inforMED
MalfunctionGAZ

VISCOUS FLUID CONTROL TUBING SET (SILICONE OIL INJ/EXT)

Received Jun 26, 2024 · Event occurred May 22, 2024

Report 1644019-2024-01365 · MDR key 19616634

Device

Generic name

Tubing, Noninvasive

Model number

NA

Catalog number

8065750957

Lot number

ASKU

Product problems

  • Suction Failure
  • Suction Failure

Patient

NA · Unknown

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

Narrative

Additional Manufacturer Narrative

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. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Description of Event or Problem

THE PHYSICIAN REPORTED THAT PRODUCT DID NOT SUCK AT ALL DURING SILICONE OIL EXTRACTION DURING VITRECTOMY SURGERY. THE SURGERY WAS COMPLETED AFTER REPLACING THE PRODUCT WITH ANOTHER ONE. THERE WAS NO PATIENT HARM.

Additional Manufacturer Narrative

THE LOT COMPLAINT HISTORY AND DEVIATION HISTORY REVIEW (DHR) WERE NOT REVIEWED AS NO LOT INFORMATION WAS AVAILABLE FOR THIS COMPLAINT. THE RETURNED SAMPLE WAS VISUALLY INSPECTED AD NO OBVIOUS DEFECTS WERE CONFIRMED. THE GRAY PLUNGER WAS FOUND AT THE BOTTOM OF THE SYRINGE BARREL. SILICONE OIL WAS OBSERVED ON THE CANNULAS. A CONSOLE, REPRESENTING CURRENT SOFTWARE VERSIONS WAS USED TO TEST THE VISCOUS FLUIDIC CONTROL (VFC) TUBING. THE SYRINGE WAS CONNECTED TO THE ADAPTER AND COULD FULLY ENGAGE. THE SYRINGE SEATED IN THE ADAPTER AND THE CANNULA¿S SEATED ON THE SYRINGE LUER LOCK BARB FIRMLY AND SECURELY. THE LIGHT-EMITTING DIODE (LED) RINGS ON THE CONSOLE TURNED GREEN AS THE GRAY CONNECTOR WAS ENGAGED TO THE CONSOLE INDICATING THE PROPER COMMUNICATION BETWEEN THE CONNECTOR AND THE CONSOLE. THE CANNULA DID NOT POP OFF DURING FUNCTIONAL TESTING. PRESSURE WAS STABLE DURING FUNCTIONAL TESTING. THE PLUNGER IN THE SYRINGE MOVED SMOOTHLY DURING OPERATION. THE ROOT CAUSE OF THE CUSTOMER'S COMPLAINT COULD NOT BE ESTABLISHED SINCE THE RETURNED SAMPLE MET SPECIFICATIONS ALL CONNECTIONS WERE FOUND TO FIT SECURELY. NO CONTRIBUTING FACTORS COULD BE IDENTIFIED THAT COULD CAUSE THE REPORTED COMPLAINT. AFTER THE INVESTIGATION OF THIS COMPLAINT, IT HAS BEEN DETERMINED THAT THIS SAMPLE MET SPECIFICATIONS. THEREFORE, NO ACTION WILL BE TAKEN AT THIS TIME. NO ADVERSE TRENDS HAVE BEEN OBSERVED ASSOCIATED WITH THE REPORTED PRODUCT AND EVENT. QUALITY ASSURANCE WILL CONTINUE TO MONITOR CUSTOMER COMPLAINTS VIA THE COMPLAINT REVIEW MEETINGS, AND WILL TAKE ACTION FOR ANY FUTURE OCCURRENCES AS IS DEEMED NECESSARY. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).