MAUDE MDR 7261062

MDR report key
7261062
Report number
3003152976-2018-00023
Event key
0
Event type
3
Date of event
2018-01-15
Date received
2018-02-09
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
BDX BRETT WILKO
Address
9450 SOUTH STATE STREET SANDY UT 84070 US
Phone
801-801-8015
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BD?PHASEAL? INJECTOR LUER LOCK N35CINJECTORBECTON DICKINSON, S.A.ONG515004UNKNOWNY R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-02-0901. O

Event Narratives#

N

Patient 1

MEDICAL DEVICE EXPIRATION DATE: UNKNOWN. (B)(6). DEVICE MANUFACTURE DATE: UNKNOWN. INVESTIGATION: THE SAMPLE WAS RECEIVED ACTIVATED. THE GRIPS WERE DAMAGED AND THEY WERE OUT OF THEIR PLACE. THE NEEDLE IS EXPOSED. THE INJECTOR WAS DEACTIVATED BY QUALITY TECHNICIAN AND THE GRIPS PLACE IN THEIR ORIGINAL POSITION, THE NEEDLE REMAINED INSIDE THE SAFETY SLEEVE. TAKING INTO ACCOUNT THAT THE GRIPS WERE FOUND DAMAGED AND OUT OF THEIR PLACE, IT SEEMS THAT THE DEFECT WAS CAUSED DURING THE USE. TO AVOID NEEDLE EXPOSURE, IT IS IMPORTANT TO HOLD ONTO THE WHITE PART OF THE INJECTOR BEFORE ENGAGING/DISENGAGING. DO NO TOUCH THE BLUE PART: IF GRIPS OF THE SAFETY SLEEVE ARE REMOVED FROM THEIR PLACE, THE INJECTOR IS ACTIVATED AND CANNULA CAUSING NEEDLE EXPOSURE. THE INJECTOR MUST BE REMOVED PULLING IT BACK: IF IT IS REMOVED WITHOUT DOING THIS THE GRIPS ARE REMOVED FROM THEIR PLACE AND NEEDLE EXPOSURE HAPPENS. IF THE INJECTOR HAS BEEN FORCED WHILE ENGAGING, THE GRIPS CAN ALSO GET DAMAGED. SEVERAL TESTS AND INSPECTION ARE CARRIED OUT TO AVOID FAULTY PARTS. AMONG THEM, THE FUNCTIONALITY OF THE INJECTOR IS VERIFIED. VISUAL INSPECTION IS ALSO PERFORMED TO ASSURE THAT THERE ARE NO DAMAGES/DIRTY COMPONENTS. AS THE LOT IS UNKNOWN, DEVICE HISTORY RECORD CANNOT BE CHECKED. BROKEN SAFETY SLEEVE THE SAMPLE WAS RECEIVED ACTIVATED. THE GRIPS WERE DAMAGED AND THEY WERE OUT OF THEIR PLACE. THE NEEDLE IS EXPOSED. IF THE INJECTOR IS DEACTIVATED AND THE GRIPS PLACE IN THEIR ORIGINAL POSITION, THE NEEDLE REMAINS INSIDE THE SAFETY SLEEVE. INSPECTIONS AND TESTS: THE TESTS PERFORMED DURING THE MANUFACTURING PROCESS TO AVOID FAULTY PARTS ARE LISTED BELOW: DURING MOLDING PROCESS (ACCORDING PH-300 CURRENT VERSION): VISUAL INSPECTIONS FOR INJECTOR PARTS (CYLINDER, NEEDLE HOUSING, SAFETY SLEEVE, PISTON AND MEMBRANE) ARE PERFORMED BY THE OPERATOR TO AVOID FAULTY PARTS (FLASHES, UNFILLED AND BURNED PARTS, ETC). CRITICAL TO QUALITY DIMENSIONS OF ALL INJECTOR COMPONENTS ARE MEASURED TO CHECK IF THE DIMENSIONS ARE WITHIN TOLERANCE. ASSEMBLY PROCESS: (ACCORDING TO PH-301 CURRENT VERSION) THE FOLLOWING VISUAL INSPECTIONS ARE PERFORMED BY THE OPERATOR: SAFETY SLEEVE MUST BE CONNECTED AND SHOULD BE TURNING WITH THE CYLINDER AND PISTON. THE FUNCTIONALITY OF THE GRIPS IS VERIFIED. VERIFY THE CORRECT WELDING OF THE MEMBRANE, COLOR AND ASPECT. CYLINDER ASSEMBLY. PISTON MUST BE FIXED BY THE SAFETY SLEEVE. NEEDLE HOUSING SHOULD ROTATE CLOCKWISE AND TIP OF THE CANNULA MUST BE OBSERVED. CANNULA LENGTH (WITH A CALLIPER GAUGE). FUNCTIONALITY AND PISTON WELDING TEST: QUALITY AND FUNCTIONALITY OF THE MEMBRANE IS VERIFIED AFTER BE WELDING AND PENETRATED BY THE CANNULA. CONCLUSION: TAKING INTO ACCOUNT THAT THE GRIPS WERE FOUND DAMAGED AND OUT OF THEIR PLACE, IT SEEMS THAT THE DEFECT WAS CAUSED DURING THE USE. THE INJECTOR WAS DEACTIVATED BY QUALITY TECHNICIAN AND THE GRIPS PLACE IN THEIR ORIGINAL POSITION, THE NEEDLE REMAINED INSIDE THE SAFETY SLEEVE. AS THE LOT IS UNKNOWN, THE DHR AND RETAINED SAMPLES CANNOT BE CHECKED. TAKING INTO ACCOUNT THAT THE GRIPS WERE FOUND DAMAGED AND OUT OF THEIR PLACE, IT SEEMS THAT THE DEFECT WAS CAUSED DURING THE USE.

D

Patient 1

IT WAS REPORTED THAT THERE WAS A NEEDLE SAFETY FAILURE OF A BD PHASEAL? INJECTOR LUER LOCK N35C. THERE WAS NO REPORT OF INJURY OR MEDICAL INTERVENTION.