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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® URINE COMPLETE CUP KIT; CULTURE MEDIA, NON-PROPAGATING TRANSPORT

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BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® URINE COMPLETE CUP KIT; CULTURE MEDIA, NON-PROPAGATING TRANSPORT Back to Search Results
Catalog Number 364956
Medical Device Problem Code Contamination /Decontamination Problem (2895)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/15/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D4.Medical device expiration date: unknown.H4.Device manufacture date: unknown.A device evaluation and/or device history review is anticipated but is not complete.Upon completion, a supplemental report will be filed.
 
Event or Problem Description
It was reported while using bd vacutainer® urine complete cup kit, an unspecified number of kits contain towelettes which break apart easily and are difficult to cleanse properly.Customer has reported an increase in contaminated urine samples.There was no other health impact or consequences reported.
 
Additional Manufacturer Narrative
Investigation summary : bd had not received any samples or photos for investigation.The device history records could not be reviewed as the lot number is unknown.This complaint has not been confirmed for the indicated failure mode: defective product/component.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 the identification of emerging trends.
 
Event or Problem Description
It was reported while using bd vacutainer® urine complete cup kit, an unspecified number of kits contain towelettes which break apart easily and are difficult to cleanse properly.Customer has reported an increase in contaminated urine samples.There was no other health impact or consequences reported.
 
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Brand Name
BD VACUTAINER® URINE COMPLETE CUP KIT
Common Device Name
CULTURE MEDIA, NON-PROPAGATING TRANSPORT
Manufacturer (Section D)
BECTON, DICKINSON & CO. (BROKEN BOW)
150 south 1st avenue
broken bow NE 68822
Manufacturer (Section G)
BECTON, DICKINSON & CO. (BROKEN BOW)
150 south 1st avenue
broken bow NE 68822
Manufacturer Contact
matt j. connor
7 loveton circle
sparks, MD 21152
4103164000
MDR Report Key22731383
Report Number1917413-2025-01041
Device Sequence Number8989812
Product Code JSM
UDI-Device Identifier00382903649563
UDI-Public(01)00382903649563
Combination Product (Y/N)Y
Initial Reporter StateOK
Initial Reporter CountryUS
PMA/510(K) Number
K024240
Number of Events Summarized1
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) 09/22/2025
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 Number364956
Device Lot NumberUNKNOWN
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 07/15/2025
Supplement Date Received by Manufacturer09/22/2025
Initial Report FDA Received Date08/06/2025
Supplement Report FDA Received Date10/22/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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