FDA Adverse Event Malfunction Summary report: N

INSYTE AUTOGUARD

MDR report key: 24957647 · Received April 22, 2026

Report

Report Number
1710034-2026-00454
Event Type
Malfunction
Date Received
April 22, 2026
Date of Event
March 9, 2026
Report Date
May 7, 2026
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
Product Code
FOZ
UDI-DI
00382903825332
PMA / PMN Number
SEE H.11
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
RISK MANAGER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: H. ATTACHED MEDWATCH. INVESTIGATION SUMMARY: THE REPORTED DEFECT COULD NOT BE REFUTED NOR CONFIRMED IN THE ABSENCE OF A SAMPLE. THE ROOT CAUSE CANNOT BE DETERMINED FOR AN UNCONFIRMED DEFECT. A COMPLAINT HISTORY CHECK WAS PERFORMED, AND THIS IS THE 2ND RELATED COMPLAINT REPORTED WITH THE DEFECT/CONDITION OF NEEDLE RETRACTION SLOW WITH LOT 6020809 REGARDING ITEM #382533. DEVICE HISTORY RECORD FOR FINAL LOT NUMBER 6020809 HAS BEEN REVIEWED. NO RELATED QUALITY ISSUES OR PROCESS DEVIATIONS WERE FOUND FOR THE SUBASSEMBLY OR FINAL LOT NUMBERS. A REVIEW OF THE APPLICABLE RISK DOCUMENTES INDICATES THAT THE POTENTIAL RISK OF THE REPORTED EVENT WAS ASSESSED APPROPRIATELY IN THE RISK MANAGEMENT DOCUMENTATION.

Additional Manufacturer Narrative · 0

G.4. K201075; K251654.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE NEEDLE DID NOT RETRACT. IV NEEDLE SLOW TO RETRACT, ONLY FULLY RETRACTED ONCE REMOVED AFTER INSERTION. LOT #6020809 BD INSYTE AUTOGUARD BC. THE NEEDLE NOT RETRACTING POSES A SAFETY RISK TO THE USER. NO PATIENT HARM NOTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
189587 INSYTE AUTOGUARD PERIPHERAL IV CATHETERS FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. 6020809 00382903825332

Patients

Seq Age Sex Outcome Treatment
1