inforMED
MalfunctionFPK

Q2 CHECKMATE EXTENSION SET

Received Nov 8, 2017 · Event occurred Aug 31, 2017

Report 1649914-2017-00077 · MDR key 7011798

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Product code (FPK)
Manufacturer (Quest Medical, Inc.)
Model (9545)

Device

Generic name

Intravascular Administration Set

Model number

9545

Catalog number

9545

Lot number

0502535D06

Product problems

  • Leak/Splash
  • Device Operates Differently Than Expected

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

THERE WERE NO PATIENT COMPLICATIONS ASSOCIATED WITH THE ALLEGED ISSUE. THE DEVICE WAS NOT RETURNED FOR EVALUATION. A SIMILAR PRODUCT WHICH UNDERGOES THE SAME MANUFACTURING PROCESS AS THE PRODUCT COMPLAINED ABOUT WAS EVALUATED AND NO LEAKAGE WAS OBSERVED. DHR REVIEW CONDUCTED DID NOT IDENTIFY ANY MANUFACTURING ISSUES. THE ROOT CAUSE OF THE ALLEGED DEFECT IS UNKNOWN.

Description of Event or Problem

THE HOSPITAL REPORTED AN ISSUE ENCOUNTERED WITH THE INTRAVENOUS ADMINISTRATION EXTENSION SET DURING USE. THE REPORT STATED THAT WHEN THEY TIGHTEN THE SPIN CONNECTOR ON THE DEVICE IT KEEPS TURNING AND "STRIPS" CAUSING PRODUCT TO LEAK; IT HAS HAPPENED ON MULTIPLE OCCASIONS. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THE ALLEGED EVENT. THE DEVICE WAS NOT RETURNED FOR EVALUATION.