FDA Adverse Event Malfunction Summary report: N

INSYTE AUTOGUARD

MDR report key: 23372471 · Received October 23, 2025

Report

Report Number
1710034-2025-01644
Event Type
Malfunction
Date Received
October 23, 2025
Date of Event
October 2, 2025
Report Date
January 21, 2026
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
UDI-DI
00382903825448
PMA / PMN Number
K201075
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

OUR QUALITY ENGINEER INSPECTED THE SAMPLES SUBMITTED FOR EVALUATION. YOUR REPORTED ISSUE THAT THE NEEDLE DID NOT FULLY RETRACT WAS CONFIRMED AND THE CAUSE APPEARED TO BE MANUFACTURING RELATED. FIVE 18G INSYTE AUTOGUARD BC DEVICES FROM LOT #5052302 WERE PROVIDED FOR INVESTIGATION. THE SAFETY MECHANISM HAD BEEN ACTIVATED ON EACH SAMPLE. TWO NEEDLES WERE RECEIVED FULLY RETRACTED. THREE NEEDLES WERE RECEIVED WITH THE FLASH NOTCH CAUGHT ON THE BLOOD CONTROL VALVE. AFTER MANIPULATING THE IV CATHETER, THE NEEDLE ENDED UP FULLY RETRACTING WITHIN THE SAFETY SHIELD. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH.

Additional Manufacturer Narrative · 0

OUR QUALITY ENGINEER INSPECTED THE SAMPLES SUBMITTED FOR EVALUATION. YOUR REPORTED ISSUE THAT THE NEEDLE DID NOT FULLY RETRACT WAS CONFIRMED AND THE CAUSE APPEARED TO BE MANUFACTURING RELATED. FIVE 18G INSYTE AUTOGUARD BC DEVICES FROM LOT #5052302 WERE PROVIDED FOR INVESTIGATION. THE SAFETY MECHANISM HAD BEEN ACTIVATED ON EACH SAMPLE. TWO NEEDLES WERE RECEIVED FULLY RETRACTED. THREE NEEDLES WERE RECEIVED WITH THE FLASH NOTCH CAUGHT ON THE BLOOD CONTROL VALVE. AFTER MANIPULATING THE IV CATHETER, THE NEEDLE ENDED UP FULLY RETRACTING WITHIN THE SAFETY SHIELD. A DEVICE HISTORY RECORD REVIEW SHOWED NO NON-CONFORMANCES ASSOCIATED WITH THIS ISSUE DURING THE PRODUCTION OF THIS BATCH. THE APPROPRIATE PERSONNEL HAVE BEEN NOTIFIED AND WE APPRECIATE YOU TAKING THE TIME TO BRING THIS OBSERVATION TO OUR ATTENTION.

Additional Manufacturer Narrative · 0

H.3. A FOLLOW UP MDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION, A DEVICE EVALUATION, OR A DEVICE HISTORY REVIEW IS COMPLETED.

Description of Event or Problem · 0

NO NEW INFORMATION.

Description of Event or Problem · 0

NO NEW INFORMATION.

Description of Event or Problem · 0

AFTER THE IV CATHETER WAS INSERTED, THE NEEDLE WAS STUCK AND DID NOT RETRACT. THE NURSE WAS ABLE TO LEAVE THE CATHETER IN THE SKIN AND PULL THE NEEDLE OUT. NEEDLE STILL DID NOT RETRACT WHEN TAKEN OUT OF THE PATIENT. ADDITIONAL INFORMATION RECEIVED ON 10OCT2025. THE BUTTON DID DEPRESS IT JUST DOES NOT TRIGGER FOR THE NEEDLE TO RETRACT. THE NEEDLE EITHER RETRACTS IN SLOW MOTION OR GETS STUCK IN THE HUB OF THE IV CATHETER. I HAVE HAD AT LEAST 10 MORE OCCURRENCES OF THE SAME ISSUE SINCE THE INITIAL COMPLAINT, WITH THE SAME LOT NUMBER. THIS ISSUE HAS NOT CAUSED AN INJURY TO A PATIENT OR A NURSE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1931615 INSYTE AUTOGUARD PERIPHERAL IV CATHETERS FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 5052302 00382903825448

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown