FDA Adverse Event Malfunction Summary report: N

BD PRECISIONGLIDE¿ NEEDLES

MDR report key: 9295706 · Received November 8, 2019

Report

Report Number
1911916-2019-01169
Event Type
Malfunction
Date Received
November 8, 2019
Date of Event
October 23, 2019
Report Date
November 20, 2019
Manufacturer
BD MEDICAL (BD WEST) MEDICAL SURGICAL
Product Code
FMI
UDI-DI
30382903051879
PMA / PMN Number
K021475
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

H.6. INVESTIGATION SUMMARY: TWO (2) PHOTOS WERE PROVIDED BY THE CUSTOMER. ONE (1) PHOTO SHOWS THE TOP WEB OF TWO (2) BLISTER PACKS PROVIDING THE PRODUCT NUMBER AND DESCRIPTION. THE BLISTER PACKS ARE STILL CONNECTED SHOWING THAT THEY WERE PACKAGED THIS WAY. THE SECOND (2ND) PHOTO SHOWS TWO (2) BLISTER PACKS VIEWED FROM THE BOTTOM WEB. THE NEEDLE HUBS AND NEEDLE LENGTHS APPEAR TO BE DIFFERENT INDICATING THAT THERE ARE TWO (2) DIFFERENT PRODUCTS PACKAGED TOGETHER AS BLISTER PACKS ARE STILL CONNECTED SHOWING THAT THEY WERE PACKAGED THIS WAY. A DEVICE HISTORY RECORD (DHR) REVIEW WAS PERFORMED ON THE BATCH ASSOCIATED WITH THIS INVESTIGATION. THE DHR REVIEWS DID NOT REVEAL ANY DEFECTS OR ISSUES REPORTED AND NO QUALITY NOTIFICATIONS WERE ISSUED. HOWEVER, DURING THE INVESTIGATION IT WAS OBSERVED THAT A LOT #8020473 OF MATERIAL #8020473 (NEEDLE 22 GA 1-1/4IN) WAS BEING PRODUCED AT THE SAME TIME AS LOT #9031984 OF MATERIAL # 50815 (NEEDLE 19GA 1-1/2IN) ON TWO (2) NEEDLE IN PROCESS (NIP) LINES WHICH WERE LOCATED NEXT TO EACH OTHER. THEREFORE, IT IS LIKELY THAT ONE (1) BAG OF LOT #8020473 OF MATERIAL #8020473 (NEEDLE 22 GA 1-1/4IN) FROM NIP 5 WAS PLACED IN THE GAYLORD FOR LOT #9031984 OF MATERIAL # 50815 (NEEDLE 19GA 1-1/2IN). THIS GAYLORD WAS THEN PACKAGED ON MULTI VAC 4 (MV 4) WITH THE MIXED PRODUCT GETTING PACKAGED WITHOUT BEING NOTICED. ON 31-OCT-2019 A GLOBAL HOLD WAS ISSUED TO MATERIAL # 305187 LOT #9030812 TO CONTAIN THIS BATCH. H3 OTHER TEXT : SEE SECTION H.10.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD PRECISIONGLIDE¿ NEEDLES CAME WITH A MIX OF PRODUCT TYPES. THIS WAS DISCOVERED BEFORE USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO.: 305187, BATCH NO.: 9030182. IT WAS REPORTED THAT TWO DIFFERENT NEEDLES WERE RECEIVED IN THE SAME LINE OF PRODUCT WITH SERRATED TEAR LINES. REPORTER STATED THAT 2 NEEDLES WERE FOUND IN SAME PACKAGE. SHE SAID THAT SHE CAN EMAIL US WITH PHOTOS AND MORE DETAILS. REPORTER SAID THAT IT WAS NOTICED "LATE YESTERDAY" (10/23/19). PER RELATED EMAIL: NEEDLES PACKAGED IN THE SAME LINE OF PRODUCT WITH SERRATED TEAR LINES. ONE HAS A BLACK HUB COLOR AND IS SHORTER WITH A SMALLER GAUGE NEEDLE. THE OTHER HAD A BROWN HUB AND IS LONGER WITH A LARGER GAUGE.

Additional Manufacturer Narrative · 1

THE CUSTOMER'S ADDRESS IS UNKNOWN. (B)(6) HAS BEEN USED AS A DEFAULT. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED, BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED THAT BD PRECISIONGLIDE¿ NEEDLES CAME WITH A MIX OF PRODUCT TYPES. THIS WAS DISCOVERED BEFORE USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: MATERIAL NO.: 305187 BATCH NO.: 9030182. IT WAS REPORTED THAT TWO DIFFERENT NEEDLES WERE RECEIVED IN THE SAME LINE OF PRODUCT WITH SERRATED TEAR LINES. REPORTER STATED THAT 2 NEEDLES WERE FOUND IN SAME PACKAGE. SHE SAID THAT SHE CAN EMAIL US WITH PHOTOS AND MORE DETAILS. REPORTER SAID THAT IT WAS NOTICED "LATE YESTERDAY" ((B)(6) 2019). PER RELATED EMAIL: NEEDLES PACKAGED IN THE SAME LINE OF PRODUCT WITH SERRATED TEAR LINES. ONE HAS A BLACK HUB COLOR AND IS SHORTER WITH A SMALLER GAUGE NEEDLE. THE OTHER HAD A BROWN HUB AND IS LONGER WITH A LARGER GAUGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1088797 BD PRECISIONGLIDE¿ NEEDLES HYPODERMIC SINGLE LUMEN NEEDLE FMI BD MEDICAL (BD WEST) MEDICAL SURGICAL 9030812 30382903051879

Patients

Seq Age Sex Outcome Treatment
1 Other