MAUDE Adverse Event Report: BECTON, DICKINSON AND COMPANY, BD BIOSCIENCES BD FACS¿ SAMPLE PREP ASSISTANT III; AUTOMATED PIPETTING, DILUTING AND SPECIMEN PROCESSING WORKSTATIONS FOR FLOW CYTO

Catalog Number	647205
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	05/01/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
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 while using bd facs¿ sample prep assistant iii the customer reported erroneous results that were reported to a clinician.No patient injury or delay in treatment was reported.The following information was provided by the initial reporter: "customer reported 2 of their instruments are giving an abnormal result".
Additional Manufacturer Narrative
H.6 investigation summary: based on the investigation results, the reported issue of abnormal results was not confirmed.Investigation results that were performed on the indicated failure mode were the following: complaint trend, manufacturing defect trend, risk review.The potential cause was not determined as the field service engineer (fse) was unable to reproduce the issue and noted in the work order notes that the instrument passed all tests with operational accuracy and performance.While results were reported to the clinician there was no delay of treatment, harm, or injury as a result of this issue.
Event or Problem Description
It was reported that while using bd facs¿ sample prep assistant iii the customer reported erroneous results that were reported to a clinician.No patient injury or delay in treatment was reported.The following information was provided by the initial reporter: "customer reported 2 of their instrument are giving an abnormal result".

• Brand Name: BD FACS¿ SAMPLE PREP ASSISTANT III
• Common Device Name: AUTOMATED PIPETTING, DILUTING AND SPECIMEN PROCESSING WORKSTATIONS FOR FLOW CYTO
• Manufacturer (Section D): BECTON, DICKINSON AND COMPANY, BD BIOSCIENCES; 155 north mccarthy boulevard; milpitas CA 95035
• Manufacturer (Section G): BECTON, DICKINSON AND COMPANY, BD BIOSCIENCES; 155 north mccarthy boulevard; milpitas CA 95035
• Manufacturer Contact: fahmy razak - mdr ; 155 north mccarthy boulevard; milpitas, CA 95035 ; 8772328995
• MDR Report Key: 22045122
• Report Number: 3027394506-2025-00023
• Device Sequence Number: 8908153
• Product Code: PER
• UDI-Device Identifier: 00382906472052
• UDI-Public: (01)00382906472052(11)120322
• Combination Product (Y/N): N
• Initial Reporter State: NC
• Initial Reporter Country: US
• PMA/510(K) Number: K131301
• 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): 07/29/2025

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 Number: 647205
• 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: 05/01/2025
• Supplement Date Received by Manufacturer: 07/29/2025
• Initial Report FDA Received Date: 05/19/2025
• Supplement Report FDA Received Date: 07/30/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 03/22/2012
• 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