FDA Adverse Event Injury Summary report: N

BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM

MDR report key: 7652870 · Received June 29, 2018

Report

Report Number
9610847-2018-00193
Event Type
Injury
Date Received
June 29, 2018
Date of Event
June 11, 2018
Report Date
August 15, 2018
Manufacturer
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
Product Code
FOZ
UDI-DI
00382903833238
PMA / PMN Number
K013800
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

EVENT DESCRIPTION:FROM: IT WAS REPORTED THAT BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". NO SERIOUS INJURY OR MEDICAL INTERVENTION REPORTED. EVENT DESCRIPTION: IT WAS REPORTED THAT BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". THE TECH WAS EXPOSED TO THE NEEDLE DURING USE. EXPOSURE TO MUCOUS, BLOOD /BODILY FLUIDS. NO REPORTS OF MEDICAL INTERVENTION NOTED. (B)(4).

Additional Manufacturer Narrative · 0

DEVICE RETURNED TO MANUFACTURER: YES.

Additional Manufacturer Narrative · 0

THE DEVICE HISTORY REPORT FOR LOT NUMBER 6277683 WAS REVIEWED, NO RELATED ABNORMALITIES WERE FOUND. MATERIAL NUMBER (B)(4) FOR LOT 6277683 WAS MANUFACTURED ON 10/12/2016. THIS IS THE FIRST INSTANCE OF THIS FAILURE MODE WITH THIS LOT NUMBER. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED, WITH NO DEFECTS BEING NOTED DURING FINAL ASSEMBLY OR IN PACKAGING VISUAL INSPECTIONS. ADDITIONALLY REPRESENTATIVE SAMPLES WERE PROVIDED FOR THE PURPOSE OF AIDING OUR QUALITY ENGINEER'S INVESTIGATION, ALL AVAILABLE UNITS WERE SUBJECTED TO PULL TESTING AND FOUND TO BE WITHIN PRODUCT SPECIFICATION. WITHOUT THE ABILITY TO OBSERVE OR DUPLICATE THE REPORTED ISSUE OUR INVESTIGATORS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT. THE REPORTED SAFETY SHIELD ACTIVATION FAILURE BY CUSTOMER WAS NOT CONFIRMED AFTER EVALUATE THE REPRESENTATIVE SAMPLES RECEIVED. 6 REPRESENTATIVE SAMPLES MET THE ACCEPTANCE CRITERIA ACCORDING SI-16SP. NO VALUES OUT OF SPECIFICATION, PROBLEMS DURING ACTIVATION OR EXPOSED CANNULA WERE FOUND. THIS REPORTED DEFECT COULD BE RELATED WITH AN INCORRECT ACTIVATION DEVICE BY THE USER; SINCE, INSTRUCTION SHEET D12556 (FIGURE 3 AND 4), SHOW CORRECT WAY TO PERFORM THIS ACTIVATION. ALWAYS REFER TO IFU FOR PRODUCT USAGE RECOMMENDATIONS. WE WILL KEEP MONITORING THE MANUFACTURING PROCESS AND IN CASE ANY EMERGING TREND IS DETECTED, FURTHER ACTIONS WILL BE TAKEN IF NECESSARY. NO CORRECTIVE ACTION REQUIRED AT THE FAILURE. PROCESS (B)(4) WAS REVIEWED AND THERE ARE PROPER CONTROLS IN PLACE TO DETECT PRODUCT MALFUNCTIONS. BASED ON INVESTIGATION RESULTS TO DATE, THE ROOT CAUSE COULD BE RELATED WITH LACK OF TRAINING IN THE USE OF THE PRODUCT. NO CORRECTIVE ACTION WAS PERFORMED SINCE THIS ISSUE COULD NOT BE CONFIRMED AS MANUFACTURING RELATED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". THE TECH WAS EXPOSED TO THE NEEDLE DURING USE. EXPOSURE TO MUCOUS, BLOOD /BODILY FLUIDS. NO REPORTS OF MEDICAL INTERVENTION NOTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". THE TECH WAS EXPOSED TO THE NEEDLE DURING USE. EXPOSURE TO MUCOUS, BLOOD /BODILY FLUIDS. NO REPORTS OF MEDICAL INTERVENTION NOTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD SAF-T-INTIMA IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". NO SERIOUS INJURY OR MEDICAL INTERVENTION REPORTED.

Additional Manufacturer Narrative · 1

A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED THAT BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM HAD THE FOLLOWING ISSUE,"THE SAFETY MECHANISM FAILED AND EXPOSED THE NEEDLE MADE CONTACT WITH THE TECH FACE". NO SERIOUS INJURY OR MEDICAL INTERVENTION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
492194 BD SAF-T-INTIMA¿ IV CATHETER SAFETY SYSTEM INTRAVASCULAR CATHETER FOZ BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. 6277683 00382903833238

Patients

Seq Age Sex Outcome Treatment
1 Other