FDA Adverse Event Malfunction Summary report: N

BD PAXGENE® BLOOD DNA

MDR report key: 8454046 · Received March 26, 2019

Report

Report Number
9617032-2019-00347
Event Type
Malfunction
Date Received
March 26, 2019
Date of Event
March 7, 2019
Report Date
May 7, 2019
Manufacturer
BECTON, DICKINSON AND COMPANY (BD)
Product Code
PJE
PMA / PMN Number
K142821
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION SUMMARY: BD HAD NOT RECEIVED SAMPLES OR PHOTOS FROM THE CUSTOMER FACILITY FOR EVALUATION; THEREFORE, THE INVESTIGATION WAS LIMITED. RETENTION SAMPLES WERE SELECTED FROM BD INVENTORY FOR TESTING AND UPON COMPLETION, NO ISSUES WERE OBSERVED RELATING TO UNDERFILL AS ALL SAMPLES MET SPECIFICATIONS. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR THE INCIDENT LOT AND, BASED ON THIS REVIEW, ALL PRODUCT SPECIFICATIONS AND REQUIREMENTS FOR LOT RELEASE WERE MET; THERE WERE NO RELATED QUALITY NON-CONFORMANCES DURING MANUFACTURING OF THE PRODUCT. INVESTIGATION CONCLUSION: BASED ON EVALUATION OF THE RETAIN SAMPLES, THE CUSTOMER¿S INDICATED FAILURE MODE FOR UNDERFILL WITH THE INCIDENT LOT WAS NOT OBSERVED AS ALL SAMPLES MET THE REQUIRED SPECIFICATIONS. ROOT CAUSE DESCRIPTION: BASED ON THE INVESTIGATION, A ROOT CAUSE COULD NOT BE DETERMINED. THE RETAIN PRODUCT WAS FOUND TO BE IN CONFORMANCE AND MEET RELEASE SPECIFICATIONS. RATIONALE: COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED. THE BD BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT CUSTOMER USED A BD PAXGENE® BLOOD DNA TUBE TO COLLECT SAMPLE, BUT SHE WAS ONLY ABLE TO DRAW 1ML OUT OF 2.5 ML. CUSTOMER¿S VERBATIM: ¿ RESEARCH STUDY AND THE TUBES ARE UNDER FILLING. SHE WAS ONLY ABLE TO DRAW 1ML OUT OF 2.5ML'S. ¿

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 CUSTOMER USED A BD PAXGENE® BLOOD DNA TUBE TO COLLECT SAMPLE, BUT SHE WAS ONLY ABLE TO DRAW 1ML OUT OF 2.5 ML. CUSTOMER¿S VERBATIM: "RESEARCH STUDY AND THE TUBES ARE UNDER FILLING. SHE WAS ONLY ABLE TO DRAW 1ML OUT OF 2.5ML'S."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
247194 BD PAXGENE® BLOOD DNA BLOOD SPECIMEN COLLECTION DEVICE PJE BECTON, DICKINSON AND COMPANY (BD) 8108757

Patients

Seq Age Sex Outcome Treatment
1 Other