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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD (SUZHOU) BD INTIMA II¿ IV CATHETER PRN ADAPTER; INTRAVASCULAR CATHETER

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BD (SUZHOU) BD INTIMA II¿ IV CATHETER PRN ADAPTER; INTRAVASCULAR CATHETER Back to Search Results
Catalog Number 383062
Device Problem Degraded (1153)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 08/16/2022
Event Type  malfunction  
Manufacturer Narrative
In response to the event reported, a device history review was conducted for lot number 0294666.Our records show that this is the only instance of this issue occurring in this production batch.According to the sampling plan applied for product performance, this lot was accepted and released without defects being noted during the final assembly or visual inspections.A sample could not be obtained for evaluation and testing; in lieu of the affected device, visual analysis was performed on retention samples for this lot, the retained devices were found to be free of any damage or other abnormalities.Unfortunately without the ability to investigate the affected unit our quality engineers were unable to determine the root cause for this complaint.Prn aging is manly caused by strong oxidation, including: thermal oxygen aging, light oxygen aging, ozone aging (such as encountered ozone disinfection).Prn aging will not occur in the production process, and this defect is related to the subsequent transportation and storage.
 
Event Description
It was reported that the prn of the bd intima ii¿ iv catheter prn adapter was found to be worn down and defective during use.The following information was provided by the initial reporter, translated from chinese: "the patient required intravenous fluids according to the doctor's advice, and when the nurse examined the indwelling needle, she found that the bottom of the indwelling needle heparin cap was aging and could not be used.".
 
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Brand Name
BD INTIMA II¿ IV CATHETER PRN ADAPTER
Type of Device
INTRAVASCULAR CATHETER
Manufacturer (Section D)
BD (SUZHOU)
no. 5 baiyu road
suzhou industrial park
suzhou
Manufacturer (Section G)
BD (SUZHOU)
no. 5 baiyu road
suzhou industrial park
suzhou
Manufacturer Contact
phillip emmert
9450 south state street
sandy, UT 84070
8015296192
MDR Report Key15584219
MDR Text Key306411882
Report Number3014704491-2022-00482
Device Sequence Number1
Product Code FOZ
UDI-Device Identifier00382903830626
UDI-Public(01)00382903830626
Combination Product (y/n)N
Reporter Country CodeCH
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
Report Date 10/07/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/11/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Expiration Date11/18/2023
Device Catalogue Number383062
Device Lot Number0294666
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received09/19/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/20/2020
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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