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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 381023
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code Needle Stick/Puncture (2462)
Date of Event 02/10/2026
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.
 
Event or Problem Description
It was reported that the nurse was accidentally pricked because the needle did not fully retract.Once the device (needle cannula) was positioned and the button to retract the needle was pressed, the nurse was accidentally pricked because the needle did not fully retract and about 1 cm of the tip remained exposed.
 
Event or Problem Description
No additional information.
 
Additional Manufacturer Narrative
Investigation summary: the reported defect could not be refuted nor confirmed in the absence of a sample.The root cause cannot be determined for an unconfirmed defect.A complaint history check was performed, and this is the 1st related complaint reported with the defect/condition of needle retraction failure with lot 5133217 regarding item #381023.Dhr for final lot number 5133217 has been reviewed.No quality issues or process deviations were found.A review of the applicable risk documents indicates that the potential risk of the reported event was assessed appropriately in the risk management documentation.
 
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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 Key24713028
Report Number1710034-2026-00330
Device Sequence Number5677084
Product Code FOZ
UDI-Device Identifier00382903810239
UDI-Public(01)00382903810239(11)250515(17)280430(10)5133217
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K251654
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/16/2026
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 Number381023
Device Lot Number5133217
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/02/2026
Supplement Date Received by Manufacturer04/16/2026
Initial Report FDA Received Date03/30/2026
Supplement Report FDA Received Date04/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/15/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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