FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® K2E (EDTA) 18.0MG PLUS BLOOD COLLECTION TUBES

MDR report key: 19578515 · Received June 20, 2024

Report

Report Number
9617032-2024-00943
Event Type
Malfunction
Date Received
June 20, 2024
Date of Event
May 23, 2024
Report Date
June 27, 2024
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
UDI-DI
30382903675259
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS HAVE BEEN UPDATED WITH ADDITIONAL/CORRECTED INFORMATION: D.9. DEVICE AVAILABLE FOR EVAL: YES. D.9. RETURNED TO MANUFACTURER ON: 25-JUN-2024. H.6. INVESTIGATION SUMMARY: BD RECEIVED 9 PHOTOGRAPHS FROM THE CUSTOMER IN SUPPORT OF THIS COMPLAINT, SHOWING UNDERFILL WITH BOTH COMPLAINT LOTS. ADDITIONALLY BD RECEIVED (B)(4) SAMPLES OF LOT 3170111 FOR INVESTIGATION AND (B)(4) SAMPLES (LOT 3170111) AND 20 RETAINED SAMPLES (LOT 4046892) WERE RANDOMLY SELECTED FOR FUNCTIONAL DRAW VOLUME TESTING. THE ISSUE OF UNDERFILL WAS NOT OBSERVED. FROM THIS TESTING, IT WAS DETERMINED THAT ALL 40 TUBES DREW WITHIN SPECIFICATION. A FURTHER 10 RETAINED SAMPLES FROM LOT NUMBER 4046892 AND 10 RETURNED SAMPLES (LOT 3170111) WERE RANDOMLY SELECTED FOR FUNCTIONAL TESTING RELATING TO STOPPER POP OFF. NONE OF THE CAP/STOPPER ASSEMBLIES POPPED OFF. BASED ON A REVIEW OF THE DEVICE HISTORY RECORD FOR THE INCIDENT LOT, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET. THERE WERE NO RELATED QUALITY ISSUES DURING MANUFACTURING OF THE PRODUCT. THIS COMPLAINT CANNOT BE CONFIRMED FOR THE INDICATED FAILURE MODE STOPPER POP OFF. THIS COMPLAINT HAS BEEN CONFIRMED FOR THE INDICATED FAILURE MODE UNDERFILL WITH REGARDS TO BOTH COMPLAINT LOTS BASED ON THE ATTACHED PHOTOGRAPHS. ALTHOUGH THE PHOTOGRAPHS PROVIDED BY THE CUSTOMER DO INDICATE A LACK OF DRAW, THERE IS NO EVIDENCE THAT THE DEVICE WAS THE CAUSE OF THIS DEFECT. TESTING OF RETURNED AND RETAINED SAMPLES FROM THESE LOT NUMBERS DID NOT CONFIRM THE REPORTED DEFECT. NO DEFINITIVE ROOT CAUSE COULD BE ESTABLISHED FOR THE REPORTED DEFECT. BD WAS NOT ABLE TO IDENTIFY AN EXACT ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Additional Manufacturer Narrative · 0

B3: DATE OF EVENT IS UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH ADDITIONAL LOT NUMBER IS AS FOLLOWS: D4. MEDICAL DEVICE LOT#: 4046892 D4. MEDICAL DEVICE EXPIRATION DATE: 31-JAN-2026 H4. DEVICE MANUFACTURE DATE: 15-FEB-2024 A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® K2E (EDTA) 18.0MG PLUS BLOOD COLLECTION TUBES, AN UNSPECIFIED NUMBER OF TUBES UNDERFILLED AND THE STOPPERS POPPED OFF WHEN ATTACHED TO THE HOLDER. THERE WAS NO HEALTH IMPACT OR CONSEQUENCES REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED WHEN USING THE BD VACUTAINER® K2E (EDTA) 18.0MG PLUS BLOOD COLLECTION TUBES, AN UNSPECIFIED NUMBER OF TUBES UNDERFILLED AND THE STOPPERS POPPED OFF WHEN ATTACHED TO THE HOLDER. THERE WAS NO HEALTH IMPACT OR CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1604128 BD VACUTAINER® K2E (EDTA) 18.0MG PLUS BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 3170111 30382903675259

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown