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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON GMBH BD¿ COLUMBIA CNA AGAR WITH 5% SHEEP BLOOD; CULTURE MEDIA, SELECTIVE AND NON-DIFFERENTIAL

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BECTON DICKINSON GMBH BD¿ COLUMBIA CNA AGAR WITH 5% SHEEP BLOOD; CULTURE MEDIA, SELECTIVE AND NON-DIFFERENTIAL Back to Search Results
Catalog Number 257306
Device Problem Contamination (1120)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/26/2022
Event Type  malfunction  
Manufacturer Narrative
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 10 plates of bd¿ columbia cna agar with 5% sheep blood were contaminated with mold.The following information was provided by the initial reporter: 10 plates contaminated with mold.
 
Manufacturer Narrative
H.6 investigation summary.Event description: customer reported contamination on the plates as well as a broken dish.Complaint history review: the complaint trends were reviewed and similar complaints were found for this catalog number.A trend was identified; therefore, a mrb (material review board) was performed and this issue will be investigated within a capa (corrective and preventive action).Batch history record (bhr) review: the batch history review did not indicate any discrepancies.All release testing was satisfactory, and no deviations were observed.Sample analysis: retain samples were reviewed and no deviation was observed.Return samples were not provided; however a picture illustrating the contamination was shared.The complained broken dish could not be identified on the shared picture.Evaluation results: at this stage of our investigation, we have excluded any systemic failure in our manufacturing process.Please note that this product does not have an sal claim.It is filled aseptically, therefore an occurrence of a contamination event cannot be entirely ruled out.We only release product batches to the market with an aql (acceptable quality level) = 0,65.Although this contamination level is very low, we cannot completely exclude that a customer may receive a contaminated plate.As several complaints were reported for this product regarding contamination, a mrb (mrb 22-006) and capa (# 4344556) were created for further evaluation.The root cause investigation is currently ongoing within the mentioned capa.Investigation conclusion: based upon our investigation the complaint was confirmed.
 
Event Description
It was reported that 10 plates of bd¿ columbia cna agar with 5% sheep blood were contaminated with mold.The following information was provided by the initial reporter: 10 plates contaminated with mold.
 
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Brand Name
BD¿ COLUMBIA CNA AGAR WITH 5% SHEEP BLOOD
Type of Device
CULTURE MEDIA, SELECTIVE AND NON-DIFFERENTIAL
Manufacturer (Section D)
BECTON DICKINSON GMBH
8-12 tullastrasse
heidelberg 69126
GM  69126
Manufacturer (Section G)
BECTON DICKINSON GMBH
8-12 tullastrasse
heidelberg 69126
GM   69126
Manufacturer Contact
phillip emmert
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key14518487
MDR Text Key300795317
Report Number9680577-2022-00068
Device Sequence Number1
Product Code JSJ
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
PREAMENDMENT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 08/05/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/26/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Expiration Date06/23/2022
Device Catalogue Number257306
Device Lot Number2088995
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received08/05/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured03/29/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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