inforMED
MalfunctionDXT

BASIXCOMPAK¿

Received May 20, 2025 · Event occurred Apr 24, 2025

Report 3011642792-2025-00086 · MDR key 22055282

Device

Generic name

Injector And Syringe, Angiographic

Catalog number

IN4130/JPH

Lot number

I3098958

Product problems

  • Mechanical Problem
  • Device Dislodged or Dislocated
  • Unintended Movement
  • Mechanical Problem
  • Device Dislodged or Dislocated
  • Unintended Movement

Patient

NA · Unknown

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

Narrative

Description of Event or Problem

THE ACCOUNT ALLEGES THAT UPON INFLATING AND DEFLATING THE STENOSIS WITHIN THE PATIENT WITH THE DEVICE, THE ENTIRE PLUNGER CAME OUT. ANOTHER DEVICE WAS USED TO COMPLETE THE PROCEDURE.

Additional Manufacturer Narrative

THE SUSPECT DEVICE HAS BEEN RETURNED FOR EVALUATION. A FOLLOW UP WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Additional Manufacturer Narrative

THE SUSPECT DEVICE WAS RETURNED FOR EVALUATION. THE COMPLAINT WAS CONFIRMED. THE ROOT CAUSE IS ATTRIBUTED TO THE MANUFACTURING PROCESS. A SEARCH OF THE COMPLAINT DATABASE WAS PERFORMED AND 1 SIMILAR COMPLAINT FOR THIS LOT NUMBER WAS FOUND. THE DEVICE HISTORY RECORD WAS REVIEWED, AND NO EXCEPTION DOCUMENTS WERE FOUND.