FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE

MDR report key: 7276463 · Received February 16, 2018

Report

Report Number
1024879-2018-00036
Event Type
Malfunction
Date Received
February 16, 2018
Date of Event
December 13, 2017
Report Date
January 25, 2018
Manufacturer
BECTON, DICKINSON & CO., (BD)
Product Code
JKA
UDI-DI
50382903686082
PMA / PMN Number
K982541
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: 7130743; MEDICAL DEVICE EXPIRATION DATE: 2022-04-30; DEVICE MANUFACTURE DATE: 2017-05-10; MEDICAL DEVICE LOT #: 7125871; MEDICAL DEVICE EXPIRATION DATE: 2022-04-30 ; DEVICE MANUFACTURE DATE: 2017-05-05. INVESTIGATION: BD HAD NOT RECEIVED SAMPLES OR PHOTOS FROM THE CUSTOMER FACILITY FOR EVALUATION; THEREFORE, THE INVESTIGATION WAS LIMITED. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR THE INCIDENT LOT AND, BASED ON THIS REVIEW, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET; THERE WERE NO RELATED QUALITY NON-CONFORMANCES DURING MANUFACTURING OF THE PRODUCT. BD HAS INITIATED FURTHER INVESTIGATION RELATING TO THIS ISSUE THROUGH A CAPA AND POTENTIAL CAUSES FROM THE MANUFACTURING PROCESS HAVE BEEN IDENTIFIED. AS A RESULT, CORRECTIVE ACTIONS HAVE BEEN ESTABLISHED AND ARE IN THE PROCESS OF BEING IMPLEMENTED. AS NO SAMPLES OR PHOTOS WERE RECEIVED FOR EVALUATION, THE CUSTOMER'S INDICATED FAILURE MODE WAS NOT OBSERVED BY BD. FURTHER INVESTIGATION ACTIVITIES HAVE BEEN CONDUCTED RELATING TO THIS PRODUCT ISSUE AND POSSIBLE ROOT CAUSES FROM THE MANUFACTURING PROCESS HAVE BEEN IDENTIFIED. AS A RESULT, CORRECTIVE ACTIONS AND PROCEDURES ARE BEING IMPLEMENTED TO MITIGATE FURTHER OCCURRENCES. ALTHOUGH NO SAMPLES OR PHOTOS WERE AVAILABLE FOR EVALUATION, BD HAS INITIATED FURTHER INVESTIGATION THROUGH A CAPA. THE INVESTIGATION HAS IDENTIFIED POSSIBLE ROOT CAUSES FROM THE MANUFACTURING PROCESS AND CORRECTIVE ACTIONS ARE IN THE PROCESS OF BEING IMPLEMENTED. BASED ON AN ASSESSMENT OF SEVERITY AND FREQUENCY, IT WAS DETERMINED THAT A CAPA IS REQUIRED AT THIS TIME IN ORDER TO DETERMINE THE ROOT CAUSE ASSOCIATED WITH THIS PRODUCT ISSUE. THE INVESTIGATION HAS IDENTIFIED POTENTIAL ROOT CAUSE(S) FROM THE MANUFACTURING PROCESS FOR THIS ISSUE AND CORRECTIVE ACTIONS ARE IN THE PROCESS OF BEING IMPLEMENTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SAFETY SHIELD OF A BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE FAILED ("FELL OFF") WHILE TRYING TO ENGAGE. THERE WAS NO REPORT OF EXPOSURE, INJURY OR MEDICAL INTERVENTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
120247 BD VACUTAINER® ECLIPSE¿ BLOOD COLLECTION NEEDLE BLOOD COLLECTION NEEDLE JKA BECTON, DICKINSON & CO., (BD) SEE H.10 50382903686082

Patients

Seq Age Sex Outcome Treatment
1 Other