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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® K2 EDTA (K2E) 3.6MG BLOOD COLLECTION TUBES; BLOOD SPECIMEN COLLECTION DEVICE

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BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® K2 EDTA (K2E) 3.6MG BLOOD COLLECTION TUBES; BLOOD SPECIMEN COLLECTION DEVICE Back to Search Results
Model Number 367841
Device Problem Short Fill (1575)
Patient Problems Discomfort (2330); Skin Inflammation/ Irritation (4545)
Event Date 03/10/2023
Event Type  malfunction  
Manufacturer Narrative
H.6.Investigation summary: no customer samples and no photos were received in support of this complaint from catalog 367841, lot number 2018841.The 100 retentions were visually inspected with the hemogard closure assembly correctly assembled and placed on the tubes.The quantity of blood drawn into evaluated tubes varies with altitude, ambient temperature, barometric pressure, tube age, venous pressure, and filling technique.10 production lot in-house retention tubes were inspected with 0 visible defects.A draw test was performed at the manufacturing site on the 10-production lot in-house retention tubes.All tubes were within specification limits.Bd was unable to confirm the customer¿s indicated failure modes of underfill based on the investigation completed.The defect was not observed in the retention sample testing.The device history records were reviewed with no issues being identified.There were no related quality notifications.All process and final inspections comply with specification requirements.Complaints received for this device and reported condition will continue to be tracked and trended.Information will be captured on trend reports and monitored.Our business team regularly reviews the collected data for identification of emerging trends.
 
Event Description
It was reported that during use with bd vacutainer® k2 edta (k2e) 3.6mg blood collection tubes there was a low draw.Patient was re-drawn.The following information was provided by the initial reporter, translated from chinese to english: the patient was admitted to the hospital for schizophrenia on (b)(6) 2023.After admission, he followed the doctor's order for routine blood collection examination.When the nurse punctured the patient with a vacuum blood collection tube, he found that the negative pressure of the vacuum blood collection tube was seriously insufficient, and the blood collection volume was not enough.How to adjust the needle if there is no bleeding in any direction, and the blood collection cannot be completed normally, the nurse immediately discards the blood collection tube, replaces it with another new one, performs a second puncture, and collects blood from the patient again, and the blood collection is successful.This adverse event made the patient's original puncture site red, swollen and painful, and prolonged the patient's waiting time, aggravating anxiety.
 
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Brand Name
BD VACUTAINER® K2 EDTA (K2E) 3.6MG BLOOD COLLECTION TUBES
Type of Device
BLOOD SPECIMEN COLLECTION DEVICE
Manufacturer (Section D)
BECTON, DICKINSON & CO. (BROKEN BOW)
150 south 1st avenue
broken bow NE 68822
Manufacturer (Section G)
BECTON, DICKINSON & CO. (BROKEN BOW)
150 south 1st avenue
broken bow NE 68822
Manufacturer Contact
phillip emmert
9450 south state street
sandy, UT 84070
8448235433
MDR Report Key16732979
MDR Text Key313235881
Report Number1917413-2023-00291
Device Sequence Number1
Product Code JKA
UDI-Device Identifier50382903678414
UDI-Public(01)50382903678414
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
BK050036
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
Report Date 04/03/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Expiration Date04/30/2023
Device Model Number367841
Device Catalogue Number367841
Device Lot Number2018841
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/24/2023
Initial Date FDA Received04/13/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured01/18/2022
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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