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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD INSYTE AUTOGUARD WINGED; PERIPHERAL IV CATHETERS

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BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. BD INSYTE AUTOGUARD WINGED; PERIPHERAL IV CATHETERS Back to Search Results
Catalog Number 381933
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 02/06/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that bd insyte autoguard winged needle was slow to retract.The following information was provided by the initial reporter, translated from french to english: the problem concerns safety: the canula retracts only very slowly.Defective batch of pink (b)(4) ga catheters batch number 4290525 observation by several carers: difficult and slow retraction of the mandrel after pressing the button provided for this purpose.Button.
 
Additional Manufacturer Narrative
H.3.A follow up mdr will be submitted if additional information, a device evaluation, or a device history review is completed.
 
Additional Manufacturer Narrative
Investigation results: a device history record review was completed by our quality engineer team for provided material number 381933 and lot number 4290525.The review did not reveal any detected abnormalities during the production process that could have contributed to this defect and all quality tests were found to be within specification.As a sample was unavailable for return, a thorough sample investigation could not be completed.Based on the investigation results, an exact cause for this incident could not be identified.
 
Event or Problem Description
No additional information.
 
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Brand Name
BD INSYTE AUTOGUARD WINGED
Common Device Name
PERIPHERAL IV CATHETERS
Manufacturer (Section D)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer (Section G)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key21426700
Report Number1710034-2025-00294
Device Sequence Number12660433
Product Code FOZ
UDI-Device Identifier00382903819331
UDI-Public(01)00382903819331(11)241016(17)270930(10)4290525
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
UNK
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative,Distributor
Initial Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date (Section B) 03/31/2025
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 Health Professional
Device Catalogue Number381933
Device Lot Number4290525
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/07/2025
Supplement Date Received by Manufacturer03/31/2025
Initial Report FDA Received Date02/20/2025
Supplement Report FDA Received Date03/31/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/16/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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