FDA Adverse Event Malfunction Summary report: N

BD PRESET¿ ECLIPSE¿

MDR report key: 20887658 · Received December 9, 2024

Report

Report Number
9617032-2024-01920
Event Type
Malfunction
Date Received
December 9, 2024
Date of Event
November 18, 2024
Report Date
November 26, 2024
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
UDI-DI
50382903643900
PMA / PMN Number
K202446
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

E1. INITIAL REPORTER FACILITY NAME: (B)(6) UNIVERSITY . INVESTIGATION SUMMARY: "MATERIAL #: 364390. LOT/BATCH #: 4151949 . BD HAD NOT RECEIVED SAMPLES, BUT 1 PHOTO WAS PROVIDED FOR INVESTIGATION. THE PHOTO WAS REVIEWED AND THE INDICATED FAILURE MODE FOR LEAKAGE WAS OBSERVED. ADDITIONALLY, 10 RETENTION SAMPLES FROM BD INVENTORY WERE EVALUATED BY FUNCTIONAL DRAW TESTING AND THE ISSUE OF LEAKAGE WAS NOT OBSERVED. BASED ON A REVIEW OF THE DEVICE HISTORY RECORD FOR THE INCIDENT LOT, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET. THERE WERE NO RELATED QUALITY ISSUES DURING MANUFACTURING OF THE PRODUCT. THIS COMPLAINT HAS BEEN CONFIRMED FOR THE INDICATED FAILURE MODE LEAKAGE. BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS."

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING A BD PRESET¿ ECLIPSE¿ SYRINGE BLOOD LEAKED PAST THE PLUNGER STOPPER. THERE WAS NO REPORT OF ADVERSE IMPACT TO PATIENTS OR USERS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2536276 BD PRESET¿ ECLIPSE¿ BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 4151949 50382903643900

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown