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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 382523
Medical Device Problem Code Material Integrity Problem (2978)
Health Effect - Clinical Code Pain (1994)
Date of Event 06/04/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
G.4.K201075; k251654.E1.Address information was not provided; therefore, il was used as the state.A device history record review was completed by our quality engineer team for provided material number 382523 and lot number 6037963.The review did not reveal any detected abnormalities during the production process that could have contributed to this defect, and all quality tests were found to be within specification.As a sample was unavailable for return, a thorough sample investigation could not be completed.Based on the investigation results, an exact cause for this incident could not be identified.There are quality controls currently in place to detect this type of defect during the production process.Further action has not been determined necessary at this time.Complaints received for this device and reported condition will continue to be tracked and trended.Our quality team regularly reviews the collected data for identification of emerging trends.
 
Event or Problem Description
It was reported that bd insyte autog bc feels flimsy.Verbatim: needles aren¿t sharp and requires more force while inserting which causes pain to the patient.Catheter does not thread well, feels very flimsy.Machine pressures out while injecting.
 
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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 Key25598897
Report Number1710034-2026-00705
Device Sequence Number12113867
Product Code FOZ
UDI-Device Identifier00382903825233
UDI-Public(01)00382903825233(17)290131(10)6037963
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 Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 06/11/2026
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 Number382523
Device Lot Number6037963
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/04/2026
Initial Report FDA Received Date06/23/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/11/2026
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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