FDA Adverse Event Injury Summary report: N

30 G X 1/2 IN. BD PRECISIONGLIDE¿ SPECIALTY USE STERILE HYPODERMIC NEEDLE

MDR report key: 6037717 · Received October 18, 2016

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

Additional Manufacturer Narrative · 1

A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. (B)(4).

Additional Manufacturer Narrative · 1

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.

Description of Event or Problem · 1

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