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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON, DICKINSON AND COMPANY (BD) BD A-LINE¿ (SYRINGE W/O NEEDLE); BLOOD SPECIMEN COLLECTION DEVICE

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BECTON, DICKINSON AND COMPANY (BD) BD A-LINE¿ (SYRINGE W/O NEEDLE); BLOOD SPECIMEN COLLECTION DEVICE Back to Search Results
Catalog Number 364356
Device Problem Material Integrity Problem (2978)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/11/2022
Event Type  malfunction  
Manufacturer Narrative
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 when using the bd a-line¿ (syringe w/o needle), the device experienced a damaged open unit seal where sterility is compromised.The following information was provided by the initial reporter.The customer stated: this is a report about a missing cap of syr abg aline.According to the customer's report, there was no rubber cap on the syringe tip.
 
Manufacturer Narrative
The following fields were updated due to additional information: d.9.Device available for eval?: yes.D.9.Returned to manufacturer on: 26-apr-2022.H.6.Investigation: bd received 1 sample for investigation.The sample was evaluated by visual examination and the indicated failure mode for missing rubber cap with the incident lot was observed.Additionally, 10 retention samples from bd inventory were evaluated by visual examination and the issue of missing rubber cap was not observed.Based on a review of the device history record for the incident lot, all product specifications and requirements for lot release were met.There were no related quality issues during manufacturing of the product.This complaint has been confirmed for the indicated failure mode missing rubber cap.Bd was not able to identify a root cause for the indicated failure mode.
 
Event Description
It was reported when using the bd a-line¿ (syringe w/o needle), the device experienced a damaged open unit seal where sterility is compromised.The following information was provided by the initial reporter.The customer stated: this is a report about a missing cap of syr abg aline.According to the customer's report, there was no rubber cap on the syringe tip.
 
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Brand Name
BD A-LINE¿ (SYRINGE W/O NEEDLE)
Type of Device
BLOOD SPECIMEN COLLECTION DEVICE
Manufacturer (Section D)
BECTON, DICKINSON AND COMPANY (BD)
belliver way
belliver industrial estate
plymouth
UK 
Manufacturer (Section G)
BECTON, DICKINSON AND COMPANY (BD)
belliver way
belliver industrial estate
plymouth
UK  
Manufacturer Contact
phillip emmert
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key14120561
MDR Text Key289456775
Report Number9617032-2022-00370
Device Sequence Number1
Product Code JKA
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
NA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 04/27/2022
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 Expiration Date11/30/2023
Device Catalogue Number364356
Device Lot Number1330621
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 04/11/2022
Initial Date FDA Received04/15/2022
Supplement Dates Manufacturer Received04/27/2022
Supplement Dates FDA Received05/05/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/26/2021
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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