FDA Adverse Event Malfunction Summary report: N

BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM

MDR report key: 9781542 · Received March 3, 2020

Report

Report Number
3006948883-2020-00071
Event Type
Malfunction
Date Received
March 3, 2020
Date of Event
February 6, 2020
Report Date
March 9, 2020
Manufacturer
BD (SUZHOU)
Product Code
FOZ
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

H.6. INVESTIGATION SUMMARY A DEVICE HISTORY REVIEW WAS CONDUCTED FOR LOT NUMBER 9141714. OUR RECORDS SHOW THAT THIS IS THE ONLY INSTANCE OF THIS ISSUE OCCURRING IN THIS PRODUCTION BATCH. ACCORDING TO THE SAMPLING PLAN APPLIED FOR PRODUCT PERFORMANCE, THIS LOT WAS ACCEPTED AND RELEASED WITHOUT DEFECTS BEING NOTED DURING THE FINAL ASSEMBLY OR VISUAL INSPECTIONS. UNFORTUNATELY A SAMPLE COULD NOT BE OBTAINED FOR EVALUATION AND TESTING. WITHOUT THE ABILITY TO INVESTIGATE THE AFFECTED UNIT OUR QUALITY ENGINEERS WERE UNABLE TO DETERMINE THE ROOT CAUSE FOR THIS COMPLAINT. BD WILL CONTINUE TO MONITOR THIS ISSUE.

Description of Event or Problem · 0

IT WAS REPORTED THAT BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM WAS DAMAGED. THIS WAS DISCOVERED DURING USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: (B)(6) 2020 DURING THE LONG-TERM INFUSION OF PATIENTS, THE INDWELLING NEEDLE WAS USED FOR INFUSION. IT WAS FOUND THAT THE Y-JUNCTION OF INDWELLING NEEDLE WAS BROKEN, SO THE INDWELLING NEEDLE WAS REPLACED AGAIN, INCREASING THE DEPARTMENT EXPENDITURE.

Additional Manufacturer Narrative · 1

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 INTIMA-II¿ CLOSED IV CATHETER SYSTEM WAS DAMAGED. THIS WAS DISCOVERED DURING USE. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER: 2020.2.6 DURING THE LONG-TERM INFUSION OF PATIENTS, THE INDWELLING NEEDLE WAS USED FOR INFUSION. IT WAS FOUND THAT THE Y-JUNCTION OF INDWELLING NEEDLE WAS BROKEN, SO THE INDWELLING NEEDLE WAS REPLACED AGAIN, INCREASING THE DEPARTMENT EXPENDITURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
246592 BD INTIMA-II¿ CLOSED IV CATHETER SYSTEM CATHETER FOZ BD (SUZHOU) 9141714

Patients

Seq Age Sex Outcome Treatment
1 Other