FDA Adverse Event
Malfunction
Summary report: N
BD VACUTAINER® K2 EDTA (K2E) PLUS BLOOD COLLECTION TUBES
MDR report key: 7481588
·
Received May 2, 2018
Report
- Report Number
- 1917413-2018-02434
- Event Type
- Malfunction
- Date Received
- May 2, 2018
- Date of Event
- November 22, 2017
- Report Date
- May 2, 2018
- Manufacturer
- BECTON, DICKINSON & CO.
- Product Code
- JKA
- PMA / PMN Number
- N/A
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
BD RECEIVED SAMPLES AND PHOTOS FROM THE CUSTOMER FACILITY FOR INVESTIGATION. THE SAMPLES AND PHOTOS WERE EVALUATED AND THE CUSTOMER¿S INDICATED FAILURE MODE FOR 190163 WITH THE INCIDENT LOT WAS OBSERVED. ADDITIONALLY, A REVIEW OF THE MANUFACTURING RECORDS WAS COMPLETED FOR THE INCIDENT LOT AND NO ISSUES WERE IDENTIFIED.
Description of Event or Problem · 1
IT WAS REPORTED THAT BD VACUTAINER® K2 EDTA (K2E) PLUS BLOOD COLLECTION TUBES CONTAINED FOREIGN MATTER ON THE STOPPER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 324503 | BD VACUTAINER® K2 EDTA (K2E) PLUS BLOOD COLLECTION TUBES | BLOOD SPECIMEN COLLECTION DEVICE | JKA | BECTON, DICKINSON & CO. | 7097853 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |