FDA Adverse Event Malfunction Summary report: N

BD INSYTE AUTOG BC

MDR report key: 19635549 · Received June 28, 2024

Report

Report Number
1710034-2024-00670
Event Type
Malfunction
Date Received
June 28, 2024
Date of Event
May 27, 2024
Report Date
October 18, 2024
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
UDI-DI
00382903825233
PMA / PMN Number
K201075
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

H3: A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED.

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: NO PHOTOS OR PHYSICAL SAMPLES THAT DISPLAY THE REPORTED CONDITION WERE AVAILABLE FOR INVESTIGATION. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED BY OUR QUALITY ENGINEER TEAM FOR PROVIDED MATERIAL NUMBER 382523 AND LOT NUMBER 4030767. 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. BASED ON THE AVAILABLE INFORMATION, AN EXACT CAUSE FOR THIS INCIDENT COULD NOT BE IDENTIFIED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR QUALITY TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: THE REPORTED COMPLAINTS OF A DEFECTIVE CATHETER AND NEEDLE PUNCTURE DAMAGE COULD NOT BE CONFIRMED FROM THE RETURNED 22G INSYTE AUTOGUARD UNITS. NO DAMAGE OR DEFECTS ASSOCIATED WITH THE MANUFACTURING PROCESS COULD BE IDENTIFIED ON THE RETURNED SAMPLES. ALTHOUGH THE REPRESENTATIVE SAMPLES AND MANUFACTURING RECORDS DO NOT SUPPORT THE COMPLAINANT¿S DESCRIPTION OF THE REPORTED EVENT, THE COMPLAINT HAS BEEN DOCUMENTED AND WILL CONTINUE TO BE MONITORED AS PART OF ONGOING EFFORTS TO IDENTIFY POTENTIAL MANUFACTURING RELATED ISSUES. MANUFACTURING CONTROLS ARE IN PLACE TO MITIGATE THE REPORTED ISSUE. THE INSERTION TECHNIQUE AND ANGLE COULD BE POTENTIAL CONTRIBUTING FACTORS OF THE REPORTED EVENT. THE INSTRUCTIONS FOR USE (IFU) ALSO INDICATE THAT THE NEEDLE SHOULD NOT BE REINSERTED INTO THE CATHETER DURING THE INSERTION PROCESS AS CATHETER DAMAGE MAY OCCUR. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INSYTE AUTOG BC CATHETER IS FLIMSY. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "WE HAVE BEEN HAVING A LOT OF TROUBLE WITH THE LAST LOT OF 22G IV I ORDERED. THEY SEEM FLIMSY AND THE NEEDLE IS GOING RIGHT THROUGH THE CATHETER."

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2215734 BD INSYTE AUTOG BC PERIPHERAL IV CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 4030767 00382903825233

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown