inforMED
MalfunctionDXT

BASIXCOMPAK¿

Received May 20, 2025 · Event occurred Apr 28, 2025

Report 3011642792-2025-00092 · MDR key 22055293

Device

Generic name

Injector And Syringe, Angiographic

Catalog number

IN4802/K

Lot number

I3085679

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

Additional Manufacturer Narrative

THE SUSPECT DEVICE WAS RETURNED FOR EVALUATION. THE COMPLAINT WAS CONFIRMED. THE ROOT CAUSE IS LIKELY DUE TO A MISSING ADHESIVE APPLICATION, PERFORMED BY THE OPERATORS. 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 HAS BEEN RETURNED FOR EVALUATION. A FOLLOW UP WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Description of Event or Problem

THE ACCOUNT ALLEGES THAT DURING USE THE INFLATION DEVICE FELL APART. ANOTHER DEVICE WAS USED TO COMPLETE THE PROCEDURE.