30 G X 1/2 IN. BD PRECISIONGLIDE¿ SPECIALTY USE STERILE HYPODERMIC NEEDLE
Report
- Report Number
- 1911916-2016-00018
- Event Type
- Injury
- Date Received
- October 18, 2016
- Date of Event
- August 25, 2016
- Report Date
- October 26, 2016
- Manufacturer
- BD MEDICAL (BD EAST) PHARMACEUTICAL SYSTEMS
- Product Code
- FMI
- PMA / PMN Number
- K021475
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. (B)(4).
RESULTS: A SAMPLE IS NOT AVAILABLE FOR EVALUATION. A REVIEW OF THE DEVICE HISTORY RECORD REVEALED NO IRREGULARITIES DURING THE MANUFACTURE OF THE REPORTED LOT # 4241643 AND THERE WERE NO ISSUES WITH SEALS OR STERILIZATION DURING THE MANUFACTURE OF THIS BATCH. CONCLUSION: WITHOUT A SAMPLE, AN ABSOLUTE ROOT CAUSE FOR THIS INCIDENT CANNOT BE DETERMINED AS BD WAS NOT ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE MODE.
IT WAS REPORTED THAT A 30 G X 1/2 IN. BD PRECISIONGLIDE SPECIALTY USE STERILE HYPODERMIC NEEDLE WAS ASSOCIATED WITH AN EVENT WHERE A PATIENT DEVELOPED ENDOPHTHALMITIS WHILE RECEIVING THE DRUG LUCENTIS. THE INITIAL REPORTER ALSO INDICATED THIS INCIDENT WAS CONSIDERED TO BE A SERIOUS MEDICAL PRODUCT COMPLAINT, HOWEVER, THE INITIAL REPORTER WAS UNABLE TO PROVIDE ADDITIONAL INFORMATION DUE TO PATIENT CONFIDENTIALITY. THEREFORE, THIS INCIDENT WAS DETERMINED TO BE MDR REPORTABLE. THE BD ADVERSE EVENTS GROUP HAS DETERMINED THE CLAIM OF A "SERIOUS MEDICAL PRODUCT COMPLAINT" IMPLIES THAT MEDICAL INTERVENTION WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 689603 | 30 G X 1/2 IN. BD PRECISIONGLIDE¿ SPECIALTY USE STERILE HYPODERMIC NEEDLE | HYPODERMIC NEEDLE | FMI | BD MEDICAL (BD EAST) PHARMACEUTICAL SYSTEMS | 4241643 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |