inforMED
MalfunctionFPK

PREPIERCED MALE ADAPTER PLUG

Received Sep 10, 2019 · Event occurred Jan 1, 2019

Report 9615050-2019-00385 · MDR key 8982466

Device

Generic name

Set, Administration, Intravascular

Catalog number

113010401

Lot number

UNKNOWN

Product problems

  • Particulates
  • Particulates

Patient

Not reported

  • No Patient Involvement
  • No Patient Involvement

Narrative

Additional Manufacturer Narrative

THE COMPLAINT OF PARTICULATE MATTER ON THE 113010401 COULD NOT BE CONFIRMED. NO PRODUCT SAMPLES, PICTURES, OR VIDEOS WERE RECEIVED FOR INVESTIGATION. WITHOUT THE RETURN OF THE SAMPLE A COMPREHENSIVE FAILURE INVESTIGATION CANNOT BE PERFORMED AND A CAUSE CANNOT BE DETERMINED. THE DHR COULD NOT BE REVIEWED DUE TO THE UNKNOWN LOT NUMBER.

Description of Event or Problem

THE EVENT OCCURRED ON AN UNKNOWN DATE THAT INVOLVED A PREPIERCED PORT. THE CUSTOMER REPORTED THAT DURING A CLINICAL DRUG TRIAL FOR AN UNSPECIFIED DRUG, THERE WERE PARTICULATES IN THE INFUSION. THERE IS NO MORE INFORMATION PROVIDED.