FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿

MDR report key: 22993007 · Received September 8, 2025

Report

Report Number
1024879-2025-01214
Event Type
Malfunction
Date Received
September 8, 2025
Date of Event
August 11, 2025
Report Date
February 4, 2026
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
30382903679837
PMA / PMN Number
BK050036
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

B3: DATE OF EVENT IS UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. E1. INITIAL REPORTER FACILITY NAME: (B)(6). THERE WERE MULTIPLE 510K NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR THE ADDITIONAL 510K IS AS FOLLOWS: G4. PMA / 510(K)#: K230855. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELDS WERE UPDATED DUE TO ADDITIONAL INFORMATION: B5: DESCRIBE EVENT OR PROBLEM: REPORT 2 OF 2: IT WAS REPORTED WHILE USING AN UNSPECIFIED NUMBER OF BD VACUTAINER® SST¿ TUBES, A GEL-LIKE SUBSTANCE COATS THE ANALYZER'S PROBE LEADING TO INSUFFICIENT SAMPLING AND ABNORMAL K+, NA+, AND CL- RESULTS. NO ERRONEOUS RESULTS WERE REPORTED. THE SAMPLE WAS RE-TESTED. THERE WAS NO OTHER HEALTH IMPACT OR CONSEQUENCES REPORTED. H6: EVENT PROBLEM AND EVALUATION CODES: IMDRF ANNEX A GRID: ADDITIONAL A CODE WAS ADDED - A0908 - INCORRECT, INADEQUATE OR IMPRECISE RESULT OR READINGS.

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY, BD RECEIVED 3 PHOTOS FOR INVESTIGATION. THE PHOTOS WERE REVIEWED AND THE INDICATED FAILURE MODE FOR OIL GEL GLOBULES WAS NOT OBSERVED. THE PHOTOS SHOW AN ANALYZER PROBE COVERED IN A GEL-LIKE SUBSTANCE, ALONG WITH LAB RESULTS INDICATING AN OUT-OF-RANGE RESULT FOR CL. THE PHOTOS PROVIDED DO NOT SHOW ANY BD TUBES SHOWING THE REPORTED DEFECT. ERRONEOUS RESULTS CANNOT BE ANALYZED THROUGH PHOTOS. THEREFORE, USING RETENTION SAMPLES; FACTORS THAT MAY CONTRIBUTE TO ERRONEOUS RESULTS WERE EVALUATED THROUGH A CLINICAL STUDY TO VERIFY THE DESIGN OF THE DEVICE MET IT¿S INTENDED USE. THE RESULT OF THE STUDY SHOWED THAT THE DEVICE PERFORMED AS EXPECTED AND WE WERE UNABLE TO DETERMINE ANY EXTERNAL CONTRIBUTOR TO THIS REPORTED ISSUE. THERE WERE NO DIFFICULTIES ENCOUNTERED DURING BLOOD COLLECTION AS ALL TUBES EXHIBITED PROPER FILL. BD WAS UNABLE TO DUPLICATE THE CUSTOMER¿S INDICATED FAILURE MODES (OIL GEL GLOBULES AND ERRONEOUS RESULTS-POTASSIUM, SODIUM, CHLORIDE) BECAUSE THE DEFECTS WERE NOT EVIDENT IN THE TESTING OF THE COMPLAINT LOT SAMPLES. REPLICATES OF BOTH RETENTION AND CONTROL SAMPLES WERE ACCEPTABLE IN TERMS OF BOTH PRECISION AND ACCURACY. ALL VISUAL OBSERVATIONS OF BOTH RETENTION AND CONTROL SAMPLES TESTED DEMONSTRATED CLINICALLY ACCEPTABLE PERFORMANCE. COMPLAINTS FOR SAMPLE QUALITY ARE UNDER STATISTICAL CONTROL FOR THE MONTH OF AUGUST 2025. BASED ON A REVIEW OF THE DEVICE HISTORY RECORD FOR THE INCIDENT LOT, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET. THERE WERE NO RELATED QUALITY ISSUES DURING MANUFACTURING OF THE PRODUCT. THIS COMPLAINT IS UNABLE TO BE CONFIRMED FOR THE INDICATED FAILURE MODES OIL GEL GLOBULES AND ERRONEOUS RESULTS (POTASSIUM, SODIUM, CHLORIDE). BD WAS NOT ABLE TO IDENTIFY A ROOT CAUSE FOR THE INDICATED FAILURE MODE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS. BD QUALITY WILL CONTINUE TO MONITOR SAMPLE QUALITY COMPLAINTS.

Description of Event or Problem · 0

REPORT 2 OF 2: IT WAS REPORTED WHILE USING BD VACUTAINER® SST¿, AN UNSPECIFIED NUMBER OF TUBES EXHIBIT OIL GEL GLOBULES. THERE WAS NO HEALTH IMPACT OR CONSEQUENCES REPORTED.

Description of Event or Problem · 0

REPORT 2 OF 2: IT WAS REPORTED WHILE USING AN UNSPECIFIED NUMBER OF BD VACUTAINER® SST¿ TUBES, A GEL-LIKE SUBSTANCE COATS THE ANALYZER'S PROBE LEADING TO INSUFFICIENT SAMPLING AND ABNORMAL K+, NA+, AND CL- RESULTS. NO ERRONEOUS RESULTS WERE REPORTED. THE SAMPLES WERE RE-TESTED. THERE WAS NO OTHER HEALTH IMPACT OR CONSEQUENCES REPORTED.

Description of Event or Problem · 0

REPORT 2 OF 2: IT WAS REPORTED WHILE USING AN UNSPECIFIED NUMBER OF BD VACUTAINER® SST¿ TUBES, A GEL-LIKE SUBSTANCE COATS THE ANALYZER'S PROBE LEADING TO INSUFFICIENT SAMPLING AND ABNORMAL K+, NA+, AND CL- RESULTS. NO ERRONEOUS RESULTS WERE REPORTED. THE SAMPLES WERE RE-TESTED. THERE WAS NO OTHER HEALTH IMPACT OR CONSEQUENCES REPORT

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2056505 BD VACUTAINER® SST¿ TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION JKA BECTON, DICKINSON & CO., (BD) 4339094 30382903679837

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown