FDA Adverse Event Malfunction Summary report: N

BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK

MDR report key: 19332881 · Received May 16, 2024

Report

Report Number
9610847-2024-00128
Event Type
Malfunction
Date Received
May 16, 2024
Date of Event
April 25, 2024
Report Date
November 19, 2024
Manufacturer
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
Product Code
FMF
UDI-DI
30382903097020
PMA / PMN Number
K110771
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: OUR QUALITY ENGINEER INSPECTED THE 6 PHOTOS AND 1 PHYSICAL SAMPLE SUBMITTED FOR EVALUATION. THE REPORTED ISSUE OF FOREIGN MATTER WAS CONFIRMED UPON INSPECTION AND TESTING OF THE SAMPLES. ANALYSIS OF THE SAMPLE SHOWED THAT A PARTICLE COULD BE OBSERVED IN THE BARREL OF THE SYRINGE. BD DETERMINED THAT THE CAUSE OF THE FAILURE WAS ASSOCIATED WITH THE ASSEMBLY PROCESS. A REVIEW OF OUR RISK MANAGEMENT DOCUMENTATION WAS PERFORMED AND INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY. PRODUCTION RECORDS WERE REVIEWED, AND THIS BATCH MEETS OUR MANUFACTURING SPECIFICATION REQUIREMENTS.

Additional Manufacturer Narrative · 0

IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD.

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: OUR QUALITY ENGINEER INSPECTED THE 6 PHOTOS AND 1 PHYSICAL SAMPLE SUBMITTED FOR EVALUATION. THE REPORTED ISSUE OF FOREIGN MATTER WAS CONFIRMED UPON INSPECTION AND TESTING OF THE SAMPLES. ANALYSIS OF THE SAMPLE SHOWED THAT A PARTICLE COULD BE OBSERVED IN THE BARREL OF THE SYRINGE. BD DETERMINED THAT THE CAUSE OF THE FAILURE WAS ASSOCIATED WITH THE ASSEMBLY PROCESS. A RETRAINING OF MANUFACTURING PERSONNEL WAS PERFORMED TO ADDRESS THIS ISSUE. A REVIEW OF OUR RISK MANAGEMENT DOCUMENTATION WAS PERFORMED AND INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY. PRODUCTION RECORDS WERE REVIEWED, AND THIS BATCH MEETS OUR MANUFACTURING SPECIFICATION REQUIREMENTS. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK HAD FOREIGN MATTER IT WAS REPORTED BY CUSTOMER THAT THEY HAVE IDENTIFIED ATYPICAL PARTICULATES, ONE OF THE RESULTS WE HAVE RECEIVED HAS ID THE PARTICULATE AS FIBERGLASS. VERBATIM: RCC RECEIVED A COMPLAINT VIA EMAIL. PER END USER, THEY WOULD LIKE TO INITIATE A PRODUCT COMPLAINT FOR MFR# (B)(4) BD 3ML SYR TRAY VENDOR LOT 3212551 AND 3212547. THEY HAVE IDENTIFIED ATYPICAL PARTICULATES, ONE OF THE RESULTS WE HAVE RECEIVED HAS ID THE PARTICULATE AS FIBERGLASS. PLEASE PROVIDE CREDIT AND OR ADVISE IF A RETURN IS NEEDED FOR 371 TR/MFR# (B)(4).

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
925063 BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK SYRINGE FMF BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. 3212547 30382903097020

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown