inforMED
MalfunctionFPB

MEDEX MICRO BORE EXTENSION SETS

Received Feb 17, 2022

Report 3012307300-2022-03547 · MDR key 13549589

Device

Generic name

Filter, Infusion Line

Model number

FS116

Catalog number

FS116

Lot number

4068818

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE PICU HAS HAD "7-8+" OCCURRENCES OF CRACKED/LEAKING FILTERS FROM THE SAME LOT, SO 9 FILES CREATED. NO PATIENT INJURY WAS REPORTED.

Additional Manufacturer Narrative

THE DEVICE WAS RETURNED TO SMITHS MEDICAL. A SAMPLE WAS TEST FOR LEAKAGE BY MANUALLY INTRODUCING WATER USING A SYRINGE. THE SAMPLE PRESENT LEAKAGE BY ONE OF THE SIDE OF THE FILTER. IT WAS OBSERVED THAT THE FILTER IS OPEN IN ONE SIDE WHERE SHOULD BE WELDED. IT PRESENT DAMAGED WHICH MAY INDICATE A WRONG HANDLING OF THE PART. DHR REVIEW WAS EXECUTED AND NO DISCREPANCIES WERE OBSERVED DURING THE MANUFACTURING OF REPORTS LOT 4068818. THE LOT USED OF FILTER P1123-07 WAS 6447/20, NO DEFECTS WERE REPORTED ON THIS LOT OF FILTER. COMPLAINT IS CONFIRMED DUE TO SAMPLE RETURN PRESENT LEAKAGE AT FILTER, HOWEVER ROOT CAUSE IS NOT ATTRIBUTABLE TO MANUFACTURING. SUPPLIER NOTIFICATION WAS ISSUED ON (B)(6) 2021 TO SUPPLIER (B)(4).

Additional Manufacturer Narrative

THE DEVICE WAS RETURNED TO SMITHS MEDICAL. A SAMPLE WAS TEST FOR LEAKAGE BY MANUALLY INTRODUCING WATER USING A SYRINGE. THE SAMPLE PRESENT LEAKAGE BY ONE OF THE SIDE OF THE FILTER. IT WAS OBSERVED THAT THE FILTER IS OPEN IN ONE SIDE WHERE SHOULD BE WELDED. IT PRESENT DAMAGED WHICH MAY INDICATE A WRONG HANDLING OF THE PART. DHR REVIEW WAS EXECUTED AND NO DISCREPANCIES WERE OBSERVED DURING THE MANUFACTURING OF REPORTS LOT 4068818. THE LOT USED OF FILTER P1123-07 WAS 6447/20, NO DEFECTS WERE REPORTED ON THIS LOT OF FILTER. COMPLAINT IS CONFIRMED DUE TO SAMPLE RETURN PRESENT LEAKAGE AT FILTER, HOWEVER ROOT CAUSE IS NOT ATTRIBUTABLE TO MANUFACTURING. SUPPLIER NOTIFICATION WAS ISSUED ON (B)(6) 2021 TO SUPPLIER (B)(4).

Description of Event or Problem

IT WAS REPORTED THAT THE PICU HAS HAD "7-8+" OCCURRENCES OF CRACKED/LEAKING FILTERS FROM THE SAME LOT, SO 9 FILES CREATED. NO PATIENT INJURY WAS REPORTED.