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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON MEDICAL SYSTEMS BD LUER-LOK

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BECTON DICKINSON MEDICAL SYSTEMS BD LUER-LOK Back to Search Results
Catalog Number 309632
Device Problem Fluid/Blood Leak (1250)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 09/12/2023
Event Type  malfunction  
Manufacturer Narrative
D.4.Other lot number includes 3101292 and other expiration date includes 03/31/2028.H.3.A device evaluation and/or device history review is anticipated but is not complete.Upon completion, a supplemental report will be filed.H.4.Other lot number device manufacture date is 04/11/2023.
 
Event Description
It was reported, that the bd luer-lok syringe had leakage.The following information was provided by the initial reporter: "it's hard to see but when the provider injects medication it comes out the side of the syringe.Speculating a hairline crack somewhere on the device.".
 
Event Description
No additional information.
 
Manufacturer Narrative
(b)(4) - follow up mdr for device evaluation.It was reported medication it comes out the side of the syringe.To aid in the investigation, one hundred seventy-three samples of 5m luer lok syringes from lots 3101292 and 3174004 were received for evaluation by our quality team.Ninety samples were from lot 3174004 and eighty-three samples were from lot 3101292.Each sample was visually inspected, and pressure tested for leakage.No samples were found to have any cracks or leakage.The samples returned are acceptable per product specification.A device history record review was completed for provided material number 309632, lots 3101292 and 3174004.The review revealed all visual inspections were performed as per requirement with no quality notifications related to the complaint defect.Lots 3101292 and 3174004 were inspected and accepted based on meeting our inspection control plan, subsequently approved for shipment and are considered in compliance with our product specification requirements.No corrective action is required at this time.We appreciate you taking the time to bring this observation to our attention.Complaints received for this device and reported condition will continue to be tracked and trended.Information will be captured on trend reports and monitored monthly.Our business team regularly reviews the collected data for identification of emerging trends.
 
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Brand Name
BD LUER-LOK
Type of Device
BD LUER-LOK
Manufacturer (Section D)
BECTON DICKINSON MEDICAL SYSTEMS
route 7 and grace way
canaan CT 06018
Manufacturer (Section G)
BECTON DICKINSON MEDICAL SYSTEMS
route 7 and grace way
canaan CT 06018
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key18156922
MDR Text Key328508010
Report Number1213809-2023-01283
Device Sequence Number1
Product Code FMF
UDI-Device Identifier30382903096320
UDI-Public(01)30382903096320
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K110771
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 02/16/2024
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 Catalogue Number309632
Device Lot Number3174004
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/20/2023
Initial Date FDA Received11/16/2023
Supplement Dates Manufacturer Received02/16/2024
Supplement Dates FDA Received02/20/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured06/23/2023
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
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