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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® LITHIUM HEPARINN (LH) 95 USP UNITS BLOOD COLLECTION TUBES; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION

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BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® LITHIUM HEPARINN (LH) 95 USP UNITS BLOOD COLLECTION TUBES; TUBES, VIALS, SYSTEMS, SERUM SEPARATORS, BLOOD COLLECTION Back to Search Results
Catalog Number 367886
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 04/02/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Investigation summary: bd received one photo for investigation.The evaluation of the photo confirmed the presence of fm in the tube.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 mode: foreign matter - unknown.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 that prior to using bd vacutainer® lithium heparinn (lh) 95 usp units blood collection tubes, foreign matter was seen inside of one tube.No adverse impact was reported regarding the patient or user.
 
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Brand Name
BD VACUTAINER® LITHIUM HEPARINN (LH) 95 USP UNITS BLOOD COLLECTION TUBES
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 Key25059409
Report Number1917413-2026-00356
Device Sequence Number10101185
Product Code JKA
UDI-Device Identifier30382903678861
UDI-Public(01)30382903678861(17)260731(10)5059121
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K901449
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 04/06/2026
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 Date07/31/2026
Device Catalogue Number367886
Device Lot Number5059121
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 04/02/2026
Initial Report FDA Received Date05/01/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/28/2025
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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