BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MANOMETER BOTTOM ASSEMBLY

    MDR report key: 14397002 · Received May 13, 2022

    Report

    Report Number
    1625685-2022-00052
    Event Type
    Malfunction
    Date Received
    May 13, 2022
    Date of Event
    December 1, 2021
    Report Date
    July 20, 2022
    Manufacturer
    CAREFUSION, INC
    Product Code
    KRK
    UDI-DI
    10885403460081
    PMA / PMN Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    PR (B)(4) INITIAL EMDR SUBMISSION. A FOLLOW UP EMDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION BECOMES AVAILABLE. DEVICE PROBLEM CODE: A0504. PATIENT PROBLEM CODE: F26.

    Additional Manufacturer Narrative · 0

    (B)(4) ADDITIONAL INFORMATION: THE MANOMETER ITSELF IS A COMPONENT PART AND NOT A FINISHED GOOD DEVICE. THE 806 FDA PACKET WAS UPDATED TO AMENDMENT 2 TO HIGHLIGHT THE MANOMETER REVISIONS. THERE IS NOT A SEPARATE FDA PACKAGE FOR THIS RECALL. THE FDA COORDINATOR (MARK E. CHAN) WAS SENT AMENDMENT 2 ON (B)(6) 2022) BY (B)(6) FROM BD. H3 OTHER TEXT : SEE MANUFACTURE NARRATION

    Additional Manufacturer Narrative · 0

    (B)(4) FOLLOW-UP EMDR FOR DEVICE EVALUATION: ONE PHOTO AND ONE VIDEO WAS PROVIDED TO OUR QUALITY TEAM FOR INVESTIGATION. VISUAL EVALUATION OF THE PICTURE AND VIDEO PROVIDED CONFIRMED THE REPORTED FAILURE MODE (LEAKAGE/ MATING ISSUE). A REVIEW OF THE INTERNAL MANUFACTURING DEVICE RECORDS AND RAW MATERIAL HISTORY FILES FOR THE REPORTED LOT NUMBER 0001417185 WAS PERFORMED AND NO RECORDED QUALITY PROBLEMS OR REJECTIONS RELATED TO THIS INCIDENT WERE FOUND. BASED ON THE QUALITY TEAM'S INVESTIGATION, A GROWING TREND IN REPORTS OF THIS FAILURE MODE WAS IDENTIFIED. A CORRECTIVE ACTION PROJECT WAS OPENED TO FURTHER INVESTIGATE THESE DEFECTS. A VOLUNTARY RECALL PI-22-4423-FA WAS ISSUE FOR THE LEAK FAILURE MODE IN THE LUMBAR PUNCTURE TRAYS. PLEASE SEE ATTACHED RECALL NOTIFICATION LETTER. COMPLAINTS RECEIVED FOR THIS DEVICE AND DEFECT WILL CONTINUE TO BE MONITORED BY OUR QUALITY TEAM FOR SIGNS OF EMERGING TRENDS.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT MANOMETER ARE LEAKING. VERBATIM: THE MANOMETER IS LEAKING. THERE IS A BUBBLE WHERE THE BOTTOM PORTION AND NEEDLE MEET WHEN USING PRESSURE. THIS IS AN OCCURRING WITH ALL DIFFERENT SIZES OF NEEDLES. I ALSO HAVE A VIDEO THAT SHOWS WHAT IS OCCURRING MORE CLEARLY, BUT NO PLACE TO SUBMIT ON CIF.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT MANOMETER ARE LEAKING VERBATIM: THE MANOMETER IS LEAKING. THERE IS A BUBBLE WHERE THE BOTTOM PORTION AND NEEDLE MEET WHEN USING PRESSURE. THIS IS AN OCCURRING WITH ALL DIFFERENT SIZES OF NEEDLES. I ALSO HAVE A VIDEO THAT SHOWS WHAT IS OCCURRING MORE CLEARLY, BUT NO PLACE TO SUBMIT ON CIF.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT MANOMETER ARE LEAKING. VERBATIM: THE MANOMETER IS LEAKING. THERE IS A BUBBLE WHERE THE BOTTOM PORTION AND NEEDLE MEET WHEN USING PRESSURE. THIS IS AN OCCURRING WITH ALL DIFFERENT SIZES OF NEEDLES. I ALSO HAVE A VIDEO THAT SHOWS WHAT IS OCCURRING MORE CLEARLY, BUT NO PLACE TO SUBMIT ON CIF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1040007 MANOMETER BOTTOM ASSEMBLY MANOMETER, BLOOD-PRESSURE, VENOUS KRK CAREFUSION, INC 0001417185 10885403460081

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown Other