inforMED
InjuryKEM

SUB-X CLEARING AGENT

Received Jun 4, 2018 · Event occurred May 4, 2018

Report 1419341-2018-00002 · MDR key 7567358

Device

Generic name

Sub-x Clearing Agent

Model number

3803672

Lot number

030718

Product problems

  • Fumes or Vapors
  • Fumes or Vapors

Patient

Not reported

  • Headache
  • Headache

Narrative

Additional Manufacturer Narrative

SUPPLIER CORRECTIVE ACTION RECORD (SCAR) 35 WAS ISSUED TO THE SUPPLIER OF SUB-X CLEARING AGENT. THE SUPPLIER CONDUCTED AN INVESTIGATION WHICH WAS COMPLETED AND APPROVED ON 24JUL2018. THE PRODUCT WAS DISPOSED OF BY THE CUSTOMER THEREFORE, A LEICA BIOSYSTEM (LBS) RICHMOND RETAIN SAMPLE WAS SENT TO THE SUPPLIER. THE RETAIN WAS FOUND TO CONTAIN APPROXIMATELY 0.12% OF A FOREIGN ALIPHATIC PRODUCT. NO ODOR WAS DETECTED IN THE SUPPLIER'S RETAIN SAMPLE. INVESTIGATION OF LBS RICHMOND'S RETAIN PROCESS WAS COMPLETED BY A CROSS FUNCTIONAL LBS RICHMOND TEAM. THE INVESTIGATION IDENTIFIED THAT THE ROOT CAUSE OF THE ODOR WAS A CONTAMINATION ORIGINATING FROM THE 55-GALLON DRUM SENT FROM THE SUPPLIER. CORRECTIVE ACTION/ PREVENTATIVE ACTIONS (CAPAS) WERE IDENTIFIED AND IMPLEMENTED WITH THE SUPPLIER REGARDING PROPER DRUM INSPECTIONS PRIOR TO FILLING PRODUCT AND PROPER HOSE CLEANING PROCEDURES ON (B)(6) 2018. NO NEW COMPLAINTS FOR THIS ISSUE HAVE BEEN REPORTED FROM (B)(6) 2018 THROUGH (B)(6) 2018. LBS RICHMOND WILL CONTINUE TO TRACK AND TREND. NO FURTHER ACTIONS ARE REQUIRED AT THIS TIME.

Additional Manufacturer Narrative

PRODUCT RETAINS CURRENTLY BEING EVALUATED BY MANUFACTURER. AN INVESTIGATION IS CURRENTLY UNDERWAY AND A FOLLOW-UP WILL BE SUBMITTED SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE FOLLOWING THE INVESTIGATION.

Description of Event or Problem

ON (B)(6) 2018, FOUR CUSTOMER EMPLOYEES WERE EXPOSED TO CHEMICAL FUMES WHILE THE PRODUCT WAS IN USE IN THE CUSTOMER'S MOBILE UNIT. ONE OF THE FOUR CUSTOMER EMPLOYEES SOUGHT MEDICAL ATTENTION FOR A MIGRAINE. SYMPTOMS WERE REPORTED TO HAVE SUBSIDED BY (B)(6) 2018.