FDA Adverse Event Malfunction Summary report: N

BD SYRINGE 5ML LL SP125

MDR report key: 22834983 · Received August 18, 2025

Report

Report Number
1213809-2025-00548
Event Type
Malfunction
Date Received
August 18, 2025
Date of Event
August 1, 2025
Report Date
October 2, 2025
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
FMF
PMA / PMN Number
K110771
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

B.3. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. 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 - PACKAGE DAMAGED / DEFECTIVE / OTHER. A TOTAL OF FORTY-TWO SAMPLES OF 5ML LUER-LOK SYRINGES (PART NUMBER 309646) WERE RECEIVED AND EVALUATED. THESE INCLUDED THIRTY-THREE SAMPLES FROM BATCH 5132909, THREE SAMPLES EACH FROM BATCHES 5023089 AND 5029101, TWO SAMPLES FROM BATCH 5069390, AND ONE SAMPLE FROM BATCH 5029100. ALL SAMPLES EXHIBITED AN OPEN SEAL WITH A GRID ALONG THE ENTIRE LENGTH OF THE SHORT SEAL ON THE PEEL TAB. INTERVIEWS WITH PROCESS ENGINEERS, A PROJECT ENGINEER SPECIALIZING IN RAW MATERIALS, AND A QUALITY ENGINEER DID NOT IDENTIFY THE PACKAGING PROCESS OR RAW MATERIALS AS CONTRIBUTING FACTORS. AS THE CONDITION COULD NOT BE TRACED TO THE MANUFACTURING SITE, NO CORRECTIVE ACTIONS ARE NECESSARY. FURTHERMORE, A DEVICE HISTORY RECORD REVIEW WAS COMPLETED FOR LOT NUMBERS 5132909, 5029100, 5069390, 5029101, AND 5023089. THE REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING 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 IN TREND REPORTS AND MONITORED MONTHLY. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA TO IDENTIFY EMERGING TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD SYRINGE 5ML LL SP125 PACKAGE WAS DAMAGED / DEFECTIVE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL#: 309646, BATCH#: 5132909, 5029100, 5069390, 5029101, 5023089. IT WAS REPORTED BY THE CUSTOMER THAT THE PACKAGING HAS NOT BEEN SEALED CORRECTLY. RCC RECEIVED A COMPLAINT VIA EMAIL. WE RECEIVED SAMPLES FOR THIS COMPLAINT. THERE WERE ALSO SEVERAL ADDITIONAL LOTS INCLUDED. MANY OF THESE ADDITIONAL LOTS DID SEEM TO SHOW THE SAME ISSUE AS THE REPORTED ONE. SEE BELOW. 138 SAMPLE(S) RECEIVED AND NOT DECONTAMINATED IN XXXXXXX. MAT#: 309646, LOT#: GRID-5112799, PACKAGES: 5112799-QTY: (B)(4), 5132909-QTY: (B)(4), 5029100-QTY: (B)(4), 5069390-QTY: (B)(4), 5029101-QTY: (B)(4), 5023089-QTY: (B)(4), SAMPLE(S) SENT TO XXXX LAB PENDING FURTHER INSTRUCTIONS.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2194684 BD SYRINGE 5ML LL SP125 PISTON SYRINGE FMF BECTON DICKINSON MEDICAL SYSTEMS 5029100

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown