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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 09/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported, syringe 50 ml ll, contamination.The following was provided by the initial reporter: i have been notified of 2 more of the 50ml bd syringes that are contaminated.
 
Additional Manufacturer Narrative
B3.The actual date of event is unknown.The date received by manufacturer was entered into the date of event field.H.3.A device evaluation and/or device history review is anticipated but is not complete.Upon completion, a supplemental report will be filed.
 
Additional Manufacturer Narrative
(b)(4) follow up it was reported there were two more of the 50ml syringes that are contaminated.Due to the absence of a physical sample, photographic evidence, or lot number, our quality engineering team was unable to conduct a comprehensive investigation.Current quality controls are in place to identify such defects during the production process.Based on the limited investigation, the cause of the reported incident remains undetermined.If you encounter any further issues with our product, we would appreciate the opportunity to perform a thorough analysis.Examination of the involved product may provide insights into the cause of the reported failure.Complaints regarding this device and the reported condition will continue to be monitored and analyzed.Our quality team regularly reviews collected data to identify emerging trends.
 
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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 Key50915174
Report Number1911916-2026-00519
Device Sequence Number17580804
Product Code FMF
UDI-Device Identifier00382903096534
UDI-Public(01)00382903096534
Combination Product (Y/N)N
Initial Reporter StateCO
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,Followup
Report Date (Section B) 10/01/2026
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 NumberUnknown
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/09/2026
Supplement Date Received by Manufacturer10/01/2026
Initial Report FDA Received Date09/28/2026
Supplement Report FDA Received Date10/02/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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