• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD INSYTE AUTOGUARD¿ BC PRO WINGED SHIELDED IV CATHETER; INTRAVASCULAR CATHETER

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD INSYTE AUTOGUARD¿ BC PRO WINGED SHIELDED IV CATHETER; INTRAVASCULAR CATHETER Back to Search Results
Catalog Number 382912
Device Problem Material Deformation (2976)
Patient Problem Perforation of Vessels (2135)
Event Date 06/29/2023
Event Type  Death  
Event Description
It was reported that during use with bd insyte autoguard¿ bc pro winged shielded iv catheter the catheter bent piercing or snapping the vein.Reported that death occurred, events regarding the patients death, and how it was related to our device has not been obtained.The following information was provided by the initial reporter, translated from french to english: management of a 25-month-old child with hyperthermia and asthenia.We observe a rapid deterioration of the patient, necessitating the insertion of a venous catheter.For this, we use the equipment made available to us by the pharmacy.The bd insyte autoguard bc pro 24g catheter is difficult to handle.Once the vein has been punctured, the catheter bends at 45°, piercing or snapping the vein.If you manage to insert the catheter, you have to keep it pressed down to inject the therapies.
 
Manufacturer Narrative
B.2 date of death: the date of death was not able to be obtained, therefore, the event date was used for this field.D.4.Medical device expiration date: unknown.H.3.A device evaluation is anticipated, but has not yet begun.Upon completion of the investigation, a supplemental report will be filed.H.4.Device manufacture date: unknown.
 
Manufacturer Narrative
H.6.Investigation summary: there was no sample or photo available to bd for evaluation.Therefore, bd was unable to perform a thorough investigation to verify the reported issue.Since, an investigation could not be performed bd was unable to determine a possible root cause.The manufacturing facility has been notified of this incident and the findings.A review of the device history record was performed and no quality issues were found during production.Complaints received for this product and condition will continue to be tracked and trended.Information will be captured on trend reports and monitored.Our business regularly reviews the collected data for identification of emerging trends.H3 other text : see h10.
 
Event Description
It was reported that during use with bd insyte autoguard¿ bc pro winged shielded iv catheter the catheter bent piercing or snapping the vein.Reported that death occurred, events regarding the patients death, and how it was related to our device has not been obtained.The following information was provided by the initial reporter, translated from french to english: management of a 25-month-old child with hyperthermia and asthenia+++.We observe a rapid deterioration of the patient, necessitating the insertion of a venous catheter.For this, we use the equipment made available to us by the pharmacy.The bd insyte autoguard bc pro 24g catheter is difficult to handle.Once the vein has been punctured, the catheter bends at 45°, piercing or snapping the vein.If you manage to insert the catheter, you have to keep it pressed down to inject the therapies.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
BD INSYTE AUTOGUARD¿ BC PRO WINGED SHIELDED IV CATHETER
Type of Device
INTRAVASCULAR CATHETER
Manufacturer (Section D)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer (Section G)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer Contact
jennifer suh
9450 south state street
sandy, UT 84070
8448235433
MDR Report Key17398764
MDR Text Key319788519
Report Number1710034-2023-00829
Device Sequence Number1
Product Code FOZ
UDI-Device Identifier00382903925124
UDI-Public(01)00382903925124
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
K201075
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 08/04/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Other
Device Catalogue Number382912
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 06/30/2023
Initial Date FDA Received07/26/2023
Supplement Dates Manufacturer Received08/04/2023
Supplement Dates FDA Received08/22/2023
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
Patient Outcome(s) Death;
-
-