FDA Adverse Event Malfunction Summary report: N

SYRINGE 1.0ML 29GA 1/2IN 10BAG 500 FE

MDR report key: 9194282 · Received October 15, 2019

Report

Report Number
1920898-2019-01146
Event Type
Malfunction
Date Received
October 15, 2019
Date of Event
October 1, 2019
Report Date
October 3, 2019
Manufacturer
BD MEDICAL - DIABETES CARE
Product Code
FMF
PMA / PMN Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION SUMMARY: CUSTOMER RETURNED PHOTOS OF SHELF CARTONS OF 1CC, 12.7MM, 29G SYRINGES FROM LOT # 8316713. CUSTOMER STATES THAT THERE IS A DUPLICATE LOT. THE PHOTOS WERE EXAMINED AND EXHIBITED DOUBLE PRINTED LOT NUMBERS ON THE SHELF CARTONS. A REVIEW OF THE DEVICE HISTORY RECORD WAS COMPLETED FOR BATCH# 8316713. ALL INSPECTIONS AND CHALLENGES WERE PERFORMED PER THE APPLICABLE OPERATIONS QC SPECIFICATIONS. THERE WERE ZERO (0) NOTIFICATIONS NOTED THAT PERTAINED TO THE COMPLAINT. INVESTIGATION CONCLUSION: BD WAS ABLE TO DUPLICATE OR CONFIRM THE CUSTOMER¿S INDICATED FAILURE. COMPLAINTS RECEIVED FOR THIS DEVICE AND REPORTED CONDITION WILL CONTINUE TO BE TRACKED AND TRENDED. INFORMATION WILL BE CAPTURED ON TREND REPORTS AND MONITORED MONTHLY. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS. ROOT CAUSE DESCRIPTION: THE AUTOPACKOUT SYSTEM RECEIVES BAGS OF SYRINGES FROM THE FF&S MACHINE. THE EQUIPMENT ERECTS THE CARTON AND LOADS THE APPROPRIATE AMOUNT OF BAGS OF SYRINGES INTO THE CARTON. THE MACHINE LASER CODES UP TO THREE LINES ON THE CARTON: LOT CODE, DATE OF MANUFACTURE, AND EXPIRATION DATE. THE CARTONS ARE CLOSED BEFORE BEING PLACED ON THE OUTFEED CONVEYOR. IF THE MACHINE IS STOPPED ABRUPTLY DURING THE APPLICATION OF THE LASER CODES; PRINTING DEFECTS CAN BE FOUND. REVIEW OF QUALITY NOTIFICATIONS DID NOT FIND ANY RELATED TO THIS COMPLAINT. UNABLE TO DETERMINE ROOT CAUSE OF THE AUTPACKOUT MACHINE ABRUPTLY STOPPING. SINGLE POINT LESSON SPL0039 FOR RESETTING THE SEQUENCE OF PACKING AFTER AN ABRUPT STOP INDICATES IN STEPS 6 & 7 TO CLEAR THE CARTONS FROM THE MACHINE." RATIONALE: BASED ON THE INVESTIGATION, NO ADDITIONAL INVESTIGATION AND NO CAPA IS REQUIRED AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT BEFORE USE OF THE SYRINGE 1.0ML 29GA 1/2IN 10BAG 500 FE THE PRINTING ON THE CASE WAS ILLEGIBLE BLURRED DOUBLED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: DUPLICATE LOT NUMBER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
983899 SYRINGE 1.0ML 29GA 1/2IN 10BAG 500 FE SYRINGE FMF BD MEDICAL - DIABETES CARE 8316713

Patients

Seq Age Sex Outcome Treatment
1 Other