BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD VACUTAINER PUSH BUTTON BLOOD COLLECTION SET

    MDR report key: 1963746 · Received January 12, 2011

    Report

    Report Number
    MW5019003
    Event Type
    Malfunction
    Date Received
    January 12, 2011
    Date of Event
    January 7, 2011
    Report Date
    January 12, 2011
    Manufacturer
    BECTON, DICKINSON AND COMPANY
    Product Code
    JKA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RN REPORTED THAT THE BD VACUTAINER PUSH BUTTON BUTTERFLY NEEDLE DID NOT RETRACT WHEN THE SAFETY BUTTON WAS PUSHED. NO INJURY TO PT OR STAFF OCCURRED. EXP DATE: 10/2012, 0.8 X 19 MM X 305 MM, 21 G X 3/4" X 12".

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD VACUTAINER PUSH BUTTON BLOOD COLLECTION SET BLOOD COLLECTION SET JKA BECTON, DICKINSON AND COMPANY NA 0301037

    Patients

    Seq Age Sex Outcome Treatment
    1 Other