BD LUER-LOK
Report
- Report Number
- 1911916-2025-00795
- Event Type
- Malfunction
- Date Received
- December 13, 2025
- Date of Event
- November 21, 2025
- Report Date
- December 18, 2025
- Manufacturer
- BD MEDICAL (BD WEST) MEDICAL SURGICAL
- Product Code
- FMF
- UDI-DI
- 00382903028320
- PMA / PMN Number
- K110771
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
(B)(4). FOLLOW UP FOR DEVICE EVALUATION IT WAS REPORTED THAT DOXORUBICIN LEAKED FROM THE OPPOSITE SIDE OF THE SYRINGE. TO SUPPORT THE INVESTIGATION, ONE HUNDRED EIGHTY-FOUR SAMPLES IN SEALED BLISTER PACKAGING WERE RECEIVED FOR EVALUATION BY THE QUALITY TEAM. A VISUAL INSPECTION OF ALL SAMPLES REVEALED NO DEFECTS OR IMPERFECTIONS. THIRTY-TWO SAMPLES WERE RANDOMLY SELECTED FOR FUNCTIONAL ASSESSMENT; EACH UNDERWENT LEAK TESTING AND PASSED. A DEVICE HISTORY RECORD (DHR) REVIEW WAS COMPLETED FOR MATERIAL NUMBER 302832, LOT 5212060. THE REVIEW DID NOT IDENTIFY ANY QUALITY ISSUES DURING PRODUCTION THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. THERE WERE NO RELATED QUALITY NOTIFICATIONS, AND ALL PROCESSES AND FINAL INSPECTIONS COMPLIED WITH SPECIFICATION REQUIREMENTS. TO DATE, NO SIMILAR EVENTS HAVE BEEN REPORTED FOR THIS LOT. BASED ON THE INVESTIGATION AND ANALYSIS OF THE RETURNED SAMPLES, THE CUSTOMER¿S REPORTED CONDITION COULD NOT BE CONFIRMED.
B.3. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.
IT WAS REPORTED THAT THE BD SYRINGE 30ML LL S/C 56 HAD LEAKAGE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL #302832 BATCH #5212060. AS PER THE REPORT: RN WENT TO ADMINISTER DOXORUBICIN THAT WAS MADE FROM PHARMACY. NURSE WENT TO PUSH THE MEDICATION INTO PATIENTS IV. DOXOUBICIN SPILLED OUT OF THE OTHER SIDE OF THE SYRINGE AND SPILLED ONTO THE BLANKET THAT THE PATIENT HAD ON HIM. ANOTHER REPORT STATED: PRIMARY RN GAVE DOXORUBICIN IV PUSH VIA MEDIPORT WITH GOOD BLOOD RETURN. UPON COMPLETION OF FIRST SYRINGE OF DOXORUBICIN, PRIMARY RN PLACED SYRINGE IN CHEMO BIN. PT NOTICED ORANGE TINT ON HER SHOE. PRIMARY RN PRESUMED TINT TO BE DOXORUBICIN SPILL. THE IMPACTED PRODUCT IS SEQUESTERED AND WE WOULD LIKE TO SEND IT BACK FOR A QUALITY REVIEW. CAN YOU PLEASE ADVISE NEXT STEPS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2712942 | BD LUER-LOK | PISTON SYRINGE | FMF | BD MEDICAL (BD WEST) MEDICAL SURGICAL | 5212060 | 00382903028320 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |