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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. INSYTE AUTOGUARD; PERIPHERAL IV CATHETERS

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BECTON DICKINSON INFUSION THERAPY SYSTEMS INC. INSYTE AUTOGUARD; PERIPHERAL IV CATHETERS Back to Search Results
Catalog Number 381434
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/02/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
B3.The date received by manufacturer has been used for this field.H.3.A follow up mdr will be submitted if additional information, a device evaluation, or a device history review is completed.
 
Event or Problem Description
We have recently received reports that the item has been tougher to retract, which could potentially cause a safety issue.They had mentioned that this didn¿t happen every time, but it has happened often enough to warrant discussion.Issue was reported out from clinical staff on (b)(6) 2025.Were previous complaints reported to bd earlier? if not kindly provide further details of the events.No complaints were logged prior to this time.When you pressed the button, did the needle fully retract? needle did fully retract.Did the needle retract slower than normal? needle retracted slower than usual (the reported concern).Did the needle start retracting and then stop, leaving the needle exposed ? not an issue that i was made aware of.Did the needle not move at all after pressing the button? not an issue that i was made aware of.Did the button depress? not an issue that i was made aware of.Was there any harm/serious injury to the patient or hcp directly related to this reported event? customer response on (b)(6) 2025.There were no reported incidents, the staff was just concerned about the possibility.
 
Event or Problem Description
No new information.
 
Additional Manufacturer Narrative
As no physical sample, picture sample, or lot number was provided for evaluation by our quality engineer team, a complete investigation could not be performed.Based on the limited investigation results, a root cause for the reported incident could not be determined.
 
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Brand Name
INSYTE AUTOGUARD
Common Device Name
PERIPHERAL IV CATHETERS
Manufacturer (Section D)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer (Section G)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
sandy UT 84070
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key23364479
Report Number1710034-2025-01638
Device Sequence Number8879841
Product Code FOZ
UDI-Device Identifier00382903814343
UDI-Public(01)00382903814343(11)250618(17)280531(10)5161791
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryUS
PMA/510(K) Number
K201075
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 10/31/2025
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 Number381434
Device Lot NumberUNKNOWN
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/02/2025
Supplement Date Received by Manufacturer10/31/2025
Initial Report FDA Received Date10/23/2025
Supplement Report FDA Received Date11/03/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/18/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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