BD VACUTAINER? PLASTIC URINE COLLECTOR CUP 364941

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,other,user facility report with the FDA on 2018-10-30 for BD VACUTAINER? PLASTIC URINE COLLECTOR CUP 364941 manufactured by Becton, Dickinson And Company (bd).

Event Text Entries

[125603799] Date of event: unknown. A device evaluation is anticipated, but has not yet begun. Upon completion of the investigation, a supplemental report will be filed.
Patient Sequence No: 1, Text Type: N, H10


[125603800] It was reported that the bd vacutainer? Plastic urine collector cup was "cloudy". There was no report of exposure, injury, or medical intervention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9617032-2018-02959
MDR Report Key8019487
Report SourceFOREIGN,OTHER,USER FACILITY
Date Received2018-10-30
Date of Report2018-11-06
Date of Event2018-10-10
Date Mfgr Received2018-10-10
Device Manufacturer Date2018-04-27
Date Added to Maude2018-10-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
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 Report3

Device Sequence Number: 0

Brand NameBD VACUTAINER? PLASTIC URINE COLLECTOR CUP
Generic NameSPECIMEN TRANSPORT AND STORAGE CONTAINER
Product CodeJKA
Date Received2018-10-30
Catalog Number364941
Lot Number8117996
Device Availability*
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No0
Device Event Key0
ManufacturerBECTON, DICKINSON AND COMPANY (BD)
Manufacturer AddressBELLIVER WAY BELLIVER INDUSTRIAL ESTATE PLYMOUTH US

Device Sequence Number: 1

Brand NameBD VACUTAINER? PLASTIC URINE COLLECTOR CUP
Generic NameSPECIMEN TRANSPORT AND STORAGE CONTAINER
Product CodeJTW
Date Received2018-10-30
Catalog Number364941
Lot Number8117996
Device Availability*
Device AgeDA
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 2018-10-30

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