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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD MEDICAL (BD WEST) MEDICAL SURGICAL BD POSIFLUSH NORMAL SALINE SYRINGE; SALINE VASCULAR ACCESS FLUSH

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BD MEDICAL (BD WEST) MEDICAL SURGICAL BD POSIFLUSH NORMAL SALINE SYRINGE; SALINE VASCULAR ACCESS FLUSH Back to Search Results
Catalog Number 306595
Device Problems Break (1069); Leak/Splash (1354)
Patient Problem No Patient Involvement (2645)
Event Date 12/13/2020
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Investigation summary: a device history record review was completed for provided material number 306595 and lot number 0156908.The review did not reveal any detected quality issues during the production process that could have contributed to this reported defect.To aid in the investigation, one photo was provided for evaluation by our quality team.The photo shows eight syringes and all of them are in the packaging flow wrap.Investigation conclusion: from the photo provided it is not possible to observe the barrel flange damaged.Root cause description: based on the investigation with the photo sample analysis the symptom reported by the customer could not be confirmed and exact cause for this incident could not be identified.Rationale: further action has not been determined necessary at this time.Complaints received for this device and reported condition will continue to be tracked and trended.Our quality team regularly reviews the collected data for identification of emerging trends.
 
Event Description
It was reported that the bd posiflush¿ normal saline syringe barrel was broken.The following information was provided by the initial reporter, translated from (b)(6) to english: "the rear end of the plastic shell outside the syringe is broken.The department where the problem occurred is orthopedics.The contact information of the department staff was not provided.The product with the same problem has two different batch numbers.It is not possible to confirm which product is punctured the operator's hand.".
 
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Brand Name
BD POSIFLUSH NORMAL SALINE SYRINGE
Type of Device
SALINE VASCULAR ACCESS FLUSH
Manufacturer (Section D)
BD MEDICAL (BD WEST) MEDICAL SURGICAL
1852 10th avenue
columbus NE 68601
Manufacturer (Section G)
BD MEDICAL (BD WEST) MEDICAL SURGICAL
1852 10th avenue
columbus NE 68601
Manufacturer Contact
brett wilko
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key11143902
MDR Text Key226040377
Report Number1911916-2021-00014
Device Sequence Number1
Product Code NGT
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
NA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,other,user facility
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 01/06/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/09/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Expiration Date05/31/2023
Device Catalogue Number306595
Device Lot Number0156908
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received12/13/2020
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/04/2020
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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