FDA Adverse Event Malfunction Summary report: N

INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC

MDR report key: 23065427 · Received September 16, 2025

Report

Report Number
3006948883-2025-00688
Event Type
Malfunction
Date Received
September 16, 2025
Date of Event
June 20, 2025
Report Date
October 28, 2025
Manufacturer
BECTON DICKINSON
Product Code
FOZ
PMA / PMN Number
UNK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION RESULTS: NO ABNORMALITY IS FOUND ON PROCESS AND RETAINED SAMPLE, AND NO SIMILAR COMPLAINTS HAVE BEEN RECEIVED FROM OTHER HOSPITALS ABOUT THIS BATCH OF PRODUCTS. AS THE DEFECTIVE SAMPLE WAS NOT RETURNED AND ITS USAGE CONDITIONS ARE UNKNOWN, RELEVANT TESTING COULD NOT BE CONDUCTED, SO THE ROOT CAUSE OF THE COMPLAINT DEFECT CANNOT BE DETERMINED. THIS COMPLAINT IS AN ISOLATED CASE, AND THE PLANT WILL CONTINUE TO TRACK THIS ISSUE.

Additional Manufacturer Narrative · 0

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

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INTIMA-II Y 24GAX0.75IN PRN EC SLM NPV - NEEDLE BROKEN. ON (B)(6) 2025, AT 9:00 AM, WHILE PERFORMING AN IV CANNULATION WITH AN INDWELLING NEEDLE, THE NURSE ENCOUNTERED A FRACTURE AT THE FIN-SHAPED NEEDLE HUB DURING NEEDLE WITHDRAWAL, RENDERING THE FRONT NEEDLE SEGMENT INEXTRICABLE. THE NEEDLE WAS IMMEDIATELY REMOVED, AND THE IV CANNULATION WAS PERFORMED AGAIN AFTER REPLACING THE INDWELLING NEEDLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2650568 INTIMA-II Y 24GAX0.75IN PRN EC SLM NPVC INTRAVASCULAR CATHETER FOZ BECTON DICKINSON 4198427

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown