FDA Adverse Event Malfunction Summary report: N

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

MDR report key: 20563410 · Received October 29, 2024

Report

Report Number
3002601200-2024-00563
Event Type
Malfunction
Date Received
October 29, 2024
Date of Event
September 21, 2024
Report Date
November 4, 2024
Manufacturer
BD SUZHOU (MDS)
Product Code
FOZ
UDI-DI
00382903830787
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

DHR/BHR REVIEW LOT# 4081463: THE PRODUCTS OF THIS BATCH WERE ASSEMBLED AT INTIMA II AUTO LINE 2 IN APRIL 2024, AND PACKAGED AT R240 PACKAGE LINE AND CFS PACKAGE LINE IN APRIL 2024. WORK ORDER QUANTITY WAS (B)(4) EACH. REVIEW THE IN-PROCESS TEST REPORTS AND OUTGOING TEST REPORTS, AND ALL TEST RESULTS MET THE PRODUCT SPECIFICATIONS. REVIEW THE PRODUCTION RECORDS WITH NO NONCONFORMANCE, DEVIATION OR REWORK ACTIVITIES. THE PLANT HAS LAUNCHED CAPA TO INVESTIGATE THE LEAKAGE AT THE SEPTUM. NO DEFECTIVE SAMPLES AND PHOTOS HAVE BEEN RECEIVED FOR THE COMPLAINT. AS THE PLANT RECEIVED SIMILAR COMPLAINTS FROM OTHER HOSPITALS ABOUT THIS BATCH OF PRODUCTS, 800MM SIMULATED CLINICAL LEAKAGE TEST WAS CONDUCTED ON THE RETAINED SAMPLES OF THIS BATCH, AND IT WAS FOUND THAT A FEW SAMPLES LEAKED AT THE END OF THE SEPTUM AFTER THE NEEDLE TIP WAS INSERTED INTO THE TEST DEVICE, AND THE LEAKAGE STOPPED AFTER THE NEEDLE CORE WAS PULLED OUT. CONCLUSION(S): NO ABNORMALITY IS FOUND IN THE PRODUCTION PROCESS. IN RESPONSE TO LEAKAGE AT THE SEPTUM, THE PLANT HAS LAUNCHED CAPA TO TRACE AND INVESTIGATE ITS ROOT CAUSE.

Additional Manufacturer Narrative · 0

H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INTIMA-II 24GAX0.75IN PRN SLM NPVC LEAKED AT SEPTUM. CHILDREN DUE TO ACUTE UPPER RESPIRATORY TRACT INFECTION ON (B)(6) 2024 INTRAVENOUS INFUSION TREATMENT, THE USE OF THE PRODUCT, THE NURSE ROUTINE OPERATION, PUNCTURE PROCESS FOUND THAT THE ISOLATION PLUG LEAKAGE OF BLOOD, LEAKAGE OF FLUID, IMMEDIATELY BE WITHDRAWN, REPLACEMENT, TO EXPLAIN TO THE CHILD AND HIS FAMILY, THE SECOND PUNCTURE TREATMENT, INCREASING THE PAIN OF THE CHILD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1168148 BD INTIMA-II 24GAX0.75IN PRN SLM NPVC INTRAVASCULAR CATHETER FOZ BD SUZHOU (MDS) 4081463 00382903830787

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown