BD SURGIPHOR¿ STERILE WOUND IRRIGATION SYSTEM
Report
- Report Number
- 1423507-2023-00102
- Event Type
- Malfunction
- Date Received
- October 16, 2023
- Date of Event
- August 3, 2023
- Report Date
- March 11, 2024
- Manufacturer
- CAREFUSION, INC
- Product Code
- FQH
- UDI-DI
- 00382909101102
- PMA / PMN Number
- K221504
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
(B)(4) INITIAL MDR. A FOLLOW UP WILL BE SUBMITTED IF ADDITIONAL INFORMATION BECOMES AVAILABLE. --- SECTION D. 2B PROCODE: FQH (LAVAGE, JET) AND FRO (DRESSING, WOUND, DRUG).
(B)(4)SUPPLEMENTAL MDR. ONE PHOTO WAS RECEIVED BY OUR QUALITY TEAM FOR EVALUATION. FROM THE PHOTO, THE BOTTLE WAS OBSERVED TO BE CRACKED AROUND THE TOP CAP AREA CONFIRMING THE CUSTOMER¿S EXPERIENCE.A DEVICE HISTORY RECORD COULD NOT BE EVALUATED AS THE LOT NUMBER IS UNKNOWN. THE MOST PROBABLE ROOT CAUSE CAN BE ATTRIBUTED TO POST MANUFACTURING HANDLING. DURING SHIPMENT, BOXES MAY BE DROPPED OR IMPACTED WHICH CAN BE EXCESSIVE HANDLING CAUSING THE LEAKAGE. THIS INCIDENT HAS BEEN ADDED TO OUR DATABASE OF REPORTED INCIDENTS. OUR BUSINESS TEAM REGULARLY REVIEWS THE COLLECTED DATA FOR IDENTIFICATION OF EMERGING TRENDS. ---- SECTION D. 2B PROCODE: FQH (LAVAGE, JET) AND FRO (DRESSING, WOUND, DRUG) H3 OTHER TEXT : SEE NARRATIVE BELOW
THE SURGIPHOR BOTTLE EXPLODED WHILE THE CAP WAS BEING SCREWED ON.
THE SURGIPHOR BOTTLE EXPLODED WHILE THE CAP WAS BEING SCREWED ON.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 704200 | BD SURGIPHOR¿ STERILE WOUND IRRIGATION SYSTEM | SURGIPHOR | FQH | CAREFUSION, INC | UNKNOWN | 00382909101102 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |