inforMED
MalfunctionFPK

MEDEX 3-WAY STOPCOCK EXTENSION SET

Received Feb 17, 2026 · Event occurred Sep 14, 2025

Report 1526863-2026-00024 · MDR key 24369022

Device

Generic name

Tubing, Fluid Delivery

Catalog number

MX43660

Lot number

NI

Product problems

  • Break
  • Fluid/Blood Leak

Patient

13 YR · Male

  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

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

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.

Description of Event or Problem

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