FDA Adverse Event Malfunction Summary report: N

SYRINGE 10ML SALINE FILL CHINA SP

MDR report key: 21806174 · Received April 9, 2025

Report

Report Number
1911916-2025-00270
Event Type
Malfunction
Date Received
April 9, 2025
Date of Event
March 22, 2025
Report Date
April 15, 2025
Manufacturer
BECTON DICKINSON
Product Code
NGT
UDI-DI
00382903065950
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(6) FOLLOW UP: A DEVICE HISTORY RECORD REVIEW WAS COMPLETED BY OUR QUALITY ENGINEER TEAM FOR PROVIDED MATERIAL NUMBER 306595 AND LOT NUMBER 4152257. THE REVIEW DID NOT REVEAL ANY DETECTED ABNORMALITIES DURING THE PRODUCTION PROCESS THAT COULD HAVE CONTRIBUTED TO THIS DEFECT AND ALL QUALITY TESTS WERE FOUND TO BE WITHIN SPECIFICATION. AS A SAMPLE WAS UNAVAILABLE FOR RETURN, A THOROUGH SAMPLE INVESTIGATION COULD NOT BE COMPLETED. BASED ON THE INVESTIGATION RESULTS, AN EXACT CAUSE FOR THIS INCIDENT COULD NOT BE IDENTIFIED. SHOULD YOU AGAIN EXPERIENCE ANY PROBLEMS WITH OUR PRODUCT WE WOULD APPRECIATE THE OPPORTUNITY TO CONDUCT A THOROUGH ANALYSIS. THERE ARE QUALITY CONTROLS CURRENTLY IN PLACE TO DETECT THIS TYPE OF DEFECT DURING THE PRODUCTION PROCESS. FURTHER ACTION HAS NOT BEEN DETERMINED NECESSARY AT THIS TIME.

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.

Description of Event or Problem · 0

THE TEACHER IN THE BREAST SURGERY WARD FOUND A FRACTURE AT THE FLUSH CONNECTOR WHEN IN USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1665268 SYRINGE 10ML SALINE FILL CHINA SP SALINE, VASCULAR ACCESS FLUSH NGT BECTON DICKINSON 4152257 00382903065950

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown