inforMED
MalfunctionFPK

MEDEX 3-WAY STOPCOCK EXTENSION SET

Received Feb 17, 2026 · Event occurred Jun 7, 2025

Report 1526863-2026-00022 · MDR key 24368688

Device

Generic name

Tubing, Fluid Delivery

Catalog number

MX43660

Lot number

NI

Product problems

  • Break
  • Fluid/Blood Leak

Patient

22 YR · Male

  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE LINE REPEATEDLY BROKE, RESULTING IN BLOOD LOSS. THE EVENT OCCURRED DURING INFUSION, MONITORING, AND REQUIRED ADDITIONAL MONITORING AND UNSPECIFIED INTERVENTIONS. THERE WAS PATIENT INVOLVEMENT, BUT NO PATIENT HARM WAS REPORTED.

Additional Manufacturer Narrative

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative

H6: CODES WERE UPDATED. ONE DEVICE WAS RETURNED FOR INVESTIGATION. THE REPORTED COMPLAINT SEPARATION WAS CONFIRMED. DURING VISUAL INSPECTION, THE PRESSURE TUBING WAS RECEIVED SEPARATED FROM THE FEMALE LUER OF THE STOPCOCK. WHEN THE END OF THE TUBING WAS MICROSCOPICALLY EXAMINED, THERE WAS INSUFFICIENT SOLVENT COVERAGE AROUND THE TUBING. THE PROBABLE CAUSE OF THE SEPARATION HAD OCCURRED DUE TO AN ERROR DURING ASSEMBLY A MONTERREY.