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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 Codes Retraction Problem (1536); Activation Problem (4042)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the needle did not retract."bd insyte autoguard bc iv needle did not retract upon insertion.Needle was carefully removed and when needle was completely free, retracted by itself.It did not affect plastic catheter, blow vein, injure patient.Although there was no harm noted to the patient, the needle had to be manually retracted and thus there was a risk for injury to the user/nurse inserting the iv.We have identified a trend with this issue/lot number lot 6020809".
 
Additional Manufacturer Narrative
G.4.K201075; k251654 h.3.A follow up mdr will be submitted if additional information, a device evaluation, or a device history review is completed.
 
Additional Manufacturer Narrative
Additional information: h.Attached medwatch.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 shielding failure with lot 6020809 regarding item #382533.Device history record for final lot number 6020809 has been reviewed.No related quality issues or process deviations were found for the subassembly or final lot numbers.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.
 
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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 Key24955887
Report Number1710034-2026-00452
Device Sequence Number10093293
Product Code FOZ
UDI-Device Identifier00382903825332
UDI-Public(01)00382903825332(17)281231(10)6020809
Combination Product (Y/N)N
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
SEE H.11
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Risk Manager
Type of Report Initial,Followup
Report Date (Section B) 05/08/2026
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 Number6020809
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/13/2026
Supplement Date Received by Manufacturer05/08/2026
Initial Report FDA Received Date04/22/2026
Supplement Report FDA Received Date05/12/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/21/2026
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient Age51 YR
Patient SexMale
Patient RaceWhite
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