FDA Adverse Event Malfunction Summary report: N

BD SMARTSITE¿ NEEDLE-FREE CONNECTOR

MDR report key: 14923577 · Received July 5, 2022

Report

Report Number
9616066-2022-00802
Event Type
Malfunction
Date Received
July 5, 2022
Date of Event
May 29, 2022
Report Date
June 10, 2022
Manufacturer
SISTEMAS MEDICOS ALARIS, S.A. DE C.V.
Product Code
FPA
PMA / PMN Number
K061285
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

2000E CHINA 510K: THIS IS AN INTERNATIONAL CODE - THE MODEL#, CATALOG#I, IS A CAREFUSION PRODUCT WHICH IS SAME OR SIMILAR TO A DEVICE THAT IS APPROVED FOR SALE DOMESTICALLY. THE DOMESTIC SIMILAR LIST NUMBER IS 2000E. THE 510K NUMBER IS FOR THE DOMESTIC SIMILAR PRODUCT: K061285. INITIAL REPORTER PHONE #: (B)(6) INVESTIGATION SUMMARY: A 2000E CHINA PRODUCT WAS NOT AVAILABLE FOR INVESTIGATION; HOWEVER, THE CUSTOMER INDICATED THE COMPLAINT SAMPLE WAS FROM LOT 21125710. THE FEEDBACK PROVIDED BY THE CUSTOMER INDICATES THE SMARTSITE WAS COMPLETELY OCCLUDED. NO FURTHER INFORMATION WAS AVAILABLE TO ASSIST THE INVESTIGATION IN THIS INSTANCE. THE DETAILS OF THIS FEEDBACK WERE FORWARDED TO THE MANUFACTURING SITE FOR INVESTIGATION. A REVIEW OF THE PRODUCTION RECORDS FOR LOT 21125710 DID NOT IDENTIFY ANY IN-PROCESS TESTING FAILURES OR QUALITY DEVIATIONS WHICH MAY HAVE RESULTED IN A REPORT OF THIS NATURE. THE ROOT CAUSE OF THE CUSTOMER¿S EXPERIENCE COULD NOT BE DETERMINED AS THE SAMPLE WAS NOT AVAILABLE FOR INVESTIGATION. IN THIS INSTANCE, WITHOUT A SAMPLE, IT IS NOT POSSIBLE TO DETERMINE WHETHER A MANUFACTURING DEFECT COULD HAVE CAUSED OR CONTRIBUTED TO THE CUSTOMER¿S EXPERIENCE. PREVIOUS COMPLAINTS FOR OCCLUSIONS HAVE BEEN RELATED TO FEATURES ON THE SURFACE OF THE MALE LUER OF THE CONNECTING PRODUCTS. THESE FEATURES INCLUDE FLASH OR A RAISED EDGE TO THE TIP OF THE MALE LUER WHICH HAVE PREVIOUSLY BEEN SHOWN TO INTERMITTENTLY LEAD TO RESTRICTED FLOW DUE TO THEM PINCHING THE BLUE PISTON OF THE SMARTSITE® AND NOT ALLOWING IT TO OPEN. THIS CAN SOMETIMES BE RESOLVED BY DISCONNECTING AND REATTACHING THE SAME LUER CONNECTION WHICH MAY REPOSITION THE LUER AGAINST THE PISTON AND IMPROVE THE FLOW, OR ALTERNATIVELY BY CHANGING THE CONNECTING MALE LUER. A REVIEW OF THE CUSTOMER FEEDBACK DATABASE INDICATES THAT THIS IS A RARE OCCURRENCE WITH A SMALL NUMBER OF SIMILAR REPORTS AGAINST THE SMARTSITE COMPONENT IN THE PAST 12 MONTHS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS BLOCKAGE WHILE USING BD SMARTSITE¿ NEEDLE-FREE CONNECTOR. NO PATIENT IMPACT REPORTED. THE FOLLOWING INFORMATION WAS PROVIDED BY THE INITIAL REPORTER, TRANSLATED FROM CHINESE TO ENGLISH: WHEN USING, IT WAS FOUND THAT THE CLOSED JOINT WITHOUT NEEDLE WAS BLOCKED, AND THE PATIENT WAS NOT AFFECTED BY TIMELY REPLACEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1618689 BD SMARTSITE¿ NEEDLE-FREE CONNECTOR INTRAVASCULAR ADMINISTRATION SET FPA SISTEMAS MEDICOS ALARIS, S.A. DE C.V. 21125710

Patients

Seq Age Sex Outcome Treatment
1 Unknown