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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARIN 56 UNITS; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION

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BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARIN 56 UNITS; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION Back to Search Results
Catalog Number 367960
Medical Device Problem Code Device Contamination with Chemical or Other Material (2944)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/17/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
There were multiple 510k numbers reported to be involved.The information is as follows: g.4.Pma / 510(k)#: k954592.Investigation summary: bd received a photo for investigation.The photo shows foreign matter in tube, but there is no air bubbles in gel.In addition, 100 retained samples were visually inspected, with one sample containing an air bubble.The defect rate is within specification limits, so no further action is required.Based on a review of the device history record for the incident lot, all product specifications and requirements for lot release were met.This complaint has been confirmed for the indicated failure modes: foreign matter - non-biological and gel airbubbles.No definitive root cause could be established for the reported defect.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 the identification of emerging trends.
 
Event or Problem Description
It was reported prior to using bd vacutainer® pst¿ gel and lithium heparin 56 units, foreign matter was found in 154 tubes and there was 476 tubes with air bubbles.No adverse impact was reported regarding the patient or user.
 
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Brand Name
BD VACUTAINER® PST¿ GEL AND LITHIUM HEPARIN 56 UNITS
Common Device Name
TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION
Manufacturer (Section D)
BECTON DICKINSON & CO (FRANKLIN LAKES)
1 becton drive
franklin lakes NJ 07417
Manufacturer (Section G)
BECTON, DICKINSON & CO. (BROKEN BOW)
150 south 1st avenue
broken bow NE 68822
Manufacturer Contact
anand singh
1 becton drive
franklin lakes, NJ 07417
2018475186
MDR Report Key24866838
Report Number1917413-2026-00282
Device Sequence Number18483646
Product Code JKA
UDI-Device Identifier30382903679608
UDI-Public(01)30382903679608(17)260831(10)5225554
Combination Product (Y/N)N
Initial Reporter CountryTW
PMA/510(K) Number
K945952
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 03/19/2026
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 Other
Device Expiration Date08/31/2026
Device Catalogue Number367960
Device Lot Number5225554
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 03/17/2026
Initial Report FDA Received Date04/13/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/01/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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