FDA Adverse Event Malfunction Summary report: N

BD POSIFLUSH¿ NS FILLED SYRINGE

MDR report key: 8206647 · Received December 31, 2018

Report

Report Number
9616657-2018-00081
Event Type
Malfunction
Date Received
December 31, 2018
Date of Event
December 14, 2018
Report Date
February 8, 2019
Manufacturer
BECTON, DICKINSON AND CO.
Product Code
NGT
UDI-DI
30382903065463
PMA / PMN Number
K141311
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING FIELD WAS UPDATED DUE TO CORRECTED INFORMATION: DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED WITH THE USE OF THE BD POSIFLUSH¿ NS FILLED SYRINGE THERE WERE 2 ISSUES WITH PIECE OF PLASTIC ATTACHED TO INSERTION TIP. INVESTIGATION: THROUGH EVALUATION OF THE RETURNED SAMPLE UNITS, OUR QUALITY ENGINEER TEAM OBSERVED EXCESS MATERIAL/PLASTIC ATTACHED TO THE TIP OF THE BARRELS. A DEVICE HISTORY RECORD REVIEW WAS PERFORMED FOR PROVIDED LOT NUMBER 8232966 AND THE REVIEW DID NOT REVEAL ANY DETECTED QUALITY ISSUES DURING THE PRODUCTION PROCESS THAT MAY HAVE CONTRIBUTED TO THIS INCIDENT. IT HAS BEEN DETERMINED THAT THIS INCIDENT MOST LIKELY RESULTED FROM A MOLDING PROCESS ERROR THAT WENT UNDETECTED DUE TO INADEQUATE INSPECTION AND DETECTION METHODOLOGIES WITHIN THE MOLDING MACHINE. IN RESPONSE TO THIS ISSUE, THE CURRENT INSPECTION AND DETECTION ACTIVITIES ARE UNDER REVIEW TO DETERMINE ADEQUACY. A CORRECTIVE AND PREVENTIVE ACTION PLAN HAS BEEN INITIATED TO FURTHER INVESTIGATE THIS ISSUE AND PREVENT ITS RECURRENCE.

Description of Event or Problem · 0

IT WAS REPORTED WITH THE USE OF THE BD POSIFLUSH¿ NS FILLED SYRINGE THERE WERE 2 ISSUES WITH PIECE OF PLASTIC ATTACHED TO INSERTION TIP.

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 WITH THE USE OF THE BD POSIFLUSH¿ NS FILLED SYRINGE THERE WAS AN ISSUE WITH PIECE OF PLASTIC ATTACHED TO INSERTION TIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1045892 BD POSIFLUSH¿ NS FILLED SYRINGE FLUSH NGT BECTON, DICKINSON AND CO. 8232966 30382903065463

Patients

Seq Age Sex Outcome Treatment
1 Other