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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BD MEDICAL (BD WEST) MEDICAL SURGICAL Luer-Lok; Syringe, Piston

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BD MEDICAL (BD WEST) MEDICAL SURGICAL Luer-Lok; Syringe, Piston Back to Search Results
Catalog Number 309653
Medical Device Problem Code Contamination (1120)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/14/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported, syringe 50 ml ll, brown spots on tip of syringe.Occurrence 8.The following was provided by the initial reporter: we have had various 50 ml luer-lock syringes that have had brown spots on them.The brown spots are on the tip and inside of the plunger.
 
Additional Manufacturer Narrative
H.3.A device evaluation and/or device history review is anticipated but is not complete.Upon completion, a supplemental report will be filed.
 
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Brand Name
Luer-Lok
Common Device Name
Syringe, Piston
Manufacturer (Section D)
BD MEDICAL (BD WEST) MEDICAL SURGICAL
1852 10th avenue
columbus NE 68601
Manufacturer (Section G)
BD MEDICAL (BD WEST) MEDICAL SURGICAL
1852 10th avenue
columbus NE 68601
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
+1(847)393-5694
MDR Report Key50854708
Report Number1911916-2026-00506
Device Sequence Number9497733
Product Code FMF
UDI-Device Identifier00382903096534
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
K110771
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 09/18/2026
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 Number309653
Device Lot Number6155014
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 09/15/2026
Initial Report FDA Received Date09/22/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/05/2026
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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