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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD NEXIVA; PERIPHERAL IV CATHETERS

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BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD NEXIVA; PERIPHERAL IV CATHETERS Back to Search Results
Catalog Number 383511
Device Problems Particulates (1451); Device Contamination with Chemical or Other Material (2944)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/28/2024
Event Type  malfunction  
Manufacturer Narrative
H.3.A follow up mdr will be submitted if additional information, a device evaluation, or a device history review is completed.
 
Event Description
It was reported that bd nexiva has foreign matter on its tip.The following information was provided by the initial reporter, translated from chinese to english: the tip of the catheter is burred and not smooth, the safety protection device is too tight to start properly, there are burrs on the catheter wall, and there are black spots on the catheter wall.
 
Manufacturer Narrative
Additional lot numbers were provided in this complaint for material number 383511.Lot # 3087425; mnf date 29 mar 2023; exp date 31 mar 2026.Lot # 3040439; mnf date 14 feb 2023; exp date 31 jan 2026.
 
Manufacturer Narrative
Internal record review conducted.Aware date for this complaint has been corrected to reflect (b)(6) 2024.
 
Manufacturer Narrative
Investigation results: a device history record review was completed by our quality engineer team for provided material number 383511 and lot number 3040439, 3087425, 2045799.The review did not reveal any detected abnormalities during the production process that could have contributed to this defect and all quality tests were found to be within specification.As a sample was unavailable for return, a thorough sample investigation could not be completed.Based on the investigation results, an exact cause for this incident could not be identified.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
No additional information.
 
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Brand Name
BD NEXIVA
Type of Device
PERIPHERAL IV CATHETERS
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
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key18993582
MDR Text Key339206575
Report Number1710034-2024-00252
Device Sequence Number1
Product Code FOZ
UDI-Device Identifier00382903835119
UDI-Public(01)00382903835119
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K183399
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup,Followup
Report Date 06/10/2024
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 Number383511
Device Lot Number3087425
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/29/2024
Initial Date FDA Received03/28/2024
Supplement Dates Manufacturer Received02/29/2024
03/04/2024
06/10/2024
Supplement Dates FDA Received03/29/2024
04/16/2024
06/11/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/14/2022
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
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