FDA Adverse Event Malfunction Summary report: N

VIAL SUREPATH COLLECTION KIT 500

MDR report key: 17549804 · Received August 15, 2023

Report

Report Number
3008007472-2023-00010
Event Type
Malfunction
Date Received
August 15, 2023
Date of Event
August 4, 2023
Report Date
November 16, 2023
Manufacturer
TRIPATH IMAGING, INC
Product Code
MKQ
UDI-DI
10382904914520
PMA / PMN Number
P970018
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H.6 INVESTIGATION SUMMARY. THE CUSTOMER COMPLAINT IS FOR VIALS WITH BROKEN CAPS FOR MATERIAL 491452 LOT 3012247. THE INVESTIGATION CONSISTED OF A REVIEW OF THE DEVICE HISTORY RECORD FROM PRODUCTION, RETAIN ANALYSIS, CUSTOMER RETURN ANALYSIS AND RELATED CUSTOMER COMPLAINT TRENDING. THE REVIEW OF THE MANUFACTURING BATCH RECORD FOR MATERIAL 491452 LOT 3012247 IDENTIFIED THAT IT WAS COMPLETE AND ACCURATE WITH NO INDICATION OF ANY ISSUES OR ABNORMAL ACTIVITIES DURING THE PRODUCTION OF THE LOT. THERE WERE ZERO DEFECTS OBSERVED DURING THE INSPECTION OF THE CAPS USED IN THE PRODUCTION OF MATERIAL 491452 LOT 3012247. A VISUAL RETAIN ANALYSIS WAS PERFORMED ON ONE CLAMSHELL (25 VIALS) FROM ITEM (B)(4) LOT 3012247. THE COMPLAINT MODE WAS NOT IDENTIFIED DURING RETAIN ANALYSIS. A RETURNED SAMPLE WAS NOT AVAILABLE SO NO FORMAL INSPECTION COULD BE PERFORMED. HOWEVER, PICTURES WERE PROVIDED THAT SHOW THE CRACKED CAP. THEREFORE, THE COMPLAINT IS CONFIRMED. A 12-MONTH COMPLAINT REVIEW FOR THE DEFECT MODE OF CRACKED CAP AND EMPTY VIAL WAS PERFORMED AND IDENTIFIED PREVIOUS COMPLAINTS FOR THE ITEM NUMBER BUT NO PREVIOUS COMPLAINTS FOR THE LOT NUMBER. BD PERFORMS REGULAR TRENDING AND AS OF THIS TIME THE THRESHOLD FOR A CORRECTIVE AND PREVENTATIVE ACTION (CAPA) HAS NOT BEEN REACHED. BD WILL CONTINUE TO MONITOR AND EVALUATE TRENDS.

Additional Manufacturer Narrative · 0

H.3. A DEVICE EVALUATION AND/OR DEVICE HISTORY REVIEW IS ANTICIPATED BUT IS NOT COMPLETE. UPON COMPLETION, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 0

REPORT 1 OF 3. IT WAS REPORTED THAT WHILE USING VIAL SUREPATH COLLECTION KIT 500, ONE VIAL CONTAINING PATIENT SAMPLE HAD A BROKEN CAP. NO PATIENT IMPACT REPORTED. "VIALS WITH BROKEN CAPS. THE HPV AREA HAS BEEN SENDING THE VIALS ALREADY BROKEN OR TOO TIGHT, WHICH CAUSES THE INSTRUMENTS TO ABORT THE RUNS ON CERTAIN OCCASIONS. PATIENT IDENTIFIER: (B)(6) M. A.".

Description of Event or Problem · 0

REPORT 1 OF 3 IT WAS REPORTED THAT WHILE USING VIAL SUREPATH COLLECTION KIT 500, 14 VIALS CONTAINING PATIENT SAMPLE HAD BROKEN OR CRACKED CAPS. NO PATIENT IMPACT REPORTED. "VIALS WITH BROKEN CAPS. CUSTOMER REPORTED: "SINCE WEDNESDAY, SOME PROBLEMS HAVE BEEN OCCURRING WITH THE CNR VALLE MULTIPROCESSORS. INITIALLY, THE USERS REPORTED THAT THE INSTRUMENTS HAD BEEN BREAKING THE CAPS OF THE VIALS; HOWEVER, TODAY IT WAS DETECTED THAT THE HPV AREA HAS BEEN SENDING THE VIALS ALREADY BROKEN OR TOO TIGHT, WHICH CAUSES THE INSTRUMENTS TO ABORT THE RUNS ON CERTAIN OCCASIONS."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
994528 VIAL SUREPATH COLLECTION KIT 500 PROCESSOR, CERVICAL CYTOLOGY SLIDE, AUTOMATED MKQ TRIPATH IMAGING, INC 3012247 10382904914520

Patients

Seq Age Sex Outcome Treatment
1 Unknown