MAUDE Adverse Event Report: BECTON, DICKINSON & CO. (SPARKS) SEE H.10; CULTURE MEDIA, NON-SELECTIVE AND NON-DIFFERENTIAL

Model Number	221283
Medical Device Problem Code	Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	01/24/2023
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Medical device brand name: bd bbl¿ trypticase¿ soy agar (soybean-casein digest agar) a device evaluation and/or device history review is anticipated but is not complete.Upon completion, a supplemental report will be filed.
Event or Problem Description
It was reported that bd bbl¿ trypticase¿ soy agar (soybean-casein digest agar) fungi contamination was discovered in the 1 case.The following information was provided by the initial reporter: reported biological contamination (fungi) for the product.Lot#2293794.Bacteria or fungi contamination ¿ colony color? fungi contamination.Gray and white colors.
Additional Manufacturer Narrative
H6.During manufacturing of material 221283, media is formulated and sent through a high temperature short time sterilizer to remove bioburden.The petri dishes are subjected to uv radiation to decrease bioburden.The petri dishes are filled in a positive pressure hepa filtered environment.The filled plates are cooled and immediately wrapped into sleeves to decrease the introduction of microbes.Sleeves are then packaged into cartons and then transferred to a refrigerated truck (2 to 8 degrees c) for shipment to the distributor.Bd distributors are provided with the storage guidelines for the shipping and handling of bd media of 2 to 8 degrees c in a dark place.The batch history record for batch 2293794 was satisfactory and no quality notifications were generated during manufacturing and inspection.The release testing that is performed on this product does include bioburden testing.A sample of plates are incubated at 25 degrees c and at 35 degrees c for approximately 72 hours.All bioburden testing performed on this batch was satisfactory per bd internal procedures.Affected product does not have any sterility claims; the product is tested for bioburden prior to release to ensure that it conforms to product specifications.However, this does not ensure that the end-user will not receive a contaminated plate.The complaint history was reviewed, and no other complaints have been taken on batch 2293794.Retention samples from batch 2293794 were not available for inspection.Thirty plates from batch 2293794 were returned as three unopened sleeves shipped in an insulated box with ice packs (time stamp 0849).Returned plates were incubated and 1/30 plates had surface growth.The affected plate was submitted to the id lab and bacillus velezensis was identified.No photos were received for investigation.This complaint can be confirmed for contamination.Bd has identified a contamination trend for this product and the investigation found opportunities for bioburden reduction in the manufacturing process.A capa (corrective and preventative actions) has been initiated and involves implementing additional cleaning events and evaluation of manufacturing procedures focused on in-process bioburden reduction.Additional trainings are planned with an ongoing training review for cleaning processes.Improvement in observation of contamination is expected as the capa progresses.Bd will continue to trend complaints for contamination.H3 other text : see h10.
Event or Problem Description
It was reported that bd bbl¿ trypticase¿ soy agar (soybean-casein digest agar) fungi contamination was discovered in the 1 case.The following information was provided by the initial reporter: reported biological contamination (fungi) for the product.Lot#2293794.Bacteria or fungi contamination ¿ colony color? fungi contamination.Gray and white colors.

• Brand Name: SEE H.10
• Common Device Name: CULTURE MEDIA, NON-SELECTIVE AND NON-DIFFERENTIAL
• Manufacturer (Section D): BECTON, DICKINSON & CO. (SPARKS); 7 loveton circle; sparks MD 21152
• Manufacturer (Section G): BECTON, DICKINSON & CO. (SPARKS); 7 loveton circle; sparks MD 21152
• Manufacturer Contact: phillip emmert ; 9450 south state street; sandy, UT 84070 ; 8015296192
• MDR Report Key: 16318675
• Report Number: 1119779-2023-00113
• Device Sequence Number: 8645385
• Product Code: JSG
• UDI-Device Identifier: 10382902212833
• UDI-Public: 10382902212833
• Combination Product (Y/N): N
• PMA/510(K) Number: NA
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,User Facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 04/28/2023

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
• Operator of Device: Other
• Device Expiration Date: 02/10/2023
• Device Model Number: 221283
• Device Catalogue Number: 221283
• Device Lot Number: 2293794
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 01/26/2023
• Supplement Date Received by Manufacturer: 04/28/2023
• Initial Report FDA Received Date: 02/08/2023
• Supplement Report FDA Received Date: 05/10/2023
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 10/20/2022
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown