FDA Adverse Event Malfunction Summary report: N

PLASTIPAK LUER-LOK

MDR report key: 24631952 · Received March 18, 2026

Report

Report Number
2243072-2026-00218
Event Type
Malfunction
Date Received
March 18, 2026
Date of Event
March 11, 2026
Report Date
May 15, 2026
Manufacturer
BECTON DICKINSON
Product Code
FMF
UDI-DI
00382903008650
PMA / PMN Number
SEE H.11
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). FOLLOW UP REPORT FOR CORRECTION. MFR REPORT # 3003152976-2026-00147 WAS FILED AS THE SITE LEGAL NAME WAS INCORRECTLY REPORTED AS FRANKLIN LAKES IN THE INITIAL MDR SUBMISSION, 2243072-2026-00218. MFR REPORT # 3003152976-2026-00147 WAS SUBMITTED TO UPDATE THE SITE LEGAL NAME TO SAN AGUSTIN, AND TO HAVE THE PROPER MFR NUMBER.

Additional Manufacturer Narrative · 0

THE FOLLOWING APPLICABLE 510K NUMBERS WERE LISTED: K182589;K980987. D.3. FRANKLIN LAKES HAS BEEN LISTED AS THE MANUFACTURER. G.1. FRANKLIN LAKES HAS BEEN LISTED AS THE MANUFACTURER. H.3. IF A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS COMPLETED, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

(B)(4). FOLLOW UP REPORT FOR CORRECTION AND DEVICE EVALUATION. THIS REPORT IS SUPPLEMENTAL TO PREVIOUSLY SUBMITTED 3003152976-2026-00147, THE FAILURE WAS DETERMINED TO NOT BE A REPORTABLE EVENT AFTER THE MDR WAS SUBMITTED. ONE PHOTO AND TWO PHYSICAL SAMPLES WERE PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. UPON EVALUATION, A GREY PARTICLE WAS OBSERVED WITHIN ONE SYRINGE, CONSISTENT WITH THE PHOTO PROVIDED. ADDITIONALLY, EMBEDDED PARTICLES WERE IDENTIFIED WITHIN THE BARREL OF THE SECOND SYRINGE. CHARACTERIZATION TESTING WAS PERFORMED AND IDENTIFIED THE GREY PARTICLE IS CONSISTENT WITH MATERIAL FROM A VIAL STOPPER. A DEVICE HISTORY REVIEW WAS PERFORMED FOR THE SUSPECTED LOTS, NO DEVIATIONS OR NON-CONFORMANCES WERE IDENTIFIED DURING THE MANUFACTURING PROCESS THAT COULD HAVE CONTRIBUTED TO THESE OBSERVATIONS. PRODUCTS FROM THIS MANUFACTURING LINE ARE ROUTINELY SAMPLED AND SUBJECTED TO VISUAL AND FUNCTIONAL INSPECTIONS THROUGHOUT VARIOUS STAGES OF PRODUCTION, IN ACCORDANCE WITH ESTABLISHED PROCEDURES. NO ISSUES RELATED TO THE REPORTED CONCERN WERE IDENTIFIED DURING THESE INSPECTIONS. BASED ON THE SAMPLE EVALUATION AND DEVICE HISTORY REVIEW, IT WAS DETERMINED THAT THE GREY PARTICLE ORIGINATED FROM THE VIAL STOPPER DURING WITHDRAWAL WHILE THE EMBEDDED MATERIAL GENERATED DURING THE MOLDING PROCESS. MACHINES UNDERGO ROUTINE CLEANING AND MAINTENANCE AND INJECTION MACHINES ARE RAN PRIOR TO USE TO REMOVE ANY EXCESS MATERIALS, REJECTING THE FIRST FEW PIECES. MANUFACTURING PERSONNEL HAVE BEEN NOTIFIED OF THIS INCIDENT TO INCREASE AWARENESS OF THIS MATTER. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL BE MONITORED BY OUR QUALITY TEAM FOR SIGNS OF EMERGING TRENDS.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD SYRINGE HAD FOREIGN MATTER. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: LOT#251101. IT WAS REPORTED THAT MEDICATION PREPARATION BY A REGISTERED NURSE: DIFFICULTY DRAWING UP A SYRINGE OF HOC FROM A BOTTLE OF SALINE SOLUTION. NEEDLE CHANGED, SAME PROBLEM. ULTIMATELY, SALINE DRAWN INTO A 50 ML SYRINGE: DISCOVERY OF A PLASTIC ¿CARROT¿ IN THE SYRINGE. SYRINGE RETAINED AND ONE NEEDLE FROM THE SAME BATCH COLLECTED FOR MEDICAL DEVICE SURVEILLANCE. PROVEN CONSEQUENCES: PLASTIC IN A SYRINGE (SEE PHOTO): MAJOR RISK TO THE PATIENT WASTED TIME.

Description of Event or Problem · 0

AS PER THE INVESTIGATION FINDINGS, CHARACTERIZATION TESTING WAS PERFORMED AND THE GREY PARTICLE NOTED WITHIN THE SYRINGE WAS IDENTIFIED TO BE CONSISTENT WITH MATERIAL FROM A VIAL STOPPER AND NOT FROM THE SYRINGE ITSELF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
347261 PLASTIPAK LUER-LOK PISTON SYRINGE FMF BECTON DICKINSON UNKNOWN 00382903008650

Patients

Seq Age Sex Outcome Treatment
1