FDA Adverse Event Malfunction Summary report: N

BD¿ SHARPS COLLECTOR

MDR report key: 7934788 · Received October 4, 2018

Report

Report Number
2243072-2018-01416
Event Type
Malfunction
Date Received
October 4, 2018
Date of Event
September 10, 2018
Report Date
September 26, 2018
Manufacturer
BECTON DICKINSON
Product Code
FMI
UDI-DI
10885403960109
PMA / PMN Number
K943139
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. INVESTIGATION SUMMARY: A COMPLAINT HISTORY CHECK WAS PERFORMED AND THIS IS THE 1ST RELATED COMPLAINT FOR DAMAGED/CRACKED ON LOT # 8082001. NO SAMPLES (INCLUDING PHOTOS) WERE RETURNED THEREFORE THE COMPLAINT COULD NOT BE CONFIRMED AND THE ROOT CAUSE IS UNDETERMINED. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. IF SAMPLES ARE RECEIVED IN THE FUTURE THE COMPLAINT WILL BE REOPENED FOR FURTHER INVESTIGATION. AS PER QE, A DHR REVIEW OF THE RISK MANAGEMENT FILE FOR THIS ISSUE SHOWS THAT THE RISK FOR THIS ISSUE IS LOW. INVESTIGATION CONCLUSION: UNCONFIRMED: BD WAS NOT ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE AS NO SAMPLES OR PHOTOS WERE RETURNED. ROOT CAUSE DESCRIPTION: THE ROOT CAUSE IS UNDETERMINED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A BD¿ SHARPS COLLECTOR HAD CRACK IN THE NECK OF THE LID. THERE WAS NO REPORT OF EXPOSURE, SERIOUS INJURY OR MEDICAL INTERVENTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
777622 BD¿ SHARPS COLLECTOR SHARPS COLLECTOR FMI BECTON DICKINSON 8082001 10885403960109

Patients

Seq Age Sex Outcome Treatment
1 Other