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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON, DICKINSON AND CO. BD POSIFLUSH XS PRE-FILLED FLUSH SYRINGE NACL 0.9%; SALINE VASCULAR ACCESS FLUSH

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BECTON, DICKINSON AND CO. BD POSIFLUSH XS PRE-FILLED FLUSH SYRINGE NACL 0.9%; SALINE VASCULAR ACCESS FLUSH Back to Search Results
Catalog Number 306572
Device Problem Packaging Problem (3007)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 04/07/2020
Event Type  malfunction  
Manufacturer Narrative
There were multiple lot numbers reported to be involved.The information for each lot number is as follows: medical device lot #: 9101610, medical device expiration date: 2022-03-31, device manufacture date: 2019-04-11, medical device lot #: 9004801, medical device expiration date: 2021-12-31, device manufacture date: 2019-01-04, medical device lot #: 9074905, medical device expiration date: 2022-02-28, device manufacture date: 2019-03-15, medical device lot #: 8185572, medical device expiration date: 2021-06-30, device manufacture date: 2018-07-04, medical device lot #: 8038554, medical device expiration date: 2021-01-31, device manufacture date: 2018-02-07, medical device lot #: 7192753, medical device expiration date: 2020-06-30, device manufacture date: 2017-07-11, medical device lot #: 7305989, medical device expiration date: 2020-10-31, device manufacture date: 2017-11-01, medical device lot #: 7023864, medical device expiration date: 2019-12-31, device manufacture date: 2017-01-23, medical device lot #: 0008212, medical device expiration date: 2022-12-31, device manufacture date: 2020-01-08, medical device lot #: 9178438, medical device expiration date: 2022-06-30, device manufacture date: 2019-06-27, medical device lot #: 9044641, medical device expiration date: 2022-01-31, device manufacture date: 2019-02-13, medical device lot #: 8165809, medical device expiration date: 2021-05-31, device manufacture date: 2018-06-14, medical device lot #: 8136860, medical device expiration date: 2021-04-30, device manufacture date: 2018-05-16, medical device lot #: 8324558, medical device expiration date: 2021-10-31, device manufacture date: 2018-11-20, medical device lot #: 9163585, medical device expiration date: 2022-05-31, device manufacture date: 2019-06-12, medical device lot #: 8094670, medical device expiration date: 2021-03-31, device manufacture date: 2018-04-04, medical device lot #: 8099787, medical device expiration date: 2021-03-31, device manufacture date: 2018-04-09.A device evaluation is anticipated, but has not yet begun.Upon completion of the investigation, a supplemental report will be filed.
 
Event Description
It was reported that several bd posiflush¿ xs pre-filled flush syringes nacl 0.9% were found before use with torn packaging.1 from lot 9101610, 2 from lot 9004801, 7 from lot 9074905, 12 from lot 8185572, 1 from lot 8038554, 2 from lot 7192753, 3 from lot 7305989, 2 from lot 7023864, 5 from lot 0008212, 2 from lot 9178438, 21 from lot 9044641, 4 from lot 8165809, 2 from lot 8136860, 4 from lot 8324558, 2 from lot 9163585, 2 from lot 8099787, and 1 from 8094670.The following information was provided by the initial reporter: "package torn, sterility compromised.9101610 (1ea), 9004801 (2ea), 8094670 (1ea), 9074905 (7ea), 8185572 (5ea), 8038554 (1ea), 7192753 (2ea), 7305989 (3ea), 7023864 (2ea), 0008212 (5ea), 9178438 (2 ea), 9044641 (21ea), 8165809 (4ea), 8136860 (2ea), 8324558 (4ea), 9163585 (2ea), 8185572 (7ea), 8099787 (2ea)".
 
Manufacturer Narrative
The following fields were updated due to additional information: d.10.Device available for eval?: yes.D.10.Returned to manufacturer on: 5/13/2020.H.6.Investigation: a device history record review was performed for the seventeen provided lot numbers.The review did not reveal any detected quality issues during the production process for any of the provided lot numbers that could have contributed to this reported incident.To aid in the investigation of this issue, both picture samples and physical samples were returned for the various lot numbers.Through examination of the picture samples, the defects of torn packaging and foreign matter were identified; however, the lots belonging to the samples pictured were not visible.All of the physical samples returned except for the samples belonging to lot number 7023864 revealed signs of package damage; however, an exact cause could not be determined for this issue as a related non-conformance could not be identified within the manufacturing process.Foreign matter was observed on several of the returned physical sample packages.The foreign matter captured within the picture samples and several physical samples was created during the steam sterilization process.The integrity of the product and the sterile barriers have not been affected.These spots appear only on the outside of the packaging and do not permeate in any way onto the product.Furthermore, microbial permeability testing, cytotoxicity testing, and testing for residual solvents and volatile species has been completed on the packages displaying the brownish stain.The testing confirmed that they do not present any risk to the use of the product and have no impact on the effectiveness, sterility, quality or safety of bd posiflush¿ xs 10ml saline flush syringe.H3 other text : see h.10.
 
Event Description
It was reported that several bd posiflush¿ xs pre-filled flush syringes nacl 0.9% were found before use with torn packaging.1 from lot 9101610, 2 from lot 9004801, 7 from lot 9074905, 12 from lot 8185572, 1 from lot 8038554, 2 from lot 7192753, 3 from lot 7305989, 2 from lot 7023864, 5 from lot 0008212, 2 from lot 9178438, 21 from lot 9044641, 4 from lot 8165809, 2 from lot 8136860, 4 from lot 8324558, 2 from lot 9163585, 2 from lot 8099787, and 1 from 8094670.The following information was provided by the initial reporter: "package torn, sterility compromised.9101610 (1ea), 9004801 (2ea), 8094670 (1ea), 9074905 (7ea), 8185572 (5ea), 8038554 (1ea), 7192753 (2ea), 7305989 (3ea), 7023864 (2ea), 0008212 (5ea), 9178438 (2 ea), 9044641 (21ea), 8165809 (4ea), 8136860 (2ea), 8324558 (4ea), 9163585 (2ea), 8185572 (7ea), 8099787 (2ea)".
 
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Brand Name
BD POSIFLUSH XS PRE-FILLED FLUSH SYRINGE NACL 0.9%
Type of Device
SALINE VASCULAR ACCESS FLUSH
Manufacturer (Section D)
BECTON, DICKINSON AND CO.
donore road
drogheda
MDR Report Key10002700
MDR Text Key204188461
Report Number9616657-2020-00065
Device Sequence Number1
Product Code NGT
Combination Product (y/n)N
PMA/PMN Number
NA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor,foreign,other
Type of Report Initial,Followup
Report Date 09/23/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/27/2020
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Catalogue Number306572
Device Lot NumberSEE SECTION H.10.
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/13/2020
Date Manufacturer Received04/07/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Other;
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