FDA Adverse Event Malfunction Summary report: N

BD US CATHENA 20GX1.00IN STRAIGHT BC

MDR report key: 21086155 · Received January 6, 2025

Report

Report Number
2243072-2024-01293
Event Type
Malfunction
Date Received
January 6, 2025
Date of Event
December 16, 2024
Report Date
January 15, 2025
Manufacturer
BECTON DICKINSON
Product Code
FOZ
UDI-DI
00382903868629
PMA / PMN Number
K220584
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

OUR QUALITY ENGINEER INSPECTED THE PHOTO SUBMITTED FOR EVALUATION. THE REPORTED ISSUE OF SAFETY SHIELD ACTIVATION FAILURE WAS CONFIRMED UPON INSPECTION OF THE PHOTO. HOWEVER, BD CANNOT CONFIRM THE CAUSE OF THE FAILURE TO OUR MANUFACTURING PROCESS SINCE NO PHYSICAL SAMPLE WAS RETURNED. A REVIEW OF OUR RISK MANAGEMENT DOCUMENTATION WAS PERFORMED AND INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY. PRODUCTION RECORDS WERE REVIEWED, AND THIS BATCH MEETS OUR MANUFACTURING SPECIFICATION REQUIREMENTS.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD US CATHENA 20GX1.00IN STRAIGHT BC SAFETY SHIELD ACTIVATION FAILED IT WAS REPORTED BY CUSTOMER THAT THE SAFETY DID NOT SLIP OVER NEEDLE. VERBATIM: SAFETY DID NOT SLIP OVER NEEDLE.

Description of Event or Problem · 0

MATERIAL # 386862. BATCH # 4160445. IT WAS REPORTED BY CUSTOMER THAT THE SAFETY DID NOT SLIP OVER NEEDLE. VERBATIM: SAFETY DID NOT SLIP OVER NEEDLE. RESPONSE ON DECEMBER 30, 2024. CUSTOMER CONFIRMED THAT PRODUCT SAMPLE IS NOT AVAILABLE. IT WAS DISCARDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
351648 BD US CATHENA 20GX1.00IN STRAIGHT BC INTRAVASCULAR CATHETER FOZ BECTON DICKINSON 4160445 00382903868629

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown