FDA Adverse Event Malfunction Summary report: N

BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBES

MDR report key: 9151641 · Received October 3, 2019

Report

Report Number
2243072-2019-02191
Event Type
Malfunction
Date Received
October 3, 2019
Date of Event
August 6, 2019
Report Date
October 15, 2019
Manufacturer
BECTON, DICKINSON & CO. (BROKEN BOW)
Product Code
JKA
PMA / PMN Number
K945952
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

CORRECTION: NEW INFORMATION WAS RECEIVED BY THE CUSTOMER. THE FOLLOWING FIELDS HAVE BEEN UPDATED: B.2. DATE OF EVENT: (B)(6) 2019. B.4. DESCRIBE EVENT OR PROBLEM: IT WAS REPORTED THAT THE BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBE PRODUCED A FALSE POSITIVE RESULT FOR TROPONIN AFTER USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER REPORTED TO HAVE A FALSE POSITIVE RESULT FOR TROPONIN USING BD PST. THIS WAS REPORTED TO BD IN THE PAST. NO FURTHER INFORMATION WAS PROVIDED." D.1. MEDICAL DEVICE BRAND NAME: BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBES. D.2. MEDICAL DEVICE CATALOG#: 367960. D.3. MEDICAL DEVICE MANUFACTURER: BECTON, DICKINSON & CO. (BROKEN BOW). D.5. UNIQUE IDENTIFIER (UDI) #: (B)(4). G.2. MANUFACTURING LOCATION: BECTON, DICKINSON & CO. (BROKEN BOW). G.5. PMA / 510(K)#: K945952 H3 OTHER TEXT : SEE SECTION H.10.

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION: THE CUSTOMER DID NOT PROVIDE BD PAS WITH PRODUCT LOT NUMBER INFORMATION, WHEN REQUESTED. AFTER 3-FOLLOW-UP ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION, BD PAS CLOSED THIS CUSTOMER COMPLAINT. NO SAMPLE RETURNED AND DHR COULD NOT BE PERFORMED. H3 OTHER TEXT : SEE H.10

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBE PRODUCED A FALSE POSITIVE RESULT FOR TROPONIN AFTER USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER REPORTED TO HAVE A FALSE POSITIVE RESULT FOR TROPONIN USING BD PST. THIS WAS REPORTED TO BD IN THE PAST. NO FURTHER INFORMATION WAS PROVIDED."

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBE PRODUCED A FALSE POSITIVE RESULT FOR TROPONIN AFTER USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER REPORTED TO HAVE A FALSE POSITIVE RESULT FOR TROPONIN USING BD PST. THIS WAS REPORTED TO BD IN THE PAST. NO FURTHER INFORMATION WAS PROVIDED."

Additional Manufacturer Narrative · 1

UNKNOWN MANUFACTURER: THERE ARE MULTIPLE BD LOCATIONS WHERE THIS UNSPECIFIED BD DEVICE MAY HAVE BEEN MANUFACTURED. A CATALOG AND LOT NUMBER COULD NOT BE CONFIRMED FOR THIS INCIDENT AND WITHOUT THIS INFORMATION WE ARE UNABLE TO DETERMINE WHERE THE DEVICE WAS MANUFACTURED. THEREFORE, BD CORPORATE HEADQUARTERS IN (B)(4) HAS BEEN LISTED AND THE (B)(4) FDA REGISTRATION NUMBER HAS BEEN USED FOR THE MANUFACTURE REPORT NUMBER. DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE UNSPECIFIED BD VACUTAINER® PST¿ BLOOD COLLECTION TUBE PRODUCED A FALSE POSITIVE RESULT FOR TROPONIN AFTER USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: "CUSTOMER REPORTED TO HAVE A FALSE POSITIVE RESULT FOR TROPONIN USING BD PST. THIS WAS REPORTED TO BD IN THE PAST. NO FURTHER INFORMATION WAS PROVIDED."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
948319 BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARINN (LH) BLOOD COLLECTION TUBES BLOOD SPECIMEN COLLECTION DEVICE JKA BECTON, DICKINSON & CO. (BROKEN BOW) UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other