FDA Adverse Event Malfunction Summary report: N

BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC

MDR report key: 19831096 · Received July 25, 2024

Report

Report Number
3002601200-2024-00350
Event Type
Malfunction
Date Received
July 25, 2024
Date of Event
June 26, 2024
Report Date
August 13, 2024
Manufacturer
BD SUZHOU (MDS)
Product Code
FOZ
UDI-DI
00382903830831
PMA / PMN Number
UNK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

IN RESPONSE TO THE EVENT REPORTED BY YOUR FACILITY A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 3052844. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED WITHOUT DEFECTS BEING NOTED DURING THE FINAL ASSEMBLY OR VISUAL INSPECTIONS. A SAMPLE COULD NOT BE OBTAINED FOR EVALUATION AND TESTING; IN LIEU OF THE AFFECTED DEVICE, FUNCTIONAL TESTING WAS PERFORMED ON RETENTION SAMPLES FOR THIS LOT, THE RESULTS OF THESE SHOW THAT THE TESTED UNITS PERFORMED WITHIN PRODUCT SPECIFICATIONS. UNFORTUNATELY, WITHOUT THE ABILITY TO INVESTIGATE THE AFFECTED UNIT OUR QUALITY ENGINEERS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC LEAKED THE PATIENT WAS HOSPITALIZED IN OUR HOSPITAL. WHEN THE NEEDLE WAS INSERTED, IT WAS FOUND THAT THE INDWELLING NEEDLE WAS BENT AND LEAKING. THE NURSE IMMEDIATELY CHANGED IT. THE PATIENT WAS FINE.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
281584 BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC INTRAVASCULAR CATHETER FOZ BD SUZHOU (MDS) 3052844 00382903830831

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown