BD VACUTAINER? Z (NO ADDITIVE) PLUS URINE TUBE 364915

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-05 for BD VACUTAINER? Z (NO ADDITIVE) PLUS URINE TUBE 364915 manufactured by Becton, Dickinson And Company (bd).

Event Text Entries

[110277297] Multiple lot numbers: there were multiple lot numbers reported to be involved. The information for each lot number is as follows: medical device lot #: 7060588, medical device expiration date: 02/28/2018, device manufacture date: 03/01/2017. (b)(6). Bd received samples from the customer facility for investigation. The samples were evaluated and the customer's indicated failure mode with the incident lot was observed. A review of the manufacturing records was completed for the incident lot and no issues were identified.
Patient Sequence No: 1, Text Type: N, H10


[110277298] It was reported that bd vacutainer? Z (no additive) plus urine tube had issues with the tubes and stopper staying in position. No report of injury or medical intervention. No report of blood exposure to mucous membrane.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9617032-2018-01346
MDR Report Key7570102
Date Received2018-06-05
Date of Report2018-05-10
Date of Event2017-08-14
Date Mfgr Received2017-08-29
Device Manufacturer Date2016-07-15
Date Added to Maude2018-06-05
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 AND COMPANY (BD)
Manufacturer StreetBELLIVER WAY BELLIVER INDUSTRIAL ESTATE
Manufacturer CityPLYMOUTH
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBD VACUTAINER? Z (NO ADDITIVE) PLUS URINE TUBE
Generic NameTRANSPORT CULTURE MEDIUM
Product CodeJSL
Date Received2018-06-05
Returned To Mfg2017-08-29
Catalog Number364915
Lot Number6197518
Device Expiration Date2017-07-31
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECTON, DICKINSON AND COMPANY (BD)
Manufacturer AddressBELLIVER WAY BELLIVER INDUSTRIAL ESTATE PLYMOUTH US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-06-05

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