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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON BD MICROTAINER® CONTACT-ACTIVATED LANCET; MANUAL SURGICAL INSTRUMENT FOR GENERAL USE

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BECTON DICKINSON BD MICROTAINER® CONTACT-ACTIVATED LANCET; MANUAL SURGICAL INSTRUMENT FOR GENERAL USE Back to Search Results
Catalog Number 366593
Device Problem Break (1069)
Patient Problem Insufficient Information (4580)
Event Date 07/10/2023
Event Type  malfunction  
Manufacturer Narrative
B3: date of event is unknown.The date received by manufacturer has been used for this field.H.6 investigation summary: "material #: 366593, lot/batch #: unknown, bd had not received samples or photos for evaluation.Additionally, bd was unable to determine the specific lot number associated with this complaint; therefore, a review of the device history record could not be conducted.This complaint is unable to be confirmed.If additional information is made available, this complaint will be reopened to assess the level of investigation needed.Complaints received for this device and reported condition will continue to be tracked and trended.Our business team regularly reviews the collected data for identification of emerging trends.".
 
Event Description
It was reported that while using the bd microtainer® contact-activated lancet that the lancet breaks off.The following information was provided by the initial reporter: this report is about possible needle breakage.Blood was drawn from the side of the finger, but the puncture was made around a hard joint and was not deep enough.The needle may have broken because it struck a hard joint area.
 
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Brand Name
BD MICROTAINER® CONTACT-ACTIVATED LANCET
Type of Device
MANUAL SURGICAL INSTRUMENT FOR GENERAL USE
Manufacturer (Section D)
BECTON DICKINSON
1 becton drive
franklin lakes NJ 07417
Manufacturer (Section G)
BECTON DICKINSON
1 becton drive
franklin lakes NJ 07417
Manufacturer Contact
jennifer suh
5859 farinon drive
san antonio, TX 78249
8448235433
MDR Report Key17411276
MDR Text Key319963250
Report Number2243072-2023-01324
Device Sequence Number1
Product Code FMK
UDI-Device Identifier00382903665933
UDI-Public0382903665933
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K223243
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 07/26/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/28/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Catalogue Number366593
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received07/10/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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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