inforMED
MalfunctionFGY

PLASTIC CANNULA HOLDEX STERILE

Received Jul 29, 2020 · Event occurred Jun 2, 2020

Report 8020040-2020-00001 · MDR key 10340938

Device

Generic name

Introduction/drainage Catheter And Accessories

Model number

450216

Catalog number

450216

Lot number

A19073FK

Product problems

  • Fluid/Blood Leak

Patient

Not reported

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

(GBO COMPLAINT NUMBER:(B)(4). DETAILS OF CLAIM: WE HAVE NO FURTHER COMPLAINTS ON THE MATERIAL/BATCH. WE HAVE NO FURTHER INVENTORY OF THE MATERIAL/BATCH. BASED ON THE COMPLAINT AND INVESTIGATION REPORT, CUSTOMER SAMPLES AND PICTURES OF THE ACTUAL DEVICE REQUESTED. WE RECEIVED 64PCS OF 450216/A19073FK FOR EVALUATION. THE COMPLAINT IS CONFIRMED AND RECALL WILL BE INITIATED. (RECALL NUMBER 20-220).

Description of Event or Problem

"CUSTOMER STATE THAT SAMPLE BEGAN LEAKING FROM THE SLEEVE COVERING THE NEEDLE INSIDE THE CANNULA AFTER SAMPLE TUBES WERE COLLECTED."

Remedial action

  • Recall