inforMED
MalfunctionFPK

MEDEX SMALL BORE EXTENSION SET

Received Nov 19, 2014

Report 2183502-2014-00880 · MDR key 4286429

Device

Generic name

Fpk - Tubing, Fluid Delivery

Model number

NA

Catalog number

MX43661

Lot number

2770170

Product problems

  • Disassembly

Patient

UNK

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

USER FACILITY REPORTED THAT THE LISTED DEVICE BECAME DISASSEMBLED DURING USE. THERE WERE NO ADVERSE EFFECTS TO PATIENT REPORTED.

Additional Manufacturer Narrative

THE DEVICE IS CURRENTLY BEING EVALUATED; THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION ONCE IT IS COMPLETED.