FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES

MDR report key: 7514545 · Received May 15, 2018

Report

Report Number
9617032-2018-02341
Event Type
Malfunction
Date Received
May 15, 2018
Date of Event
September 11, 2017
Report Date
May 1, 2018
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
JKA
PMA / PMN Number
K023331
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MULTIPLE 510K NUMBERS: BK050036. (B)(6). 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 133750 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® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES HAD AIR BUBBLES IN THE GEL. NO SERIOUS INJURY OR MEDICAL INTERVENTION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358470 BD VACUTAINER® SST¿ II ADVANCE PLUS BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON AND COMPANY (BD) 7037673

Patients

Seq Age Sex Outcome Treatment
1 Other