FDA Adverse Event Malfunction Summary report: N

BD UNKNOWN PIVC

MDR report key: 19878244 · Received July 31, 2024

Report

Report Number
3002601200-2024-00364
Event Type
Malfunction
Date Received
July 31, 2024
Date of Event
June 23, 2024
Report Date
August 13, 2024
Manufacturer
BD SUZHOU (MDS)
Product Code
ONB
UDI-DI
00382903830992
PMA / PMN Number
K123213
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 4033159. OUR RECORDS SHOW THAT THIS IS THE ONLY INSTANCE OF THIS ISSUE OCCURRING IN THIS PRODUCTION BATCH. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD UNKNOWN PIVC LEAKED THE PATIENT WITH "COLITIS, DIZZINESS, AND SHOCK" WAS ADMITTED AND GIVEN AN INDWELLING NEEDLE FOR INFUSION. DURING THE INFUSION, IT WAS FOUND THAT THE INDWELLING NEEDLE WAS LEAKING. THE HEPARIN CAP WAS REPLACED. IF THERE WAS STILL LEAKAGE, THE INDWELLING NEEDLE WAS REPLACED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
517601 BD UNKNOWN PIVC INTRAVASCULAR CATHETER ONB BD SUZHOU (MDS) 4033159 00382903830992
912187 BD UNKNOWN PIVC INTRAVASCULAR CATHETER ONB BD SUZHOU (MDS) 4033159 00382903830992

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown