MAUDE Adverse Event Report: Becton Dickinson & CO (Franklin Lakes) BD Vacutainer® UltraTouch¿ Push Button Blood Collection Set; Set, administration, intravascular

Catalog Number	367364
Medical Device Problem Code	Fluid/Blood Leak (1250)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/29/2026
Type of Reportable Event	Malfunction
Event or Problem Description
Report 2 of 2 it was reported that when using the bd vacutainer® ultratouch¿ push button blood collection set, one (1) unit exhibited blood leakage due to a crack in the connector.No adverse impact was reported regarding the patient or user.
Additional Manufacturer Narrative
E.1.Initial reporter facility name: (b)(6) there were multiple medical device types reported to be involved.The information for the additional device type is as follows.D.2.A medical device type: jka.D.2.B common device name: tubes, vials, systems, serum separators, blood collection.Investigation summary: bd received 8 photos for review.Evaluation of the provided photos indicated a split female luer adapter.Additionally, 10 retained samples were visually inspected, and no split female luer adapters were found.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 been confirmed for the indicated failure mode: damaged.Bd has initiated corrective and preventive action to address the reported issue.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.

• Brand Name: BD Vacutainer® UltraTouch¿ Push Button Blood Collection Set
• Common Device Name: Set, administration, intravascular
• Manufacturer (Section D): Becton Dickinson & CO (Franklin Lakes); 1 becton drive; franklin lakes NJ 07417
• Manufacturer (Section G): BECTON, DICKINSON AND COMPANY (BD); belliver way; belliver industrial estate; plymouth ; UK
• Manufacturer Contact: anand singh ; 1 becton drive; franklin lakes, NJ 07417 ; +1(201)847-5186
• MDR Report Key: 50914944
• Report Number: 9617032-2026-01714
• Device Sequence Number: 20169629
• Product Code: FPA
• UDI-Device Identifier: 30382903673644
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K212724
• Number of Events Summarized: 1
• 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): 09/09/2026

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 Number: 367364
• Device Lot Number: 6146270
• 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: 08/31/2026
• Initial Report FDA Received Date: 09/28/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 05/26/2026
• 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 Number: 1
• Patient Sex: Unknown