FDA Adverse Event Malfunction Summary report: N

NEEDLE 18X1-1/2 BLUNT FILL

MDR report key: 21899415 · Received April 24, 2025

Report

Report Number
1911916-2025-00303
Event Type
Malfunction
Date Received
April 24, 2025
Date of Event
April 14, 2025
Report Date
May 2, 2025
Manufacturer
BECTON DICKINSON
Product Code
GAA
UDI-DI
30382903051800
PMA / PMN Number
K941562
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, 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. THE ACTUAL DATE OF EVENT IS UNKNOWN. THE DATE RECEIVED BY MANUFACTURER WAS ENTERED INTO THE DATE OF EVENT FIELD.

Additional Manufacturer Narrative · 0

(B)(6) FOLLOW UP: AS NO PHYSICAL SAMPLE, PICTURE SAMPLE, OR LOT NUMBER WAS PROVIDED FOR EVALUATION BY OUR QUALITY ENGINEER TEAM, A COMPLETE INVESTIGATION COULD NOT BE PERFORMED. THERE ARE CURRENT QUALITY CONTROLS IN PLACE TO DETECT THIS TYPE OF DEFECT DURING THE PRODUCTION PROCESS. BASED ON THE LIMITED INVESTIGATION RESULTS, A CAUSE FOR THE REPORTED INCIDENT COULD NOT BE DETERMINED. SHOULD YOU AGAIN EXPERIENCE ANY PROBLEMS WITH OUR PRODUCT WE WOULD APPRECIATE THE OPPORTUNITY TO CONDUCT A THOROUGH ANALYSIS. EXAMINATION OF THE PRODUCT INVOLVED MAY PROVIDE CLARIFICATION AS TO THE CAUSE FOR THE REPORTED FAILURE.

Description of Event or Problem · 0

MATERIAL # 305180, BATCH # 4178014, 4178027, UNKNOWN. IT WAS REPORTED BY CUSTOMER THAT "VIAL STOPPER CORING IS REPORTED WHEN ACCESSING BD® BLUNT FILL NEEDLE WITH BD LUER-LOK." VERBATIM: RCC RECEIVED A COMPLAINT VIA EMAIL. FRESENIUS KABI USA LLC HAS RECEIVED REPORTS IN WHICH VIAL STOPPER CORING IS REPORTED WHEN ACCESSING FRESENIUS KABI¿S DIPRIVAN WITH: BD® BLUNT FILL NEEDLE WITH BD LUER-LOK¿. THE PRODUCT INFORMATION BELOW IS FOR YOUR REFERENCE IN NO ORDER OR INDICATION TO THE NUMBER OF REPORTS INVOLVED. FRESENIUS KABI IS UNABLE TO PROVIDE FURTHER INFORMATION, SAMPLE RETURNS, PHOTOGRAPHS, OR CUSTOMER RELATED INFORMATION AT THIS TIME. PLEASE CONSIDER ALL INFORMATION WITH NO ACCESS TO FOLLOW-UP INFORMATION. FUTURE REPORTS MAYBE FORWARDED DIRECTLY TO BD FOR FURTHER REVIEW. LOT: UNKNOWN, REF 305180, LOT: 4080728, LOT: 4178014, LOT: 4178027.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
477466 NEEDLE 18X1-1/2 BLUNT FILL NEEDLE, ASPIRATION AND INJECTION, DISPOSABLE GAA BECTON DICKINSON UNKNOWN 30382903051800

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown