inforMED
InjuryPXU

PERICARDIOCENTESIS KIT

Received Mar 25, 2025 · Event occurred Mar 18, 2025

Report 1125782-2025-00003 · MDR key 21694165

Device

Generic name

Fluid Drainage Tray

Catalog number

PC101/JPB

Lot number

T3088168

Product problems

  • Fracture
  • Material Integrity Problem
  • Fracture
  • Material Integrity Problem

Patient

NA · Unknown

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

Narrative

Additional Manufacturer Narrative

THE SUSPECT DEVICE WAS RETURNED FOR EVALUATION. THE COMPLAINT WAS CONFIRMED. THE CATHETER SHAFT HAD SEPARATED FROM THE STRAIN RELIEF, BUT THE CATHETER TIP WAS FOUND TO BE INTACT ON THE CATHETER BODY. THE SEPARATION OCCURRED TO MISALIGNMENT OF THE CATHETER PARTS DURING MOLDING. A SEARCH OF THE COMPLAINT DATABASE WAS PERFORMED AND NO SIMILAR COMPLAINTS FOR THIS LOT NUMBER WERE FOUND. THE DEVICE HISTORY RECORD WAS REVIEWED, AND NO EXCEPTION DOCUMENTS WERE FOUND.

Additional Manufacturer Narrative

THE SUSPECT DEVICE IS EXPECTED TO RETURN FOR EVALUATION. A FOLLOW UP WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Description of Event or Problem

THE ACCOUNT ALLEGES THAT THE CATHETER DETACHED FROM THE JUNCTION WITHIN THE PATIENT. THE TIP WAS RETRIEVED.