inforMED
MalfunctionOEQ

CUSTOM KIT

Received Jun 3, 2026 · Event occurred Feb 25, 2026

Report 1721504-2026-00098 · MDR key 25382649

Device

Generic name

Convenience Kit (multiple Products)

Catalog number

K09-MS3216A

Lot number

H3411950

Product problems

  • Contamination

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

THE SUSPECT DEVICE HAS BEEN RETURNED FOR EVALUATION. THE COMPLAINT IS CONFIRMED. NO DEFINITIVE ROOT CAUSE COULD BE DETERMINED HOWEVER, IT IS ATTRIBUTED TO THE MANUFACTURING PROCESS. A SEARCH OF THE COMPLAINT DATABASE WAS PERFORMED AND NO SIMILAR COMPLAINTS FOR THIS LOT NUMBER WERE FOUND. THE DEVICE HISTORY RECORD WAS REVIEWED, AND NO EXCEPTION DOCUMENTS WERE FOUND. NONCONFORMANCES OF THIS NATURE ARE MONITORED BY THE OPERATION TEAM. THIS COMPLAINT WILL BE USED TO TREND FOR SIMILAR COMPLAINTS.

Description of Event or Problem

THE ACCOUNT ALLEGES THAT THERE WAS CONTAMINATION IN THE FLUID PATHWAY. THE DEFECT WAS IDENTIFIED DURING PREPARATIONS FOR A MEDICAL PROCEDURE. NO PATIENT INTERACTION OR INJURY TO REPORT.