FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿

MDR report key: 23512018 · Received November 10, 2025

Report

Report Number
1024879-2025-01753
Event Type
Malfunction
Date Received
November 10, 2025
Date of Event
October 14, 2025
Report Date
October 16, 2025
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

E1. INITIAL REPORTER PHONE #: (B)(6). 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.

Description of Event or Problem · 0

IT WAS REPORTED WHILE USING BD VACUTAINER® SST¿, 1 TUBE UNDERFILLED. THERE WAS NO HEALTH IMPACT OR CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2582307 BD VACUTAINER® SST¿ TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION JKA BECTON, DICKINSON & CO., (BD) 5101446 30382903679837

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown