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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD NEXIVA DIFFUSICS 22G X 1.00 IN; INTRAVASCULAR CATHETER

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BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD NEXIVA DIFFUSICS 22G X 1.00 IN; INTRAVASCULAR CATHETER Back to Search Results
Catalog Number 383591
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/28/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H.3.If a device evaluation and/or device history review is completed, a supplemental report will be filed.
 
Event or Problem Description
It was reported that bd nexiva diffusics 22g x 1.00 in leaked it was reported by customer that the catheter was leaking from.The iv catheter was placed and flushed.Once the iv began to infuse it was realized that fluid was leaking from the tubing extension at the y-site (arrow indicates leaking area).Verbatim: i attached a picture below.I thought this would be the easiest way to explain where the catheter was leaking from.The iv catheter was placed and flushed.Once the iv began to infuse it was realized that fluid was leaking from the tubing extension at the y-site (arrow indicates leaking area).
 
Additional Manufacturer Narrative
Investigation results: our quality engineer inspected the 1 photo and 1 opened physical sample submitted for evaluation.The reported issue of leakage was not confirmed upon inspection and testing of the samples.Analysis of the sample showed that the reported defect was not observed with a visual inspection as well as the evaluation by leak test.Bd could not determine a manufacturing related root cause since the reported defect was not confirmed during the evaluation of the sample.A review of our risk management documentation was performed and indicates that the potential risk of the reported event was assessed appropriately.Production records were reviewed, and this batch meets our manufacturing specification requirements.Complaints received for this device and reported condition will continue to be tracked and trended.Information will be captured on trend reports and monitored.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 NEXIVA DIFFUSICS 22G X 1.00 IN
Common Device Name
INTRAVASCULAR CATHETER
Manufacturer (Section D)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX 
Manufacturer (Section G)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX  
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key22284662
Report Number9610847-2025-00197
Device Sequence Number15658397
Product Code FOZ
UDI-Device Identifier00382903835911
UDI-Public(01)00382903835911(11)241216(17)271130(10)4334829
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
K173354
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 07/16/2025
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 Number383591
Device Lot Number4334829
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/29/2025
Supplement Date Received by Manufacturer07/16/2025
Initial Report FDA Received Date06/18/2025
Supplement Report FDA Received Date07/23/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/16/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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