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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 381012
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/28/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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
The customer complained that the needle retracted slowly after button activation.Was affected product used on a patient? no.
 
Additional Manufacturer Narrative
The complaint of slow needle retraction was confirmed, and the cause appeared to be manufacturing related.One photograph and 20 unused 20g insyte autoguard units from lot #4281723 were provided for investigation.A functional test revealed that the retraction time of some needles exceeded the specification.The retraction time appeared to be associated with the dispersion of gel that was added around the spring.A trend has been identified for the reported failure and further actions have been initiated to investigate this type of incident and identify the root cause.The appropriate manufacturing personnel were notified of this complaint.A review of our risk management documentation was performed and indicates that the potential risk of the reported event was assessed appropriately.
 
Event or Problem Description
No new information.
 
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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 Key23764370
Report Number1710034-2025-01924
Device Sequence Number21254528
Product Code FOZ
UDI-Device Identifier00382903810123
UDI-Public(01)00382903810123
Combination Product (Y/N)N
Initial Reporter CountryHK
PMA/510(K) Number
NA
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 01/12/2026
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 Number381012
Device Lot Number4281723
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 11/19/2025
Supplement Date Received by Manufacturer01/12/2026
Initial Report FDA Received Date12/09/2025
Supplement Report FDA Received Date01/12/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/08/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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