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 2019-03-29 for BD VACUTAINER? Z (NO ADDITIVE) PLUS URINE TUBE 364915 manufactured by Becton, Dickinson And Company (bd).

Event Text Entries

[140937507] Medical device expiration date: unknown. Batch number [818377] was not found for material number [364915] (b)(6). Device manufacture date: unknown. Investigation summary: bd received samples and photos from the customer facility for investigation. The photos were evaluated and the customer? S indicated failure mode for collapsed tubes with the incident lot was observed. Additionally, evaluation of the customer samples was performed and collapsed tubes was observed. A review of the device history record was completed for the incident lot and, based on this review, all product specifications and requirements for lot release were met; there were no related quality non-conformance during manufacturing of the product. Bd has initiated further investigation relating to this issue through a capa and potential causes have been identified. As a result, corrective actions have been established and are in the process of being implemented. Investigation conclusion: based on evaluation of the customer photos, the customer? S indicated failure mode for collapsed tubes with the incident lot was observed. Additionally, evaluation of the customer samples was conducted and collapsed tubes was observed. Further investigation activities have been conducted through a capa and the most likely root cause has been identified. As a result, corrective actions and procedures are being implemented to mitigate further occurrences. Root cause description: a capa was conducted to document further investigation and root cause analysis relating to this issue. The investigation has identified the most likely root causes and corrective actions are in the process of being implemented. Rationale: based on an assessment of severity and frequency, it was determined that a capa is required at this time in order to determine the root cause associated with this issue. The investigation has identified potential root cause(s) for this issue and corrective actions are in the process of being implemented.
Patient Sequence No: 1, Text Type: N, H10


[140937508] It was reported that before use of the bd vacutainer? Z (no additive) plus urine tube was collapsed. The tubes being collapsed was observed by end user prior to use. There were 11 occurrence. The following information was provided by the initial reporter: collapsed tubes observed by end user prior to use.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9617032-2019-00365
MDR Report Key8465357
Date Received2019-03-29
Date of Report2019-03-20
Date of Event2019-03-05
Date Mfgr Received2019-03-08
Date Added to Maude2019-03-29
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 Phone8015652341
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 Received2019-03-29
Returned To Mfg2019-03-22
Catalog Number364915
Lot NumberUNKNOWN
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 2019-03-29

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