inforMED
MalfunctionFPK

MEDEX 3-WAY STOPCOCK EXTENSION SET

Received Feb 17, 2026 · Event occurred Dec 27, 2025

Report 1526863-2026-00030 · MDR key 24370009

Device

Generic name

Tubing, Fluid Delivery

Catalog number

MX43660

Lot number

NI

Product problems

  • Break
  • Fluid/Blood Leak

Patient

4 YR · Male

  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE LINE KEPT BREAKING AND RESULTED IN BLOOD LOSS. ADDITIONAL UNSPECIFIED INTERVENTIONS AND MONITORING REQUIRED. THE EVENT OCCURRED DURING SET UP TO CHANGE THE EXTENSION THAT BROKE. THERE WAS NO PATIENT INVOLVEMENT AND THERE WAS NO PATIENT HARM.

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

H3: NO DEVICE OR DEVICE PHOTO WAS RETURNED FOR INVESTIGATION. DUE TO THIS, NO ROOT CAUSE WAS DETERMINED. THE DEVICE HISTORY REVIEW COULD NOT BE PERFORMED AS THE LOT NUMBER WAS NOT PROVIDED. IF THE PRODUCT IS RETURNED, THIS COMPLAINT WILL BE REOPENED FOR FURTHER INVESTIGATION.