inforMED
MalfunctionKSS

GPS III MINI KIT W/30ML ACDA

Received Sep 15, 2020 · Event occurred Aug 27, 2020

Report 0001825034-2020-03488 · MDR key 10535189

Device

Generic name

Biologics

Model number

N/A

Catalog number

800-0505A

Lot number

802656

Product problems

  • Output Problem
  • Output Problem

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

(B)(4). (UDI): N/A. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS IT WAS DISCARDED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED FOLLOWING PATIENT CAME IN TO AN OUT PATIENT URGENT CARE FOR TREATMENT. THE EVENT HAPPENED DURING THIS APPOINTMENT. THE GPS III MINI TECHNIQUE, OBTAIN THE BLOOD WITH ACDA SPINNING DOWN WITH THE APPROPRIATELY FILLED COUNTER BOI IN PLACE, THERE WAS A SMALL CLOT AND THE SEPARATION FAILED. THE DOCTOR WAS LEFT WITH 16ML DRAW. NO ADDITIONAL INFORMATION.

Additional Manufacturer Narrative

(B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.