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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 381433
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/31/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
G.4.K201075; k251654.B3.The date received by manufacturer has been used for this field.Since no samples displaying the condition reported were available for examination, we were unable to fully investigate this incident.However, the reported defect of needle retraction slow is confirmed since a trend has been identified for the reported failure mode and corrective actions have been initiated to investigate this type of incident and identify the root cause.A device history record review showed no non-conformance's associated with this issue during the production of this batch.Complaints received for this device and reported condition will continue to be tracked and trended.Information will be captured on trend reports and monitored.Our business team regularly reviews the collected data for identification of emerging trends.
 
Event or Problem Description
It was reported that the needle did not retract.Needle does not retract fast enough it slowly falls almost like the spring inside does not function correctly additional information 4/6/2026: i was made aware of this issue 3/6/2026.No patient harm, we took them off the shelf and sent back.
 
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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 Key24834690
Report Number1710034-2026-00391
Device Sequence Number9187323
Product Code FOZ
UDI-Device Identifier00382903814336
UDI-Public(01)00382903814336(10)5008842
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
SEE H.11
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 04/07/2026
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 Number381433
Device Lot Number5008842
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/31/2026
Initial Report FDA Received Date04/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/08/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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