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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 381834
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/20/2026
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.
 
Event or Problem Description
It was reported that ¿upon completion of the vvp insertion, the canula did not retract fully (approximately 1 cm remained protruding).I tried pressing the button again to retract the canula, but it would not retract any further.¿ the patient did not suffer any harm.The user did not suffer any harm; however, she nearly pricked herself with the canula used and could have had a blood exposure incident.Indeed, the canula is normally retracted after applying the kt.
 
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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 Key25533373
Report Number1710034-2026-00655
Device Sequence Number13197636
Product Code FOZ
UDI-Device Identifier00382903818341
UDI-Public(01)00382903818341(10)5232708
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
SEE H.11
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 06/26/2026
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 Number381834
Device Lot Number5232708
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 05/27/2026
Supplement Date Received by Manufacturer06/26/2026
Initial Report FDA Received Date06/17/2026
Supplement Report FDA Received Date06/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/20/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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