FDA Adverse Event Malfunction Summary report: N

LUER-LOK

MDR report key: 21905830 · Received April 24, 2025

Report

Report Number
1213809-2025-00303
Event Type
Malfunction
Date Received
April 24, 2025
Date of Event
January 15, 2025
Report Date
August 26, 2025
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
FMF
UDI-DI
30382903096283
PMA / PMN Number
K941562
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4) - SUPPLEMENTAL MDR/CORRECTION - FOREIGN MATTER. CORRECTION: FOLLOWING SUBMISSION OF INITIAL MDR, LOT NUMBER WAS CHANGED TO UNKNOWN. A POTENTIAL LOT NUMBER WAS PROVIDED. LOT 4054302 EXP DATE: 2029-JAN-31, 3122722 EXP DATE: 2028-APR-30, 3285677 EXP DATE: 2028-SEP-30, 3291217 EXP DATE: 2028-SEP-30. EVALUATION: IT WAS REPORTED A GREEN PARTICLE WAS OBSERVED IN THE PRODUCT FLOW PATH WITHIN THE NEEDLE HUB CONNECTION. AS A PHYSICAL SAMPLE WAS NOT RETURNED, A THOROUGH SAMPLE EVALUATION COULD NOT BE PERFORMED. TO AID IN THE INVESTIGATION, FOUR PHOTOS WERE PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. TWO IMAGES SHOWED THE SYRINGE BARREL TIP CONNECTED TO AN UNKNOWN NEEDLE WITH A SMALL GREEN PARTICULATE VISIBLE IN THE NEEDLE HUB AREA, ONE IMAGE DISPLAYED THE PARTICULATE IN A LOOSE STATE, AND THE FINAL IMAGE PRESENTED FOURIER TRANSFORM INFRARED SPECTROSCOPY (FTIR) ANALYSIS OF THE PARTICULATE. AS THIS PRODUCT IS SOLD WITHOUT A NEEDLE INCLUDED, NO CORRECTIVE ACTIONS ARE REQUIRED FROM THE SYRINGE MANUFACTURING PLANT. 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

H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

(B)(4)- SUPPLEMENTAL MDR - FOREIGN MATTER IT WAS REPORTED A GREEN PARTICLE WAS OBSERVED IN THE PRODUCT FLOW PATH WITHIN THE NEEDLE HUB CONNECTION. TO SUPPORT THE INVESTIGATION, ONE UNPACKAGED SAMPLE, A GLASS PLATE CONTAINING A GREEN-COLORED PARTICLE, AND THREE PHOTOGRAPHS WERE SUBMITTED FOR EVALUATION. TWO IMAGES SHOWED THE SYRINGE BARREL TIP CONNECTED TO AN UNKNOWN NEEDLE WITH A SMALL GREEN PARTICULATE VISIBLE IN THE NEEDLE HUB AREA, ONE IMAGE DISPLAYED THE PARTICULATE IN A LOOSE STATE, AND THE FINAL IMAGE PRESENTED FOURIER TRANSFORM INFRARED SPECTROSCOPY (FTIR) ANALYSIS OF THE PARTICULATE. AS THIS PRODUCT IS SOLD WITHOUT A NEEDLE INCLUDED, NO CORRECTIVE ACTIONS ARE REQUIRED FROM THE SYRINGE MANUFACTURING PLANT. 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

PR 11894035 - SUPPLEMENTAL MDR - FOREIGN MATTER. IT WAS REPORTED THAT A GREEN PARTICLE WAS OBSERVED IN THE PRODUCT FLOW PATH WITHIN THE NEEDLE HUB CONNECTION. TO SUPPORT THE INVESTIGATION, ONE UNPACKAGED SAMPLE, A GLASS PLATE CONTAINING A GREEN-COLORED PARTICLE, AND FOUR PHOTOGRAPHS WERE SUBMITTED FOR EVALUATION. ALTHOUGH FOUR SYRINGE LOT NUMBERS WERE SPECIFIED IN THE COMPLAINT, ONLY ONE SYRINGE OF UNKNOWN LOT WAS RETURNED. TWO IMAGES SHOWED THE SYRINGE BARREL TIP CONNECTED TO AN UNKNOWN NEEDLE WITH A SMALL GREEN PARTICULATE VISIBLE IN THE NEEDLE HUB AREA, ONE IMAGE DISPLAYED THE PARTICULATE IN A LOOSE STATE, AND THE FINAL IMAGE PRESENTED FOURIER TRANSFORM INFRARED SPECTROSCOPY (FTIR) ANALYSIS OF THE PARTICULATE WHICH IDENTIFIED THE FOREIGN MATERIAL AS A SYNTHETIC PLASTIC. THE FOREIGN MATTER WAS VISUALLY EVALUATED, AND THE FOURIER TRANSFORM INFRARED SPECTROSCOPY (FTIR) ANALYSIS WAS COMPARED WITH KNOWN SOURCES WITHIN BD. THE ANALYSIS CONFIRMED TO HAVE NOT ORIGINATED FROM BD¿S SYRINGE MANUFACTURING PROCESS. AS THIS PRODUCT IS SOLD WITHOUT A NEEDLE INCLUDED, NO CORRECTIVE ACTIONS ARE REQUIRED FROM THE SYRINGE MANUFACTURING PLANT. FURTHERMORE, A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR PROVIDED LOT NUMBERS 4054302, 3122722, 3285677, 3291217. A REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. 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.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD SYRINGE 1ML LL HAD FOREIGN MATTER. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL#: 309628, BATCH#: 4054302. RCC RECEIVED A COMPLAINT VIA EMAIL. ON 15JAN2025, WAS INFORMED OF AN EVENT WITH EYLEA 8MG VIAL KIT WHICH WAS CATEGORIZED WITH THE DEFECT FOREIGN MATTER FM- SYRINGE. ON 27JAN2025, ONE SYRINGE RETURNED WITH GREEN PARTICLE OBSERVED IN PRODUCT FLOW PATH WITHIN THE NEEDLE HUB CONNECTION. FILTER NEEDLE: CATALOG: 305211, LOT: 4031348, 1 ML SYRINGE, CATALOG: 309628, LOT: 4054302, INJECTION NEEDLE, CATALOG: 305106, LOT: 3334821. CUSTOMER RESPONDED ON 21-APR. 1. CAN YOU PLEASE PROVIDE AN EXACT DATE OF EVENT IN FORMAT MM-DD-YYYY? 15JAN2025. 2. ANY ADVERSE EVENT OR SERIOUS INJURY REPORTED TO PATIENT OR HEALTHCARE PROFESSIONAL? IF YES, PLEASE PROVIDE THE DETAILS. N/A. 3. COULD YOU PLEASE CONFIRM IF THERE ARE ANY SAMPLES AVAILABLE TO SEND TO BD FOR INVESTIGATION? SAMPLE WILL NOT BE FORWARDED AT THIS TIME.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1275575 LUER-LOK PISTON SYRINGE FMF BECTON DICKINSON MEDICAL SYSTEMS UNKNOWN 30382903096283

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown