FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES

MDR report key: 7462788 · Received April 25, 2018

Report

Report Number
9617032-2018-00928
Event Type
Malfunction
Date Received
April 25, 2018
Date of Event
March 20, 2017
Report Date
April 20, 2018
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
UDI-DI
50382903679558
PMA / PMN Number
BK050036
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MULTIPLE LOT NUMBERS: THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: 6011721. MEDICAL DEVICE EXPIRATION DATE: 07/31/2017. DEVICE MANUFACTURE DATE: 01/11/2016. BD HAD NOT RECEIVED SAMPLES OR PHOTOS FROM THE CUSTOMER FACILITY FOR EVALUATION; THEREFORE, THE INVESTIGATION WAS LIMITED.

Description of Event or Problem · 1

IT WAS REPORTED THAT BD VACUTAINER® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES "SSTII-367955-UNDERFILL."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
300121 BD VACUTAINER® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 5295526 50382903679558

Patients

Seq Age Sex Outcome Treatment
1 Other