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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON INDUSTRIAS CIRURGICAS, LTDA. INSYTE AUTOGUARD; PERIPHERAL IV CATHETERS

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BECTON DICKINSON INDUSTRIAS CIRURGICAS, LTDA. INSYTE AUTOGUARD; PERIPHERAL IV CATHETERS Back to Search Results
Catalog Number 38183414
Medical Device Problem Code Material Perforation (2205)
Health Effect - Clinical Code Perforation of Vessels (2135)
Date of Event 12/23/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the attempt at peripheral venous puncture, it was observed that two intravenous catheters, both with safety devices, had bent tips at the moment of insertion, with opening/collapse of the cannula, which resulted in injury and rupture of the vein used during the procedure, making it impossible to continue the puncture.
 
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.E1.All demographic information on the regulatory document states "confidential".
 
Additional Manufacturer Narrative
A device history record review was completed by our quality engineer team for provided material number 38183414 and lot number 5126230.The review did not reveal any detected abnormalities during the production process that could have contributed to the reported issue, 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 similar issues 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.Our quality team regularly reviews the collected data for identification of emerging trends.
 
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 INDUSTRIAS CIRURGICAS, LTDA.
ave. pres.juscelino kubitschek
273 francisco bernardino
juiz de fora
BR 
Manufacturer (Section G)
BECTON DICKINSON INFUSION THERAPY SYSTEMS INC.
9450 south state street
273 francisco bernardino
sandy UT 84070
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key24226010
Report Number9610048-2026-00016
Device Sequence Number9366567
Product Code FOZ
UDI-Device Identifier00382903059164
UDI-Public(01)00382903059164(11)250506(17)300430(10)5126230
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K201075
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/17/2026
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 Number38183414
Device Lot Number5126230
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 01/26/2026
Supplement Date Received by Manufacturer02/17/2026
Initial Report FDA Received Date01/30/2026
Supplement Report FDA Received Date02/17/2026
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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