HUDSON RCI
Received Dec 1, 2025 · Event occurred Nov 1, 2025
Report 1417592-2025-00669 · MDR key 23687083
Device
Generic name
Adapter,universal,cuff,22mm Id
Manufacturer
Medline Industries, LpCatalog number
HUD1421
Lot number
74A2301511
Product problems
- Crack
- Crack
Patient
21 MO · Male
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
ACCORDING TO THE CUSTOMER, THE ADAPTOR CRACKED DURING USE WHILE THE PATIENT WAS "MOVING". THE CUSTOMER REPORTED THAT AFTER THE INCIDENT OCCURRED THERE WAS A "LARGE LEAK IN SYSTEM" REQUIRING THE ADAPTOR TO BE CHANGED "URGENTLY". THE CUSTOMER REPORTED THAT THE PATIENT IS "STABLE" AND THERE WAS NO MEDICAL TREATMENT REQUIRED. THE CUSTOMER REPORTED DID NOT REPORT ANY SERIOUS INJURY RELATED TO THE REPORTED INCIDENT. NO ADDITIONAL DETAILS ARE AVAILABLE RELATED TO THE CUSTOMER REPORTED ISSUE. IT HAS BEEN DETERMINED THAT THE REPORTED EVENT COULD CAUSE OR CONTRIBUTE TO SERIOUS INJURY IF IT WERE TO OCCUR AGAIN. IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED OR OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.
Description of Event or Problem
ACCORDING TO THE CUSTOMER, THE ADAPTOR CRACKED DURING USE WHILE THE PATIENT WAS "MOVING".