inforMED
MalfunctionPWH

CADD INFUSION DISPOSABLES PORTFOLIO WITH NRFIT

Received Jun 2, 2023 · Event occurred Apr 5, 2022

Report 3012307300-2023-05994 · MDR key 17054433

Device

Generic name

Administrations Sets With Neuraxial Connectors

Model number

21-7309-24

Catalog number

21-7309-24

Lot number

4084915

Product problems

  • Leak/Splash
  • Leak/Splash

Patient

Unknown

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

Narrative

Description of Event or Problem

IT WAS REPORTED THAT MOISTURE WAS DISCOVERED IN THE BAG, AFTER FILLING CASSETTE AND PACKING INSIDE THE BAG. UPON INSPECTION, IT TURNED OUT THAT THERE WAS A LEAK. NO PATIENT INJURY WAS REPORTED.

Additional Manufacturer Narrative

THIS REMEDIATION MDR WAS GENERATED UNDER PROTOCOL B10010116, AS A RESULT OF WARNING LETTER CMS# (B)(4). NO PROBLEMS OR ISSUES WERE IDENTIFIED DURING THE DEVICE HISTORY RECORD REVIEW. TWO SAMPLES WERE RECEIVED WITHOUT THEIR ORIGINAL PACKAGING, INSIDE A PLASTIC BAG. DURING THE VISUAL INSPECTION, THE SAMPLES DID NOT PRESENT ANY DAMAGE, SCUFFS, PINCH MARKS, CRACKS, CRAZING, CUTS, ETC. THAT COULD CAUSE THE FAILURE MODE REPORTED, HOWEVER SOME COMPONENTS ARE MISSING, THE BLUE CLIP, THE SPRING, AND THE GREEN ARM. SINCE THERE WERE MISSING COMPONENTS IN THE SAMPLES RETURNED NO FUNCTIONAL TEST CAN BE PERFORMED. THE ROOT CAUSE COULD NOT BE DETERMINED SINCE THE SAMPLES WERE RECEIVED WITH MISSING COMPONENTS AND LOOKED LIKE THEY WERE MANIPULATED DURING USE. NO ACTIONS TAKEN SINCE THE COMPLAINT COULD NOT BE REPLICATED.