UNSPECIFIED BD? NEEDLE UNKNOWN

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 2020-03-18 for UNSPECIFIED BD? NEEDLE UNKNOWN manufactured by Becton Dickinson.

Event Text Entries

[188031854] Unknown manufacturer: there are multiple bd locations where this unspecified bd device may have been manufactured. A catalog and lot number could not be confirmed for this incident and without this information we are unable to determine where the device was manufactured. Therefore, bd corporate headquarters in (b)(4) has been listed and the (b)(4) fda registration number has been used for the manufacture report number. Medical device expiration date: unknown. Device manufacture date: unknown. Investigation summary: bd was unable to perform a thorough investigation as no sample, lot, or batch number were provided. Complaints received for this device and reported condition will continue to be tracked and trended. Information will be captured on trend reports and monitored monthly. Our business team regularly reviews the collected data for identification of emerging trends. Investigation conclusion: bd was not able to duplicate or confirm the customer? S indicated failure as no sample, batch, or lot code was provided. This complaint will be entered into the complaint management system and will be tracked & trended for future occurrences. Root cause description: undetermined. Rationale: capa not required at this time.
Patient Sequence No: 1, Text Type: N, H10


[188031855] It was reported that unspecified bd? Needle was leaking during use. This occurred on 2 occasions. The following information was provided by the initial reporter: material no. : unknown batch no. :unknown. It was reported that the customer experienced leaking form the connection between the needle and the syringe. (this complaint documents the leakage from the needle at the hub. ) per excel spreadsheet: description of issue: customer reported leaking from the connection between the needle and the syringe. Number of occurrences: 2. Did the customer insert the needle into the cartridge and encounter fill resistance? No. Proceed to step 4. For bd product only, are samples available for investigation? No. Did issue cause any injury? If yes, what type of injury? No. Medical intervention needed? If yes, who was the 3rd party and what was the assistance/treatment? N/a. Resolution: customer declined bd follow up for returning product. No further follow up is required. Cts to send replacements cartridges. Cts informed customer to call back if similar issue occur. Customer acknowledged and understood. Note: product category = needle/syringe issue.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2243072-2020-00440
MDR Report Key9850887
Report SourceFOREIGN,OTHER,USER FACILITY
Date Received2020-03-18
Date of Report2020-03-17
Date of Event2020-02-14
Date Mfgr Received2020-03-13
Date Added to Maude2020-03-18
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
Manufacturer Street1 BECTON DRIVE
Manufacturer CityFRANKLIN LAKES NJ 07417
Manufacturer CountryUS
Manufacturer Postal Code07417
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNSPECIFIED BD? NEEDLE
Generic NameNEEDLE
Product CodeFMI
Date Received2020-03-18
Catalog NumberUNKNOWN
Lot NumberUNKNOWN
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBECTON DICKINSON
Manufacturer Address1 BECTON DRIVE FRANKLIN LAKES NJ 07417 US 07417


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-18

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