BD VACUTAINER? PLASTIC URINE COLLECTION CUP 364941

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-12-07 for BD VACUTAINER? PLASTIC URINE COLLECTION CUP 364941 manufactured by Becton, Dickinson & Co..

Event Text Entries

[94823223] Results: bd received ten samples from the customer facility for investigation. The samples were evaluated and the customer's indicated failure mode for leakage with the incident lot was observed in one out of the ten. Conclusion: complaint confirmed. However, no root cause could be determined after investigation of the plant records.
Patient Sequence No: 1, Text Type: N, H10


[94823224] It was reported that the bd vacutainer? Plastic urine collection cup leaked. No injury or medical intervention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1917413-2017-00444
MDR Report Key7097948
Date Received2017-12-07
Date of Report2018-03-22
Date of Event2017-03-13
Date Mfgr Received2017-03-13
Device Manufacturer Date2016-09-28
Date Added to Maude2017-12-07
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactBDX BRETT WILKO
Manufacturer Street9450 SOUTH STATE STREET
Manufacturer CitySANDY UT 84070
Manufacturer CountryUS
Manufacturer Postal84070
Manufacturer Phone8015652845
Manufacturer G1BECTON, DICKINSON & CO.
Manufacturer Street150 SOUTH 1ST AVENUE
Manufacturer CityBROKEN BOW NE 68822
Manufacturer CountryUS
Manufacturer Postal Code68822
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBD VACUTAINER? PLASTIC URINE COLLECTION CUP
Generic NameURINE COLLECTION CUP
Product CodeJTW
Date Received2017-12-07
Returned To Mfg2017-04-05
Catalog Number364941
Lot Number6272823
Device Expiration Date2018-10-31
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECTON, DICKINSON & CO.
Manufacturer Address150 SOUTH 1ST AVENUE BROKEN BOW NE 68822 US 68822


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-12-07

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