inforMED
MalfunctionFPK

MEDEX 3-WAY STOPCOCK EXTENSION SET

Received Feb 17, 2026 · Event occurred Dec 21, 2025

Report 1526863-2026-00027 · MDR key 24369636

Device

Generic name

Tubing, Fluid Delivery

Catalog number

MX43660

Lot number

NI

Product problems

  • Break
  • Fluid/Blood Leak

Patient

7 YR · Male

  • No Clinical Signs, Symptoms or Conditions

Narrative

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 AND MONITORING AND REQUIRED ADDITIONAL MONITORING AND UNSPECIFIED INTERVENTIONS. THERE WAS PATIENT INVOLVEMENT, BUT NO PATIENT HARM WAS REPORTED.

Additional Manufacturer Narrative

H6: CODES WERE UPDATED. NO DEVICE WAS RECEIVED FOR INVESTIGATION. THEREFORE, THE REPORTED COMPLAINT IS UNABLE TO BE CONFIRMED. IF THE DEVICE IS RECEIVED, THE INVESTIGATION WILL BE RE-OPENED FOR FURTHER EVALUATIONS. A DEVICE HISTORY RECORD (DHR) REVIEW REPORTED NO DISCREPANCIES OR NON-CONFORMANCES DURING THE MANUFACTURING OF THE REPORTED LOT NUMBER.