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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON BD SHARPS COLLECTORS; HYPODERMIC SINGLE LUMEN NEEDLE

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BECTON DICKINSON BD SHARPS COLLECTORS; HYPODERMIC SINGLE LUMEN NEEDLE Back to Search Results
Catalog Number 305487
Medical Device Problem Code Device Markings/Labelling Problem (2911)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/27/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Oem manufacturer:the manufacturing location for this product is [flextronics].This site is an oem manufacturing site.Therefore, bd corporate headquarters in franklin lakes, nj has been listed in sections d.3.And g.1.And the franklin lakes fda registration number has been used for the manufacture report number.D.4.Medical device expiration date: none.H.3.A device evaluation is anticipated, but has not yet begun.Upon completion of the investigation, a supplemental report will be filed.
 
Event or Problem Description
It was reported that the label was missing from the bd sharps collectors.The following was translated from japanese to english: this is a report about sharps collector's label peeling off.
 
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Brand Name
BD SHARPS COLLECTORS
Common Device Name
HYPODERMIC SINGLE LUMEN NEEDLE
Manufacturer (Section D)
BECTON DICKINSON
1 becton drive
franklin lakes NJ 07417
Manufacturer (Section G)
BECTON DICKINSON
1 becton drive
franklin lakes NJ 07417
Manufacturer Contact
jennifer suh
5859 farinon drive
san antonio, TX 78249
8448235433
MDR Report Key17916632
Report Number2243072-2023-01824
Device Sequence Number17805654
Product Code FMI
UDI-Device Identifier00382903054879
UDI-Public(01)00382903054879
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K943139
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 10/04/2023
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 Number305487
Device Lot Number3132906
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 Not provided
Initial Report FDA Received Date10/11/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured05/22/2023
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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