FDA Adverse Event Malfunction Summary report: N

BD SAFE-CLIP¿ NEEDLE CLIPPING & STORAGE DEVICE

MDR report key: 7992293 · Received October 22, 2018

Report

Report Number
2243072-2018-01522
Event Type
Malfunction
Date Received
October 22, 2018
Date of Event
October 1, 2018
Report Date
October 25, 2018
Manufacturer
BECTON DICKINSON
Product Code
FMI
UDI-DI
00382903282357
PMA / PMN Number
K943683
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

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. BASED ON THE SAMPLES/PHOTO(S) RECEIVED THE INVESTIGATION CONCLUDED: UNCONFIRMED: BD WAS NOT ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE AS NO SAMPLES OR PHOTOS WERE RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD SAFE-CLIP NEEDLE CLIPPING & STORAGE DEVICES WILL NOT OPEN AFTER CLIPPING. THERE WAS NO REPORT OF EXPOSURE, SERIOUS INJURY, OR MEDICAL INTERVENTION.

Additional Manufacturer Narrative · 1

DATE OF EVENT: UNKNOWN. THE MANUFACTURING LOCATION FOR THIS PRODUCT IS (B)(4). THIS SITE IS AN OEM MANUFACTURING SITE. 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 SAFE-CLIP¿ NEEDLE CLIPPING & STORAGE DEVICES WILL NOT OPEN AFTER CLIPPING. THERE WAS NO REPORT OF EXPOSURE, SERIOUS INJURY, OR MEDICAL INTERVENTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
829375 BD SAFE-CLIP¿ NEEDLE CLIPPING & STORAGE DEVICE NEEDLE CLIPPING DEVICE FMI BECTON DICKINSON 7334560 00382903282357

Patients

Seq Age Sex Outcome Treatment
1 Other