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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 382533
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 02/11/2026
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.E1.Address information was not provided; therefore, (b)(6) was used as the state.
 
Event or Problem Description
Iv catheter retraced prior to pushing white button on iv, rn reported that three bd insyte autoguard bc shielded iv catheters from the same box retracted prior to activation of the safety button during attempted iv insertion.
 
Event or Problem Description
No new information.
 
Additional Manufacturer Narrative
A device history record review was completed by our quality engineer team for provided material number 382533 and lot number 5267705.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.
 
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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 Key24471309
Report Number1710034-2026-00194
Device Sequence Number10126129
Product Code FOZ
UDI-Device Identifier00382903825332
UDI-Public(01)00382903825332(17)280831(10)5267705
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K201075
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 03/05/2026
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 Number382533
Device Lot Number5267705
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 02/11/2026
Supplement Date Received by Manufacturer03/05/2026
Initial Report FDA Received Date02/27/2026
Supplement Report FDA Received Date03/05/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/26/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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