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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD SAF-T-INTIMA IV CATHETER SAFETY SYSTEM INTRAVASCULAR CATHETER

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BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD SAF-T-INTIMA IV CATHETER SAFETY SYSTEM INTRAVASCULAR CATHETER Back to Search Results
Model Number 383323
Device Problem Device Contamination with Chemical or Other Material (2944)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 08/26/2021
Event Type  malfunction  
Manufacturer Narrative
Date of event: unknown. The original date received by manufacturer has been used for this field. Investigation summary: bd received 8 representative samples submitted for evaluation. The reported issue was confirmed upon testing of the samples. During internal flow testing, 2 samples were occluded. Further examination showed that excess medical grade silicone from our lubrication process was found within the cannula. The excess was stuck to the needle, clogging the cannula, resulting in occlusion. A device history record review showed no non-conformance's associated with this issue during the production of this batch. A review of our risk management documentation was performed and indicates that the potential risk of the reported event was assessed appropriately. Corrective actions have been initiated and a manufacturing root cause has been identified. Actions have been made to address the issue. Complaints received for this device and reported condition will continue to be tracked and trended. Information will be captured on trend reports and monitored. Our business team regularly reviews the collected data for identification of emerging trends.
 
Event Description
It was reported that 2 bd saf-t-intima¿ iv catheter safety systems' needles were occluded with excess silicone. The following information was provided by the initial reporter: "we are having an issue with lot# 1053941 of the 22g saf-t-intima safety system with y adapter. All of the sudden, we are having a hard time starting iv's. Not every time. But way more often that usual. It feels and looks like you are in the vein, but there is no "flash" of blood and the needle seems slightly dull. " via bd investigation: "during internal flow testing, 2 samples were occluded. Further examination showed that excess medical grade silicone from our lubrication process was found within the cannula. The excess was stuck to the needle, clogging the cannula, resulting in occlusion. ".
 
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Brand NameBD SAF-T-INTIMA IV CATHETER SAFETY SYSTEM
Type of DeviceINTRAVASCULAR CATHETER
Manufacturer (Section D)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX
Manufacturer (Section G)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX
Manufacturer Contact
katie swenson
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key12586644
MDR Text Key275244081
Report Number9610847-2021-00489
Device Sequence Number1
Product Code FOZ
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K013800
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other,user facility
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 10/06/2021
1 Device was Involved in the Event
0 Patients were Involved in the Event:
Date FDA Received10/06/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Model Number383323
Device Catalogue Number383323
Device Lot Number1053941
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/02/2021
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received10/05/2021
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured03/05/2021
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

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