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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD MEDICAL - DIABETES CARE BD SAFETYGLIDE¿ ALLERGY TREATMENT SYRINGE TRAY; ANTISTICK SYRINGE

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BD MEDICAL - DIABETES CARE BD SAFETYGLIDE¿ ALLERGY TREATMENT SYRINGE TRAY; ANTISTICK SYRINGE Back to Search Results
Catalog Number 305950
Medical Device Problem Code Illegible Information (4050)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/19/2023
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that unspecified amount of the bd safetyglide¿ allergy treatment syringe tray scale markings were not illegible.The following information was provided by the initial reporter: we also have several that don't have the ml markers printed on it.They fade away the further it goes.Usually disappearing completely by 0.5.
 
Additional Manufacturer Narrative
B.3.Date of event: unknown.The date received by manufacturer has been used for this field.H3.A device evaluation is anticipated but has not yet begun.Upon completion of the investigation, a supplemental report will be filed.
 
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Brand Name
BD SAFETYGLIDE¿ ALLERGY TREATMENT SYRINGE TRAY
Common Device Name
ANTISTICK SYRINGE
Manufacturer (Section D)
BD MEDICAL - DIABETES CARE
1329 west highway 6
holdrege NE 68949
Manufacturer (Section G)
BD MEDICAL - DIABETES CARE
1329 west highway 6
holdrege NE 68949
Manufacturer Contact
jennifer suh
5859 farinon drive
san antonio, TX 78249
8448235433
MDR Report Key17467061
Report Number1920898-2023-00526
Device Sequence Number15237611
Product Code MEG
UDI-Device Identifier00382903059508
UDI-Public00382903059508
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
K992734
Number of Events Summarized1
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
Report Date (Section B) 07/21/2023
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 Catalogue Number305950
Device Lot Number2251990
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/19/2023
Initial Report FDA Received Date08/05/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured09/08/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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