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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK

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BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V. BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK Back to Search Results
Catalog Number 309702
Medical Device Problem Codes Break (1069); Product Quality Problem (1506)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/12/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H.3.If a device evaluation and/or device history review is completed, a supplemental report will be filed.
 
Event or Problem Description
It was reported that bd syringe 3ml ll tip bulk convenience pak plunger rod was broken / damaged.It was reported by customer that there were 4 syringes found that plunger had defects during the sugammadex.Verbatim: " i have had a couple reports about some with defective plungers".
 
Additional Manufacturer Narrative
Additional information: (e) initial reporter address.Investigation results: a device history record review was completed by our quality engineer team for provided material number 309702 and lot number 5037874, 5146941, 5127588, 5255912.The review did not reveal any detected abnormalities during the production process that could have contributed to this defect, and all quality tests were found to be within specification.As a sample was unavailable for return, a thorough sample investigation could not be completed.Based on the investigation results, an exact cause for this incident could not be identified.There are quality controls currently in place to detect this type of defect during the production process.Further action has not been determined necessary at this time.Complaints received for this device and reported condition will continue to be tracked and trended.
 
Event or Problem Description
No additional information.
 
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Brand Name
BD SYRINGE 3ML LL TIP BULK CONVENIENCE PAK
Common Device Name
SYRINGE
Manufacturer (Section D)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX 
Manufacturer (Section G)
BD INFUSION THERAPY SYSTEMS INC. S.A. DE C.V.
periferico luis donaldo
colosio no. 579
nogales
MX  
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key24080077
Report Number9610847-2026-00006
Device Sequence Number5976436
Product Code FMF
UDI-Device Identifier30382903097020
UDI-Public(01)30382903097020(17)300131(10)5127588
Combination Product (Y/N)N
Initial Reporter StateID
Initial Reporter CountryUS
PMA/510(K) Number
K110771
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 03/06/2026
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 Number309702
Device Lot Number5127588
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 12/24/2025
Supplement Date Received by Manufacturer03/06/2026
Initial Report FDA Received Date01/15/2026
Supplement Report FDA Received Date03/11/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/28/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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