inforMED
MalfunctionOJA

MEDEX EXTENSION SETS MULTI LINE

Received Oct 26, 2023 · Event occurred Oct 18, 2022

Report 3012307300-2023-09940 · MDR key 18015035

Device

Generic name

Intravascular Administration Set

Catalog number

MX618

Product problems

  • Blocked Connection
  • Blocked Connection

Patient

Unknown

  • Insufficient Information
  • Insufficient Information

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE DEVICE WAS BLOCKED. REPORTED LOT NUMBER WAS 430691, BUT THIS NUMBER COULD NOT BE VERIFIED. PATIENT INVOLVEMENT IS UNKNOWN.

Additional Manufacturer Narrative

OTHER TEXT: D4: LOT NUMBER, EXPIRATION DATE, UDI SECTION, G5: 510K AND H4: MANUFACTURE DATE ARE UNKNOWN, NO INFORMATION HAS BEEN PROVIDED TO DATE. NO PRODUCT SAMPLE WAS RECEIVED; THEREFORE, VISUAL AND FUNCTIONAL TESTING COULD NOT BE PERFORMED. THE REPORTED ISSUE COULD NOT BE CONFIRMED. THE PRODUCT'S HISTORY RECORDS WERE REVIEWED AND THERE WERE NO NON-CONFORMANCES NOR SERVICE-RELATED ISSUES THAT WOULD HAVE RESULTED IN THE REPORTED COMPLAINT. IF THE PRODUCT IS RETURNED, THE MANUFACTURER WILL REOPEN THIS COMPLAINT FOR FURTHER INVESTIGATION.