FDA Adverse Event Malfunction Summary report: N

INSYTE AUTOGUARD

MDR report key: 23378270 · Received October 24, 2025

Report

Report Number
1710034-2025-01654
Event Type
Malfunction
Date Received
October 24, 2025
Date of Event
October 4, 2025
Report Date
December 23, 2025
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
IL, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

THE COMPLAINT THAT THE NEEDLE DOES NOT FULLY RETRACT WAS CONFIRMED AND THE CAUSE APPEARED TO BE MANUFACTURING RELATED. REPRESENTATIVE SAMPLES FROM LOT 5010456 WERE RECEIVED IN SEALED UNIT PACKAGES. A FUNCTIONAL TEST REVEALED THAT THE NEEDLES WERE PARTIALLY RETRACTED AND THE FLASH NOTCH ON 5 OF THE 20 TESTED UNITS BECAME CAUGHT ON THE BLOOD CONTROL VALVE UPON ACTIVATING THE SAFETY MECHANISM. THE DIMENSIONS OF THE NEEDLE WERE WITHIN SPECIFICATION. NO SLOW RETRACTION WAS IDENTIFIED ON THE REPRESENTATIVE SAMPLES. AS THE SAMPLES FROM SEALED UNIT PACKAGES FAILED TO FULLY RETRACT, THE COMPLAINT WAS CONFIRMED, AND THE CAUSE APPEARED TO BE MANUFACTURING RELATED. A NOTIFICATION OF THE CONFIRMED DEFECT WAS SENT TO OUR MANUFACTURING PERSONNEL FOR AWARENESS. A REVIEW OF OUR RISK MANAGEMENT DOCUMENTATION WAS PERFORMED AND INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY.

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. E1. ADDRESS INFORMATION WAS NOT PROVIDED; THEREFORE, (B)(6) WAS USED AS THE STATE.

Description of Event or Problem · 0

NO NEW INFORMATION.

Description of Event or Problem · 0

UPON OPENING A FEW CATHETERS AND PRESSING THE WHITE BUTTON, I OBSERVED THAT THE NEEDLE DID NOT RETRACT FULLY AND WAS SLOW TO RETRACT HALFWAY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1446097 INSYTE AUTOGUARD PERIPHERAL IV CATHETERS FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 5010456 00382903825448

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown