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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 382512
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/04/2026
Type of Reportable Event Malfunction
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.E1.Address information was not provided; therefore, il was used as the state.
 
Event or Problem Description
Bd instyle autoguard bc needle failed to retract after nurse used it on patient.Infusion center manager and charge nurse randomly selected another from the same lot and the retractor stuck again, but with additional pressing finally retracted.All needles with this lot# were pulled from the floor and backstock.
 
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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 Key25319982
Report Number1710034-2026-00559
Device Sequence Number5267593
Product Code FOZ
UDI-Device Identifier00382903825127
UDI-Public(01)00382903825127(17)281031(10)6022552
Combination Product (Y/N)N
Initial Reporter StateIL
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,User Facility
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/04/2026
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 Number382512
Device Lot Number6022552
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/08/2026
Supplement Date Received by ManufacturerNot provided
Not provided
Initial Report FDA Received Date05/28/2026
Supplement Report FDA Received Date05/29/2026
06/04/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/22/2026
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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