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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD NEXIVA¿ CLOSED IV CATHETER SYSTEM; INTRAVASCULAR CATHETER

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BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD NEXIVA¿ CLOSED IV CATHETER SYSTEM; INTRAVASCULAR CATHETER Back to Search Results
Model Number 383517
Device Problem Defective Component (2292)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 05/19/2022
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 that the bd nexiva¿ closed iv catheter system experienced catheter damage.The following information was provided by the initial reporter: the head nurse of ct room reported that there were burrs when she opened the package.
 
Manufacturer Narrative
H6: investigation summary our quality engineer inspected the photograph submitted for evaluation.Bd received one photo of a 20 ga x 1.25in nexiva single port.A visual inspection of the photo discovered some flash on the catheter tip.The reported issue was confirmed.Although the reported issue was confirmed, it could not be determined if the damage resulted from the manufacturing of the device or from the user environment.This may originate during the manufacturing process due to alignment of the set together station, bent tubing, or air blow inconsistency.There is a 100% vision system inspection and a sampling plan implemented for lie distance, which mitigates the occurrence of this defect.This defect is also common during tip adhesion break during use.Without the physical device to perform further testing the cause is undetermined.A device history record review showed no non-conformances associated with this issue during the production of this batch.
 
Event Description
It was reported that the bd nexiva¿ closed iv catheter system experienced catheter damage.The following information was provided by the initial reporter: the head nurse of ct room reported that there were burrs when she opened the package.
 
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Brand Name
BD NEXIVA¿ CLOSED IV CATHETER SYSTEM
Type of Device
INTRAVASCULAR CATHETER
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
phillip emmert
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key15085572
MDR Text Key304632155
Report Number1710034-2022-00381
Device Sequence Number1
Product Code FOZ
UDI-Device Identifier30382903835172
UDI-Public30382903835172
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,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 08/26/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/22/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Model Number383517
Device Catalogue Number383517
Device Lot Number1315343
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received08/26/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured11/11/2021
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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