FDA Adverse Event Malfunction Summary report: N

NEEDLE 30X1/2 RB

MDR report key: 21458133 · Received February 25, 2025

Report

Report Number
1911916-2025-00146
Event Type
Malfunction
Date Received
February 25, 2025
Date of Event
February 13, 2025
Report Date
March 24, 2025
Manufacturer
BECTON DICKINSON
Product Code
FMI
UDI-DI
30382903051060
PMA / PMN Number
K021475
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BECTON DICKINSON AND COMPANY'S (BD) MEDICATION DELIVERY SOLUTIONS (MDS) BUSINESS UNIT WILL DISCONTINUE MALFUNCTION MDR REPORTING FOR CERTAIN DEVICE FAILURES THAT HAVE NOT CAUSED OR CONTRIBUTED TO DEATHS OR SERIOUS INJURIES IN THE PAST TWO YEARS, AND WHERE THE LIKELIHOOD OF A DEATH OR SERIOUS INJURY AS A RESULT OF THESE MALFUNCTIONS IS REMOTE. THIS DECISION FOLLOWS FDA GUIDELINES (MEDICAL DEVICE REPORTING FOR MANUFACTURERS GUIDANCE FOR INDUSTRY AND FOOD AND DRUG ADMINISTRATION STAFF ISSUED NOV 8, 2016, REFERENCE SECTION 2.15). BD NOTIFIED FDA OF THIS DECISION ON MAR 3, 2025. FDA HAS REVIEWED AND RESPONDED TO BD¿S NOTIFICATION (REFERENCE FDA DOCUMENT # (B)(4)) ON MARCH 7, 2025. THIS DOCUMENTATION IS AVAILABLE IN BD DOCUMENT MANAGEMENT SYSTEM (SAP) AS (B)(4). THIS SUPPLEMENTAL MDR IS BEING FILED TO DOCUMENT THAT THE BELOW DEVICE FAILURE WILL NO LONGER BE CONSIDERED A REPORTABLE MALFUNCTION MDR FOR THE PRODUCT FAMILY BELOW: PRODUCT FAMILY: CONVENTIONAL NEEDLES. DEVICE FAILURE: DISCOLORATION / VARIATION IN COLOR / CLOUDY.

Additional Manufacturer Narrative · 0

(B)(4) FOLLOW UP: IT WAS REPORTED THERE WAS DISCOLORATION OF THE NEEDLE. AS A PHYSICAL NEEDLE SAMPLE WAS NOT RETURNED, A THOROUGH SAMPLE EVALUATION COULD NOT BE PERFORMED. TO AID IN THE INVESTIGATION, THREE PHOTOS WERE RECEIVED FOR EVALUATION BY OUR QUALITY TEAM. TWO PHOTOS SHOW PACKAGING BLISTER TOP WEBS. THE THIRD PHOTO SHOWS A NEEDLE ASSEMBLY WITH NO PACKAGING BLISTER OR PLASTIC SHIELD. FROM THE PHOTO, IT IS NOT POSSIBLE TO OBSERVE NEEDLE DISCOLORATION. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED MATERIAL NUMBER 305106, LOT 4103557. THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION OF THIS LOT THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. THERE WERE NO RELATED QUALITY NOTIFICATIONS. ALL PROCESSES AND FINAL INSPECTIONS COMPLIED WITH SPECIFICATION REQUIREMENTS. TO DATE, THERE HAVE BEEN NO OTHER SIMILAR EVENTS REPORTED FOR THIS LOT. BASED ON THE INVESTIGATION WITH THE PHOTO SAMPLE ANALYSIS THE SYMPTOM REPORTED BY THE CUSTOMER COULD NOT BE CONFIRMED. WITHOUT THE ACTUAL PHYSICAL SAMPLE ANALYSIS, A PROBABLE ROOT CAUSE COULD NOT BE OFFERED.

Additional Manufacturer Narrative · 0

PR (B)(4) FOLLOW UP REPORT FOR DEVICE EVALUATION. POST INVESTIGATION FINDINGS REVEALED FOREIGN MATTER. IT WAS REPORTED THERE WAS DISCOLORATION OF THE NEEDLE. TO AID IN THE INVESTIGATION, TWO SAMPLES IN OPENED PACKAGING BLISTERS AND THREE PHOTOS WERE RECEIVED FOR EVALUATION BY OUR QUALITY TEAM. A VISUAL INSPECTION WAS PERFORMED WITH 30X MAGNIFICATION. BOTH SAMPLES HAVE DARK COLORED SPECKS OF DUST ADHERED TO THE LUBRICANT APPLIED TO THE OUTER SURFACE OF THE NEEDLE. AFTER REMOVING THE DUST, THE SPECKS WERE NO LONGER VISIBLE. DUST ADHERED TO THE NEEDLE OCCURS DURING MAINTENANCE OR EQUIPMENT REPAIR. IN THE PHOTOS PROVIDED, TWO PHOTOS SHOW PACKAGING BLISTER TOP WEBS. THE THIRD PHOTO SHOWS A NEEDLE ASSEMBLY WITH NO PACKAGING BLISTER OR PLASTIC SHIELD. FROM THE PHOTO, IT IS NOT POSSIBLE TO OBSERVE NEEDLE DISCOLORATION. A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED MATERIAL NUMBER 305106, LOT 4103557. THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION OF THIS LOT THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. THERE WERE NO RELATED QUALITY NOTIFICATIONS. ALL PROCESSES AND FINAL INSPECTIONS COMPLIED WITH SPECIFICATION REQUIREMENTS. THE SAMPLES WILL BE SHOWN AND DISCUSSED WITH ASSOCIATES. TO DATE, THERE HAVE BEEN NO OTHER SIMILAR EVENTS REPORTED FOR THIS LOT. BASED ON THE INVESTIGATION WITH THE RETURNED SAMPLE ANALYSIS THE SYMPTOM REPORTED BY THE CUSTOMER IS CONFIRMED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED MONTHLY. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

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. THE ACTUAL DATE OF EVENT IS UNKNOWN. THE DATE RECEIVED BY MANUFACTURER WAS ENTERED INTO THE DATE OF EVENT FIELD.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION RECEIVED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Description of Event or Problem · 0

MATERIAL: 305106, LOT: 4103557. VERBATIM: RCC RECEIVED A COMPLAINT VIA EMAIL. I WANTED TO REACH OUT AND SEE WHAT WHO WE REPORT AN ISSUE WITH BD NEEDLES TO. OUR RN HERE IN DERMATOLOGY FOUND 2 NEEDLES TODAY THAT HAVE A DISCOLORATION ON THE NEEDLE ITSELF. 2) THE DISCOLORATION WAS ON THE NEEDLE SHAFT ITSELF. 3) THE NEEDLE WAS NOT USED, OUR NURSE NOTICED IT AS SOON AS SHE OPENED THE PACKAGING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
411482 NEEDLE 30X1/2 RB NEEDLE, HYPODERMIC, SINGLE LUMEN FMI BECTON DICKINSON 4103557 30382903051060

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown