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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® CPT¿ CELL PREPARATION TUBE WITH SODIUM HEPARIN; LYMPHOCYTE SEPARATION MEDIUM

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BECTON DICKINSON & CO (FRANKLIN LAKES) BD VACUTAINER® CPT¿ CELL PREPARATION TUBE WITH SODIUM HEPARIN; LYMPHOCYTE SEPARATION MEDIUM Back to Search Results
Catalog Number 362753
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/08/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
E.1.Initial reporter facility name: (b)(6).Investigation summary: bd did not receive any samples or photos for investigation.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 not been confirmed for the indicated failure mode: glass breakage.Bd was not able to identify a root cause for the indicated failure mode.Complaints received for this device and reported condition will continue to be tracked and trended.Our business team regularly reviews the collected data for the identification of emerging trends.
 
Event or Problem Description
It was reported after using bd vacutainer® cpt¿ cell preparation tube with sodium heparin, one (1) tube broke inside the centrifuge.No adverse impact was reported regarding the patient or user.
 
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Brand Name
BD VACUTAINER® CPT¿ CELL PREPARATION TUBE WITH SODIUM HEPARIN
Common Device Name
LYMPHOCYTE SEPARATION MEDIUM
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 Key25086643
Report Number1917413-2026-00374
Device Sequence Number13405281
Product Code JCF
UDI-Device Identifier30382903627531
UDI-Public(01)30382903627531(11)251114(17)261130(10)5318137
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
NA
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) 04/09/2026
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 Catalogue Number362753
Device Lot Number5318137
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 04/08/2026
Initial Report FDA Received Date05/05/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/14/2025
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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