FDA Adverse Event Malfunction Summary report: N

BD SYRINGE

MDR report key: 9483282 · Received December 17, 2019

Report

Report Number
3002682307-2019-00673
Event Type
Malfunction
Date Received
December 17, 2019
Date of Event
November 29, 2019
Report Date
December 31, 2019
Manufacturer
BECTON DICKINSON, S.A.
Product Code
FMF
PMA / PMN Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

BD HAS NOT BEEN PROVIDED WITH PHOTOS OR SAMPLES FOR CATALOG 301942 LOT 1811193 TO INVESTIGATE FOR THIS RECORD. UNFORTUNATELY, AS A RESULT, BD WAS UNABLE TO VERIFY THE REPORTED ISSUE OR DETERMINE A DEFINITIVE ROOT CAUSE. THE MATERIAL USED TO MANUFACTURE DISCARDIT SYRINGES HAS BEEN SELECTED AND TESTED TO RESIST NORMAL CONDITIONS OF USE. THE ASSEMBLING MACHINES HAVE AN ON-LINE DETECTION SYSTEM THAT INSPECTS 100% THE SYRINGES, REJECTING AUTOMATICALLY THE SYRINGES WITH BROKEN PARTS LIKE THE TIP OF THE BARREL. DHR SHOWED NO INDICATION OF THE ALLEGED DEFECT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BD¿ SYRINGE TUBE BROKE DURING THE DOSING PROCESS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM (B)(6) TO ENGLISH: "THE SYRINGE TUBE WAS BROKEN DURING THE DOSING PROCESS"

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 THE BD¿ SYRINGE TUBE BROKE DURING THE DOSING PROCESS. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM (B)(6) TO ENGLISH: "THE SYRINGE TUBE WAS BROKEN DURING THE DOSING PROCESS."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1280067 BD SYRINGE SYRINGE FMF BECTON DICKINSON, S.A. 1811193

Patients

Seq Age Sex Outcome Treatment
1 Other