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 2018-11-16 for BD VACUTAINER? EST Z (NO ADDITIVE) PLUS BLOOD COLLECTION TUBES 362725 manufactured by Becton, Dickinson And Company (bd).
[127456028]
Were multiple lot numbers reported to be involved. The information for each lot number is as follows: medical device lot #: 8085590. Medical device expiration date: 2019-09-30. Device manufacture date: 2018-03-26. Medical device lot #: 8054689. Medical device expiration date: 2019-08-31. Device manufacture date: 2018-02-23. 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
[127456029]
It was reported that during use of the bd vacutainer? Est z (no additive) plus blood collection tubes started to crack from the bottom of the tube. There was no report of exposure, serious injury or medical intervention.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9617032-2018-03068 |
| MDR Report Key | 8078514 |
| Report Source | FOREIGN,OTHER,USER FACILITY |
| Date Received | 2018-11-16 |
| Date of Report | 2018-12-19 |
| Date of Event | 2018-10-01 |
| Date Mfgr Received | 2018-10-23 |
| Date Added to Maude | 2018-11-16 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | BDX BRETT WILKO |
| Manufacturer Street | 9450 SOUTH STATE STREET |
| Manufacturer City | SANDY UT 84070 |
| Manufacturer Country | US |
| Manufacturer Postal | 84070 |
| Manufacturer Phone | 8015652845 |
| Manufacturer G1 | BECTON, DICKINSON AND COMPANY (BD) |
| Manufacturer Street | BELLIVER WAY BELLIVER INDUSTRIAL ESTATE |
| Manufacturer City | PLYMOUTH |
| Manufacturer Country | US |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BD VACUTAINER? EST Z (NO ADDITIVE) PLUS BLOOD COLLECTION TUBES |
| Generic Name | SPECIMEN TRANSPORT AND STORAGE CONTAINER |
| Product Code | FHM |
| Date Received | 2018-11-16 |
| Catalog Number | 362725 |
| Lot Number | SEE H.10 |
| Device Availability | * |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECTON, DICKINSON AND COMPANY (BD) |
| Manufacturer Address | BELLIVER WAY BELLIVER INDUSTRIAL ESTATE PLYMOUTH US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2018-11-16 |