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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® BUFFERED SODIUM CITRATE (9NC) BLOOD COLLECTION TUBES; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION

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BECTON, DICKINSON & CO. (BROKEN BOW) BD VACUTAINER® BUFFERED SODIUM CITRATE (9NC) BLOOD COLLECTION TUBES; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION Back to Search Results
Catalog Number 363080
Medical Device Problem Code Short Fill (1575)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/23/2025
Type of Reportable Event Malfunction
Event or Problem Description
Report 1 of 2: it was reported while using bd vacutainer® buffered sodium citrate (9nc) blood collection tubes, 26 tubes underfilled.Tubes were either replaced or recollected.There was no other health impact or consequences reported.
 
Additional Manufacturer Narrative
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
Report 1 of 2: it was reported while using bd vacutainer® buffered sodium citrate (9nc) blood collection tubes, 26 tubes underfilled.Tubes were either replaced or recollected.There was no other health impact or consequences reported.
 
Additional Manufacturer Narrative
The following fields were updated due to additional information: d9: device available for evaluation: yes h.3 device eval by manufacturer? yes d9: returned to manufacturer on: 25-aug-2025 investigation summary bd received 5 samples and 6 photos for investigation related to lot 5015927.The samples were inspected with no issues identified, and the photos showed the indicated failure mode.Additionally, 100 retained samples from both lots were visually inspected, and all tubes were within specification limits with no issues identified.Furthermore, a functional test was performed on 10 retained samples from both lots, and all were within specification limits.Based on a review of the device history record for the incident lots, all product specifications and requirements for lot release were met.This complaint has been confirmed for the lots 5015927 for the indicated failure mode: underfill.No definitive root cause could be established for the reported defect.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.
 
Additional Manufacturer Narrative
The following fields have been updated with additional information: h.6 investigation summary: bd received 6 photos and 5 samples for each of the 2 complaint lots for investigation.The samples were expired at the time of review therefore no functional testing could be performed.A visual inspected was performed and no issues were identified.The photos were reviewed and the indicated failure mode underfill was observed for both lots.Additionally, 100 retained samples from each lot were visually inspected, and no issues identified.A functional test was performed on 10 retained samples from both lots, and all tubes drew within specification limits.Based on a review of the device history record for the incident lots, all product specifications and requirements for lot release were met.This complaint has been confirmed for the lots 5015927 and 5048247, for the indicated failure mode underfill.No definitive root cause could be established for the reported defect.Based on the low defect rate for the batch in question, no actions are planned at this time.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
Report 1 of 2: it was reported while using bd vacutainer® buffered sodium citrate (9nc) blood collection tubes, 26 tubes underfilled.Tubes were either replaced or recollected.There was no other health impact or consequences reported.
 
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Brand Name
BD VACUTAINER® BUFFERED SODIUM CITRATE (9NC) BLOOD COLLECTION TUBES
Common Device Name
TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION
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 Key22812233
Report Number1917413-2025-01108
Device Sequence Number12696092
Product Code JKA
UDI-Device Identifier30382903630807
UDI-Public(01)30382903630807(17)250731(10)5015927
Combination Product (Y/N)N
Initial Reporter CountryMX
PMA/510(K) Number
K013971
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 10/08/2025
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 Expiration Date07/31/2025
Device Catalogue Number363080
Device Lot Number5015927
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 07/23/2025
Supplement Date Received by Manufacturer09/09/2025
10/08/2025
Initial Report FDA Received Date08/14/2025
Supplement Report FDA Received Date10/06/2025
10/08/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/15/2025
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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