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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 381423
Medical Device Problem Code Material Puncture/Hole (1504)
Health Effect - Clinical Code Pain (1994)
Date of Event 02/28/2026
Type of Reportable Event Malfunction
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 through catheter with lot 5329175 regarding item #381423.Device history record for batch number 5329175 has been reviewed.No related quality issues or process deviations were found during the manufacture of the subassembly lots and packaging line.A review of the applicable risk documents indicates that the potential risk of the reported event was assessed appropriately in the risk management documentation.
 
Event or Problem Description
No additional information.
 
Event or Problem Description
It was reported that the needle pierced the catheter.Injuries or adverse event: no."patient complained of pain when rn was starting patient iv.Rn removed iv and found that the needle was sticking out of the side of the catheter instead of out of the end.".
 
Additional Manufacturer Narrative
G.4.K201075; k251654.
 
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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 Key24931840
Report Number1710034-2026-00435
Device Sequence Number16134222
Product Code FOZ
UDI-Device Identifier00382903814237
UDI-Public(01)00382903814237(10)5329175
Combination Product (Y/N)N
Initial Reporter StateCO
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
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 05/05/2026
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 Number381423
Device Lot Number5329175
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/09/2026
Supplement Date Received by Manufacturer05/05/2026
Initial Report FDA Received Date04/20/2026
Supplement Report FDA Received Date05/06/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/26/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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