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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD MEDICAL - DIABETES CARE BD ULTRA-FINE¿ INSULIN SYRINGE; PISTON SYRINGE

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BD MEDICAL - DIABETES CARE BD ULTRA-FINE¿ INSULIN SYRINGE; PISTON SYRINGE Back to Search Results
Catalog Number 328421
Device Problem Fluid/Blood Leak (1250)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 06/23/2023
Event Type  malfunction  
Manufacturer Narrative
H3.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 while using the bd ultra-fine¿ insulin syringe it leaked.The following was received by the initial reporter: verbatim: on (b)(6) 2023, the patient went to hospital due to diabetes, and his blood sugar was 27.8 mml/l after measurement.Ordinary insulin 5u subcutaneous injection was given to the patient based on the doctor's advice before lunch.When drawing out the liquid medicine, the liquid medicine leaked from the connection between the rubber stopper and the body of the needle tube.Immediately replacing it with a new disposable sterile insulin syringe and explaining to the patient and the family members.The incident did not cause harm to the patient.
 
Event Description
It ws reported that while using the bd ultra-fine¿ insulin syringe it leaked.The following was received by the initial reporter: verbatim: on june 23rd, 2023, the patient went to hospital due to diabetes, and his blood sugar was 27.8 mml/l after measurement.Ordinary insulin 5u subcutaneous injection was given to the patient based on the doctor's advice before lunch.When drawing out the liquid medicine, the liquid medicine leaked from the connection between the rubber stopper and the body of the needle tube.Immediately replacing it with a new disposable sterile insulin syringe and explaining to the patient and the family members.The incident did not cause harm to the patient.
 
Manufacturer Narrative
H.6.Investigation summary: no samples (including photos) were returned therefore the complaint could not be confirmed and the root cause is undetermined.This is the 1st complaint for the reported lot number.A review of the manufacturing records was performed, and no non-conformances were raised in association with this type of event for this lot.Complaints received for this device and reported condition will continue to be tracked and trended.If samples are received in the future the complaint will be reopened for further investigation.Based on the above, no additional investigation and no corrective/preventative action (capa) or situational analysis (sa) is required at this time.
 
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Brand Name
BD ULTRA-FINE¿ INSULIN SYRINGE
Type of Device
PISTON SYRINGE
Manufacturer (Section D)
BD MEDICAL - DIABETES CARE
1329 west highway 6
holdrege NE 68949
Manufacturer (Section G)
BD MEDICAL - DIABETES CARE
1329 west highway 6
holdrege NE 68949
Manufacturer Contact
jennifer suh
5859 farinon drive
san antonio, TX 78249
8448235433
MDR Report Key17435996
MDR Text Key320884403
Report Number1920898-2023-00493
Device Sequence Number1
Product Code FMF
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 Other,Foreign
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 08/09/2023
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 Health Professional
Device Catalogue Number328421
Device Lot Number1229338
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 07/12/2023
Initial Date FDA Received08/01/2023
Supplement Dates Manufacturer Received08/09/2023
Supplement Dates FDA Received08/24/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/17/2021
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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