PORT ACCESS INSERT OUTPNT
Received Jul 29, 2025 · Event occurred Jun 27, 2025
Report 1417592-2025-00363 · MDR key 22645093
Device
Generic name
Port Access Insert Outpnt
Manufacturer
Medline Industries, LpCatalog number
CVI5190A
Lot number
25ABG414
Product problems
- Break
- Break
Patient
69 YR · Female
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
UPDATE TO D9: SAMPLE NOT RETURNED. UPDATE TO H3: DEVICE NOT EVALUATED. UPDATE TO H6: TYPE OF INVESTIGATION. UPDATE TO H6: INVESTIGATION FINDINGS.
Description of Event or Problem
IT WAS REPORTED THAT ON (B)(6) 2025 WHEN THE PORT WAS BEING FLUSHED IT WAS IDENTIFIED THAT THE "SYRINGE WING WAS BROKEN AND RIPPED THE NURSE'S GLOVE".
Additional Manufacturer Narrative
IT WAS REPORTED THAT ON (B)(6) 2025 WHEN THE PORT WAS BEING FLUSHED IT WAS IDENTIFIED THAT THE "SYRINGE WING WAS BROKEN AND RIPPED THE NURSE'S GLOVE". NO ADDITIONAL DETAILS ARE AVAILABLE RELATED TO THE CUSTOMER REPORTED ISSUE. TO DATE, NO INFORMATION HAS BEEN RECEIVED TO INDICATE THAT A USER OR A PATIENT EXPERIENCED A DEATH, SERIOUS INJURY, MEDICAL INTERVENTION, FOLLOW-UP CARE, OR OTHER ADVERSE HEALTH IMPACT ASSOCIATED WITH THE REPORTED PROBLEM/ISSUE. IN AN ABUNDANCE OF CAUTION, AND IN RESPONSE TO AN FDA 483 ISSUED FOR (B)(6) ON 22-JAN-2024, THIS MEDWATCH IS BEING FILED FOR THE REPORTED PROBLEM/ISSUE. IF ADDITIONAL RELEVANT INFORMATION BECOMES AVAILABLE A SUPPLEMENTAL MEDWATCH WILL BE FILED.