FDA Adverse Event Malfunction Summary report: N

INJECTOR N35-O

MDR report key: 21399731 · Received February 18, 2025

Report

Report Number
3003152976-2025-00055
Event Type
Malfunction
Date Received
February 18, 2025
Date of Event
February 5, 2025
Report Date
April 10, 2025
Manufacturer
BECTON DICKINSON
Product Code
ONB
UDI-DI
00382905150708
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

INITIAL MDR SUBMISSION. A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED.

Additional Manufacturer Narrative · 0

PR (B)(4) FOLLOW UP MDR FOR DEVICE EVALUATION: ONE PHOTO WAS PROVIDED TO OUR QUALITY TEAM FOR EVALUATION. UPON VISUAL INSPECTION, TRACES OF DRUG CAN BE OBSERVED NEAR THE HUB. THERE IS NO DAMAGE OR OTHER VISIBLE DEFECT THAT CAN BE IDENTIFIED WITHIN THE PHOTO TO INDICATE WHY A LEAK MAY HAVE OCCURRED. PRODUCT UNDERGOES A SERIES OF VISUAL AND FUNCTIONAL EVALUATIONS THROUGHOUT THE MANUFACTURING PROCESS TO ENSURE THE QUALITY AND FUNCTIONALITY OF THE DEVICE, INCLUDING VERIFICATION ALL CRITICAL DIMENSIONS ARE WITHIN SPECIFICATION. AS THE LOT INVOLVED IN THIS INCIDENT IS UNKNOWN, A DEVICE HISTORY REVIEW COULD NOT BE PERFORMED. BASED ON THE AVAILABLE INFORMATION, A ROOT CAUSE RELATED TO OUR MANUFACTURING PROCESS CANNOT BE ESTABLISHED AT THIS TIME. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR QUALITY TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Description of Event or Problem · 0

MATERIAL#: UNKNOWN BATCH NUMBER#: UNKNOWN. WE HAD A PATIENT WITH A HOME PUMP WHO CAME FOR THEIR PUMP DC AND THE NURSE NOTED DRUG RESIDUE ON THE LINE NEAR THE BLUE COVER. I DO NOT HAVE ANY LOT/EXP INFORMATION FOR THE LINE OR PHASEAL. THE NURSE REPORTED THAT EVERYTHING WAS CONNECTED APPROPRIATELY. I CANNOT SAY FOR SURE WHETHER THIS IS A USER ERROR OR AN ISSUE WITH THE PHASEAL OR LINE. PLEASE LET ME KNOW YOUR THOUGHTS. I KNOW YOU HAVE ALREADY DONE REPEAT STAFF EDUCATION. PER RESPONSE ON (B)(6) 2025: 1. I DO NOT HAVE THE LOT EXPIRATION DATA SINCE IT WAS DISCOVERED 2 DAYS AFTER THE CONNECTION. THE PRODUCTS INVOLVED WERE BD PHASEAL OPTIMA INFUSION CLAMP M25-O (515085), OPTIMA CONNECTOR C35-O (515070), AND OPTIMA INJECTOR N35-O (515052). 2. NO PATIENT HARM, INJURY, COMPLICATION OR NEGATIVE OUTCOME OCCURRED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
59717 INJECTOR N35-O CLOSED ANTINEOPLASTIC AND HAZARDOUS DRUG RECONSTITUTION AND TRANSFER SYSTEM ONB BECTON DICKINSON UNKNOWN 00382905150708

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown