BD? DEHP FREE INFUSION SET 590502

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-04 for BD? DEHP FREE INFUSION SET 590502 manufactured by Becton Dickinson.

Event Text Entries

[110576544] The manufacturing location for this product is (b)(4). 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. Investigation results: summary: one sample was returned to (b)(4) , lot number 2707261, (b)(4) checked the sample and found there was hair between y-connector body and shrinking film. House sample inspection: (b)(4) inspected 15 pcs of house sample for lot 2707261, no foreign matter was found on the samples. Device history record review: (b)(4) checked manufacturing records including receiving inspection report, process inspection report and finished product test report for lot 2707261, no abnormality was observed. (b)(4) complaint record review: (b)(4) reviewed customer complaint record and there is no repeated same issue from other customer. Y connector assembly process - (b)(4) investigation the process flow of y connector, and found the fm (hair) between y-connector body and shrinking film would have occurred in the manual assembly process of shrinking film with y-connector body & rubber cap. Root cause: the foreign matter of the complaint sample, hair, most likely occurred in the manual assembly process of shrinking film with y-connector body & rubber cap. (b)(4) investigated and concluded that due to insufficient cleanroom protocol cleanliness / dressing standards, production workers in the assembly line might have induced foreign matter (hair) into the products unknowingly. (b)(4) have also reviewed receiving inspection report and i. V set manufacturing process about this case but, there was no abnormal issue. Corrective actions: (b)(4) had quality training on this customer complaint for i. V set assembly line workers and quality inspectors. (b)(4) implement tightened product & process monitoring and strengthening quality inspection for y-connector inspection and i. V set process inspection. (b)(4) conduct cleaning manufacturing line, inspection table and assembly table 3 time a day, before start work, before lunch and after finish work, according to working place clean procedure. (b)(4) enhance cleanroom clothes regulation for all workers (anti-dust inner cap with anti-dust cap) to prevent fm(hair) in the i. V set assembly process. The inner cap could catch hair inside the cap so, hair drop could be prevented.
Patient Sequence No: 1, Text Type: N, H10


[110576545] It was reported that foreign matter "hair" was found in a bd? Dehp free infusion set, specifically in the gap between y-port connections. There was no report of exposure, serious injury, or medical intervention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2243072-2018-00317
MDR Report Key7566665
Date Received2018-06-04
Date of Report2018-06-01
Date of Event2018-05-10
Date Mfgr Received2018-05-10
Device Manufacturer Date2017-08-09
Date Added to Maude2018-06-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactBDX BRETT WILKO
Manufacturer Street9450 SOUTH STATE STREET
Manufacturer CitySANDY UT 84070
Manufacturer CountryUS
Manufacturer Postal84070
Manufacturer Phone8015652845
Manufacturer G1BECTON DICKINSON
Manufacturer Street1 BECTON DRIVE
Manufacturer CityFRANKLIN LAKES NJ 07417
Manufacturer CountryUS
Manufacturer Postal Code07417
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBD? DEHP FREE INFUSION SET
Generic NameIV TUBING
Product CodeFPK
Date Received2018-06-04
Returned To Mfg2018-05-14
Catalog Number590502
Lot Number2707261
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBECTON DICKINSON
Manufacturer Address1 BECTON DRIVE FRANKLIN LAKES NJ 07417 US 07417


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-06-04

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