inforMED
MalfunctionOJA

MEDEX EXTENSION SETS MULTI LINE

Received Dec 29, 2022 · Event occurred Nov 8, 2022

Report 3012307300-2022-28303 · MDR key 16074945

Device

Generic name

Intravascular Administration Set

Catalog number

MX618CZ

Lot number

4306091

Product problems

  • Flushing Problem
  • Flushing Problem

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

NO PRODUCT INFORMATION HAS BEEN PROVIDED TO DATE. INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE.

Description of Event or Problem

IT WAS REPORTED THAT THERE WAS A PROBLEM WITH THE CHECK VALVES WHEN TRYING TO FLUSH TWO OF THESE LINES AND ONLY TWO OF THE LUMENS WERE NOT FLUSHABLE, THE THIRD SET WORKED FINE. THE LINE WAS GOING TO BE USED ON A PATIENT HOWEVER THEY FOUND THE LINE WOULDN'T FLUSH SO IT WAS REMOVED BEFORE USE.

Additional Manufacturer Narrative

H6. HEALTH IMPACT AND EVALUATION CODES: UPDATED. NO PRODUCT WAS RETURNED THEREFORE AN INVESTIGATION COULD NOT BE PERFORMED. A DEVICE HISTORY RECORD (DHR) REVIEW SHOWED THERE WERE NO OBSERVATIONS RECORDED DURING THE MANUFACTURING OF THE REPORTED LOT NUMBER. THIS ISSUE WILL CONTINUE TO BE MONITORED AND FURTHER ACTIONS TAKEN ACCORDINGLY. IF THE DEVICE IS RETURNED THE MANUFACTURER WILL RE-OPEN THE INVESTIGATION.