FDA Adverse Event Malfunction Summary report: N

BD US CATHENA 20GX1.00IN STRAIGHT BC

MDR report key: 20612797 · Received November 5, 2024

Report

Report Number
2243072-2024-01095
Event Type
Malfunction
Date Received
November 5, 2024
Date of Event
October 11, 2024
Report Date
November 27, 2024
Manufacturer
BECTON DICKINSON
Product Code
FOZ
UDI-DI
00382903868629
PMA / PMN Number
K220584
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
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

BASED ON DEVICE HISTORY RECORD REVIEW, NO ABNORMALITY WAS OBSERVED DURING THE PRODUCTION OF THE AFFECTED BATCH. AS CURRENT CONTROL, THERE ARE FUNCTIONAL TEST TO CHECK AND DETECT SAFETY ACTIVATION FAILURE. AS NO PHOTO AND SAMPLE IS RETURNED FOR EVALUATION, ROOT CAUSE COULD NOT BE ESTABLISHED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD US CATHENA 20GX1.00IN STRAIGHT BC SAFETY SHIELD ACTIVATION FAILED (CATHETER) IT WAS REPORTED BY CUSTOMER THAT NURSE WAS INSERTING AN IV AND THE SAFETY LOCK DID NOT ENGAGE. VERBATIM: RCC RECEIVED A COMPLAINT VIA EMAIL. EMAIL(S) ATTACHED NURSE WAS INSERTING AN IV AND THE SAFETY LOCK DID NOT ENGAGE. ITEM -386862 LOT -4022034.

Description of Event or Problem · 0

MATERIAL# 386862. BATCH# 4022034. IT WAS REPORTED BY CUSTOMER THAT NURSE WAS INSERTING AN IV AND THE SAFETY LOCK DID NOT ENGAGE. VERBATIM: RCC RECEIVED A COMPLAINT VIA EMAIL. NURSE WAS INSERTING AN IV AND THE SAFETY LOCK DID NOT ENGAGE. ITEM -386862. LOT -4022034.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
71557 BD US CATHENA 20GX1.00IN STRAIGHT BC INTRAVASCULAR CATHETER FOZ BECTON DICKINSON 4022034 00382903868629

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown