FDA Adverse Event
Malfunction
Summary report: N
SYRINGE 50CC LL TIP CONVENIENCE PAK
MDR report key: 24551446
·
Received March 9, 2026
Report
- Report Number
- 9610847-2026-00095
- Event Type
- Malfunction
- Date Received
- March 9, 2026
- Date of Event
- February 24, 2026
- Report Date
- April 30, 2026
- Manufacturer
- BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
- Product Code
- FMF
- PMA / PMN Number
- K110771
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.
Description of Event or Problem · 0
IT WAS REPORTED BY CUSTOMER THAT TWO OF THEM HAVE THE SAME ISSUE WITH THE ADDITION OF HAVING ALSO PARTICLES INSIDE THE SYRINGE RCC RECEIVED A COMPLAINT VIA PHONE. CASE DESCRIPTION: CUSTOMER STATES THAT THEY RECEIVED TWO DIFFERENT BOXES FROM TWO DIFFERENT LOT NUMBERS WITH A SIMILAR ISSUE. WITH THE FIRST BOX (LOT# 3139736), THREE OF THE SYRINGES HAVE PARTICLES MELTED INTO THE PLASTIC. WITH THE SECOND BOX (LOT# 3150714), TWO OF THEM HAVE THE SAME ISSUE WITH THE ADDITION OF HAVING ALSO PARTICLES INSIDE THE SYRINGE. PRODUCT: BD LUER-LOK SYRINGE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 336043 | SYRINGE 50CC LL TIP CONVENIENCE PAK | SYRINGE | FMF | BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. | 3139736 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |