inforMED
MalfunctionCBT

ATELLICA VTR SYRINGES

Received Mar 7, 2025

Report 2028807-2025-00003 · MDR key 21551954

Device

Generic name

3ml Vented, Luer Lock Syringe, Balanced Heparin, Vented Tip Cap,

Manufacturer

Westmed Llc

Model number

11561350

Catalog number

NA

Lot number

456820

Product problems

  • Failure to Seal
  • Failure to Seal

Patient

NA · Unknown

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

Narrative

Additional Manufacturer Narrative

THE PRODUCT INVOLVED IN THE REPORT HAS NOT BEEN RETURNED FOR EVALUATION. A REVIEW OF THE DEVICE HISTORY RECORD IS IN-PROGRESS. ALL INFORMATION REASONABLY KNOWN AS OF 07 MAR 2025 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY SUN MED HOLDINGS LLC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO SUN MED HOLDINGS LLC. SUN MED HOLDINGS LLC. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE SUN MED HOLDINGS COMPLAINT DATABASE AND IDENTIFIED AS (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN SUN MED HOLDINGS LLC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Description of Event or Problem

SUNMED HOLDINGS LLC. RECEIVED A SINGLE REPORT THAT REFERENCED THREE DIFFERENT INCIDENCES, WHICH WERE ASSOCIATED WITH SEPARATE UNITS, INVOLVING THREE DIFFERENT PATIENTS. THIS IS THE SECOND OF THREE REPORTS. REFER TO 2028807-2025-00002 FOR THE FIRST REPORT, REFER TO 2028807-2025-00004 FOR THE THIRD REPORT. IT WAS REPORTED, THE SYRINGES WERE UNABLE TO ADEQUATELY RETAIN ARTERIAL BLOOD, DUE TO POOR SEALING OF THE PLUNGER WHICH RESULTED IN: BLOOD LOSS THROUGH THE PLUNGER; THE EFFICIENCY OF COLLECTIONS; DIFFICULTY IN CARRYING OUT ARTERIAL BLOOD SAMPLING, BLOOD LEAKING ONTO SURFACES AND INTO THE ENVIRONMENT. THERE WAS NO REPORTED INJURY.