inforMED
MalfunctionGCD

DRAINAGE BAG CONNECTOR CONNECTING TUBE

Received Dec 12, 2024 · Event occurred Dec 6, 2024

Report 1820334-2024-01639 · MDR key 20916002

Device

Generic name

Gcd Connector, Catheter

Manufacturer

Cook Inc

Model number

G02327

Catalog number

CTU14.0-40-ST

Lot number

16292452

Product problems

  • Unsealed Device Packaging
  • Unsealed Device Packaging

Patient

NA · Unknown

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

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE SEAL OF A DRAINAGE BAG CONNECTOR CONNECTING TUBE WAS MISSING. NO DAMAGE TO THE SHIPPING CONTAINER WAS OBSERVED. THE MISSING SEAL WAS DISCOVERED PRIOR TO PATIENT CONTACT.

Additional Manufacturer Narrative

E3 - OCCUPATION: MATERIAL MANAGEMENT, G4 - PMA/510(K) #: EXEMPT. THIS REPORT INCLUDES INFORMATION KNOWN AT THIS TIME. A FOLLOW UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Additional Manufacturer Narrative

BLANK FIELDS ON THIS FORM INDICATE THE INFORMATION IS UNKNOWN OR UNAVAILABLE. CORRECTION: ON 17DEC2024, IT WAS CONFIRMED BY THE CUSTOMER THAT THE DEVICE WITH A MISSING SEAL WAS NOT A COOK DEVICE. THIS EVENT IS NO LONGER REPORTABLE UNDER FDA 21 CFR PART 803 AS IT DOES NOT MEET THE CRITERIA FOR A DEATH, SERIOUS INJURY AND/OR REPORTABLE PRODUCT MALFUNCTION. THERE IS NO ALLEGED MALFUNCTION OF A COOK DEVICE. THIS REPORT INCLUDES INFORMATION KNOWN AT THIS TIME. A FOLLOW UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Description of Event or Problem

THIS EVENT NO LONGER MEETS THE REQUIREMENTS OF A COMPLAINT. SEE H10.