FDA Adverse Event Malfunction Summary report: N

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

MDR report key: 20588011 · Received November 1, 2024

Report

Report Number
3002601200-2024-00572
Event Type
Malfunction
Date Received
November 1, 2024
Date of Event
September 28, 2024
Report Date
November 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

1. DHR/BHR REVIEW LOT#4081459. 1-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) EA. 2-REVIEW THE IN-PROCESS TEST REPORTS AND OUTGOING TEST REPORTS, AND ALL TEST RESULTS MEET THE PRODUCT SPECIFICATIONS. 3-REVIEW THE PRODUCTION RECORDS WITH NO NONCONFORMANCE, DEVIATION OR REWORK ACTIVITIES. 2. NO DEFECTIVE SAMPLES AND PHOTOS HAVE BEEN RECEIVED, AND THE SPECIFIC SITE AND STATES OF THE CATHETER BREAKAGE CANNOT BE IDENTIFIED. 3. THE RETAINED SAMPLE OF THIS BATCH IS TAKEN FOR THE RELEVANT FUNCTIONAL TESTS OF THE CATHETER: THE 45PSI LEAKAGE TEST AND THE PULL FORCE TEST OF THE CATHETER. THE TEST RESULTS SHOW THAT NO LEAKAGE IS FOUND AT THE CATHETER, AND THE PULL FORCE OF THE CATHETER IS WITHIN THE PRODUCT SPECIFICATIONS. PLEASE SEE THE ATTACHMENT FOR TEST REPORTS. 4. NO SIMILAR COMPLAINTS HAVE BEEN RECEIVED FROM OTHER HOSPITALS REGARDING THIS BATCH OF PRODUCTS. CONCLUSION(S): SINCE NO ABNORMALITIES ARE FOUND IN THE PROCESS AND RETAINED SAMPLE, NO SIMILAR COMPLAINTS HAVE BEEN RECEIVED FROM OTHER HOSPITALS REGARDING THIS BATCH OF PRODUCTS, AND NO DEFECTIVE SAMPLE HAS BEEN RECEIVED FOR FURTHER INSPECTION, THE ROOT CAUSE OF THE CATHETER BREAKAGE CANNOT BE CONFIRMED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC CATHETER BROKE / SEPARATED AFTER PLACEMENT PATIENT DEMENTIA, FOR THE FEMUR FRACTURE POSTOPERATIVE. ON (B)(6) 09:30 NURSE IN ACCORDANCE WITH MEDICAL ADVICE TO OPEN THE PACKAGING INTACT CLOSED INTRAVENOUS NEEDLE, GIVE THE PATIENT FOR THE NEEDLE PUNCTURE PAIN MEDICATION INFUSION, 11:00 THERE ARE MORE THAN THE END OF THE INFUSION. NURSE AT 12:00 ROUNDS FOUND THAT THE INDWELLING NEEDLE HAS BEEN REMOVED BY ITSELF, NO STUMP, IMMEDIATELY GIVE THE PATIENT COMPRESSION HEMOSTASIS, HAND LOCAL SUPERFICIAL ULTRASOUND, DID NOT SEE THE STUMP OF THE INDWELLING NEEDLE. THE SEARCH CONTINUED AND THE BROKEN END WAS FOUND AT THE BEDSIDE 15 MINUTES LATER. MEASURES: PATIENT WAS GIVEN COMPRESSION HEMOSTASIS, LOCALIZED SUPERFICIAL COLOR ULTRASOUND OF THE HAND, AND THE STUMP WAS FOUND AT THE BEDSIDE 15 MINUTES LATER. MEDICAL ADVICE WAS CHANGED TO INTRAMUSCULAR INJECTION AND ORAL PAIN MEDICATION. THERE WERE NO SERIOUS EFFECTS ON THE PATIENT.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2176261 BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC INTRAVASCULAR CATHETER FOZ BD SUZHOU (MDS) 4081459 00382903830831

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown