MAUDE Adverse Event Report: BECTON DICKINSON SHARPS COLL 2GAL PEARL; HYPODERMIC SINGLE LUMEN NEEDLE

Catalog Number	305422
Medical Device Problem Code	Component Missing (2306)
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	07/16/2019
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The manufacturing location for this product is flextronics.This site is an oem manufacturing site.Therefore, bd corporate headquarters in (b)(4) has been listed and the (b)(4) fda registration number has been used for the manufacture report number.Device expiration date: n/a.A device evaluation is anticipated, but has not yet begun.Upon completion of the investigation, a supplemental report will be filed.
Event or Problem Description
Material no: 305422, batch no: 9112926.It was reported that before use of the sharps coll 2gal pearl the sharps containers were received with the incorrect lids.There were ten sharps containers that had the wrong lid.The following information was provided by the initial reporter: "the 305422 (2g sharps containers) arrive with different tops that do not fit the bd wall cabinets.".
Additional Manufacturer Narrative
H.6.Investigation: the actual product was returned, and photo representation was provided.A review of the dhr showed there were no issues reported like incorrect lids during the manufacturing process.A review of the nonconformance material reports was performed and the result showed there were no issues reported for the same part number throughout the last twelve months.According to the evidence provided, the issue seems to be related to an incorrect subassembly (box of lids) supplied, which is a manufacturing issue.The corrective action will be documented under supplier capa record car-jrz-00000174 h3 other text : see h.10.
Event or Problem Description
Material no: 305422, batch no: 9112926.It was reported that before use of the sharps coll 2gal pearl the sharps containers were received with the incorrect lids.There were ten sharps containers that had the wrong lid.The following information was provided by the initial reporter: "the 305422 (2g sharps containers) arrive with different tops that do not fit the bd wall cabinets.".

• Brand Name: SHARPS COLL 2GAL PEARL
• Common Device Name: HYPODERMIC SINGLE LUMEN NEEDLE
• Manufacturer (Section D): BECTON DICKINSON; 1 becton drive; franklin lakes NJ 07417
• MDR Report Key: 8855250
• Report Number: 2243072-2019-01573
• Device Sequence Number: 13929153
• Product Code: FMI
• UDI-Device Identifier: 50382903054225
• UDI-Public: 50382903054225
• Combination Product (Y/N): N
• Initial Reporter State: MS
• Initial Reporter Country: US
• PMA/510(K) Number: K943141
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: other,user facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 09/12/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Operator of Device: Other
• Device Catalogue Number: 305422
• Device Lot Number: 9112926
• Initial Date Received by Manufacturer: 07/19/2019
• Supplement Date Received by Manufacturer: 07/19/2019
• Initial Report FDA Received Date: 08/02/2019
• Supplement Report FDA Received Date: 09/12/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other