FDA Adverse Event Malfunction Summary report: N

BD SEDITAINER¿ 0.105M 1.25ML BUFFERED SODIUM CITRATE BLOOD COLLECTION TUBES

MDR report key: 7494944 · Received May 8, 2018

Report

Report Number
9617032-2018-02328
Event Type
Malfunction
Date Received
May 8, 2018
Date of Event
September 5, 2017
Report Date
April 27, 2018
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
UDI-DI
50382903660655
PMA / PMN Number
K953994
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. BD HAD NOT RECEIVED SAMPLES OR PHOTOS FROM THE CUSTOMER FACILITY FOR EVALUATION; THEREFORE, THE INVESTIGATION WAS LIMITED. RETENTION SAMPLES WERE SELECTED FROM BD INVENTORY FOR EVALUATION, AND THE CUSTOMER'S INDICATED FAILURE MODE FOR 132623 WAS NOT OBSERVED AS ALL SAMPLES MET SPECIFICATIONS. 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 SEDITAINER¿ 0.105M 1.25ML BUFFERED SODIUM CITRATE BLOOD COLLECTION TUBES HAD ISSUES WITH UNDERFILL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
336030 BD SEDITAINER¿ 0.105M 1.25ML BUFFERED SODIUM CITRATE BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 6312552 50382903660655

Patients

Seq Age Sex Outcome Treatment
1 Other