FDA Adverse Event Malfunction Summary report: N

NEEDLE 18X1-1/2 BLUNT FILL

MDR report key: 21899434 · Received April 24, 2025

Report

Report Number
1911916-2025-00304
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 A DEVICE HISTORY RECORD REVIEW WAS COMPLETED BY OUR QUALITY ENGINEER TEAM FOR PROVIDED MATERIAL NUMBER 305180 AND LOT NUMBER 4178014. 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.

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. EMAIL(S) ATTACHED. 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
503303 NEEDLE 18X1-1/2 BLUNT FILL NEEDLE, ASPIRATION AND INJECTION, DISPOSABLE GAA BECTON DICKINSON 4178014 30382903051800

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown