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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 NEXIVA¿ DIFFUSICS¿ CLOSED IV CATHETER; INTRAVASCULAR CATHETER

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BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD NEXIVA¿ DIFFUSICS¿ CLOSED IV CATHETER; INTRAVASCULAR CATHETER Back to Search Results
Model Number 383594
Device Problems Device Contamination with Chemical or Other Material (2944); Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/11/2021
Event Type  malfunction  
Event Description
It was reported that the bd nexiva¿ diffusics¿ closed iv catheter had "yellow tinting" and defective catheter tips.The following information was provided by the initial reporter: yellow tinting and bulging on tip of catheter.
 
Manufacturer Narrative
"multiple lot numbers: there were multiple lot numbers reported to be involved.The information for each lot number is as follows: medical device lot #: 9324380, medical device expiration date: 2022-11-30 device manufacture date: 2019-12-27.Medical device lot #: 1015996, medical device expiration date: 2024-01-31, device manufacture date: 2021-03-03.Medical device lot #: 1078180, medical device expiration date: 2024-05-31, device manufacture date: 2021-06-15.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 the bd nexiva¿ diffusics¿ closed iv catheter had "yellow tinting" and defective catheter tips.The following information was provided by the initial reporter: yellow tinting and bulging on tip of catheter.
 
Manufacturer Narrative
H.6.Investigation: bd was not able to confirm the customer¿s indicated failure mode because no samples or pictures were received to perform investigation.Dhr for this lot was reviewed and there are no internal rejects related to the reported issue by the customer.Root cause could not be determined.H3 other text : see h.10.
 
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Brand Name
BD NEXIVA¿ DIFFUSICS¿ CLOSED IV CATHETER
Type of Device
INTRAVASCULAR 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 Key12864781
MDR Text Key283104823
Report Number9610847-2021-00566
Device Sequence Number1
Product Code FOZ
UDI-Device Identifier30382903835943
UDI-Public30382903835943
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K123734
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,Followup
Report Date 11/29/2021
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 Model Number383594
Device Catalogue Number383594
Device Lot NumberSEE H10
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/27/2021
Initial Date FDA Received11/23/2021
Supplement Dates Manufacturer Received11/29/2021
Supplement Dates FDA Received12/17/2021
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
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