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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON MEDICAL SYSTEMS BD LUER-LOK; PISTON SYRINGE

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BECTON DICKINSON MEDICAL SYSTEMS BD LUER-LOK; PISTON SYRINGE Back to Search Results
Catalog Number 309581
Medical Device Problem Code Volume Accuracy Problem (1675)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/26/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
B.3.The date received by manufacturer has been used for this field.H.3.If a device evaluation and/or device history review is completed, a supplemental report will be filed.
 
Event or Problem Description
Material # 309581.Lot # 4157077.It was provided that the bd luer-lok had a scale marking issue.The following information was provided by the initial reporter:   verbatim: rcc received a complaint via email.Email(s) attached.I was dispensed a bd luer-lok syringe from the pharmacy to use to administer vitamin b12 injections.The markings on the syringe were misprinted/crooked.This did not allow for the correct dose to be drawn up.Lot #: 4157077, expiration: 5/31/2025.
 
Additional Manufacturer Narrative
Since no samples displaying the condition reported are available for examination, we were unable to fully investigate this incident.No root cause can be determined as no samples were received.Furthermore, a device history record review showed no rejected inspections or quality issues during the production of the provided lot number that could have contributed to the reported defect.We would be very interested in examining product that does not meet your expectations and our quality standards.Should you again experience any problems with our product we would appreciate the opportunity to conduct a thorough analysis.Examination of the product involved may provide clarification as to the cause for the reported failure.Complaints received for this device and reported condition will continue to be tracked and trended.Information will be captured on trend reports and monitored monthly.Our business team regularly reviews the collected data for identification of emerging trends.
 
Event or Problem Description
No additional information.
 
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Brand Name
BD LUER-LOK
Common Device Name
PISTON SYRINGE
Manufacturer (Section D)
BECTON DICKINSON MEDICAL SYSTEMS
route 7 and grace way
canaan CT 06018
Manufacturer (Section G)
BECTON DICKINSON MEDICAL SYSTEMS
route 7 and grace way
canaan CT 06018
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key21172525
Report Number1213809-2025-00006
Device Sequence Number17212486
Product Code FMF
UDI-Device Identifier30382903095811
UDI-Public(01)30382903095811(11)240605(17)290531(10)4157077
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
K110771
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/19/2025
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 Number309581
Device Lot Number4157077
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/26/2024
Supplement Date Received by Manufacturer02/19/2025
Initial Report FDA Received Date01/16/2025
Supplement Report FDA Received Date02/20/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/05/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexFemale
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