FDA Adverse Event Malfunction Summary report: N

BD LUER-LOK

MDR report key: 23408620 · Received October 28, 2025

Report

Report Number
1911916-2025-00704
Event Type
Malfunction
Date Received
October 28, 2025
Date of Event
September 3, 2025
Report Date
November 7, 2025
Manufacturer
BD MEDICAL (BD WEST) MEDICAL SURGICAL
Product Code
FMF
UDI-DI
00382903096534
PMA / PMN Number
K110771
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: (H) ATTACHED MEDWATCH INVESTIGATION RESULTS: BASED ON THE INVESTIGATION AND WITH NO SAMPLE ANALYSIS THE SYMPTOM REPORTED BY THE CUSTOMER COULD NOT BE CONFIRMED. WE WILL CONTINUE MONITORING THE COMPLAINT TREND FOR THE PRODUCT AND SYMPTOM. WITH NO ACTUAL SAMPLE ANALYSIS, A PROBABLE ROOT CAUSE COULD NOT BE OFFERED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD SYRINGE 60ML LL TIP 1ML LUER WAS CRACKED / DAMAGED / DEFORMED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL#: 309653, BATCH#: 5142417. RCC RECEIVED A COMPLAINT VIA EMAIL. WHILE PERFORMING THERAPEUTIC PHLEBOTOMY VIA VAD, WHEN NURSING REMOVED A 50ML LUER LOCK SYRINGE FROM LARGE BORE STOPCOCK WITH ROTATING MALE LUER LOCK(BARD) THE TIP OF THE LUER LOCK OF THE 50ML SYRINGE HAD SEVERED/BROKEN. NURSING REMOVED ALL EQUIPMENT FROM PATIENT. ATTACHED SYRINGE DIRECTLY TO VAD ASPIRATED/DISCARDED 10ML BLOOD AND FLUSHED VAD WITHOUT INCIDENT. NO INJURY TO PATIENT. LOT#: 5142417.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
234081 BD LUER-LOK PISTON SYRINGE FMF BD MEDICAL (BD WEST) MEDICAL SURGICAL 5142417 00382903096534

Patients

Seq Age Sex Outcome Treatment
1 66 YR Male