FDA Adverse Event Malfunction Summary report: N

BD INSYTE AUTOGUARD WINGED

MDR report key: 21439620 · Received February 21, 2025

Report

Report Number
1710034-2025-00298
Event Type
Malfunction
Date Received
February 21, 2025
Date of Event
February 7, 2025
Report Date
April 11, 2025
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
PMA / PMN Number
UNK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

TYPO CORRECTION FOR INVESTIGATION RESULTS: OUR QUALITY ENGINEER INSPECTED SAMPLES SUBMITTED FOR EVALUATION. BD RECEIVED 3 UNSEALED AND 1 SEALED 22 GA X 1.00 IN. INSYTE AUTOGUARD WINGED UNITS FROM LOT NUMBER 4222720. YOUR REPORT THAT THE NEEDLE FAILED TO RETRACT COULD NOT BE CONFIRMED. THREE SAMPLES WERE RECEIVED IN OPEN PACKAGING AND THE NEEDLES WERE FULLY RETRACTED. ONE UNIT WAS RECEIVED IN SEALED PACKAGING. A FUNCTIONAL TEST SHOWED THAT THE NEEDLES WOULD FULLY RETRACT, AND NO DAMAGE OR DEFECTS WERE NOTED ON THE RETURNED SAMPLES. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH. HOWEVER, A TREND HAS BEEN IDENTIFIED FOR THE REPORTED FAILURE AND CORRECTIVE ACTIONS HAVE BEEN INITIATED TO INVESTIGATE THIS TYPE OF INCIDENT AND IDENTITY THE ROOT CAUSE.

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: OUR QUALITY ENGINEER INSPECTED SAMPLES SUBMITTED FOR EVALUATION. BD RECEIVED 3 UNSEALED AND 1 SEALED 22GA X 1.00IN. INSYTE AUTOGUARD WINGED UNITS FROM LOT NUMBER 4222720. YOUR REPORT THAT THE NEEDLE FAILED TO RETRACT COULD NOT BE CONFIRMED. THREE SAMPLES WERE RECEIVED IN OPEN PACKAGING AND THE NEEDLES WERE FULLY RETRACTED. ONE UNIT WAS RECEIVED IN SEALED PACKAGING. A FUNCTIONAL TEST SHOWED THAT THE NEEDLES WOULD FULLY RETRACT, AND NO DAMAGE OR DEFECTS WERE NOTED ON THE RETURNED SAMPLES. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH. HOWEVER, A TREND HAS BEEN IDENTIFIED FOR THE REPORTED FAILURE AND CORRECTIVE ACTIONS HAVE BEEN INITIATED TO INVESTIGATE THIS TYPE OF INCIDENT AND IDENTITY THE ROOT CAUSE.

Additional Manufacturer Narrative · 0

H.3. A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED.

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: OUR QUALITY ENGINEER INSPECTED SAMPLES SUBMITTED FOR EVALUATION. BD RECEIVED 3 UNSEALED AND 1 SEALED 22GA X 1.00IN. INSYTE AUTOGUARD WINGED UNITS FROM LOT NUMBER 4222720. YOUR REPORT THAT THE NEEDLE FAILED TO RETRACT COULD NOT BE CONFIRMED FROM THE FOUR 24GA INSYTE-N AUTOGUARD UNITS FROM LOT: 4208538. THREE SAMPLES WERE RECEIVED IN OPEN PACKAGING AND THE NEEDLES WERE FULLY RETRACTED. ONE UNIT WAS RECEIVED IN SEALED PACKAGING. A FUNCTIONAL TEST SHOWED THAT THE NEEDLES WOULD FULLY RETRACT, AND NO DAMAGE OR DEFECTS WERE NOTED ON THE RETURNED SAMPLES. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH. HOWEVER, A TREND HAS BEEN IDENTIFIED FOR THE REPORTED FAILURE AND CORRECTIVE ACTIONS HAVE BEEN INITIATED TO INVESTIGATE THIS TYPE OF INCIDENT AND IDENTITY THE ROOT CAUSE.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INSYTE AUTOGUARD WINGED NEEDLE DID NOT RETRACT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DATE OF INCIDENT (YYYY-MM-DD): (B)(6) 2025 TYPE OF INCIDENT/PROBLEM: FAILURE LEVEL OF HARM: HAZARD ¿ CLOSE CALL. INCIDENT DETAILS: MULTIPLE ISSUES WITH NEEDLE NOT RETRACTING ON BD INSYTE AUTOGUARD WINGED NEEDLES. STAFF HAVE HAS MULTIPLE ISSUES WHEN PRESSING THE BUTTON THE NEEDLE DOES NOT RETRACT. PRESENTS SIGNIFICANT SAFETY RISK OF NEEDLE POKE. I HAVE 7 NEEDLES, ALL THE SAME LOT NUMBER, FROM FEB 7 PROCEDURE: IV INITIATION.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1619829 BD INSYTE AUTOGUARD WINGED PERIPHERAL IV CATHETERS FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 4222720

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown