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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 381512
Medical Device Problem Code Product Quality Problem (1506)
Health Effect - Clinical Code Discomfort (2330)
Date of Event 01/29/2026
Type of Reportable Event Malfunction
Event or Problem Description
Inserting 24g bd insyte iv catheter with lot number 5267948 for infusion.Catheter appeared wnl prior to insertion.Upon insertion and blood flash attempted to advance catheter off of needle and felt it "catch" after partial advancement.Patient reported increased discomfort with that.Given the unexpected feel of advancing and patients report of increase discomfort.Decision made to withdraw needle and catheter and start over.Upon removing needle & catheter the catheter was noted to have a plastic" spur sticking out of the side approx 1/3 up the catheter.All pieces of plastic appeared to be present and no pieces were noted to be missing.Second iv attempt made with iv from rn stock with different lot number was successful and proceeded as expected.
 
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.
 
Additional Manufacturer Narrative
A device history record review was completed by our quality engineer team for provided material number 381512 and lot number 5267948.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.Should you again experience any problems with our product we would appreciate the opportunity to conduct a thorough analysis.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 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 Key24279942
Report Number1710034-2026-00111
Device Sequence Number8365560
Product Code FOZ
UDI-Device Identifier00382903815128
UDI-Public(01)00382903815128(11)250924(17)280831(10)5267948
Combination Product (Y/N)N
Initial Reporter StateOR
Initial Reporter CountryUS
PMA/510(K) Number
K201075
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/13/2026
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 Number381512
Device Lot Number5267948
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 01/29/2026
Supplement Date Received by Manufacturer02/13/2026
Initial Report FDA Received Date02/06/2026
Supplement Report FDA Received Date02/13/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/24/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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