| Brand Name | BD ECLIPSE |
| Common Device Name | NEEDLE, HYPODERMIC, SINGLE LUMEN |
| Manufacturer (Section D) |
| BECTON, DICKINSON AND COMPANY |
| 1 becton dr. |
| franklin lakes NJ 07417 |
|
| MDR Report Key | 22628608 |
| Report Number | 22628608 |
| Device Sequence Number | 20909326 |
| Product Code |
FMI
|
| UDI-Device Identifier | 00382903057597 |
| UDI-Public | (01)00382903057597 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MA |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
User Facility
|
| Initial Reporter Occupation |
Risk Manager
|
| Type of Report
| Initial |
| Report Date (Section B) |
07/09/2025 |
| Report Date (Section F) |
07/09/2025 |
| 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 Model Number | 305759 |
| Device Catalogue Number | 305759 |
| Device Lot Number | 4250308 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
Yes
|
| Event Location |
Hospital
|
| Date Report to Manufacturer | 07/28/2025 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 07/28/2025 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
| Date Report Sent to FDA | 07/09/2025 |
|
|