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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 Code Retraction Problem (1536)
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.Iv needle slow to retract, only fully retracted once removed after insertion.Lot #6020809 bd insyte autoguard bc.The needle not retracting poses a safety risk to the user.No patient harm noted.
 
Additional Manufacturer Narrative
G.4.K201075; k251654.
 
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 2nd related complaint reported with the defect/condition of needle retraction slow 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 documentes 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 Key24957647
Report Number1710034-2026-00454
Device Sequence Number12114034
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) 05/07/2026
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 Number382533
Device Lot Number6020809
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/14/2026
Supplement Date Received by Manufacturer05/07/2026
Initial Report FDA Received Date04/22/2026
Supplement Report FDA Received Date05/11/2026
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 Age80 YR
Patient SexFemale
Patient RaceWhite
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