Event Type
Malfunction
Date Received
March 29, 2024
Date of Event
March 5, 2024
Report Date
October 11, 2024
Manufacturer
BECTON DICKINSON HUNGARY KFT (BD)
Product Code
FMI
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H.3. A DEVICE EVALUATION IS ANTICIPATED BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: D9: DEVICE AVAILABLE FOR EVAL YES, D9: RETURNED TO MANUFACTURER ON: 19-MAR-2024 H.6.: INVESTIGATION SUMMARY: CONFIRMED: REPORTED CONDITION IS WITHIN SPECIFICATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE 2 OF THE BD ULTRASAFE PASSIVE NEEDLE GUARD COULD NOT ACTIVATE SAFETY GUARD. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DURING ROUTINE FDF CHECK, TWO INJECTOR DEVICES (NSD) HAD THEIR FIXING HOOKS DEFORMED. THIS DEFECT WAS DETECTED WITHIN ONE DEVICE FROM EACH FDF SAMPLE PACKAGE (ONE OUT OF 5 INJECTORS IN START AND ONE OUT OF 5 INJECTORS IN END)

Description of Event or Problem · 0

IT WAS REPORTED THAT THE 2 OF THE BD ULTRASAFE PASSIVE NEEDLE GUARD COULD NOT ACTIVATE SAFETY GUARD. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DURING ROUTINE FDF CHECK, TWO INJECTOR DEVICES (NSD) HAD THEIR FIXING HOOKS DEFORMED. THIS DEFECT WAS DETECTED WITHIN ONE DEVICE FROM EACH FDF SAMPLE PACKAGE (ONE OUT OF 5 INJECTORS IN START AND ONE OUT OF 5 INJECTORS IN END).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2258921 BD ULTRASAFE PASSIVE NEEDLE GUARD HYPODERMIC SINGLE LUMEN NEEDLE FMI BECTON DICKINSON HUNGARY KFT (BD) 3244971

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown