BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD SYRINGE 30ML LL BNS

    MDR report key: 9162543 · Received October 7, 2019

    Report

    Report Number
    1911916-2019-01054
    Event Type
    Malfunction
    Date Received
    October 7, 2019
    Date of Event
    September 19, 2019
    Report Date
    October 22, 2019
    Manufacturer
    BD MEDICAL (BD WEST) MEDICAL SURGICAL
    Product Code
    FMF
    PMA / PMN Number
    K980987
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    H.6. INVESTIGATION SUMMARY: NO SAMPLES DISPLAYING THE CONDITION REPORTED ARE AVAILABLE FOR EXAMINATION, SO WE WERE UNABLE TO FULLY INVESTIGATE THIS INCIDENT, THEREFORE A ROOT CAUSE COULD NOT BE DETERMINED. FURTHERMORE, A DEVICE HISTORY RECORD REVIEW SHOWED NO REJECTED INSPECTIONS OR QUALITY ISSUES DURING THE PRODUCTION OF THE PROVIDED LOT NUMBER THAT COULD HAVE CONTRIBUTED TO THE REPORTED DEFECT. H3 OTHER TEXT : SEE SECTION H.10.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT PRIOR TO USE PRODUCT WAS DISCOVERED TO BE DAMAGED, HAVE FOREIGN MATTER AND SCALE MARKING ISSUES WITH A BD SYRINGE 30ML LL BNS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DAMAGED, FM, SCALE MARKING ISSUE.

    Additional Manufacturer Narrative · 1

    DATE OF EVENT: UNKNOWN. THE DATE RECEIVED BY MANUFACTURER HAS BEEN USED FOR THIS FIELD. "MULTIPLE LOT NUMBERS: THERE WERE MULTIPLE LOT NUMBERS REPORTED TO BE INVOLVED. THE INFORMATION FOR EACH LOT NUMBER IS AS FOLLOWS: MEDICAL DEVICE LOT #: 7206506, MEDICAL DEVICE EXPIRATION DATE: 7/31/2022, DEVICE MANUFACTURE DATE: 7/25/2017, MEDICAL DEVICE LOT #: 8060847, MEDICAL DEVICE EXPIRATION DATE: 3/31/2023, DEVICE MANUFACTURE DATE: 3/1/2018, MEDICAL DEVICE LOT #: 8066852, MEDICAL DEVICE EXPIRATION DATE: 3/31/2023, DEVICE MANUFACTURE DATE: 3/7/2018, MEDICAL DEVICE LOT #: 8110976, MEDICAL DEVICE EXPIRATION DATE: 4/30/2023, DEVICE MANUFACTURE DATE: 4/20/2018, MEDICAL DEVICE LOT #: 8110978, MEDICAL DEVICE EXPIRATION DATE: 4/30/2023, DEVICE MANUFACTURE DATE: 4/20/2018, MEDICAL DEVICE LOT #: 8110979, MEDICAL DEVICE EXPIRATION DATE: 4/30/2023, DEVICE MANUFACTURE DATE: 4/20/2018, MEDICAL DEVICE LOT #: 8201666, MEDICAL DEVICE EXPIRATION DATE: 7/31/2023, DEVICE MANUFACTURE DATE: 7/20/2018, MEDICAL DEVICE LOT #: 8201667, MEDICAL DEVICE EXPIRATION DATE: 7/31/2023 DEVICE MANUFACTURE DATE: 7/20/2018 MEDICAL DEVICE LOT #: 8227913 MEDICAL DEVICE EXPIRATION DATE: 8/31/2023, DEVICE MANUFACTURE DATE: 8/15/2018, MEDICAL DEVICE LOT #: 8269850, MEDICAL DEVICE EXPIRATION DATE: 9/30/2023, DEVICE MANUFACTURE DATE: 9/26/2018, MEDICAL DEVICE LOT #: 8269853, MEDICAL DEVICE EXPIRATION DATE: 9/30/2023, DEVICE MANUFACTURE DATE: 9/26/2018, MEDICAL DEVICE LOT #: 8303898, MEDICAL DEVICE EXPIRATION DATE: 10/31/2023, DEVICE MANUFACTURE DATE: 10/30/2018, MEDICAL DEVICE LOT #: 8303902, MEDICAL DEVICE EXPIRATION DATE: 10/31/2023, DEVICE MANUFACTURE DATE: 10/30/2018, MEDICAL DEVICE LOT #: 8332866, MEDICAL DEVICE EXPIRATION DATE: 10/31/2023, DEVICE MANUFACTURE DATE: 11/28/2018, MEDICAL DEVICE LOT #: 8332868, MEDICAL DEVICE EXPIRATION DATE: 10/31/2023, DEVICE MANUFACTURE DATE: 11/28/2018, MEDICAL DEVICE LOT #: 8332875, MEDICAL DEVICE EXPIRATION DATE: 11/30/2023, DEVICE MANUFACTURE DATE: 11/28/2018, MEDICAL DEVICE LOT #: 8360632, MEDICAL DEVICE EXPIRATION DATE: 12/31/2023, DEVICE MANUFACTURE DATE: 12/26/2018, MEDICAL DEVICE LOT #: 8360635, MEDICAL DEVICE EXPIRATION DATE: 12/31/2023, DEVICE MANUFACTURE DATE: 12/26/2018, MEDICAL DEVICE LOT #: 8360636, MEDICAL DEVICE EXPIRATION DATE: 12/31/2023, DEVICE MANUFACTURE DATE: 12/26/2018, MEDICAL DEVICE LOT #: 9029952, MEDICAL DEVICE EXPIRATION DATE: 1/31/2024, DEVICE MANUFACTURE DATE: 1/29/2019, MEDICAL DEVICE LOT #: 9029954, MEDICAL DEVICE EXPIRATION DATE: 1/31/2024, DEVICE MANUFACTURE DATE: 1/29/2019, MEDICAL DEVICE LOT #: 9056749, MEDICAL DEVICE EXPIRATION DATE: 2/29/2024, DEVICE MANUFACTURE DATE: 2/25/2019, MEDICAL DEVICE LOT #: 9056754, MEDICAL DEVICE EXPIRATION DATE: 2/29/2024, DEVICE MANUFACTURE DATE: 2/25/2019, MEDICAL DEVICE LOT #: 9056756, MEDICAL DEVICE EXPIRATION DATE: 2/29/2024, DEVICE MANUFACTURE DATE: 2/25/2019, MEDICAL DEVICE LOT #: 9085686, MEDICAL DEVICE EXPIRATION DATE: 3/31/2024, DEVICE MANUFACTURE DATE: 3/26/2019, MEDICAL DEVICE LOT #: 9085688, MEDICAL DEVICE EXPIRATION DATE: 3/31/2024, DEVICE MANUFACTURE DATE: 3/26/2019." 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 PRIOR TO USE PRODUCT WAS DISCOVERED TO BE DAMAGED, HAVE FOREIGN MATTER AND SCALE MARKING ISSUES WITH A BD SYRINGE 30ML LL BNS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DAMAGED, FM, SCALE MARKING ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    958693 BD SYRINGE 30ML LL BNS PISTON SYRINGE FMF BD MEDICAL (BD WEST) MEDICAL SURGICAL SEE H.10

    Patients

    Seq Age Sex Outcome Treatment
    1 Other