FDA Adverse Event Malfunction Summary report: N

NEXIVA

MDR report key: 22613773 · Received July 25, 2025

Report

Report Number
1710034-2025-01222
Event Type
Malfunction
Date Received
July 25, 2025
Date of Event
July 9, 2025
Report Date
August 1, 2025
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
UDI-DI
00382903835393
PMA / PMN Number
K183399
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

B3. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. H.3. A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED.

Additional Manufacturer Narrative · 0

A DEVICE HISTORY RECORD REVIEW WAS COMPLETED BY OUR QUALITY ENGINEER TEAM FOR PROVIDED MATERIAL NUMBER 383539 AND LOT NUMBER 4242229. THE REVIEW DID NOT REVEAL ANY DETECTED ABNORMALITIES DURING THE PRODUCTION PROCESS THAT COULD HAVE CONTRIBUTED TO THE REPORTED ISSUE, 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD NEXIVA LEAKED AT THE SEPTUM. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: #18 GAUGE IV INSERTED IN PATIENT, WHEN NEEDLE WAS RETRACTED BACK AND REMOVED BLOOD LEAKED FROM THE HUB. IV REMOVED AND NEW IV PLACED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2199545 NEXIVA PERIPHERAL IV CATHETERS FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 4242229 00382903835393

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown