FDA Adverse Event Malfunction Summary report: N

BD SYRINGE LUER-LOK TIP

MDR report key: 9070173 · Received September 16, 2019

Report

Report Number
1213809-2019-00930
Event Type
Malfunction
Date Received
September 16, 2019
Date of Event
August 29, 2019
Report Date
October 28, 2019
Manufacturer
BECTON DICKINSON MEDICAL SYSTEMS
Product Code
FMF
UDI-DI
30382903009122
PMA / PMN Number
K980987
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

CORRECTION: AN ADDITIONAL BATCH NUMBER WAS PROVIDED BY THE CUSTOMER. THE FOLLOWING FIELDS HAVE BEEN UPDATED: B.5. DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED THAT THERE WAS EXCESS SILICONE FOUND IN THE BD SYRINGE LUER-LOK¿ TIP PISTON BEFORE USE. LOT #'S 9142984 AND 9142988 WERE REPORTED TO HAVE BEEN INVOLVED IN THIS EVENT, BUT IT IS UNKNOWN HOW MANY OCCURRENCES HAPPENED WITHIN EACH LOT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "TO MUCH SILICONE OIL IN PISTON" THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: D.4. MEDICAL DEVICE LOT #: 9142984 D.4. MEDICAL DEVICE EXPIRATION DATE: 2024-05-31 H.4. DEVICE MANUFACTURE DATE: 2019-05-22 D.4. MEDICAL DEVICE LOT #: 9142988 D.4. MEDICAL DEVICE EXPIRATION DATE: 2024-05-31 H.4. DEVICE MANUFACTURE DATE: 2019-05-22.

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: EIGHT 10ML SYRINGES WERE RECEIVED AND EVALUATED. SEVEN WERE LOOSE AND ONE WAS IN A FULLY SEALED BLISTER PACK FROM BATCH 9142984 (P/N 300912). THERE WERE ALSO TWO OPENED AND EMPTY BLISTER PACKS FROM BATCH 9142988 (P/N 300912). ALL EIGHT SYRINGES WERE OBSERVED TO HAVE THE NORMAL AND EXPECTED AMOUNT OF SILICONE PER PRODUCT SPECIFICATION. SILICONE IS AN INERT, NON-TOXIC MEDICAL SUBSTANCE USED AS A LUBRICANT FOR DISPOSABLE HYPODERMIC PRODUCTS. IT IS AN INTEGRAL PART OF THE SYRINGE, ENABLING IT TO PERFORM AS REQUIRED IN VARIOUS CLINICAL APPLICATIONS AND DOES NOT PRESENT A SAFETY OR EFFICACY ISSUE NOR DOES IT IMPACT PRODUCT FUNCTION. THE SILICONE APPLICATION PROCESS IS DESIGNED TO PROVIDE AN EVEN DISTRIBUTION OF SILICONE ON THE INTERIOR OF THE SYRINGE BARREL. SILICONE HAS BEEN IN USE IN THIS APPLICATION FOR OVER 20 YEARS. NO REPORTS ARE KNOWN OF ADVERSE CLINICAL EFFECTS ASSOCIATED WITH THESE PRODUCTS AND UNINTENTIONAL DELIVERY OF SILICONE FLUID LUBRICANT. THE REPORTED DEFECT WAS NOT IDENTIFIED IN THE SAMPLES RECEIVED. A DEVICE HISTORY RECORD REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER(S) THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS EXCESS SILICONE FOUND IN THE BD SYRINGE LUER-LOK¿ TIP PISTON BEFORE USE. LOT #'S 9142984 AND 9142988 WERE REPORTED TO HAVE BEEN INVOLVED IN THIS EVENT, BUT IT IS UNKNOWN HOW MANY OCCURRENCES HAPPENED WITHIN EACH LOT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "TO MUCH SILICONE OIL IN PISTON".

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS EXCESS SILICONE FOUND IN THE BD SYRINGE LUER-LOK¿ TIP PISTON BEFORE USE. LOT #'S 9142984 AND 9142988 WERE REPORTED TO HAVE BEEN INVOLVED IN THIS EVENT, BUT IT IS UNKNOWN HOW MANY OCCURRENCES HAPPENED WITHIN EACH LOT. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "TO MUCH SILICONE OIL IN PISTON".

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 THERE WAS EXCESS SILICONE FOUND IN THE BD SYRINGE LUER-LOK¿ TIP PISTON BEFORE USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "TOO MUCH SILICONE OIL IN PISTON."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
866508 BD SYRINGE LUER-LOK TIP PISTON SYRINGE FMF BECTON DICKINSON MEDICAL SYSTEMS 9142984 30382903009122

Patients

Seq Age Sex Outcome Treatment
1 Other